Cyber-Physical Systems in Healthcare: Design, Interoperability and Security Challenges
TL;DR
A review of the literature from 2020 to the present (2025) shows that architectural fragmentation has continued, that there is a lack of harmonised security-by-design standards, and that there is a lack of regulatory guidance on real-time MCPS deployments, and a research agenda for interoperability protocols, context-aware security models, and international regulatory convergence are recommended.
Abstract
Cyber-Physical Systems (CPS), a combination of embedded computing, communication networks, and physical processes, are increasingly reshaping clinical practice, pharmaceutical supply chains, and hospital infrastructure. This review covers key principles of Medical CPS design; major interoperability frameworks such as FHIR (Fast Healthcare Interoperability Resources), IEEE 11073, and DICOM; and critical cybersecurity risks that threaten patient safety and data integrity, including ransomware, man-in-the-middle, denial-of-service, and data injection attacks. A review of the literature from 2020 to the present (2025) shows that architectural fragmentation has continued, that there is a lack of harmonised security-by-design standards, and that there is a lack of regulatory guidance on real-time MCPS deployments. Some promising mitigation strategies, such as blockchain-based trust frameworks, AI-powered intrusion detection, and digital twin validation, are introduced. The papers conclusion recommends a research agenda for interoperability protocols, context-aware security models, and international regulatory convergence as essential factors for implementing safe and scalable MCPS.