## 1 Introduction  
In the last decade, the internet of things (IoT) has experienced rapid growth and has become a disruptive technology in various sectors, including healthcare. The internet of medical things (IoMT) is a specialized branch of the IoT that focuses on integrating interconnected medical devices and information systems in the healthcare environment [1]. This technology has revolutionized the healthcare industry by enabling real-time data collection, analysis, and transmission, providing new opportunities for remote patient monitoring, medical process improvement, and clinical decision-making [2]. The IoMT is based on a network of connected medical devices, sensors, and information systems, allowing for the collection and transmission of health data automatically and continuously. These devices can include anything from vital signs monitors and medication delivery devices to fitness tracking sensors and home monitoring devices [3, 4]. The information collected by these devices can be transmitted to health professionals, hospitals, or information systems in the cloud for analysis and storage [5]. This opens the door to several innovative medical applications, such as the remote monitoring of chronic patients, personalized healthcare, and improved diagnosis and treatment. However, as IoMT technology has developed and expanded, there have also been several challenges that need to be addressed to ensure its success and widespread adoption [6]. These challenges include data security and privacy, the interoperability of devices and systems, efficient data management, and long-term sustainability. One of the main challenges in the field of the IoMT is the security and privacy of patient data. Collectingand transmitting sensitive and confidential medical data raises concerns about privacy protection and information security. Therefore, protecting patient data from hacking and unauthorized access is crucial. To address this challenge, robust security measures must be implemented at all levels of the IoMT system, including user and device authentication, data confidentiality, and information integrity. Another major challenge in the field of the IoMT is interoperability. Since the IoMT involves a wide variety of medical devices and information systems, it is critical to ensure they are compatible and can work together effectively. Interoperability enables seamless data integration from different devices and systems, facilitating the sharing of medical information and collaboration between healthcare providers. To address this challenge, it is necessary to develop common standards and protocols that enable interoperability between IoMT devices and systems. Integration with existing systems in the healthcare environment also poses a significant challenge [7]. IoMT systems must be compatible and seamlessly integrated with existing healthcare systems and processes, such as electronic health records, hospital management systems, and clinical practices [8]. This implies overcoming technical barriers and achieving a coherent systems architecture that allows for efficient information exchange and collaboration between different actors in the healthcare system. Long-term sustainability is another critical challenge for the IoMT. As the number of IoMT devices and systems increases, there is a need to ensure the efficient management of resources, including power, bandwidth, and storage capacity [9]. In addition, the life cycle of IoMT devices and systems must be considered to ensure the availability of technology updates and improvements over time. To address these challenges, a framework for a secure and sustainable IoMT has been developed. This framework is based on implementing security measures, such as user and device authentication, data encryption, and access control. In addition, it focuses on incorporating sustainability models that allow for the efficient management of resources and promote responsible practices from an environmental point of view.