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<p>The metaverse is rapidly developing and has the potential to transform healthcare delivery. Nevertheless, many existing studies focus on individual technologies, resulting in technological fragmentation and limited interoperability. This paper presents a coherent healthcare metaverse architecture governed by a novel Cross-Layer Orchestration Logic (CLOL), which integrates Artificial Intelligence (AI), the Internet of Medical Things (IoMT), and blockchain into a unified ecosystem. The CLOL protocol provides a deterministic execution pathway for multimodal data ingestion and AI-driven decision-making based on confidence-threshold triggers, along with immutable data logging through blockchain anchoring. The feasibility and relevance of the proposed framework are illustrated through a case study of augmented reality (AR)-guided spine surgery. Reported results from existing AR-assisted surgical systems indicate 98.9% accuracy in screw placement, a 20% reduction in operating time, and a 30% reduction in radiation exposure, highlighting the potential benefits of the integrated architecture. Furthermore, existing studies on edge computing and 5G-enabled healthcare systems indicate that near real-time performance is achievable, with end-to-end latency approaching 20&#xa0;ms under favorable network conditions. These findings support the feasibility of the proposed orchestration framework for time-sensitive clinical applications. The paper also outlines key implementation challenges, including the need for standardized HL7 FHIR APIs and advanced 5G/6G network slicing. Overall, this work provides a protocol-driven, scalable, and interoperable foundation for healthcare metaverse systems.</p>

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An Integrated Healthcare Metaverse Framework with a Cross-Layer Orchestration Protocol Using AI, IoMT, and Blockchain

  • 期刊论文

  • 发表日期：

    2026年4月18日

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  • Krishna Kumar Mohbey

摘要

The metaverse is rapidly developing and has the potential to transform healthcare delivery. Nevertheless, many existing studies focus on individual technologies, resulting in technological fragmentation and limited interoperability. This paper presents a coherent healthcare metaverse architecture governed by a novel Cross-Layer Orchestration Logic (CLOL), which integrates Artificial Intelligence (AI), the Internet of Medical Things (IoMT), and blockchain into a unified ecosystem. The CLOL protocol provides a deterministic execution pathway for multimodal data ingestion and AI-driven decision-making based on confidence-threshold triggers, along with immutable data logging through blockchain anchoring. The feasibility and relevance of the proposed framework are illustrated through a case study of augmented reality (AR)-guided spine surgery. Reported results from existing AR-assisted surgical systems indicate 98.9% accuracy in screw placement, a 20% reduction in operating time, and a 30% reduction in radiation exposure, highlighting the potential benefits of the integrated architecture. Furthermore, existing studies on edge computing and 5G-enabled healthcare systems indicate that near real-time performance is achievable, with end-to-end latency approaching 20 ms under favorable network conditions. These findings support the feasibility of the proposed orchestration framework for time-sensitive clinical applications. The paper also outlines key implementation challenges, including the need for standardized HL7 FHIR APIs and advanced 5G/6G network slicing. Overall, this work provides a protocol-driven, scalable, and interoperable foundation for healthcare metaverse systems.