healthcare it teams

Abstract: Computer-use agents built on large language models (LLMs) work in software that can change while they act: an appointment moves, a policy is revised, a record is updated. Testing agents under such changes is harder than it looks. When an agent fails, the cause may be the agent, but it may also be a change that did not fire as intended, an update the agent never received, or a grader that scored the episode wrongly. We introduce EnvOS, a framework for building and certifying environments that change mid-task. Before any agent runs, EnvOS checks that each change fires correctly, that the task remains solvable, and that the grader separates correct from incorrect behavior; after each run, separate code re-checks the verdict from archived evidence. We apply it to stale information, where a value the agent has already seen changes before the agent acts on it. In clinic booking, Claude Opus 5 succeeds on 0/16 tasks when nothing extra is shown, 2/16 when reminded to re-check the source, and 15/16 when the updated value is shown; the gain over the reminder holds after correcting for all tests (p = 0.00293). In insurance-claim approval, Opus 5 re-checks on its own and succeeds on 10/10, whereas Claude Sonnet 5 rises from 1/10 to 9/10 when the current policy is shown again, a gain significant in its pre-registered test but not after correcting for all tests. Whether an agent caught a change thus varied with the model and the interface. We also stress-test the grading itself: on corrupted episodes designed blind from the rules, the EnvOS pipeline accepted none of 26 as clean, and on an externally generated set it caught 25 of 39, against 4 for simple log checks. Because every EnvOS environment is generated from a seed and graded by an audited automatic verifier, the same environments are natural candidates for training agents with reinforcement learning from verifiable rewards.

Abstract: Password-based authentication remains challenging for many users, especially for those who face usability and accessibility issues. The burden of maintaining security can cause user fatigue, frustration and non-engagement. To address these issues, we conducted a pilot study to assess ECG-based biometric authentication as a passwordless alternative and to gather adult participants' perspectives on this approach. The research consisted of a survey study, an authentication prototype and a follow-up usability experience questionnaire. Our approach combined an online survey of 337 adults examining authentication practices and perceptions, with a separate usability evaluation in which 49 participants interacted with a simulated ECG-authentication and password interface in a health-care application prototype, then completed a post-test usability test questionnaire. The survey examined how adults across age groups use and perceive various authentication techniques, their experiences with biometrics, their views on security and convenience, and their willingness to adopt ECG authentication. In parallel, the usability prototype and questionnaire captured participants' responses after hands-on interaction with an ECG authentication prototype.

Abstract: This paper focuses on algorithmic bias of machine learning and artificial intelligence applications in healthcare information systems. Based on the quantitative data and qualitative comments from a survey and interviews with healthcare professionals, who have different job roles (e.g., clinical vs. administrative), this study provides findings about the relationships between algorithmic bias, perceived fairness, and the intended acceptance and adoption of ML algorithms and algorithm generated outcomes. The results suggest that the opinions of healthcare professionals toward the causes of algorithmic bias, the criteria of algorithm assessment, the perceived fairness, and bias mitigation approaches may vary depending on their job roles, perspectives, tasks, and the algorithm characteristics. More research is needed to investigate algorithmic bias to ensure fairness and equality in healthcare.

Abstract: Medical workflows often require multiple interdependent analyses, but existing specialist and generalist AI models are not designed to coordinate them. We introduce MMedAgent-Plus, a multimodal medical tool-use agent that combines a vision-language planner with 18 leading specialist models spanning 12 tasks and 8 modalities. Through a unified tool interface, the planner selects specialists, executes them in sequence, and synthesizes responses grounded in their outputs. The planner is instruction-tuned on 208,928 samples from 32 public medical benchmarks, covering single- and multi-tool interactions across single and multiple rounds. We separately evaluate tool orchestration, response synthesis, and end-to-end execution on held-out samples. MMedAgent-Plus achieves tool-call accuracies of 91.0%, 98.1%, and 80.7% in single-tool multi-round, multi-tool multi-round, and multi-tool single-round settings, respectively. Given correct tool outputs, MMedAgent-Plus achieves scores of 14.4-14.8 out of 15 for faithfulness, completeness, and conciseness across 600 evaluation samples. In end-to-end execution without pre-supplied tool outputs, MMedAgent-Plus correctly invokes the required specialist in 90.6% of 350 evaluation cases spanning seven tasks. Its final-answer accuracy reaches 0.98, matching the dedicated leading specialist and exceeding the strongest baseline (0.28).

Abstract: Interactive clinical agents acquire evidence through patient dialogue and diagnostic examinations, yet their performance also depends on how the interaction environment exposes information, available actions, and examination results. When these conditions are implicit or inconsistently controlled, final-answer accuracy can conflate diagnostic reasoning with the effects of the interaction protocol. We propose the \textbf{E}vidence-\textbf{G}rounded \textbf{I}nteraction \textbf{P}rotocol (EGIP), which enforces role-specific information boundaries, exposes diagnostic actions without revealing their results, retrieves examination results from stored clinical records, and organizes acquired evidence for final decision-making. By separating evidence acquisition from terminal prediction, EGIP enables different decision strategies to operate on the same observations. We evaluate EGIP across two clinical-agent frameworks, five datasets, and six language models. EGIP improves diagnostic accuracy over native baselines across all primary comparisons. A clinician review further shows that the proportion of automatically scored correct responses jointly judged evidence-supported rises from 10.20\% to 36.55\%. These findings support the effectiveness of EGIP as a unified interaction protocol for improving clinical-agent performance through controlled evidence access and acquisition.

Abstract: Medical Vision-Language Models (Med-LVLMs) have shown strong performance in Medical Visual Question Answering (MVQA), yet they may still produce factually inconsistent responses. Retrieval-Augmented Generation (RAG) can mitigate this issue by incorporating external clinical evidence; however, retrieval is often guided by a single modality, potentially overlooking the joint semantics of medical images and clinical questions. We introduce a multimodal RAG framework that learns a joint query representation through a Gated Multimodal Unit, enabling evidence retrieval to leverage information from both modalities while keeping the underlying Med-LVLM frozen. We evaluate the proposed approach on benchmark datasets. Results show that the multimodal query representation consistently outperforms a reference Med-LVLM and remains competitive with state-of-the-art methods. Our findings demonstrate the potential of multimodal query representations for more effective evidence retrieval in Medical VQA.

Abstract: Medical multi-agent systems, in which LLM agents discuss a case, are increasingly studied for clinical decision support. Prompt injection, text that an attacker adds to a model's input, can manipulate LLMs into wrong decisions. How it affects these systems, and how to protect them, remains unclear. Across two systems, two model families and three benchmarks, a single injected passage succeeds in up to 61% of cases, and collaboration does not consistently protect against it. Existing defenses help only partly: they miss injections that look like ordinary clinical text. Yet when asked to check the injected text against the patient's findings, a model that followed the injection usually rejects it. We therefore propose a training-free defense that verifies the clinical judgments behind the system's decision. Following clinical practice, it separates the patient's findings from clinical judgments, such as diagnoses, recommendations and instructions, and checks each judgment against the findings alone, so the decision rests only on supported judgments. Our defense outperforms all baselines on every benchmark, lowering attack success on MedQA to 4-7% while maintaining accuracy on cases without an attack, and remains effective with a medical model and against defense-aware and adaptive attacks.

Abstract: Large language models (LLMs) can generate differential diagnoses for complex cases, but a useful second opinion must also be factually grounded, clinically coherent, actionable, and safe. We developed a multidimensional benchmark using 300 diagnostically resolved NEJM--MedQA cases: 110 for physician reference ratings and Judge calibration and 190 for held-out evaluation. Eight single-model pipelines generated independent role-specific opinions and interactive-consilium reports under free-form and structured clinical-reasoning conditions. A physician-calibrated LLM Judge evaluated 3,040 final reports and the corresponding structured primary-role outputs. Model identity separated report quality more strongly than response format. Structured final reports had higher overall mean scores in seven of eight model pipelines, with their clearest advantage in management (2.740 vs. 2.436). Compared with the structured pre-consilium primary-role opinion, the complete structured synthesis had higher pooled scores across all five shared criteria, with the largest increases in problem prioritization, factual grounding, and reasoning coherence. GPT-5.6-Sol led every evaluated component and reached consensus in the fewest review rounds. These findings show that the benchmark can distinguish model capability, the contribution of multidisciplinary synthesis, criterion-specific effects of response structure, deliberation dynamics, and inference requirements within one common-case evaluation.

Abstract: Existing federated data condensation methods face privacy risks, as uploaded synthetic data may preserve sensitive information and remain vulnerable to reconstruction attacks. Moreover, their generation often incurs considerable client-side computational overhead, limiting deployment on resource-constrained devices. To address these issues, we propose FedSumUp, which employs a learnable lossy compressor on clients to generate compact and visually interpretable representations. By controlling information capacity, FedSumUp reduces privacy leakage while allowing users to directly assess the privacy-utility tradeoff. We further introduce a dual-objective optimization mechanism to preserve task-relevant semantics while suppressing reconstruction risks. The compressor is trained on the server and only performs lightweight inference on clients. Since the server cannot access raw data, we develop a data-free closed-loop optimization strategy that optimizes the compressor by minimizing the discrepancy between original and twice-compressed representations after structure-preserving upsampling. Experiments on BloodMNIST, CIFAR-10, and ChestMNIST demonstrate reconstruction PSNR as low as 8.56 dB (with synthetic PSNR as low as 5.45 dB), client runtime reductions up to 96.5% (from 778s to 27s on ChestMNIST), and competitive classification accuracy (89.72% ChestMNIST, 82.24% BloodMNIST, 65.63% CIFAR-10), while remaining inherently robust to non-IID data distributions.

Abstract: Clinical reasoning LLMs need external medical knowledge, but retrieved evidence and reasoning chains can be outdated, poisoned, or hallucinated. Harmful knowledge can cause regression: changing a correct answer into an incorrect one. We construct a medical knowledge-poisoning benchmark covering retrieved evidence and reasoning chains, with seven attack families filtered by a three-judge "subtle-but-wrong" vote and paired clean exams that separate poisoning effects from question difficulty. No fixed knowledge-use strategy is robust across these settings: strong RAG methods trade robustness to poisoned evidence against accuracy when evidence is useful. We formulate knowledge use as per-instance routing and introduce Med-TrustRouter, a lightweight controller that keeps the solver frozen. From leakage-free runtime signals, it estimates each action's expected correctness gain and uncertainty, preserving the base answer unless another action is confidently better. Across seven medical reasoning settings, Med-TrustRouter achieves 78.9 macro and 69.2 worst-case accuracy, matching the strongest competitor on macro accuracy while substantially improving the worst-case floor. Its gains transfer across solvers and evidence judges, unlike a hand-coded router using the same signals. Similar performance across linear, tree, and neural action-value heads suggests that the benefit comes from routing rather than estimator complexity. These results support learning when to trust external knowledge for robust clinical reasoning.

Abstract: Choosing the right physician is a key challenge for patients seeking medical care. Physician recommendation systems identify relevant doctors, but patients still find it difficult to compare their profiles to make a decision. We formulate slate presentation optimization: given a patient's medical case and a fixed, ranked list of physicians, we generate short, case-specific summaries that make doctors easier to compare, while remaining grounded in the information in their profiles. To optimize physician presentations without relying on real patient interactions, we develop an offline framework that uses persona-conditioned LLMs to simulate patient choices. We generate patient personas from attributes extracted from each medical case and evaluate presentations for factual accuracy, relevance, naturalness and simulated patient choice. We also use a second LLM judge, unseen during optimization, to assess simulator-specific overfitting. We compare automatic prompt-level optimization with GEPA, parameter-level optimization with GRPO, and their combination across two model sizes. GRPO substantially outperforms GEPA in satisfying the full set of constraints, and its gains in simulated conversion persist under the unseen judge. GEPA alone brings smaller improvements, but using its optimized prompt to initialize GRPO speeds up training and achieves the highest simulated conversion. These results show that prompt-level and parameter-level optimization play complementary roles in improving how physician recommendations are presented.

Abstract: A medical vision-language model may analyze a given CT scan and correctly detect both kidneys in view. Continuing this conversation, if a user provides a prescription with an opposite direction, medical VLMs often sycophantically choose to realign their diagnosis. In this work, we study regressive sycophancy under fabricated evidence, where a model abandons a correct answer when pushback comes with a fake document. We test four open VLMs on 400 VQA-RAD yes/no questions in 19,200 multi-turn conversations, with and without a fabricated prescription. Without a disclosure that documents are synthetic, the models abandon 80.1% of 6,488 correct answers. Notably, under one script each, the same prescription raises the flip rate of Qwen2.5-VL-7B from 45.9% to 89.6% and lowers that of Qwen3-VL-8B from 77.7% to 50.9%. A model rejected the prescription while still preserving the correct answer in 915 of 3,232 conversations with the prescription (28.3%), and 40% of these flipped in later turns. System-prompt sentences that disclose the documents as synthetic lower one model's flip rate from 77.8% to 47.3%. Thus, we conclude that awareness about a forgery does not prevent a model from adopting its answer.

Abstract: Graphical consoles offer a practical interface for medical acquisition assistance, allowing agents to work through the controls and visual feedback used by human operators. Reliable assistance requires linking on-screen anatomy to acquisition decisions that determine what image evidence becomes available next. We introduce MedImageOSWorld, a benchmark for evaluating this capability in simulated CT, MR, and ultrasound consoles. Using screenshots and mouse-and-keyboard actions, agents configure protocols, plan acquisitions, inspect the resulting images, and make corrective adjustments across seven capability levels, from console operation to feedback-driven control. Evaluation combines task-specific workflow checks with hidden anatomical ground truth to assess procedural completion and acquisition outcomes separately. A common evaluation protocol specifies episode conditions and interaction budgets, while recorded trajectories support analysis of how agents observe, act, and respond to acquisition feedback. Across eleven open-weight agents, success rates range from 3.0 to 25.0 on a 0-100 scale while workflow-progress rates reach 21.5-74.5: agents complete much of the console workflow but rarely acquire the intended anatomy. Success collapses between perception and planning, from 79-90% at the lowest three levels for the best agent to at most 12% for millimetre-level planning and 0% for closed-loop control among open-weight agents. Two proprietary agents reach success rates of about 34 and exceed the best open-weight agent mainly in acquisition quality (61 versus 42). MedImageOSWorld provides a controlled setting for studying whether general-purpose GUI agents can translate visual observations into effective medical acquisition decisions.

Abstract: Hallucination detection is particularly important for medical language models, but repeated-sampling approaches are expensive and existing uncertainty-head resources do not directly transfer to a new backbone and language. We adapt the LLM Uncertainty Head (LUH) framework to Aya-Expanse-8B-based Persian medical models, using Gaokerena-V and Gaokerena-R as two previously developed backbones. We first examine response variability on a 168-question Iranian medical entrance examination and observe substantially lower five-run consistency for Gaokerena-V than for Aya-Expanse-8B, whereas Gaokerena-R is comparable to Aya-Expanse-8B. We then construct two paired claim-level hallucination datasets directly in Persian, containing 1,600 responses for each backbone, and train lightweight claim-level heads on frozen backbone attention maps and token probabilities. On held-out test splits, the heads obtain PR-AUCs of 0.4820 and 0.4652, corresponding to 2.30 and 2.66 times their respective random baselines, and ROC-AUCs of 0.7852 and 0.7810. The heads require neither retrieval nor repeated sampling at inference time. These results provide an initial study of single-pass claim-level uncertainty estimation for Persian medical language models; the test splits are small and the labels are automatically generated.

Abstract: As large language models (LLMs) are increasingly used in clinical settings, it is critical to evaluate their reliability under realistic variation in clinical text. We study this question in clinical triage, comparing LLMs to practicing physicians under text perturbations that preserve the underlying clinical setting. We introduce a benchmark of over 6,000 clinical scenarios, 7,000 physician annotations, and 225,000 model responses. Using this benchmark, we make two key observations. First, LLMs are more likely than physicians to recommend unnecessary care at baseline, and this tendency increases under perturbed inputs. Further, we find that LLM recommendations are more sensitive to gender and tone perturbations than human recommendations. Together, these results demonstrate that LLMs can vary under clinically irrelevant textual changes, highlighting the need for deployment-oriented evaluations grounded in expert physician behavior.

Abstract: Large language model (LLM) agents that reason over clinical records must track changes in a patient's state while preserving the history needed to understand them. Simply accumulating memories leaves it unclear which information still applies, whereas overwriting earlier memories can erase evidence needed to reconstruct treatment history and clinical trajectories. We introduce STAM, a state-transition-aware memory framework that records state changes as new clinical entries arrive. STAM combines semantic retrieval with typed clinical relations to identify affected memories, maintaining current information in Active and superseded or resolved information in History. At read time, a query-dependent gate selectively serves historical memory. Across four longitudinal clinical benchmarks, we evaluate STAM with downstream question answering, direct state-maintenance diagnostics, and comparisons at approximately matched context lengths.

Abstract: Dense retrieval, the key component of Retrieval Augmented Generation (RAG), retrieves the most relevant documents by comparing dense vector representations of queries and passages from a large corpus. In privacy-sensitive applications, the server observes the query and controls which evidence is returned, creating both confidentiality and integrity risks. We formulate private dense retrieval as providing query privacy and retrieval integrity against a malicious server, and develop a two-round cryptographic protocol that provides both guarantees. Our protocol reduces private and verifiable retrieval to multiplication of a committed matrix by an encrypted vector and uses low-bit quantization to make this computation practical. We evaluate the resulting trade-off between cryptographic cost, retrieval quality, and downstream RAG accuracy across six embedding models, four language models, and corpora of up to 2.68 million passages. Our results show that, with a clipped quantizer, three-bit quantization largely preserves retrieval quality and downstream accuracy, while a private query over a corpus the size of a clinical reference requires one to three minutes of server time. These results suggest that private dense retrieval is already practical for moderately sized, privacy-sensitive corpora when minute-scale latency is acceptable.

Abstract: Patients often have several co-occurring clinical conditions, and the findings needed to identify and disambiguate them emerge over the course of a consultation. Evaluating clinical reasoning in this setting requires both multi-turn interaction and multi-label diagnosis. We introduce CLIMB, a benchmark in which a doctor model interviews a simulated patient to recover a ground truth set of co-occurring clinical conditions. Cases are synthesized from clinical decision algorithms and diagnostic datasets, grounding multimorbid presentations in structured clinical knowledge. Across six frontier and open models, none recovers the exact set of conditions in more than 10% of interactive cases. Diagnostic performance declines when conditions co-occur, even when models receive the full clinical record and the true number of conditions. Interaction reduces performance further. In controlled experiments, models behave like single-hypothesis trackers: they anchor on the diagnosis suggested by the opening findings, keep questioning around it, and recover a second condition mainly when a finding in view points to it. Questioning them further does not complete the set but adds mostly wrong diagnoses. We formalise this pattern with a theoretical reference model of single-hypothesis tracking. The benchmark, generator, and evaluation code are available at https://anonymous.4open.science/r/CLIMB-8340.

Abstract: The Model Context Protocol (MCP) provides a common interface through which AI applications discover and use external resources and tools. It allows language-model agents to ground their reasoning in current system state and interact with heterogeneous services. In medical environments, however, exposing device state and action affordances requires deterministic constraints on possible effects. We present an IEEE 11073 Service-Oriented Device Connectivity (SDC)-to-MCP gateway that exposes metrics, alarms, context references, and semantic metadata as read-only resources, while representing selected action affordances as policy-validated dry-run tools. The term safety-bounded denotes a narrow no-execution property: agent-facing requests dispatch no SDC device operation. A Python prototype supports simulated fault and lifecycle experiments, a software-reference protocol path spanning independent Java and Python implementations, deterministic baselines, representation ablations, and multi-model agent evaluation. The results show semantically explicit resource exposure, visible rejection of invalid or outdated state, and preservation of the no-execution boundary across resource, proposal, and authorization paths. Explicit semantic metadata improved conformity to required metric identifiers in structured alarm outputs relative to a generic representation, while retained structured-output failures reveal a distinction between plausible narrative answers and task-compliant machine-readable results.

Abstract: Today's digital healthcare services rely on various applications and functions that must be continuously accessible. Cloud computing enables global access to these services through public networks, which often also introduce increased latency, higher bandwidth consumption, and additional security risks compared to local operation. Edge computing mitigates these challenges by deploying cloud services closer to the end users and data sources, thereby improving resilience to network disruptions and reducing latency, bandwidth usage, and exposure to security threats. However, service deployment typically relies on the availability of centralized registry servers. Consequently, if the network connection or the registry server itself becomes unavailable, service deployment at the target edge node may fail. To address this, we propose a three-tier registry architecture to enhance deployment reliability and service availability, considering DockerHub as a remote public registry, an MEC-based off-premises registry as a remote private registry, and a LAN-based on-premises registry as a local private registry. The performance and efficiency are analyzed through measurements related to the estimated deployment time, inflicted network and computational load, and energy consumption, while the required nanoservices are deployed from different tiers. The experimental results indicate that alongside the improved tolerance to network disruptions, the local private and remote private registries also outperform the remote public registry in the deployment performance. The findings highlight the effectiveness of proximity-aware service distribution in improving the resilience, performance and efficiency of service deployment.

Abstract: Clinical domain classification plays an important role in organizing and analyzing large volumes of unstructured medical text. However, medical transcription datasets are often highly imbalanced, which can substantially degrade classification performance, particularly for underrepresented clinical specialties. In this work, we present a comparative study of machine learning and transformer-based approaches for clinical domain classification from medical transcriptions. We evaluate six traditional machine learning classifiers---Naive Bayes, Support Vector Machine (SVM), Decision Tree, Random Forest, K-Nearest Neighbors (KNN), and XGBoost---along with two pretrained transformer models, BERT and XLNet, and a few-shot large language model prompting approach. Experiments are conducted on medical transcription data collected from MTSamples, comprising 5,013 samples across 40 clinical specialties. To address severe class imbalance, we investigate two balancing strategies: text augmentation using NLP-based synonym replacement and Synthetic Minority Over-sampling Technique (SMOTE). Experimental results demonstrate that data balancing substantially improves classification performance across the evaluated models. In particular, BERT achieves the highest F1-score of 0.996 on the SMOTE-balanced dataset while requiring lower training time than XLNet. The results highlight the effectiveness of transformer-based representations combined with appropriate data balancing strategies for clinical domain classification and provide a systematic comparison of classical machine learning, transformer models, and few-shot prompting for medical transcription analysis.

Abstract: Traditional blockchain-based document notarization follows a snapshot-oriented model in which each document revision is represented as an independent state anchored on-chain through a cryptographic reference. While effective for immutable artifacts, this approach becomes inadequate when documents evolve through collaborative editing. Concurrent modifications create divergent document versions that must be reconciled outside the notarization layer, while even minor changes require generating and distributing new document snapshots. Conversely, collaborative replication frameworks such as CRDTs provide deterministic reconciliation of concurrent updates, but do not inherently provide independently verifiable evidence of when contributions were published. This paper introduces Fluid Notarization, a notarization paradigm in which document evolution itself becomes the object of notarization. Rather than certifying isolated states, Fluid Notarization certifies a graph of causally related evolution artifacts generated by a JSON-native delta-CRDT. The proposed model builds upon Melda, which represents document changes as compact, content-addressed deltas linked through causal dependencies. Blockchain notarization is reduced to recording identifiers of these evolution artifacts, while synchronization, reconstruction, and conflict resolution remain entirely off-chain. The resulting architecture combines two complementary guarantees: deterministic convergence provided by the CRDT and independently auditable proof-of-existence, provenance, and publication evidence provided by the blockchain. A prototype implementation and validation scenario based on collaboratively edited electronic health records demonstrate the feasibility of the approach and highlight the advantages of notarizing document evolution rather than successive document snapshots.

Abstract: Automating clinical documentation from long-form doctor-patient conversations remains challenging for modern audio-language models. While cascaded ASR systems perform well, end-to-end (E2E) models often struggle with information loss and hallucinations on extended audio. For the BeTraC 2026 challenge, the ASLP team presents a fully E2E multimodal system that generates structured SOAP notes directly from audio, bypassing intermediate transcripts. We constructed a 1.41-million-sample multi-task corpus and applied a multi-stage pipeline: domain pre-training, supervised fine-tuning, and reward optimization. Evaluating the architecture under both Lightweight (3B) and Heavyweight (30B) constraints reveals that each training stage progressively enhances performance. Furthermore, scaling to 30B parameters substantially boosts concept extraction and summarization quality. Ultimately, our E2E systems consistently outperform representative cascaded ASR+LLM baselines, proving the efficacy of direct multimodal optimization for clinical documentation.

Abstract: Visual Question Answering (VQA) systems, jointly interpreting images and natural language queries, hold significant promise across many domains, yet the privacy-sensitive nature of user data creates a fundamental barrier. Centralized training requires access to all data, while federated learning requires each client to host the full model. We propose USPLIT-VQA, a U-shaped split learning framework for privacy-preserving VQA in which each client retains the initial layers and the classification head while the server hosts the computationally heavy intermediate layers, keeping raw inputs and labels on the client device. We further introduce Contribution-Aware Weighted Aggregation (CAWA), a gradientsimilarity-based client scoring mechanism designed to reduce the influence of malicious updates. Experiments on four VQA datasets (VQA-RAD, SLAKE, PathVQA, and VizWiz) with two backbones show accuracy gains over Federated Learning for the Custom model and reduced accuracy for BiomedCLIP under the evaluated fixed split, alongside client memory reductions of up to 5.8X and communication reductions of up to 10.8X. With one malicious client, CAWA reduces the attacker's influence by over 98%, while experiments at higher corruption levels identify its limitations. Reconstruction experiments further show lower inversion quality under the evaluated attacks.

Abstract: Healthcare Internet of Things (HIoT) technology is revolutionising the healthcare industry by enabling real-time data collection and analysis for personalised patient care. However, the rapid expansion of HIoT technology introduces challenges such as increased latency and higher energy consumption in fog computing environments, particularly when managing battery-operated devices. To address these issues, this work proposes a novel scheduling strategy that optimises both power consumption and latency through task-oriented scheduling for HIoT tasks. The proposed strategy, named PLATOS (Power and Latency Aware Task Oriented Scheduling), is implemented in four sequential phases. In the first phase, HIoT tasks are categorised into three groups: priority-oriented, storage-oriented, and computational-oriented. The second phase focuses on latency optimisation by identifying the fog computing resources that yield the lowest execution delay for each task category. In the third phase, power optimisation is achieved by selecting the resources that minimise energy consumption. Finally, in the decision-making phase, high-performance fog resources are allocated to high-priority tasks while the remaining tasks are scheduled based on a mapped list derived from the latency and power optimisation phases. Simulation experiments conducted in iFogSim2 demonstrate that PLATOS reduces energy consumption by 18.72% and latency by 8.65% when compared to the state-of-the-art. These improvements enhance the efficiency and responsiveness of HIoT systems and contribute to more effective patient care and proactive healthcare service delivery.