TeleZK-FL: enabling trustless and verifiable remote patient monitoring via quantized zero-knowledge federated learning
Abstract
Background: The rapid expansion of Internet of Medical Things (IoMT) and telehealth platforms has generated vast amounts of patient data suitable for training diagnostic Artificial Intelligence (AI) models. However, strict privacy regulations (HIPAA, GDPR) and the risk of data breaches prevent the centralization of this sensitive information. While Federated Learning (FL) allows for collaborative training without sharing raw patient data, it introduces a critical "trust deficit": central aggregators cannot verify the integrity of local model updates without inspecting the private data, leaving the system vulnerable to model poisoning and malicious actors.
Methods: We introduce TeleZK-FL, a privacy-preserving framework designed specifically for resource-constrained telehealth environments. Unlike existing Zero-Knowledge Proof (ZKP) systems that require high-performance computing or offload proof generation to trusted edge servers, TeleZK-FL integrates (1) Post-Training Quantization (PTQ) to compress model gradients from 32-bit floating-point to 8-bit integers, and (2) optimized Look-Up Table (LUT) arguments to generate cryptographic proofs of client-side training integrity directly on edge devices. We evaluated the framework on two clinical modalities-CheXpert (chest X-rays) and PTB-XL (12-lead ECGs)-using simulated medical edge gateways (Raspberry Pi 4) under both homogeneous and heterogeneous data distributions.
Results: TeleZK-FL accelerates cryptographic proof generation…
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