Auditable Continuous Verification for Adaptive Security in Healthcare

Digital health services increasingly rely on devices and workflows that remain connected for extended periods, including remote patient monitoring, clinical care pathways, and medical image transfer. In such settings, one-time authentication at onboarding provides limited assurance because risk can change during operation due to compromise, misconfiguration, or misuse. Frequent reauthentication can raise assurance, yet it can disrupt time-sensitive workflows and add overhead for constrained devices. This paper presents a concept for adaptive security management in healthcare based on continuous verification with auditable governance. Verification is enforced at the edge using a simple trust state that adapts to recent evidence and workflow context. A permissioned blockchain ledger records compact security events and policy actions for governance and audit, while clinical payloads such as patient data remain outside the ledger. We motivate the suitability of this approach for healthcare domain using teleradiology and field-oriented imaging scenarios, including mobile outreach, outbreak response that reduces physical contact, and emergency imaging where timely transfer and interpretation can support clinical decision-making. We contribute an implementation-oriented blueprint that includes an event model, audit queries, data minimization rules, and deployment considerations for regulated healthcare environments.