Securing Smart Healthcare Cyber-Physical Systems against Blackhole and Greyhole Attacks Using a Blockchain-Enabled Gini Index Framework  
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4 Institute of Innovation, Science, and Sustainability, Federation University, Brisbane, QLD 4000, Australia; 4  
and society by enhancing productivity, safety, and sustainability [3]. CPSs have a tremendous amount of potential for influencing a future in which the physical and digital worlds are closely connected. Smart healthcare through CPS stands as a transformative force, revolutionizing the landscape of medical care delivery. The importance of integrating CPSs in healthcare lies in their ability to enhance patient outcomes, optimize resource utilization, and streamline the entire healthcare ecosystem [4]. Through interconnected devices, real-time monitoring, and data analytics, smart healthcare systems offer a comprehensive and personalized approach to patient care. Remote patient monitoring, predictive analytics, and smart medical devices contribute to early disease detection, allowing for proactive interventions and personalized treatment plans [5]. The advantages extend beyond individual patient care to the optimization of healthcare operations. CPSs facilitate efficient resource management, reducing costs, minimizing errors, and enhancing overall system resilience. Additionally, the seamless exchange of information among healthcare stakeholders ensures coordinated and timely interventions, improving the quality of care across the continuum [6]. In essence, smart healthcare through CPS empowers healthcare professionals with valuable insights and ensures a patient-centric, data-driven, and interconnected healthcare ecosystem. An exemplary real-life manifestation of smart healthcare through CPS is evident in the deployment of remote patient monitoring systems [7], such as the \"Tele-ICU\" programs implemented in various hospitals. These CPSs leverage a network of interconnected medical devices and sensors to monitor patients in real time, even from remote locations. In critical care settings, where timely interventions can be life-saving, Tele-ICU programs utilize smart monitoring devices to continuously track vital signs and other relevant health parameters [8]. The collected data are transmitted securely to a central hub, where healthcare professionals can analyze and respond to emerging trends or anomalies promptly. This not only enables early detection of potential health complications but also facilitates timely adjustments to treatment plans [9]. Importantly, these systems enhance the efficiency of healthcare delivery by reducing the need for constant bedside presence, optimizing resource allocation, and increasing the geographic range of critical care expertise. The successful implementation of Tele-ICU programs shows how smart healthcare CPS can bridge geographical gaps, improve patient outcomes, and redefine smart healthcare [10]. Smart healthcare CPS systems are revolutionizing patient care and healthcare delivery. Wearable health trackers such as smart watches and fitness bands have enabled individuals to monitor their activity levels, heart rate, and sleep patterns in real time [11]. Remote patient monitoring devices, including blood pressure monitors and glucose meters, empower patients to manage chronic conditions from the comfort of their homes while providing healthcare professionals with valuable data for proactive interventions [7]. Implantable medical devices, like pacemakers and insulin pumps, have facilitated continuous monitoring and adjustment of physiological functions [12]. Tele-health platforms facilitate virtual consultations, connecting patients with healthcare providers regardless of geographical distances. Smart pill dispensers and inhalers contribute to medication adherence, enhancing treatment efficacy. The pervasive use of IoT-enabled medical equipment and smart health apps further underscores the interconnected nature of these systems [13].