A Critical Evaluation of IoMT Security Frameworks in Resource-Constrained Healthcare Systems

The increasing adoption of Internet of Medical Things (IoMT) technologies within healthcare systems has significantly improved real-time patient monitoring, clinical decision-making, and health information exchange. However, the integration of interconnected medical devices has simultaneously expanded the cybersecurity threat landscape, particularly within resource-constrained healthcare environments characterized by limited technical capacity, inadequate governance mechanisms, and insufficient cybersecurity expertise. This study critically evaluated existing cybersecurity frameworks for Information Sharing-Enabled IoMT systems, including the National Institute of Standards and Technology (NIST) Cybersecurity Framework, COBIT, Critical Information Infrastructure Protection (CIIP), and the IoT Security Foundation (IoTSF) Security Compliance Framework. The study employed a mixed-method exploratory research design combining systematic literature review, comparative framework analysis, and descriptive quantitative assessment conducted at St. Francis Hospital Nsambya and Uganda Martyrs Hospital Lubaga. Quantitative findings were analyzed using descriptive statistics, while qualitative findings were synthesized thematically. The findings revealed that existing frameworks provide fragmented security solutions that inadequately integrate technical security controls, governance mechanisms, healthcare operational requirements, and socio-behavioral determinants necessary for secure IoMT implementation in low-resource healthcare contexts. Based on the identified gaps, the study proposes an integrated healthcare-oriented IoMT cybersecurity framework that combines governance, technical safeguards, compliance mechanisms, and socio-behavioral dimensions to strengthen secure information sharing and cybersecurity resilience within resource-constrained healthcare institutions. The study concludes that context-specific and integrated cybersecurity frameworks are essential for enhancing secure information sharing and sustainable IoMT adoption in developing healthcare systems.