A Blockchain-Based Notarization Service for Biomedical Knowledge Retrieval

A framework for sharing of clinical and genetic data for precision medicine applications

Precision medicine has the potential to provide more accurate diagnosis, appropriate treatment and timely prevention strategies by considering patients' biological makeup. However, this cannot be realized without integrating clinical and omics data in a data-sharing framework that achieves large sample sizes. Systems that integrate clinical and genetic data from multiple sources are scarce due to their distinct data types, interoperability, security and data ownership issues. Here we present a secure framework that allows immutable storage, querying and analysis of clinical and genetic data using blockchain technology. Our platform allows clinical and genetic data to be harmonized by combining them under a unified framework. It supports combined genotype-phenotype queries and analysis, gives institutions control of their data and provides immutable user access logs, improving transparency into how and when health information is used. We demonstrate the value of our framework for precision medicine by creating genotype-phenotype cohorts and examining relationships within them. We show that combining data across institutions using our secure platform increases statistical power for rare disease analysis. By offering an integrated, secure and decentralized framework, we aim to enhance reproducibility and encourage broader participation from communities and patients in data sharing.

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.

Secure data sharing with blockchain for remote health monitoring applications: a review

Remote Health Monitoring (RHM) is going to reinvent the future healthcare industry and bring about abundant value to hospitals, doctors, and patients by overcoming the many challenges currently being faced in monitoring patient's well-being, promoting preventive care, and managing the quality of drugs and equipment. Despite the many benefits of RHM, it is yet to be widely deployed due to the healthcare data security and privacy challenges. Healthcare data are highly sensitive and require fail-safe measures against unauthorized data access, leakages, and manipulations, and as such, there are stringent regulations governing how healthcare data can be secured, communicated, and stored, such as General Data Protection Regulation (GDPR) and the Health Insurance Portability and Accountability Act (HIPAA). The challenges and regulatory demands in RHM applications can be addressed using blockchain technology due to its distinguishing features of decentralization, immutability, and transparency to address the challenges of data security and privacy. This article will provide a systematic review on the use of blockchain in RHM, focusing primarily on data security and privacy.

Analysis of critical success factors for blockchain technology implementation in healthcare sector

Purpose

Recently, blockchain technology (BT) has resolved healthcare data management challenges. It helps healthcare providers automate medical records and mining to aid in data sharing and making more accurate diagnoses. This paper attempts to identify the critical success factors (CSFs) for successfully implementing BT in healthcare.

Design/methodology/approach

The paper is methodologically structured in four phases. The first phase leads to identifying success factors by reviewing the extant literature. In the second phase, expert opinions were solicited to authenticate the critical success factors required to implement BT in the healthcare sector. Decision Making Trial and Evaluation Laboratory (DEMATEL) method was employed to find the cause-and-effect relationship among the third phase’s critical success factors. In phase 4, the authors resort to validating the final results and findings.

Findings

Based on the analysis, 21 CSFs were identified and grouped under six dimensions. After applying the DEMATEL technique, nine factors belong to the causal group, and the remaining 12 factors fall under the effect group. The top three influencing factors of blockchain technology implementation in the healthcare ecosystem are data transparency, track and traceability and government support, whereas; implementation cost was the least influential.

Originality/value

This study provides a roadmap and may facilitate healthcare professionals to overcome contemporary challenges with the help of BT.

The Use of Blockchain Technology in the Health Care Sector: Systematic Review

Background

Blockchain technology is a part of Industry 4.0’s new Internet of Things applications: decentralized systems, distributed ledgers, and immutable and cryptographically secure technology. This technology entails a series of transaction lists with identical copies shared and retained by different groups or parties. One field where blockchain technology has tremendous potential is health care, due to the more patient-centric approach to the health care system as well as blockchain’s ability to connect disparate systems and increase the accuracy of electronic health records.

Objective

The aim of this study was to systematically review studies on the use of blockchain technology in health care and to analyze the characteristics of the studies that have implemented blockchain technology.

Methods

This study used a systematic review methodology to find literature related to the implementation aspect of blockchain technology in health care. Relevant papers were searched for using PubMed, SpringerLink, IEEE Xplore, Embase, Scopus, and EBSCOhost. A quality assessment of literature was performed on the 22 selected papers by assessing their trustworthiness and relevance.

Results

After full screening, 22 papers were included. A table of evidence was constructed, and the results of the selected papers were interpreted. The results of scoring for measuring the quality of the publications were obtained and interpreted. Out of 22 papers, a total of 3 (14%) high-quality papers, 9 (41%) moderate-quality papers, and 10 (45%) low-quality papers were identified.

Conclusions

Blockchain technology was found to be useful in real health care environments, including for the management of electronic medical records, biomedical research and education, remote patient monitoring, pharmaceutical supply chains, health insurance claims, health data analytics, and other potential areas. The main reasons for the implementation of blockchain technology in the health care sector were identified as data integrity, access control, data logging, data versioning, and nonrepudiation. The findings could help the scientific community to understand the implementation aspect of blockchain technology. The results from this study help in recognizing the accessibility and use of blockchain technology in the health care sector.

Blockchain-based architecture design for personal health record (Preprint)

Background

The importance of blockchain-based architectures for personal health record (PHR) lies in the fact that they are thought and developed to allow patients to control and at least partly collect their health data. Ideally, these systems should provide the full control of such data to the respective owner. In spite of this importance, most of the works focus more on describing how blockchain models can be used in a PHR scenario rather than whether these models are in fact feasible and robust enough to support a large number of users.

Objective

To achieve a consistent, reproducible, and comparable PHR system, we build a novel ledger-oriented architecture out of a permissioned distributed network, providing patients with a manner to securely collect, store, share, and manage their health data. We also emphasize the importance of suitable ledgers and smart contracts to operate the blockchain network as well as discuss the necessity of standardizing evaluation metrics to compare related (net)works.

Methods

We adopted the Hyperledger Fabric platform to implement our blockchain-based architecture design and the Hyperledger Caliper framework to provide a detailed assessment of our system: first, under workload, ranging from 100 to 2500 simultaneous record submissions, and second, increasing the network size from 3 to 13 peers. In both experiments, we used throughput and average latency as the primary metrics. We also created a health database, a cryptographic unit, and a server to complement the blockchain network.

Results

With a 3-peer network, smart contracts that write on the ledger have throughputs, measured in transactions per second (tps) in an order of magnitude close to 10² tps, while those contracts that only read have rates close to 10³ tps. Smart contracts that write also have latencies, measured in seconds, in an order of magnitude close to 10¹ seconds, while that only read have delays close to 10⁰ seconds. In particular, smart contracts that retrieve, list, and view history have throughputs varying, respectively, from 1100 tps to 1300 tps, 650 tps to 750 tps, and 850 tps to 950 tps, impacting the overall system response if they are equally requested under the same workload. Varying the network size and applying an equal fixed load, in turn, writing throughputs go from 10² tps to 10¹ tps and latencies go from 10¹ seconds to 10² seconds, while reading ones maintain similar values.

Conclusions

To the best of our knowledge, we are the first to evaluate, using Hyperledger Caliper, the performance of a PHR blockchain architecture and the first to evaluate each smart contract separately. Nevertheless, blockchain systems achieve performances far below what the traditional distributed databases achieve, indicating that the assessment of blockchain solutions for PHR is a major concern to be addressed before putting them into a real production.

Blockchain-enabled wireless communications: a new paradigm towards 6G

With the deployment of fifth-generation (5G) wireless networks worldwide, research on sixth-generation (6G) wireless communications has commenced. It is expected that 6G networks can accommodate numerous heterogeneous devices and infrastructures with enhanced efficiency and security over diverse, e.g. spectrum, computing and storage, resources. However, this goal is impeded by a number of trust-related issues that are often neglected in network designs. Blockchain, as an innovative and revolutionary technology that has arisen in the recent decade, provides a promising solution. Building on its nature of decentralization, transparency, anonymity, immutability, traceability and resiliency, blockchain can establish cooperative trust among separate network entities and facilitate, e.g. efficient resource sharing, trusted data interaction, secure access control, privacy protection, and tracing, certification and supervision functionalities for wireless networks, thus presenting a new paradigm towards 6G. This paper is dedicated to blockchain-enabled wireless communication technologies. We first provide a brief introduction to the fundamentals of blockchain, and then we conduct a comprehensive investigation of the most recent efforts in incorporating blockchain into wireless communications from several aspects. Importantly, we further propose a unified framework of the blockchain radio access network (B-RAN) as a trustworthy and secure paradigm for 6G networking by utilizing blockchain technologies with enhanced efficiency and security. The critical elements of B-RAN, such as consensus mechanisms, smart contract, trustworthy access, mathematical modeling, cross-network sharing, data tracking and auditing and intelligent networking, are elaborated. We also provide the prototype design of B-RAN along with the latest experimental results.

Steganographic Analysis of Blockchains

Steganography is one of the ways to hide data between parties. Its use can be worrisome, e.g., to hide illegal communications. Researchers found that public blockchains can be an attractive place to hide communications; however, there is not much evidence of actual use in blockchains. Besides, previous work showed a lack of steganalysis methods for blockchains. In this context, we present a steganalysis approach for blockchains, evaluating it in Bitcoin and Ethereum, both popular cryptocurrencies. The main objective is to answer if one can find steganography in real case scenarios, focusing on LSB of addresses and nonces. Our sequential analysis included 253 GiB and 107 GiB of bitcoin and ethereum, respectively. We also analyzed up to 98 million bitcoin clusters. We found that bitcoin clusters could carry up to 360 KiB of hidden data if used for such a purpose. We have not found any concrete evidence of hidden data in the blockchains. The sequential analysis may not capture the perspective of the users of the blockchain network. In this case, we recommend clustering analysis, but it depends on the clustering method’s accuracy. Steganalysis is an essential aspect of blockchain security.

A Blockchain-Enabled Framework for mHealth Systems

Presently modern technology makes a significant contribution to the transition from traditional healthcare to smart healthcare systems. Mobile health (mHealth) uses advances in wearable sensors, telecommunications and the Internet of Things (IoT) to propose a new healthcare concept centered on the patient. Patients' real-time remote continuous health monitoring, remote diagnosis, treatment, and therapy is possible in an mHealth system. However, major limitations include the transparency, security, and privacy of health data. One possible solution to this is the use of blockchain technologies, which have found numerous applications in the healthcare domain mainly due to theirs features such as decentralization (no central authority is needed), immutability, traceability, and transparency. We propose an mHealth system that uses a private blockchain based on the Ethereum platform, where wearable sensors can communicate with a smart device (a smartphone or smart tablet) that uses a peer-to-peer hypermedia protocol, the InterPlanetary File System (IPFS), for the distributed storage of health-related data. Smart contracts are used to create data queries, to access patient data by healthcare providers, to record diagnostic, treatment, and therapy, and to send alerts to patients and medical professionals.

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.

Analysis of the Optimal Application of Blockchain-Based Smart Lockers in the Logistics Industry Based on FFD-SAGA and Grey Decision-Making

Blockchain technology has been applied to logistics tracking, but it is not cost-effective. The development of smart lockers has solved the problem of repeated distribution to improve logistics efficiency, thereby becoming a solution with convenience and privacy compared to the in-store purchase and pickup alternative. This study prioritized the key factors of smart lockers using a simulated annealing–genetic algorithm by fractional factorial design (FFD-SAGA) and grey relational analysis, and investigated the main users of smart lockers by grey multiple attribute decision analysis. The results show that the Web application programming interface (API) concatenation and money flow provider are the key success factors of smart lockers, and office workers are the main users of the lockers. Hence, how to better meet the needs of office workers will be an issue of concern for service providers.

Blockchain Paradigm for Healthcare: Performance Evaluation

Electronic health records (EHRs) have become a popular method to store and manage patients’ data in hospitals. Sharing these records makes the current healthcare data management system more accurate and cost-efficient. Currently, EHRs are stored using the client/server architecture by which each hospital retains the stewardship of the patients’ data. The records of a patient are scattered among different hospitals using heterogeneous database servers. These limitations constitute a burden towards a personalized healthcare, when it comes to offering a cohesive view and a shared, secure and private access to patients’ health history for multiple allied professionals and the patients. The data availability, privacy and security characteristics of the blockchain have a propitious future in the healthcare presenting solutions to the complexity, confidentiality, integrity, interoperability and privacy issues of the current client/server architecture-based EHR management system. This paper analyzes and compares the performance of the blockchain and the client/server paradigms. The results reveal that notable performance can be achieved using blockchain in a patient-centric approach. In addition, the immutable and valid patients’ data in the blockchain can aid allied health professionals in better prognosis and diagnosis support through machine learning and artificial intelligence.

Blockchain in healthcare and health sciences-A scoping review

BACKGROUND

Blockchain can be described as an immutable ledger, logging data entries in a decentralized manner. This new technology has been suggested to disrupt a wide range of data-driven domains, including the health domain.

OBJECTIVE

The purpose of this study was to systematically review, assess and synthesize peer-reviewed publications utilizing/proposing to utilize blockchain to improve processes and services in healthcare, health sciences and health education.

METHOD

A structured literature search on the topic was conducted in October 2018 relevant bibliographic databases.

RESULT

39 publications fulfilled the inclusion criteria. The result indicates that Electronic Health Records and Personal Health Records are the most targeted areas using blockchain technology. Access control, interoperability, provenance and data integrity are all issues that are meant to be improved by blockchain technology in this field. Ethereum and Hyperledger fabric seem to be the most used platforms/frameworks in this domain.

CONCLUSION

This study shows that the endeavors of using blockchain technology in the health domain are increasing exponentially. There are areas within the health domain that potentially could be highly impacted by blockchain technology.

Electronic health records in a Blockchain: A systematic review

Blockchain could reinvent the way patient’s electronic health records are shared and stored by providing safer mechanisms for health information exchange of medical data in the healthcare industry, by securing it over a decentralized peer-to-peer network. Intending to support and ease the understanding of this distributed ledger technology, a solid Systematic Literature Review was conducted, aiming to explore the recent literature on Blockchain and healthcare domain and identify existing challenges and open questions, guided by the raise of research questions regarding EHR in a Blockchain. More than 300 scientific studies published in the last ten years were surveyed, resulting in an up-to-date taxonomy creation, challenges and open questions identified, and the most significant approaches, data types, standards and architectures regarding the use of Blockchain for EHR were assessed and discussed.

Blockchain Applications in the Biomedical Domain: A Scoping Review

Blockchain is a distributed, immutable ledger technology introduced as the enabling mechanism to support cryptocurrencies. Blockchain solutions are currently being proposed to address diverse problems in different domains. This paper presents a scoping review of the scientific literature to map the current research area of blockchain applications in the biomedical domain. The goal is to identify biomedical problems treated with blockchain technology, the level of maturity of respective approaches, types of biomedical data considered, blockchain features and functionalities exploited and blockchain technology frameworks used. The study follows the PRISMA-ScR methodology. Literature search was conducted on August 2018 and the systematic selection process identified 47 research articles for detailed study. Our findings show that the field is still in its infancy, with the majority of studies in the conceptual or architectural design phase; only one study reports real world demonstration and evaluation. Research is greatly focused on integration, integrity and access control of health records and related patient data. However, other diverse and interesting applications are emerging, addressing medical research, clinical trials, medicines supply chain, and medical insurance.

Blockchain Technologies: Opportunities for Solving Real-World Problems in Healthcare and Biomedical Sciences

Introduction:

Blockchain technology is associated with the financial industry, but it can be applied to other industries. The supporting architecture of blockchain has the immense potential to transform the delivery of healthcare, medical, clinical, and life sciences, due to the extended functionality and distinct features of its distributed ledger. The potential scale of impact is comparable to that seen with the introduction of TCP/IP. Blockchain technology has captured the interest of healthcare providers and biomedical scientists within various healthcare domains such as longitudinal healthcare records, automated claims, drug development, interoperability in population health, consumer health, patient portals, medical research, data security, and reducing costs with supply chain management. It is not yet clear if blockchain is going to disrupt healthcare, but healthcare organizations are monitoring its potential closely for prospective concepts like secure patient IDs. Realistically, the adoption and implementation of blockchains will be a gradual evolution over time, but now is the time to take a fresh look at its possibilities in healthcare and biomedical sciences. Blockchain technology revolutionary solutions are bringing us closer to the possibility of every patient record being able to send updates to an open-source, community-wide trusted ledger that is accessible and understood across organizations with guaranteed integrity.

Aim and Methods:

This paper discusses as a review some potential areas of opportunity for blockchain in the health and biomedical sciences fields.

Results and Conclusions:

This paper describes and synthesizes 20 examples of real-world use-case scenarios for blockchains in healthcare and biomedical practice.