Blockchain-Based Medical Records Secure Storage and Medical Service Framework

Integrating blockchain and ZK-ROLLUP for efficient healthcare data privacy protection system via IPFS

With the rapid development of modern medical technology and the dramatic increase in the amount of medical data, traditional centralized medical information management is facing many challenges. In recent years blockchain, which is a peer-to-peer distributed database, has been increasingly accepted and adopted by different industries and use cases. Key areas of healthcare blockchain applications include electronic medical record (EMR) management, medical device supply chain management, remote condition monitoring, insurance claims and personal health data (PHD) management, among others. Even so, there are a number of challenges in applying blockchain concepts to healthcare and its data, including interoperability, data security privacy, scalability, TPS and so on. While these challenges may hinder the development of blockchain in healthcare scenarios, they can be improved with existing technologies In this paper, we propose a blockchain-based healthcare operations management framework that is combined with the Interplanetary File System (IPFS) for managing EMRs, protects data privacy through a distributed approach while ensuring that this medical ledger is tamper-proof. Doctors act as full nodes, patients can participate in network maintenance either as light nodes or as full nodes, and the hospital acts as the endpoint database of data, i.e., the IPFS node, which saves the arithmetic power of nodes and allows the data stored in the hospitals and departments to be shared with the other organizations that have uploaded the data. Therefore, the integration of blockchain and zero-knowledge proof proposed in this paper helps to protect data privacy and is efficient, better scalable, and more throughput.

The need for cybersecurity self-evaluation in healthcare

The Australian healthcare sector is a complex mix of government departments, associations, providers, professionals, and consumers. Cybersecurity attacks, which have recently increased, challenge the sector in many ways; however, the best approaches for the sector to manage the threat are unclear. This study will report on a semi-structured focus group conducted with five representatives from the Australian healthcare and computer security sectors. An analysis of this focus group transcript yielded four themes: 1) the challenge of securing the Australian healthcare landscape; 2) the financial challenges of cybersecurity in healthcare; 3) balancing privacy and transparency; 4) education and regulation. The results indicate the need for sector-specific tools to empower the healthcare sector to mitigate cybersecurity threats, most notably using a self-evaluation tool so stakeholders can proactively prepare for incidents. Despite the vast amount of research into cybersecurity, little has been conducted on proactive cybersecurity approaches where security weaknesses are identified weaknesses before they occur.

Dual blockchain-based data sharing mechanism with privacy protection for medical internet of things

In the period of big data, the Medical Internet of Things (MIoT) serves as a critical technology for modern medical data collection. Through medical devices and sensors, it enables real-time collection of a large amount of patients' physiological parameters and health data. However, these data are often generated in a high-speed, large-scale, and diverse manner, requiring integration with traditional medical systems, which further exacerbates the phenomenon of scattered and heterogeneous medical data. Additionally, the privacy and security requirements for the devices and sensor data involved in the MIoT are more stringent. Therefore, when designing a medical data sharing mechanism, the data privacy protection capability of the mechanism must be fully considered. This paper proposes an alliance chain medical data sharing mechanism based on a dual-chain structure to achieve secure sharing of medical data among entities such as medical institutions, research institutions, and cloud privacy centers, and at the same time provide privacy protection functions to achieve a balanced combination of privacy protection capability and data accessibility of medical data. First, a knowledge technology based on ciphertext policy attribute encryption with zero-knowledge concise non-interactive argumentation is used, combined with the data sharing structure of the federation chain, to ensure the integrity and privacy-protecting capability of medical data. Second, the approach employs certificate-based signing and proxy re-encryption technology, ensuring that entities can decrypt and verify medical data at the cloud privacy center using this methodology, consequently addressing the confidentiality concerns surrounding medical data. Third, an efficient and secure key identity-based encryption protocol is used to ensure the legitimacy of user identity and improve the security of medical data. Finally, the theoretical and practical performance analysis proves that the mechanism is feasible and efficient compared with other existing mechanisms.

Secure Biomedical Document Protection Framework to Ensure Privacy Through Blockchain

In the recent health care era, biomedical documents play a crucial role, and they contain much evidence-based documentation associated with many stakeholders data. Protecting those confidential research documents is more difficult and effective, and a significant process in the medical-based research domain. Those bio-documentation related to health care and other relevant community-valued data are suggested by medical professionals and processed. Many traditional security mechanisms such as akteonline and Health Insurance Portability and Accountability Act (HIPAA) are used to protect the biomedical documents as they consider the problem of non-repudiation and data integrity related to the retrieval and storage of documents. Thus, there is a need for a comprehensive framework that improves protection in terms of cost and response time related to biomedical documents. In this research work, blockchain-based biomedical document protection framework (BBDPF) is proposed, which includes blockchain-based biomedical data protection (BBDP) and blockchain-based biomedical data retrieval (BBDR) algorithms. BBDP and BBDR algorithms provide consistency on the data to prevent data modification and interception of confidential data with proper data validation. Both the algorithms have strong cryptographic mechanisms to withstand post-quantum security risks, ensuring the integrity of biomedical document retrieval and non-deny of data retrieval transactions. In the performance analysis, Ethereum blockchain infrastructure is deployed BBDPF and smart contracts using Solidity language. In the performance analysis, request time and searching time are determined based on the number of request to ensure data integrity, non-repudiation, and smart contracts for the proposed hybrid model as it gets increased gradually. A modified prototype is built with a web-based interface to prove the concept and evaluate the proposed framework. The experimental results revealed that the proposed framework renders data integrity, non-repudiation, and support for smart contracts with Query Notary Service, MedRec, MedShare, and Medlock.

Proposed association rule hiding based privacy preservation model with block chain technology for IoT healthcare sector

The purpose of this study is to improve healthcare system performance by utilizing cutting-edge computing technologies like blockchain and the Internet of Things. Blockchain-based data transfer, Association Rule hiding, and ideal key generation are the three primary aspects of the proposed work. Initially, data are altered using blockchain, then the data enter the Proposed Association Rule concealing stage. In this research a novel association rule concealment phase is implemented, which has three crucial processes: (1) data pattern mining using the improved apiori algorithm, (2) detection of sensitive data based on the improved apiori algorithm, and (3) a method for cleaning and restoring data. Using the generated optimal key, the sanitized sensitive data are recovered. Keys are critical to both the data sanitization and restoration procedures. Hence, a multi-objective hybrid optimization model is known as the Rock Hyraxes Updated Marriage in Honey Bee Optimization (RHUMBO) is employed. Then, the confidentiality of the suggested model's performance has been validated. From the experimental analysis the proposed model achieved 97% for Cleveland dataset at 90th learning percentage which is the best score. And the cost function of the suggested model is minimum (∼0.08 at 100th iteration).

Exploring applications of blockchain in healthcare: road map and future directions

Blockchain technology includes numerous elements such as distributed ledgers, decentralization, authenticity, privacy, and immutability. It has progressed past the hype to find actual use cases in industries like healthcare. Blockchain is an emerging area that relies on a consensus algorithm and the idea of a digitally distributed ledger to eliminate any intermediary risks. By enabling them to trace data provenance and any changes made, blockchain technology can enable different healthcare stakeholders to share access to their networks without violating data security and integrity. The healthcare industry faces challenges like fragmented data, security and privacy concerns, and interoperability issues. Blockchain technology offers potential solutions by ensuring secure, tamper-proof storage across multiple network nodes, improving interoperability and patient privacy. Encrypting patient data further enhances security and reduces unauthorized access concerns. Blockchain technology, deployed over the Internet, can potentially use the current healthcare data by using a patient-centric approach and removing the intermediaries. This paper discusses the effective utilization of blockchain technology in the healthcare industry. In contrast to other applications, the exoteric evaluation in this paper shows that the innovative technology called blockchain technology has a major role to play in the existing and future applications of the healthcare industry and has significant benefits.

A blockchain-based traceable and secure data-sharing scheme

The traditional data-sharing model relies on a centralized third-party platform, which presents challenges such as poor transaction transparency and unsecured data security. In this article, we propose a blockchain-based traceable and secure data-sharing scheme. Firstly, we designed an attribute encryption-based method to protect data and enable fine-grained shared access. Secondly, we developed a secure data storage scheme that combines on-chain and off-chain collaboration. The InterPlanetary File System (IPFS) is used to store encrypted data off-chain, and the hash value of encrypted data is stored on the blockchain. To improve data security, elliptic curve cryptography (ECC) encryption is performed before the hash value is stored. Finally, we designed a smart contract-based log tracking mechanism. The mechanism stores data sharing records on the blockchain and displays them in a visual form to meet the identity tracking needs of both data sharing parties. Experimental results show that our scheme can effectively secure data, track the identities of both parties sharing data in real-time, and ensure high data throughput.

Securing and managing healthcare data generated by intelligent blockchain systems on cloud networks through DNA cryptography

Purpose

The purpose of this paper is to ensure the anonymity and security of health data and improve the integrity and authenticity among patients, doctors and insurance providers. Simulation and validation algorithms are proposed in this work to ensure the proper implementation of the distributed system to secure and manage healthcare data. The author also aims to examine the methodology of Wireless Body Area Networks and how it contributes to the health monitoring system.

Design/methodology/approach

Wireless Body Area Network (WBAN) plays an important role in patient health data monitoring. In this paper, a novel framework is designed and proposed to generate data by the sensor machines and be stored in the cloud, and the transactions can be secured by blockchain. DNA cryptography is used in the framework to encrypt the hashes of the blocks. The proposed framework will ensure the anonymity and security of the health data and improve the integrity and authenticity among the patients, doctors and insurance providers.

Findings

Cloud Computing and Distributed Networking have transformed the IT industry and their amalgamation with intelligent systems would revolutionize the Healthcare Industry. The data being generated by devices is huge and storing it in the cloud environment would be a better decision. However, the privacy and security of healthcare data are still a concern because medical data is very confidential and desires to be safe and secure. The blockchain is a promising distributed network that ensures the security aspect of the data and makes the transactions authentic and transparent. In this work, the data is collected using various sensor devices and is transmitted to the cloud through the WBAN via the blockchain network.

Research limitations/implications

In this paper, a framework for securing and managing the healthcare data generated by intelligent systems is proposed. As the data generated by these devices are heterogeneous and huge in nature, the cloud environment is chosen for its storage and analysis. Therefore, the transactions to and from the cloud are secured by using the blockchain-based distributed network.

Practical implications

The target end-users of our system are the patients to keep themselves informed and healthy, healthcare providers to monitor the conditions of their patients virtually, and the health insurance providers to have a track of the history of the patients, so that no fraudulent claims can be made.

Originality/value

The target end-users of our system are the patients for keeping themselves informed and healthy, healthcare providers for monitoring the conditions of their patients virtually and the health insurance providers to have a track of the history of the patients, so that no fraudulent claims can be made.

Integration of Healthcare 4.0 and blockchain into secure cloud-based electronic health records systems

Since the last decade, cloud-based electronic health records (EHRs) have gained significant attention to enable remote patient monitoring. The recent development of Healthcare 4.0 using the Internet of Things (IoT) components and cloud computing to access medical operations remotely has gained the researcher's attention from a smart city perspective. Healthcare 4.0 mainly consisted of periodic medical data sensing, aggregation, data transmission, data sharing, and data storage. The sensitive and personal data of patients lead to several challenges while protecting it from hackers. Therefore storing, accessing, and sharing the patient medical information on the cloud needs security attention that data should not be compromised by the authorized user's components of E-healthcare systems. To achieve secure medical data storage, sharing, and accessing in cloud service provider, several cryptography algorithms are designed so far. However, such conventional solutions failed to achieve the trade-off between the requirements of EHR security solutions such as computational efficiency, service side verification, user side verifications, without the trusted third party, and strong security. Blockchain-based security solutions gained significant attention in the recent past due to the ability to provide strong security for data storage and sharing with the minimum computation efforts. The blockchain made focused on bitcoin technology among the researchers. Utilizing the blockchain which secure healthcare records management has been of recent interest. This paper presents the systematic study of modern blockchain-based solutions for securing medical data with or without cloud computing. We implement and evaluate the different methods using blockchain in this paper. According to the research studies, the research gaps, challenges, and future roadmap are the outcomes of this paper that boost emerging Healthcare 4.0 technology.

Blockchain-based medical health record access control scheme with efficient protection mechanism and patient control

The patient's medical health record (PMHR) has always provided a large amount of research data to medical institutions and pharmaceutical companies, etc., and has contributed to the development in medical research. However, such PMHR data contains the patient's personal privacy and should be shared under the control of the patients, not the hospital where this data is acquired. In order to protect the privacy of PMHR data while realizing efficient data sharing, this paper proposes a blockchain-based sharing and protection scheme. In this solution, the PMHR data are encrypted and stored in a cloud server, which is equipped with an access control scheme implemented as a smart contract on a blockchain. Different from previous works, in order to ensure efficient access and reduce the workload of patients, the types of users who can apply for access are limited to hospitals and pharmaceutical companies. In order to resist the potential Man-in-the-middle (MITM) attack, we have introduced an improved proxy re-encryption scheme to ensure the secrecy of PMHR data while reducing the computational complexity. The whole system is implemented using Solidity and tested on 10 nodes for function verification. Experimental result shows that the proposed system is more efficient than previous systems. Security under the MITM attack is also ensured by security analysis.

Double chain system for online and offline medical data sharing private and consortium blockchain: A system design study

With the informatization development and digital construction in the healthcare industry, electronic medical records and Internet medicine facilitate people's medical treatment. However, the current data storage method has the risk of data loss, leakage, and tampering, and can't support extensive and secure sharing of medical data. To realize effective and secure medical data storage and sharing among offline medical institutions and Internet medicine platforms, this study used a combined private blockchain and consortium blockchain to design a medical blockchain double-chain system (MBDS). This system can store encrypted medical data in distributed storage mode and systematically integrate the medical data of patients in offline medical institutions and Internet medicine platforms, to achieve equality, credibility, and data sharing among participating nodes. The MBDS system constructed in this study incorporated Internet medicine care services into the current healthcare system and provided new solutions and practical guidance for the future development of collaborative medical care. This study helped to solve the problems of medical data interconnection and resource sharing, improve the efficiency and effect of disease diagnosis, alleviate the contradiction between doctors and patients, and facilitate personal health management. This study has substantial theoretical and practical implications for the research and application of medical data storage and sharing.

University Archives Autonomous Management Control System under the Internet of Things and Deep Learning Professional Certification

The current work aims to meet the needs of the development of archives work in colleges and universities and the modernization of management to realize the standards and standardization of all aspects of archives business construction in colleges and universities, so as to improve the political and professional quality of archives cadres. First, the radio frequency identification (RFID) technology based on the Internet of things (IoT) digitizes the university archive labels. Meanwhile, the filing cabinet's intelligent security system preserves confidential files. Second, the convolutional neural network (CNN) algorithm under deep learning is introduced and college profile information is identified. Finally, the concept of professional certification is used to clarify the purpose of the university archives automation management system. Different activation functions are used to analyze the recognition accuracy loss and recognition accuracy of university archives. The identification error of You Only Look Once (YOLO) of the ReLU-convolutional neural network (R–CNN) of college archives is analyzed. The results show that the selection of rectified linear units (ReLU) activation function for CNN can effectively reduce the loss of identification accuracy of college archives and can improve the accuracy of identification of college archives. The algorithm based on the ReLU activation function has a smaller recognition error accuracy in college archives than that of the YOLO algorithm. The recognition error of the YOLO algorithm is slightly higher than that of the R–CNN. The font recognition error of archival information based on the R–CNN is relatively large. However, the conclusion is reasonable due to the recognition difficulties of handwritten archival fonts. The file positioning recognition error rate is 19.00%, the file printing font recognition error rate is 4.75%, and the image recognition error rate is 1.90%. These results have a certain reference value for the process of identifying information in the automatic management of university archives by CNN under different activation functions.

Blockchain technology used in medicine. A brief survey

Blockchain is the technology that allows people to make transactions without intermediaries. Bitcoin was the first cryptocurrency launched. Cryptocurrencies are digital tokens that can be used for transactions. They use cryptography to establish their authenticity and are not linked to a central authority. Blockchain has many advantages for the healthcare industry and can be used in various fields such as: implementation and improvement of electronic patient records, in clinical trials, neuroscience, pharmaceutical industry and research. Its security can help to improve the confidentiality of patient data and can also help secure the supply chain of medicines. The security and transparency of the blockchain will play a crucial role in the medical industry. This will allow companies to register their products and conduct secure transactions. QR codes can also be placed on the back of medicine containers to help customers identify the authenticity of the products they purchase. The exchange of health information through the blockchain will also have various challenges, such as maintaining the confidentiality of patient data. At the same time, due to the different regulations in different countries, it can be difficult to establish an efficient and secure exchange. Unlike other cryptocurrencies, blockchains are usually immutable, which means that the data added in the chain will always remain. This eliminates the risk of data loss

Blockchain and cloud computing-based secure electronic healthcare records storage and sharing

Healthcare information is essential for both service providers and patients. Further secure sharing and maintenance of Electronic Healthcare Records (EHR) are imperative. EHR systems in healthcare have traditionally relied on a centralized system (e.g., cloud) to exchange health data across healthcare stakeholders, which may expose private and sensitive patient information. EHR has struggled to meet the demands of several stakeholders and systems in terms of safety, isolation, and other regulatory constraints. Blockchain is a distributed, decentralized ledger technology that can provide secured, validated, and immutable data sharing facilities. Blockchain creates a distributed ledger system using techniques of cryptography (hashes) that are consistent and permit actions to be carried out in a distributed manner without needing a centralized authority. Data exploitation is difficult and evident in a blockchain network due to its immutability. We propose an architecture based on blockchain technology that authenticates the user identity using a Proof of Stake (POS) cryptography consensus mechanism and Secure Hash Algorithm (SHA256) to secure EHR sharing among different electronic healthcare systems. An Elliptic Curve Digital Signature Algorithm (ECDSA) is used to verify EHR sensors to assemble and transmit data to cloud infrastructure. Results indicate that the proposed solution performs exceptionally well when compared with existing solutions, which include Proof-Of-Work (POW), Secure Hash Algorithm (SHA-1), and Message Digest (MD5) in terms of power consumption, authenticity, and security of healthcare records.

PHDMF: A Flexible and Scalable Personal Health Data Management Framework Based on Blockchain Technology

Currently, most of the personal health data (PHD) are managed and stored separately by individual medical institutions. When these data need to be shared, they must be transferred to a trusted management center and approved by data owners through the third-party endorsement technology. Therefore, it is difficult for personal health data to be shared and circulated over multiple medical institutions. On the other hand, the use of directly exchanging and sharing the original data has become inconsistent with the data rapid growth of medical institutions because of the need of massive data transferring across agencies. In order to secure sharing and managing the mass personal health data generated by various medical institutions, a federal personal health data management framework (PHDMF, https://hvic.biosino.org/PHDMF) has been developed, which had the following advantages: 1) the blockchain technology was used to establish a data consortium over multiple medical institutions, which could provide a flexible and scalable technical solution for member extension and solve the problem of third-party endorsement during data sharing; 2) using data distributed storage technology, personal health data could be majorly stored in their original medical institutions, and the massive data transferring process was of no further use, which could match up with the data rapid growth of these institutions; 3) the distributed ledger technology was utilized to record the hash value of data, given the anti-tampering feature of the technology, malicious modification of data could be identified by comparing the hash value; 4) the smart contract technology was introduced to manage users’ access and operation of data, which made the data transaction process traceable and solved the problem of data provenance; and 5) a trusted computing environment was provided for meta-analysis with statistic information instead of original data, the trusted computing environment could be further applied to more health data, such as genome sequencing data, protein expression data, and metabolic profile data through combining the federated learning and blockchain technology. In summary, the framework provides a convenient, secure, and trusted environment for health data supervision and circulation, which facilitate the consortium establish over medical institutions and help achieve the value of data sharing and mining.

Drivers, barriers and supply chain variables influencing the adoption of the blockchain to support traceability along fashion supply chains

The critical role of blockchain technology in ensuring a proper level of traceability and visibility along supply chains is increasingly being explored in the literature. This critical examination must focus on the factors that either encourage or hinder (i.e. the drivers or barriers) the implementation of this technology in extended supply chains. On the assumption that the blockchain will need to be adopted at the supply chain level, the enabling factors and the contingent variables of different supply chains must be identified and analysed. The appropriate identification of supply chain partners is becoming a critical factor of success since the globalization of supply chains makes their management and control increasingly difficult. This is particularly true of the fashion industry. Five blockchain providers and seven focal companies working in the fashion industry were interviewed to compare their different viewpoints on this topic. The results highlight which drivers, barriers, and supply chain variables impact the implementation of the blockchain and specific research propositions are formulated.

Literature Review on Artificial Intelligence Methods for Glaucoma Screening, Segmentation, and Classification

Artificial intelligence techniques are now being applied in different medical solutions ranging from disease screening to activity recognition and computer-aided diagnosis. The combination of computer science methods and medical knowledge facilitates and improves the accuracy of the different processes and tools. Inspired by these advances, this paper performs a literature review focused on state-of-the-art glaucoma screening, segmentation, and classification based on images of the papilla and excavation using deep learning techniques. These techniques have been shown to have high sensitivity and specificity in glaucoma screening based on papilla and excavation images. The automatic segmentation of the contours of the optic disc and the excavation then allows the identification and assessment of the glaucomatous disease’s progression. As a result, we verified whether deep learning techniques may be helpful in performing accurate and low-cost measurements related to glaucoma, which may promote patient empowerment and help medical doctors better monitor patients.

Privacy-Preserved EMR Information Publishing and Sharing: A Blockchain-Enabled Smart Healthcare System

Electronic Medical Records (EMR) can facilitate information publishing and sharing among doctors, hospitals, and academic researchers in a smart healthcare system. Since the personalized attributes in EMRs can be tempered by attackers or accessed by unauthorized users for malicious purposes. We construct an individual-centric privacy-preserved EMR information publishing and sharing system. First, we design an intelligent matching model using utility functions to quantitatively evaluate privacy elements and compute maximum benefits between transaction participants, i.e., EMRs publishers and EMRs requesters. After that, we classify the personalized attributes of EMRs according to healthcare applications and design a blockchain-enabled privacy-preserved framework to protect the attributes during the lifetime of data publishing and sharing. We design multiple smart contracts deployed on the blockchain framework to guarantee the identity anonymous, dynamic access control, and tracebility of transactions in a smart healthcare system. Finally, we develop a prototype system and test our approach using 100,000 EMRs. The experimental results show that the proposed privacy-preserved scheme can make stable matching and security transactions between publishers and requesters.

Applications of Blockchain in the Medical Field: Narrative Review

Background

As a distributed technology, blockchain has attracted increasing attention from stakeholders in the medical industry. Although previous studies have analyzed blockchain applications from the perspectives of technology, business, or patient care, few studies have focused on actual use-case scenarios of blockchain in health care. In particular, the outbreak of COVID-19 has led to some new ideas for the application of blockchain in medical practice.

Objective

This paper aims to provide a systematic review of the current and projected uses of blockchain technology in health care, as well as directions for future research. In addition to the framework structure of blockchain and application scenarios, its integration with other emerging technologies in health care is discussed.

Methods

We searched databases such as PubMed, EMBASE, Scopus, IEEE, and Springer using a combination of terms related to blockchain and health care. Potentially relevant papers were then compared to determine their relevance and reviewed independently for inclusion. Through a literature review, we summarize the key medical scenarios using blockchain technology.

Results

We found a total of 1647 relevant studies, 60 of which were unique studies that were included in this review. These studies report a variety of uses for blockchain and their emphasis differs. According to the different technical characteristics and application scenarios of blockchain, we summarize some medical scenarios closely related to blockchain from the perspective of technical classification. Moreover, potential challenges are mentioned, including the confidentiality of privacy, the efficiency of the system, security issues, and regulatory policy.

Conclusions

Blockchain technology can improve health care services in a decentralized, tamper-proof, transparent, and secure manner. With the development of this technology and its integration with other emerging technologies, blockchain has the potential to offer long-term benefits. Not only can it be a mechanism to secure electronic health records, but blockchain also provides a powerful tool that can empower users to control their own health data, enabling a foolproof health data history and establishing medical responsibility.

Hyperledger blockchain enabled secure medical record management with deep learning-based diagnosis model

In recent times, advanced developments in healthcare sector result in the generation of massive amounts of electronic health records (EHRs). EHR system enables the data owner to control his/her data and share it with designated people. The vast volume of data in the healthcare system makes it difficult for data to ensure security and diagnostic processes. To resolve these issues, this paper develops a new hyperledger blockchain enabled secure medical data management with deep learning (DL)-based diagnosis (HBESDM-DLD) model. The presented model involves distinct stages of operations such as encryption, optimal key generation, hyperledger blockchain-based secure data management, and diagnosis. The presented model allows the user to control access to data, permit the hospital authorities to read/write data, and alert emergency contacts. For encryption, SIMON block cipher technique is applied. At the same time, to improve the efficiency of the SIMON technique, a group teaching optimization algorithm (GTOA) is applied for the optimal key generation of the SIMON technique. Moreover, the sharing of medical data takes place using multi-channel hyperledger blockchain that utilizes a blockchain for storing patient visit data and for the medical institutions to record links for the EHRs saved in external databases. Once the data are decrypted at the receiving end, finally, variational autoencoder (VAE)-based diagnostic model is applied to detect the existence of the diseases. The performance validation of the HBESDM-DLD model takes place on benchmark medical dataset and the results are inspected under various performance measures. The experimental results proves that the HBESDM-DLD methodology is superior to state-of-the-art methods.

Digital and Decentralized Management of Patient Data in Healthcare Using Blockchain Implementations

Blockchain solutions offer efficient approaches for trustworthy data management, especially in the medical field when storing and processing sensitive patient data. Many institutional and industrial facilities have already recognized the importance of the technology for the health sector and have also formulated basic ideas, concepts and main use cases, but concrete implementations and executions are comparatively rare. This mini review examines current research on specific blockchain implementations in healthcare that go beyond the state of concept studies or theoretical implementation ideas and describes the most promising systems based on systematic literature research. The review shows that secure storage and easy access to complete patient data is becoming increasingly important. Blockchain technology can be used as a secure, transparent and digital way to meet these needs. Hybrid solutions consisting of conventional data storage and blockchain-based access management are increasingly being developed and implemented. The automation of blockchain processes through smart contracts is also recommended. The review further reveals ambiguities in the use of permissioned and permissionless blockchain frameworks, machine learning (ML) integration as well as the question of which data should be stored in the blockchain and how this should be viewed legally. Therefore, there is still a need for further research, especially on these aspects, in order to further establish the use of blockchains in healthcare.

Integrating multiple blockchains to support distributed personal health records

Blockchain technologies have evolved in recent years, as have the use of personal health record (PHR) data. Initially, only the financial domain benefited from Blockchain technologies. Due to efficient distribution format and data integrity security, however, these technologies have demonstrated potential in other areas, such as PHR data in the healthcare domain. Applying Blockchain to PHR data faces different challenges than applying it to financial transactions via crypto-currency. To propose and discuss an architectural model of a Blockchain platform named "OmniPHR Multi-Blockchain" to address key challenges associated with geographical distribution of PHR data. We analyzed the current literature to identify critical barriers faced when applying Blockchain technologies to distribute PHR data. We propose an architecture model and describe a prototype developed to evaluate and address these challenges. The OmniPHR Multi-Blockchain architecture yielded promising results for scenarios involving distributed PHR data. The project demonstrated a viable and beneficial alternative for processing geographically distributed PHR data with performance comparable with conventional methods. Blockchain's implementation tools have evolved, but the domain of healthcare still faces many challenges concerning distribution and interoperability. This study empirically demonstrates an alternative architecture that enables the distributed processing of PHR data via Blockchain technologies.

The Assessment of Big Data Adoption Readiness with a Technology–Organization–Environment Framework: A Perspective towards Healthcare Employees

Big data is rapidly being seen as a new frontier for improving organizational performance. However, it is still in its early phases of implementation in developing countries’ healthcare organizations. As data-driven insights become critical competitive advantages, it is critical to ascertain which elements influence an organization’s decision to adopt big data. The aim of this study is to propose and empirically test a theoretical framework based on technology–organization–environment (TOE) factors to identify the level of readiness of big data adoption in developing countries’ healthcare organizations. The framework empirically tested 302 Malaysian healthcare employees. The structural equation modeling was used to analyze the collected data. The results of the study demonstrated that technology, organization, and environment factors can significantly contribute towards big data adoption in healthcare organizations. However, the complexity of technology factors has shown less support for the notion. For technology practitioners, this study showed how to enhance big data adoption in healthcare organizations through TOE factors.

BlockPres: A Novel Blockchain-Based Incentive Mechanism to Mitigate Inequalities for Prescription Management System

The study presents a blockchain-based incentive mechanism intended to encourage those in underserved communities to engage with healthcare services. The smart healthcare system, which is the result of the amalgamation of advanced technologies, has emerged recently and is increasingly seen as essential to meet the needs of modern society. An important part of the healthcare system is the prescription management system, but studies show that prescription affordability and accessibility play a part in creating unequal access for underserved communities. This is a form of unequal access that results in those living in underserved communities to become disengaged from accessing healthcare services. In New Zealand, the prescription management system plays a crucial role and this study seeks to address the issue by presenting the BlockPres framework, which uses a novel incentive mechanism to encourage patients to participate and engage with services in order to be rewarded. The blockchain attribute of immutability in BlockPres enhances equality and participation by providing sophisticated authorisation and authentication capabilities for healthcare providers and patients. BlockPres empowers the patient by assigning ownership or control of some patient information to the patient. A simulation is carried out using the Ethereum blockchain and the evaluation of successful transaction completion and superficial performance assessment demonstrates that the blockchain would be sufficient to cope with the needs of a prescription management system. Furthermore, for the simulation, a BlockPres Smart Contract is developed using solidity and implemented in Remix. The Ropsten network is used as the simulation environment and the initial results show that the proposed incentive mechanism mitigates unequal access.

WITHDRAWN: The role of medical and health policies in the health risk management system

Ahead of Print article withdrawn by publisher.

Developing Recommendations for Cumulative Endpoints and Lifetime Use for Research Animals

Research animals are important for scientific advancement, and therefore, their long-term welfare needs to be monitored to not only minimize suffering, but to provide positive affective states and experiences. Currently, there is limited guidance in countries around the world on cumulative and experimental endpoints. This paper aims to explore current opinions and institutional strategies regarding cumulative use and endpoints through a scoping survey and review of current regulations and welfare assessment tools, and ultimately to provide recommendations for assessment of cumulative and lifetime use of research animals. The survey found that only 36% of respondents indicated that their institution had cumulative use endpoint policies in place, but these policies may be informal and/or vary by species. Most respondents supported more specific guidelines but expressed concerns about formal policies that may limit their ability to make case-by-case decisions. The wide diversity in how research animals are used makes it difficult for specific policies to be implemented. Endpoint decisions should be made in an objective manner using standardized welfare assessment tools. Future research should focus on robust, efficient welfare assessment tools that can be used to support planning and recommendations for cumulative endpoints and lifetime use of research and teaching animals.

Proposing a reliable method of securing and verifying the credentials of graduates through blockchain

Education acts as a soul in the overall societal development, in one way or the other. Aspirants, who gain their degrees genuinely, will help society with their knowledge and skills. But, on the other side of the coin, the problem of fake certificates is alarming and worrying. It has been prevalent in different forms from paper-based dummy certificates to replicas backed with database tampering and has increased to astronomic levels in this digital era. In this regard, an overlay mechanism using blockchain technology is proposed to store the genuine certificates in digital form and verify them firmly whenever needed without delay. The proposed system makes sure that the certificates, once verified, can be present online in an immutable form for further reference and provides a tamper-proof concealment to the existing certification system. To confirm the credibility of the proposed method, a prototype of blockchain-based credential securing and verification system is developed in ethereum test network. The implementation and test results show that it is a secure and feasible solution to online credential management system.

Security of Blockchain-Based Supply Chain Management Systems: Challenges and Opportunities

Blockchain is a revolutionary technology that is being used in many applications, including supply chain management. Although, the primary motive of using a blockchain for supply chain management is to reduce the overall production cost while providing the comprehensive security to the system. However, current blockchain-based supply-chain management (BC-SCM) systems still hold the possibility of cyber attacks. Therefore, the goal of this study is to investigate practical threats and vulnerabilities in the design of BC-SCM systems. As a starting point, we first establish key requirements for the reliability and security of supply chain management systems, i.e., transparency, privacy and traceability, and then discern a threat model that includes two distinctive but practical threats including computational (i.e., the ones that threaten the functionality of the application) and communication (i.e., the ones that threaten information exchange among interconnected services of the application). For investigation, we follow a unique approach based on the hypothesis that reliability is pre-requisite of security and identify the threats considering (i) design of smart contracts and associated supply chain management applications, (ii) underlying blockchain execution environment and (iii) trust between all interconnected supply management services. Moreover, we consider both academic and industry solutions to identify the threats. We identify several challenges that hinder to establish reliability and security of the BC-SCM systems. Importantly, we also highlight research gaps that can help to establish desired security of the BC-SCM. To the best of our knowledge, this paper is the first effort that identifies practical threats to blockchain-based supply chain management systems and provides their counter measures. Finally, this work establishes foundation for future investigation towards practical security of BC-SCM system.

A Scoping Review of Integrated Blockchain-Cloud (BcC) Architecture for Healthcare: Applications, Challenges and Solutions

Blockchain is a disruptive technology for shaping the next era of a healthcare system striving for efficient and effective patient care. This is thanks to its peer-to-peer, secure, and transparent characteristics. On the other hand, cloud computing made its way into the healthcare system thanks to its elasticity and cost-efficiency nature. However, cloud-based systems fail to provide a secured and private patient-centric cohesive view to multiple healthcare stakeholders. In this situation, blockchain provides solutions to address security and privacy concerns of the cloud because of its decentralization feature combined with data security and privacy, while cloud provides solutions to the blockchain scalability and efficiency challenges. Therefore a novel paradigm of blockchain-cloud integration (BcC) emerges for the domain of healthcare. In this paper, we provide an in-depth analysis of the BcC integration for the healthcare system to give the readers the motivations behind the emergence of this new paradigm, introduce a classification of existing architectures and their applications for better healthcare. We then review the development platforms and services and highlight the research challenges for the integrated BcC architecture, possible solutions, and future research directions. The results of this paper will be useful for the healthcare industry to design and develop a data management system for better patient care.

Health Care Cybersecurity Challenges and Solutions Under the Climate of COVID-19: Scoping Review

BACKGROUND

COVID-19 has challenged the resilience of the health care information system, which has affected our ability to achieve the global goal of health and well-being. The pandemic has resulted in a number of recent cyberattacks on hospitals, pharmaceutical companies, the US Department of Health and Human Services, the World Health Organization and its partners, and others.

OBJECTIVE

The aim of this review was to identify key cybersecurity challenges, solutions adapted by the health sector, and areas of improvement needed to counteract the recent increases in cyberattacks (eg, phishing campaigns and ransomware attacks), which have been used by attackers to exploit vulnerabilities in technology and people introduced through changes to working practices in response to the COVID-19 pandemic.

METHODS

A scoping review was conducted by searching two major scientific databases (PubMed and Scopus) using the search formula "(covid OR healthcare) AND cybersecurity." Reports, news articles, and industry white papers were also included if they were related directly to previously published works, or if they were the only available sources at the time of writing. Only articles in English published in the last decade were included (ie, 2011-2020) in order to focus on current issues, challenges, and solutions.

RESULTS

We identified 9 main challenges in cybersecurity, 11 key solutions that health care organizations adapted to address these challenges, and 4 key areas that need to be strengthened in terms of cybersecurity capacity in the health sector. We also found that the most prominent and significant methods of cyberattacks that occurred during the pandemic were related to phishing, ransomware, distributed denial-of-service attacks, and malware.

CONCLUSIONS

This scoping review identified the most impactful methods of cyberattacks that targeted the health sector during the COVID-19 pandemic, as well as the challenges in cybersecurity, solutions, and areas in need of improvement. We provided useful insights to the health sector on cybersecurity issues during the COVID-19 pandemic as well as other epidemics or pandemics that may materialize in the future.

Blockchain Personal Health Records: Systematic Review

Background

Blockchain technology has the potential to enable more secure, transparent, and equitable data management. In the health care domain, it has been applied most frequently to electronic health records. In addition to securely managing data, blockchain has significant advantages in distributing data access, control, and ownership to end users. Due to this attribute, among others, the use of blockchain to power personal health records (PHRs) is especially appealing.

Objective

This review aims to examine the current landscape, design choices, limitations, and future directions of blockchain-based PHRs.

Methods

Adopting the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, a cross-disciplinary systematic review was performed in July 2020 on all eligible articles, including gray literature, from the following 8 databases: ACM, IEEE Xplore, MEDLINE, ScienceDirect, Scopus, SpringerLink, Web of Science, and Google Scholar. Three reviewers independently performed a full-text review and data abstraction using a standardized data collection form.

Results

A total of 58 articles met the inclusion criteria. In the review, we found that the blockchain PHR space has matured over the past 5 years, from purely conceptual ideas initially to an increasing trend of publications describing prototypes and even implementations. Although the eventual application of blockchain in PHRs is intended for the health care industry, the majority of the articles were found in engineering or computer science publications. Among the blockchain PHRs described, permissioned blockchains and off-chain storage were the most common design choices. Although 18 articles described a tethered blockchain PHR, all of them were at the conceptual stage.

Conclusions

This review revealed that although research interest in blockchain PHRs is increasing and that the space is maturing, this technology is still largely in the conceptual stage. Being the first systematic review on blockchain PHRs, this review should serve as a basis for future reviews to track the development of the space.

Could Blockchain Technology Empower Patients, Improve Education, and Boost Research in Radiology Departments? An Open Question for Future Applications

Blockchain can be considered as a digital database of cryptographically validated transactions stored as blocks of data. Copies of the database are distributed on a peer-to-peer network adhering to a consensus protocol for authentication of new blocks into the chain. While confined to financial applications in the past, this technology is quickly becoming a hot topic in healthcare and scientific research. Potential applications in radiology range from upgraded monitoring of training milestones achievement for residents to improved control of clinical imaging data and easier creation of secure shared databases.

Blockchain-Based Access Control Scheme for Secure Shared Personal Health Records over Decentralised Storage

Blockchain technology provides a tremendous opportunity to transform current personal health record (PHR) systems into a decentralised network infrastructure. However, such technology possesses some drawbacks, such as issues in privacy and storage capacity. Given its transparency and decentralised features, medical data are visible to everyone on the network and are inappropriate for certain medical applications. By contrast, storing vast medical data, such as patient medical history, laboratory tests, X-rays, and MRIs, significantly affect the repository storage of blockchain. This study bridges the gap between PHRs and blockchain technology by offloading the vast medical data into the InterPlanetary File System (IPFS) storage and establishing an enforced cryptographic authorisation and access control scheme for outsourced encrypted medical data. The access control scheme is constructed on the basis of the new lightweight cryptographic concept named smart contract-based attribute-based searchable encryption (SC-ABSE). This newly cryptographic primitive is developed by extending ciphertext-policy attribute-based encryption (CP-ABE) and searchable symmetric encryption (SSE) and by leveraging the technology of smart contracts to achieve the following: (1) efficient and secure fine-grained access control of outsourced encrypted data, (2) confidentiality of data by eliminating trusted private key generators, and (3) multikeyword searchable mechanism. Based on decisional bilinear Diffie–Hellman hardness assumptions (DBDH) and discrete logarithm (DL) problems, the rigorous security indistinguishability analysis indicates that SC-ABSE is secure against the chosen-keyword attack (CKA) and keyword secrecy (KS) in the standard model. In addition, user collusion attacks are prevented, and the tamper-proof resistance of data is ensured. Furthermore, security validation is verified by simulating a formal verification scenario using Automated Validation of Internet Security Protocols and Applications (AVISPA), thereby unveiling that SC-ABSE is resistant to man-in-the-middle (MIM) and replay attacks. The experimental analysis utilised real-world datasets to demonstrate the efficiency and utility of SC-ABSE in terms of computation overhead, storage cost and communication overhead. The proposed scheme is also designed and developed to evaluate throughput and latency transactions using a standard benchmark tool known as Caliper. Lastly, simulation results show that SC-ABSE has high throughput and low latency, with an ultimate increase in network life compared with traditional healthcare systems.

Blockchain and smart contract for IoT enabled smart agriculture

The agricultural sector is still lagging behind from all other sectors in terms of using the newest technologies. For production, the latest machines are being introduced and adopted. However, pre-harvest and post-harvest processing are still done by following traditional methodologies while tracing, storing, and publishing agricultural data. As a result, farmers are not getting deserved payment, consumers are not getting enough information before buying their product, and intermediate person/processors are increasing retail prices. Using blockchain, smart contracts, and IoT devices, we can fully automate the process while establishing absolute trust among all these parties. In this research, we explored the different aspects of using blockchain and smart contracts with the integration of IoT devices in pre-harvesting and post-harvesting segments of agriculture. We proposed a system that uses blockchain as the backbone while IoT devices collect data from the field level, and smart contracts regulate the interaction among all these contributing parties. The system implementation has been shown in diagrams and with proper explanations. Gas costs of every operation have also been attached for a better understanding of the costs. We also analyzed the system in terms of challenges and advantages. The overall impact of this research was to show the immutable, available, transparent, and robustly secure characteristics of blockchain in the field of agriculture while also emphasizing the vigorous mechanism that the collaboration of blockchain, smart contract, and IoT presents.

A Blockchain-Based Secret-Data Sharing Framework for Personal Health Records in Emergency Condition

Blockchain technology is the most trusted all-in-one cryptosystem that provides a framework for securing transactions over networks due to its irreversibility and immutability characteristics. Blockchain network, as a decentralized infrastructure, has drawn the attention of various startups, administrators, and developers. This system preserves transactions from tampering and provides a tracking tool for tracing past network operations. A personal health record (PHR) system permits patients to control and share data concerning their health conditions by particular peoples. In the case of an emergency, the patient is unable to approve the emergency staff access to the PHR. Furthermore, a history record management system of the patient's PHR is required, which exhibits hugely private personal data (e.g., modification date, name of user, last health condition, etc.). In this paper, we suggest a healthcare management framework that employs blockchain technology to provide a tamper protection application by considering safe policies. These policies involve identifying extensible access control, auditing, and tamper resistance in an emergency scenario. Our experiments demonstrated that the proposed framework affords superior performance compared to the state-of-the-art healthcare systems concerning accessibility, privacy, emergency access control, and data auditing.

A Secure Storage and Sharing Scheme of Stroke Electronic Medical Records Based on Consortium Blockchain

The maintenance and sharing of electronic medical records are one of the essential tasks in the medical treatment combination. Traditional cloud-based electronic medical record storage system is difficult to realize data security sharing. The tamper resistance and traceability of blockchain technology provide the possibility for the sharing of highly sensitive medical data. This paper proposes a safe sharing scheme of stroke electronic medical records based on the consortium blockchain. The scheme adopts the storage method of ciphertext of medical records stored in the cloud and index of medical records stored on the blockchain. The privacy protection mechanism proposed in this paper innovatively combines proxy reencryption and searchable encryption which supports patient pseudoidentity search. The mechanism could achieve controllable sharing of medical records and precise search. According to the organizational characteristics of the stroke medical treatment combination, this paper proposes an improved Practical Byzantine Fault Tolerance mechanism to reach a consensus between consensus nodes. Then, the proposed scheme is analyzed and evaluated from three aspects of medical record integrity, user privacy, and data security. The results show that the scheme can not only ensure the privacy of patient identity information and private key data but also resist the tampering and deletion attacks of internal and external malicious nodes on the medical record data. Therefore, the proposed scheme is conducive to the improvement of the timeliness of stroke treatment and the safe sharing of electronic medical records in stroke medical treatment combination.

Construction of a Medical Resource Sharing Mechanism Based on Blockchain Technology: Evidence from the Medical Resource Imbalance of China

Health equity is a very important part of social equity. The outbreak of the novel coronavirus pneumonia (COVID-19) in a short period of time exposed the problems existing in the allocation of medical resources and the response to major public health emergencies in China. By using Kernel density estimation and Data envelopment analysis (DEA), it is found that the allocation and imbalance of medical resources in China are greatly different among regions, and the polarization phenomenon is obvious. As an important part of the information technology system, blockchain technology is characterized by decentralization and non-tampering. It can realize sharing of medical resources through a mechanism of resource storage, circulation, supervision, and protection. The construction of a medical resource sharing mechanism under the condition of blockchain technology will greatly improve the degree of medical resource sharing, will narrow the differences in resource allocation between regions, and can effectively respond to an outbreak of major public health emergencies.

Blockchain and IoMT against Physical Abuse: Bullying in Schools as a Case Study

By law, schools are required to protect the well-being of students against problems such as on-campus bullying and physical abuse. In the UK, a report by the Office for Education (OfE) showed 17% of young people had been bullied during 2017–2018. This problem continues to prevail with consequences including depression, anxiety, suicidal thoughts, and eating disorders. Additionally, recent evidence suggests this type of victimisation could intensify existing health complications. This study investigates the opportunities provided by Internet of Medical Things (IoMT) data towards next-generation safeguarding. A new model is developed based on blockchain technology to enable real-time intervention triggered by IoMT data that can be used to detect stressful events, e.g., when bullying takes place. The model utilises private permissioned blockchain to manage IoMT data to achieve quicker and better decision-making while revolutionising aspects related to compliance, double-entry, confidentiality, and privacy. The feasibility of the model and the interaction between the sensors and the blockchain was simulated. To facilitate a close approximation of an actual IoMT environment, we clustered and decomposed existing medical sensors to their attributes, including their function, for a variety of scenarios. Then, we demonstrated the performance and capabilities of the emulator under different loads of sensor-generated data. We argue to the suitability of this emulator for schools and medical centres to conduct feasibility studies to address sensor data with disruptive data processing and management technologies.

Efficient and Secure Strategy for Energy Systems of Interconnected Farmers′ Associations to Meet Variable Energy Demand

Since ancient times, agriculture has been one of the most important resources of national development. At a national level, clean energy is a strategic objective of Romania, in accordance with the EC directive 2016/30.11.2016 (“Clean Energy for All”). At a European level, the European Commission published in January 2019 the “Towards a Sustainable Europe by 2030” strategy, highlighting the strategic importance of the Internet of Things (IoT) and blockchain technologies. In this context, the synergy between the energy management of a hybrid energy system and blockchain technology, applied to farmers’ associations, represents a priority research direction in the field of information and communication technology, blockchain, and security. This paper presents the integration of the management of the energy produced by photovoltaic panels owned by farmers’ association, to support the variable energy demand (necessary for water pumps, charging stations of the electric agricultural machines, the animal farms, and the auxiliary equipment) based on the IoT, DLT, blockchain technologies and smart contracts applied to farmers associations registered as users of the SmartFarm platform.

Blockchain-Based Diversion-Point System for Balancing Customer Flow in Shopping Mall

Changing the store layout of a shopping mall is usually costly in terms of time, resources, and money. Balancing customer flow is obviously an economical way to rationalize the store layout without displacing stores or changing their locations. However, it has long been a big challenge for managers of shopping malls, because it is difficult to build trust among stores for the sake of regulating customer flow. This trust depends on a multi-party cooperation model, of which the agreements are implemented on asymmetric information. Unfortunately, any form of endorsement with human intervention cannot support building trust on asymmetric information. To solve this problem technically, this paper proposes a diversion-point system to dynamically divert part of customer flow from popular stores to less popular ones. The system operates diversion-points and -vouchers on an asymmetric basis. It also employs a Blockchain subsystem to replace the centralized endorsement and preserve the information asymmetry, thereby building trust into the cooperation among customers, the shopping mall, and the stores therein. The evaluation shows that the proposed system is effective in remedying imperfect store layout of the shopping mall.

Combating Health Care Fraud and Abuse: Conceptualization and Prototyping Study of a Blockchain Antifraud Framework

BACKGROUND

An estimated US $2.6 billion loss is attributed to health care fraud and abuse. With traditional health care claims verification and reimbursement, the health care provider submits a claim after rendering services to a patient, which is then verified and reimbursed by the payer. However, this process leaves out a critical stakeholder: the patient for whom the services are actually rendered. This lack of patient participation introduces a risk of fraud and abuse. Blockchain technology enables secure data management with transparency, which could mitigate this risk of health care fraud and abuse.

OBJECTIVE

The aim of this study is to develop a framework using blockchain to record claims data and transactions in an immutable format and to enable the patient to act as a validating node to help detect and prevent health care fraud and abuse.

METHODS

We developed a health care fraud and abuse blockchain technical framework and prototype using key blockchain tools and application layers including consensus algorithms, smart contracts, tokens, and governance based on digital identity on the Ethereum platform (Ethereum Foundation).

RESULTS

Our technical framework maps to the claims adjudication process and focuses on Medicare claims, with the US Centers for Medicare and Medicaid Services (CMS) as the central authority. A prototype of the framework system was developed using the blockchain platform Ethereum (Ethereum Foundation), with its design features, workflow, smart contract functions, system architecture, and software implementation outlined. The software stack used to build the system consisted of a front-end user interface framework, a back-end processing server, and a blockchain network. React was used for the user interface framework, and NodeJS and an Express server were used for the back-end processing server; Solidity was the smart contract language used to interact with a local Ethereum blockchain network.

CONCLUSIONS

The proposed framework and the initial prototype have the potential to improve the health care claims process by using blockchain technology for secure data storage and consensus mechanisms, which make the claims adjudication process more patient-centric for the purposes of identifying and preventing health care fraud and abuse. Future work will focus on the use of synthetic or historic CMS claims data to assess the real-world viability of the framework.