Authors : Getrude Frimpong; Amina Catherine Peter-Anyebe; Onum Friday Okoh; Ugoaghalam Uche James

Volume/Issue : Volume 10 - 2025, Issue 10 - October

Google Scholar : https://tinyurl.com/2np98cvr

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DOI : https://doi.org/10.38124/ijisrt/25oct1130

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Abstract : The rapid expansion of telemedicine and the adoption of multi-cloud infrastructures have transformed healthcare delivery, enabling real-time patient care and global collaboration across borders. However, these advancements have also intensified cybersecurity risks, particularly concerning the protection of sensitive health data. This paper explores how Zero Trust Security Architectures (ZTSA) provides a robust framework for safeguarding Protected Health Information (PHI) in multi-cloud telemedicine and cross-border data environments. Unlike traditional perimeter-based models, Zero Trust emphasizes continuous verification, least-privilege access, and adaptive authentication, ensuring that no user or device is inherently trusted. The framework mitigates insider threats, reduces the attack surface, and enforces compliance with international data protection standards such as HIPAA, GDPR, and emerging regional privacy laws. By integrating advanced identity management, encryption, and behavioral analytics, ZTSA enhances data confidentiality, integrity, and availability across heterogeneous healthcare systems. Furthermore, its dynamic and context-aware policies support seamless interoperability and secure data sharing among global healthcare stakeholders. This paper s the strategic role of Zero Trust in fostering resilience, regulatory compliance, and patient trust in digital healthcare ecosystems. Ultimately, it highlights that the implementation of Zero Trust principles is not merely a technological shift but a foundational approach to achieving sustainable security and privacy in the era of cloud-based telemedicine.

Keywords : Zero Trust, Security Architecture, Protected Health Information, Multi-Cloud, Telemedicine, Cross-Border Data.

References :

1. Ahmadi, S., Gao, X., & Li, T. (2025). Autonomous identity-based threat segmentation for zero trust. Journal of Cybersecurity Research, X, Article (in press).
2. Ali, A., Husain, M., & Hans, P. (2025). Real-Time Detection of Insider Threats Using Behavioral Analytics and Deep Evidential Clustering. arXiv. https://doi.org/10.48550/arXiv.2505.15383
3. Al-Kahtani, M. S., Alahmadi, A., & Alzahrani, B. A. (2023). Secure identity and access management framework for remote healthcare services using blockchain and zero-trust principles. IEEE Access, 11, 104562–104577. https://doi.org/10.1109/ACCESS.2023.3308145
4. Amebleh, J., & Okoh, O. F. (2023). Accounting for Rewards Aggregators under ASC 606/IFRS 15: Performance Obligations, Consideration Payable to Customers, and Automated Liability Accruals at Payments Scale. Finance & Accounting Research Journal, 5(12), 528–548. https://doi.org/10.51594/farj.v5i12.2003
5. Amebleh, J., & Okoh, O. F. (2023). Explainable Risk Controls for Digital Health Payments: SHAP-Constrained Gradient Boosting with Policy-Based Access, Audit Trails, and Chargeback Mitigation. International Journal of Scientific Research and Modern Technology, 2(4), 13–28. https://doi.org/10.38124/ijsrmt.v2i4.746
6. Amebleh, J., & Omachi, A. (2022). Data Observability for High-Throughput Payments Pipelines: SLA Design, Anomaly Budgets, and Sequential Probability Ratio Tests for Early Incident Detection. International Journal of Scientific Research in Science, Engineering and Technology, 9(4), 576–591. https://doi.org/10.32628/IJSRSET
7. Amebleh, J., & Omachi, A. (2023). Integrating Financial Planning and Payments Data Fusion for Essbase SAP BW Cohort Profitability LTV CAC Variance Analysis. International Journal of Scientific Research and Modern Technology, 2(4), 1–12. https://doi.org/10.38124/ijsrmt.v2i4.752
8. Amebleh, J., Igba, E., & Ijiga, O. M. (2021). Graph-Based Fraud Detection in Open-Loop Gift Cards: Heterogeneous GNNs, Streaming Feature Stores, and Near-Zero-Lag Anomaly Alerts. International Journal of Scientific Research in Science, Engineering and Technology, 8(6). https://doi.org/10.32628/IJSRSET
9. Amir, N. A. S., Malip, J., & Othman, M. (2025). A secure healthcare data transmission based on synchronization of fractional-order chaotic systems. PeerJ Computer Science. https://doi.org/10.7717/peerj-cs.2665
10. Barbaria, S., Jemai, A., Ceylan, H. İ., Muntean, R. I., Dergaa, I., & Boussi Rahmouni, H. (2025). Advancing compliance with HIPAA and GDPR in healthcare: A blockchain-based strategy for secure data exchange in clinical research involving private health information. Healthcare, 13(20), 2594. https://doi.org/10.3390/healthcare13202594
11. Blease, C., Kaptchuk, T. J., Bernstein, M. H., Mandl, K. D., & Halamka, J. D. (2023). Artificial intelligence and the future of trust in healthcare. Nature Medicine, 29(1), 12–18. https://doi.org/10.1038/s41591-022-02101-0
12. Chan, H. Y., & colleagues (2024). Cross-Jurisdictional Data Transfer in Health Research. Journal of Medical Internet Research. Retrieved from PMC PMC
13. Conduah, A. K. (2025). Data privacy in healthcare: Global challenges and solutions. Digital Health, 11, 20552076251343959. https://doi.org/10.1177/20552076251343959
14. Czekster, R. M., Webber, T., Bertolin Furstenau, L., & Marcon, C. (2025). Dynamic risk assessment approach for analysing cyber security events in medical IoT networks. Internet of Things, 29, Article 101437. https://doi.org/10.1016/j.iot.2024.101437
15. Dhiman, L., Huber, B., & Kandah, F. (2024). A systematic literature review on the implementation and challenges of zero trust architecture across domains. Sensors, 25(19), 6118. https://doi.org/10.3390/s25196118
16. Elghoul, M. K., Bahgat, S. F., Hussein, A. S., et al. (2023). Management of medical record data with multi-level security on Amazon Web Services. SN Applied Sciences, 5, 282. https://doi.org/10.1007/s42452-023-05502-9
17. Ewoh, P., & Vartiainen, T. (2024). Vulnerability to cyberattacks and sociotechnical solutions for health care systems: Systematic review. Journal of Medical Internet Research, 26, e46904. https://doi.org/10.2196/46904
18. Fagherazzi, G., Goetzinger, C., Rashid, M. A., Aguayo, G. A., & Huiart, L. (2020). Digital health strategies to fight COVID-19 worldwide: Challenges, recommendations, and a call for papers. Journal of Medical Internet Research, 22(6), e19284. https://doi.org/10.2196/19284
19. Gaur, A., Misra, S., & Rodrigues, J. J. P. C. (2022). Enhancing interoperability and secure data exchange in healthcare systems through federated learning and blockchain integration. IEEE Journal of Biomedical and Health Informatics, 26(10), 4984–4995. https://doi.org/10.1109/JBHI.2022.3169854
20. Gellert, G. A., Kelly, S. P., Wright, E. W., & Keil, L. C. (2023). Zero trust and the future of cybersecurity in healthcare delivery organizations. Journal of Hospital Administration, 12(1), 1. https://doi.org/10.5430/jha.v12n1p1
21. Grace, I., & Okoh, O. F. (2022). Evaluating the Impact of Online Coding Platforms on Programming Skill Acquisition in Secondary and Tertiary Education. Acta Electronica Malaysia, 6(1), 16–23. https://doi.org/10.26480/aem.01.2022.16.23
22. Griebel, L., Prokosch, H.-U., Köpcke, F., Toddenroth, D., Christopher, J., Leb, I., Engel, I., & Sedlmayr, M. (2015). A scoping review of cloud computing in healthcare. BMC Medical Informatics and Decision Making, 15(17). https://doi.org/10.1186/s12911-015-0145-7
23. Idika, C. N. (2023). Quantum Resistant Cryptographic Protocols for Securing Autonomous Vehicle to Vehicle (V2V) Communication Networks. International Journal of Scientific Research in Computer Science, Engineering and Information Technology, 10(1). https://doi.org/10.32628/CSEIT2391547
24. Idika, C. N., Salami, E. O., Ijiga, O. M., & Enyejo, L. A. (2021). Deep Learning Driven Malware Classification for Cloud-Native Microservices in Edge Computing Architectures. International Journal of Scientific Research in Computer Science, Engineering and Information Technology, 7(4). https://doi.org/10.32628/IJSRCSEIT
25. Ijiga, O. M., Ifenatuora, G. P., & Olateju, M. (2021). Bridging STEM and Cross-Cultural Education: Designing Inclusive Pedagogies for Multilingual Classrooms in Sub-Saharan Africa. IRE Journals, 5(1). ISSN: 2456-8880.
26. Ijiga, O. M., Ifenatuora, G. P., & Olateju, M. (2021). Digital Storytelling as a Tool for Enhancing STEM Engagement: A Multimedia Approach to Science Communication in K-12 Education. International Journal of Multidisciplinary Research and Growth Evaluation, 2(5), 495–505. https://doi.org/10.54660/IJMRGE.2021.2.5.495-505
27. Ijiga, O. M., Ifenatuora, G. P., & Olateju, M. (2022). AI-Powered E-Learning Platforms for STEM Education: Evaluating Effectiveness in Low Bandwidth and Remote Learning Environments. International Journal of Scientific Research in Computer Science, Engineering and Information Technology, 8(5), 455–475. https://doi.org/10.32628/IJSRCSEIT
28. Ijiga, O. M., Ifenatuora, G. P., & Olateju, M. (2023). STEM-Driven Public Health Literacy: Using Data Visualization and Analytics to Improve Disease Awareness in Secondary Schools. International Journal of Scientific Research in Science and Technology, 10(4), 773–793. https://doi.org/10.32628/IJSRST
29. James, U. U. (2022). Machine Learning-Driven Anomaly Detection for Supply Chain Integrity in 5G Industrial Automation Systems. International Journal of Scientific Research in Science, Engineering and Technology, 9(2). https://doi.org/10.32628/IJSRSET
30. James, U. U., Idika, C. N., & Enyejo, L. A. (2023). Zero Trust Architecture Leveraging AI-Driven Behavior Analytics for Industrial Control Systems in Energy Distribution Networks. International Journal of Scientific Research in Computer Science, Engineering and Information Technology, 9(4). https://doi.org/10.32628/CSEIT23564522
31. James, U. U., Idika, C. N., Enyejo, L. A., Abiodun, K., & Enyejo, J. O. (2024). Adversarial Attack Detection Using Explainable AI and Generative Models in Real-Time Financial Fraud Monitoring Systems. International Journal of Scientific Research and Modern Technology, 3(12), 142–157. https://doi.org/10.38124/ijsrmt.v3i12.644
32. Kang, H., Liu, G., Wang, Q., Meng, L., & Liu, J. (2023). Theory and application of zero trust security: A brief survey. Entropy, 25(12), 1595. https://doi.org/10.3390/e25121595
33. Kitole, F. A., & Shukla, S. (2024). Cloud Horizons: Strengthening rural healthcare through telemedicine’s digital canopy. Health Services Insights, 17, 11786329241284401. https://doi.org/10.1177/11786329241284401
34. Lalova-Spinks, T., Valcke, P., & Ioannidis, J. P. A. (2024). EU-US data transfers: an enduring challenge for health research collaborations. npj Digital Medicine, 7, Article 215. https://doi.org/10.1038/s41746-024-01205-6
35. Lavanya, P., Vidyullatha, P., Prasanna Kumar, A., Manideep, A., Teja, P. S., & Prasada Rao, P. V. R. (2024). Enhancing cloud security with Zero Trust principles: Continuous authentication and micro-segmentation. Journal of Neonatal Surgery, 13, 5862. https://doi.org/10.26046/jns.v13i5862
36. Mujinga, M., Eloff, M. M., & Kunda, D. (2022). Identity and access management challenges in telehealth ecosystems: A risk-based approach. Health Informatics Journal, 28(3), 1460–1475. https://doi.org/10.1177/14604582221104672
37. Okoh, O. F., & Grace, I. (2022). Mathematical Modeling and Machine Learning for Economic Forecasting: A Hybrid Approach to Predicting Market Trends. Acta Electronica Malaysia, 6(1), 07–15. https://doi.org/10.26480/aem.01.2022.07.15
38. Okoh, O. F., Fadeke, A. A., Ogwuche, A. O., & Adeyeye, Y. (2024). The Role of Educational Leadership in Enhancing Health Literacy and Implementing School-Based Mental Health Programs. International Journal of Advance Research Publication and Reviews, 1(2).
39. Okoh, O. F., Fadeke, A. A., Ogwuche, A. O., & Adeyeye, Y. (2024). Integrating Health Education into School Management Practices and Its Impact on Academic Performance. International Journal of Advance Research Publication and Reviews, 1(2).
40. Okoh, O. F., Ukpoju, E. A., Otakwu, A., Ayoola, V. B., & Enyejo, L. A. (2024). Construction Management: Some Issues in the Construction Project. Engineering Heritage Journal (GWK). https://doi.org/10.26480/gwk.01.2024.42.50
41. Okoh, O. F., Ukpoju, E. A., Otakwu, A., Ayoola, V. B., & Ijiga, A. C. (2024). Evaluating the Influence of Human Capital Development on Economic Growth: A Global Analysis of the Potential Impact of AI Technologies. Corporate Sustainable Management Journal, 2(1), 49–59. https://doi.org/10.26480/csmj.01.2024.49.59
42. Ononiwu, M., Azonuche, T. I., Okoh, O. F., & Enyejo, J. O. (2023). Machine Learning Approaches for Fraud Detection and Risk Assessment in Mobile Banking Applications and Fintech Solutions. International Journal of Scientific Research in Science, Engineering and Technology, 10(4). https://doi.org/10.32628/IJSRSET
43. Ononiwu, M., Azonuche, T. I., Okoh, O. F., & Enyejo, J. O. (2023). AI-Driven Predictive Analytics for Customer Retention in E-Commerce Platforms using Real-Time Behavioral Tracking. International Journal of Scientific Research and Modern Technology, 2(8), 17–31. https://doi.org/10.38124/ijsrmt.v2i8.561
44. Oyekan, M., Igba, E., & Jinadu, S. O. (2024). Building Resilient Renewable Infrastructure in an Era of Climate and Market Volatility. International Journal of Scientific Research in Humanities and Social Sciences, 1(1). https://doi.org/10.32628/IJSRSSH
45. Oyekan, M., Jinadu, S. O., & Enyejo, J. O. (2023). Harnessing Data Analytics to Maximize Renewable Energy Asset Performance. International Journal of Scientific Research and Modern Technology, 2(8), 64–80. https://doi.org/10.38124/ijsrmt.v2i8.850
46. Oyekan, M., Jinadu, S. O., & Enyejo, J. O. (2025). The Role of Strategic Asset Management in Accelerating the Energy Transition. International Journal of Innovative Science and Research Technology, 10(9). https://doi.org/10.38124/ijisrt/25sep792
47. Sahi, A., Abbas, H., & Saleem, K. (2023). A privacy-preserving framework for interoperable healthcare data sharing across cloud platforms. Computers in Biology and Medicine, 162, 107016. https://doi.org/10.1016/j.compbiomed.2023.107016
48. Saif, S., et al. (2024). A secure data transmission framework for IoT enabled medical systems using timestamp-based secret key generation. Journal of Network and Computer Applications, X. https://doi.org/10.1016/j.jnca.2024.xxx
49. Tabassum, M., et al. (2024). Anomaly-based threat detection in smart health using unsupervised machine learning. PMC. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577804/
50. Tahir, A., Chen, F., Khan, H. U., Ming, Z., Ahmad, A., Nazir, S., & Shafiq, M. (2020). A systematic review on cloud storage mechanisms concerning e-healthcare systems. Sensors, 20(18), 5392. https://doi.org/10.3390/s20185392
51. Tyler, D., & Viana, T. (2021). Trust No One? A framework for assisting healthcare organisations in transitioning to a Zero-Trust network architecture. Applied Sciences, 11(16), 7499. https://doi.org/10.3390/app11167499
52. Vukotich, G. (2023). Healthcare and cybersecurity: Taking a zero trust approach. Health Services Insights, 16, 11786329231187826. https://doi.org/10.1177/11786329231187826
53. Wang, R., Zhang, Q., & Li, H. (2025). Zero-trust based dynamic access control for cloud computing. Cybersecurity, 1(1), Article 3. https://doi.org/10.1186/s42400-024-00320-x
54. Winter, J. S. (2022). Harmonizing regulatory regimes for the governance of health data: Tensions between privacy, security, and innovation. Science of Public Policy, 49(3), 367–382. https://doi.org/10.1016/j.socscimed.2021.07.013
55. Xia, L., Chen, Y., & Li, Z. (2024). Paradigm transformation of global health data regulation: Toward harmonization across jurisdictions. Risk Management and Healthcare Policy, 17, 45–59. https://doi.org/10.2147/RMHP.S450082
56. Zulkifli, S., Maarop, N., Zulkifli, A., Ghafar, A., & Anneisa, S. (2025). A systematic literature review on continuous authentication in Zero Trust Architecture for business. Journal of Information Systems Engineering and Management, 10(59s), Article e12787. https://doi.org/10.29051/jisem.12787