Devices, systems and methods are provided to implement key generation forsecure pairing between first and seconddevices using embedded out-of-band (OOB) key generation and without requiringthe devices to have input/output (IO) capability toenter authentication information. Bluetooth Smart or Low Energy (BLE) OOBpairing option can be used for pairing medical deviceswith added security of OOB key generation. The OOB key generation comprisesproviding first and second devices with the samepredefined credential and secure hashing algorithm, and making input of thehashing algorithm of the first and second devices thesame. The first device transmits unique data to second device (e.g., via BLEadvertising) to share and compute a similar input. Thefirst and second devices use the credential and shared data with the hashingfunction to generate a key that is the same at each of firstand second devices.