Blockchain Applications in the Biomedical Domain: A Scoping Review

A systematic review of the blockchain application in healthcare research domain: toward a unified conceptual model

Recently, research on blockchain applications in the healthcare research domain has attracted increasing attention due to its strong potential. However, the existing literature reveals limited studies on defining use cases of blockchain in clinical research, categorizing and comparing available studies. Therefore, this study aims to explore the significant potential and use cases of blockchain in clinical research through a comprehensive systematic literature review (SLR). To thoroughly investigate all aspects of the subject, we analyzed primary studies based on research questions (RQs) and developed a unified conceptual model using step-based model creation. Studies from 2015 to 2023 were reviewed, and 34 primary studies were comprehensively analyzed by using the PICO template. In our findings, privacy emerged as the most frequently cited requirement in clinical research. The most mentioned use cases for blockchain are ensuring data immutability and security. A significant issue identified beyond the common blockchain limitations of capacity and scalability is the lack of standards for compliance with legal frameworks like GDPR and HIPAA. After all these efforts, we developed a conceptual model, which, to our best knowledge, is the first in the literature to support software developers and clinical researchers in developing and using blockchain-based research platforms efficiently.

Blockchain in clinical trials: Bibliometric and network studies of applications, challenges, and future prospects based on data analytics

This study conducts a comprehensive analysis on the usage of the blockchain technology in clinical trials, based on a curated corpus of 107 scientific articles from the year 2016 through the first quarter of 2024. Utilizing a methodological framework that integrates bibliometric analysis, network analysis, thematic mapping, and latent Dirichlet allocation, the study explores the terrain and prospective developments within this usage based on data analytics. Through a meticulous examination of the analyzed articles, the present study identifies seven key thematic areas, highlighting the diverse applications and interdisciplinary nature of blockchain in clinical trials. Our findings reveal blockchain capability to enhance data management, participant consent processes, as well as overall trial transparency, efficiency, and security. Additionally, the investigation discloses the emerging synergy between blockchain and advanced technologies, such as artificial intelligence and federated learning, proposing innovative directions for improving clinical research methodologies. Our study underscores the collaborative efforts in dealing with the complexities of integrating blockchain into the areas of clinical trials and healthcare, delineating the transformative potential of blockchain technology in revolutionizing these areas by addressing challenges and promoting practices of efficient, secure, and transparent research. The delineated themes and networks of collaboration provide a blueprint for future inquiry, showing the importance of empirical research to narrow the gap between theoretical promise and practical implementation.

Increasing the security and traceability of biological samples in biobanks by blockchain technology

BACKGROUND AND OBJECTIVE

One of the main tasks in a biobank consists in storing biological samples in a high-quality condition in order to future research. At moment, there exist many applications to manage a biobank. However, in general, these are web-based applications. In these web-based applications different tasks can be done. Among them, it is possible to remark the following: informed consent, confidentiality, non-profit, respect for quality and safety standards, including traceability of samples. In this paper, we describe a blockchain smart contract to ensure the traceability of the processes done in a biobank meaning a step forward to guarantee this traceability.

METHODS

Use of blockchain technology to improve security, integrity and traceability of the processes carried out in a biobank. In particular IBM Hyperledger Fabric.

RESULTS

As a result, a set of smart contracts have been developed describing the biobank processes.

CONCLUSIONS

Improvement of the security, integrity, and traceability of samples in biobanks.

Blockchain for genomics and healthcare: a literature review, current status, classification and open issues

The tremendous boost in the next generation sequencing technologies and in the "omics" technologies resulted in the generation of hundreds of gigabytes of data per day. Nowadays, via integrating -omics data with other data types, such as imaging and electronic health record (EHR) data, panomics studies attempt to identify novel and potentially actionable biomarkers for personalized medicine applications. In this respect, for the accurate analysis of -omics data and EHR, there is a need to establish secure and robust pipelines that take the ethical aspects into consideration, regulate privacy and ownership issues, and data sharing. These days, blockchain technology has picked up significant attention in diverse fields, including genomics, since it offers a new solution for these problems from a different perspective. Blockchain is an immutable transaction ledger, which offers secure and distributed system without a central authority. Within the system, each transaction can be expressed with cryptographically signed blocks, and the verification of transactions is performed by the users of the network. In this review, firstly, we aim to highlight the challenges of EHR and genomic data sharing. Secondly, we attempt to answer "Why" or "Why not" the blockchain technology is suitable for genomics and healthcare applications in detail. Thirdly, we elucidate the general blockchain structure based on the Ethereum, which is a more suitable technology for the genomic data sharing platforms. Fourthly, we review current blockchain-based EHR and genomic data sharing platforms, evaluate the advantages and disadvantages of these applications, and classify these applications using different metrics. Finally, we conclude by discussing the open issues and introducing our suggestion on the topic. In summary, to facilitate the diagnosis, monitoring and therapy of diseases with the effective analysis of -omics data with other available data types, through this review, we put forward the possible implications of the blockchain technology to life sciences and healthcare.

A Systematic Review of Machine Learning Based Gait characteristics in Parkinson's disease

OBJECTIVE

Parkinson's disease is a pervasive neuro disorder that affects people's quality of life throughout the world. The unsatisfactory results of clinical rating scales open the door for more research. PD treatment using current biomarkers seems a difficult task. So automatic evaluation at an early stage may enhance the quality and time-period of life.

METHODS

Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Population, intervention, comparison, and outcome (PICO) search methodology schemes are followed to search the data and eligible studies for this survey. Approximate 1500 articles were extracted using related search strings. After the stepwise mapping and elimination of studies, 94 papers are found suitable for the present review.

RESULTS

After the quality assessment of extracted studies, nine inhibitors are identified to analyze people's gait with Parkinson's disease, where four are critical. This review also differentiates the various machine learning classification techniques with their PD analysis characteristics in previous studies. The extracted research gaps are described as future perspectives. Results can help practitioners understand the PD gait as a valuable biomarker for detection, quantification, and classification.

CONCLUSION

Due to less cost and easy recording of gait, gait-based techniques are becoming popular in PD detection. By encapsulating the gait-based studies, it gives an in-depth knowledge of PD, different measures that affect gait detection and classification.

A big data framework for E-Government in Industry 4.0

The next generation of E-Government and healthcare has the potential to increase the more intelligent governance with improvements in transparency, accountability, efficiency, and effectiveness. It enables organizations to use the benefits of information via big data analysis to settle the difficulties effectively. Big Data has emerged which plays a significant role in many sectors around the world. Global trends in taking advantage of the benefits from big data are considered with an overview of the US, European Union, and several developing countries. To deeply understand the utilization of big data in several domains, this study has presented a brief survey of key concepts (such as IoT-enabled data, blockchain-enabled data, and intelligent systems data) to deeply understand the utilization of big data in several domains. Our analysis sets out also the similarities and differences in these concepts. We have also surveyed state-of-the-art technologies including cloud computing, multi-cloud, webservice, and microservice which are used to exploit potential benefits of big data analytics. Furthermore, some typical big data frameworks are surveyed and a big data framework for E-Government is also proposed. Open research questions and challenges are highlighted (for researchers and developers) following our review. Our goal in presenting the novel concepts presented in this article is to promote creative ideas in the research endeavor to perform efficaciously next-generation E-Government in the context of Industry 4.0.

Sharing Biomedical Data: Strengthening AI Development in Healthcare

Artificial intelligence (AI)-based solutions have revolutionized our world, using extensive datasets and computational resources to create automatic tools for complex tasks that, until now, have been performed by humans. Massive data is a fundamental aspect of the most powerful AI-based algorithms. However, for AI-based healthcare solutions, there are several socioeconomic, technical/infrastructural, and most importantly, legal restrictions, which limit the large collection and access of biomedical data, especially medical imaging. To overcome this important limitation, several alternative solutions have been suggested, including transfer learning approaches, generation of artificial data, adoption of blockchain technology, and creation of an infrastructure composed of anonymous and abstract data. However, none of these strategies is currently able to completely solve this challenge. The need to build large datasets that can be used to develop healthcare solutions deserves special attention from the scientific community, clinicians, all the healthcare players, engineers, ethicists, legislators, and society in general. This paper offers an overview of the data limitation in medical predictive models; its impact on the development of healthcare solutions; benefits and barriers of sharing data; and finally, suggests future directions to overcome data limitations in the medical field and enable AI to enhance healthcare. This perspective is dedicated to the technical requirements of the learning models, and it explains the limitation that comes from poor and small datasets in the medical domain and the technical options that try or can solve the problem related to the lack of massive healthcare data.

Commercially Successful Blockchain Healthcare Projects: A Scoping Review

Background

The healthcare industry is the new frontier for blockchain technology. Given its properties of immutability and decentralization, blockchain represents an opportunity for unprecedented level of privacy and security for all stakeholders by ensuring data integrity while giving patients control over their own health data. On a backdrop of rising interest in blockchain in general and blockchain healthcare applications in particular, there has been a proliferation of blockchain healthcare projects over the past few years. The aim of this review is to identify and understand real-world blockchain healthcare projects that have attained commercial success in the highly competitive blockchain market.

Methods and findings

A scoping review was performed in January 2021 on all projects in the CoinMarketCap database. Following a pre-defined inclusion and exclusion criteria, eligible projects were selected. A single reviewer then reviewed each project's official website and whitepaper (where available) and performed data abstraction; 10 blockchain healthcare projects fulfilled the selection criteria. The review found that these projects made up 0.24% of the total number of actively tracked projects on CoinMarketCap. In terms of market capitalization, the total market capitalization for the projects was US$65,078,849, comprising less than 0.01% of the total market capitalization of all projects. Among the projects, the most frequent type was for personal health tracking.

Conclusions

This review revealed that blockchain health projects currently comprise a small fraction of the overall number of commercially successful blockchain projects. However, because this sub-industry is still in its early stages, there are reasons to be optimistic that many more blockchain health projects will emerge and attain commercial success in future. Findings from this review done from an entrepreneurial perspective should help with the identification of future projects most likely to succeed.

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.

Toward Blockchain-Enabled Supply Chain Anti-Counterfeiting and Traceability

Existing product anti-counterfeiting and traceability solutions across today’s internationally spanning supply chain networks are indeed developed and implemented with centralized system architecture relying on centralized authorities or intermediaries. Vulnerabilities of centralized product anti-counterfeiting solutions could possibly lead to system failure or susceptibility of malicious modifications performed on product records or various potential attacks to the system components by dishonest participant nodes traversing along the supply chain. Blockchain technology has progressed from simply being a use case of immutable ledger for cryptocurrency transactions, to a programmable interactive environment of developing decentralized and reliable applications addressing different use cases globally. Key areas of decentralization, fundamental system requirements, and feasible mechanisms of developing decentralized product anti-counterfeiting and traceability ecosystems utilizing blockchain technology are identified in this research, via a series of security analyses performed against solutions currently implemented in supply chain industry with centralized architecture. The decentralized solution will be a secure and immutable scientific data provenance tracking and management platform where provenance records, providing compelling properties on data integrity of luxurious goods, are recorded and verified automatically across the supply chain.

Decentralizing Supply Chain Anti-Counterfeiting and Traceability Systems Using Blockchain Technology

An interesting research problem in the supply chain industry is evaluating and determining the provenance of physical goods—demonstrating the authenticity of luxury goods such as bottled wine. However, many supply chain systems and networks have been built and implemented with centralized system architecture, relying on centralized authorities or any form of intermediary, and leading to issues such as single-point processing, storage and failure, which could be susceptible to malicious modifications to product records or various potential attacks to system components by dishonest participant nodes traversing along the supply chain. Blockchain technology has evolved from merely being a decentralized, distributed and immutable ledger of cryptocurrency transactions to a programmable interactive environment for building decentralized and reliable applications addressing different use-cases and existing problems in the world. In this research, with a chosen research method of proof-by-demonstration, the Decentralized NFC-Enabled Anti-Counterfeiting System (dNAS) is proposed and developed, decentralizing a legacy anti-counterfeiting system of the supply-chain industry using Blockchain technology to facilitate trustworthy data provenance retrieval, verification and management, as well as strengthening the capability of the product’s anti-counterfeiting and traceability qualities in the wine industry, with the capacity to further extend this to the supply chain industry as a whole. The proposed dNAS utilizes a decentralized blockchain network with a consensus protocol compatible with the concept of enterprise blockchain, programmable smart contracts and a distributed file storage system to develop a secure and immutable scientific-data provenance tracking and management platform on which provenance records, providing compelling properties of the data integrity of luxurious goods, are recorded, verified and validated automatically.

A collaborative approach to maintaining optimal inventory and mitigating stockout risks during a pandemic: capabilities for enabling health-care supply chain resilience

Purpose

Inventory management systems in health-care supply chains (HCSC) have been pushed to breaking point by the COVID-19 pandemic. Unanticipated demand shocks due to stockpiling of medical supplies caused stockouts, and the stockouts triggered systematic supply chain (SC) disruptions inconceivable for risk managers working individually with limited information about the pandemic. The purpose of this paper is to respond to calls from the United Nations (UN) and World Health Organization (WHO) for coordinated global action by proposing a research agenda based on a review of current knowledge and knowledge gaps on the role of collaboration in HCSCs in maintaining optimal stock levels and reinforcing resilience against stockout disruptions during pandemics.

Design/methodology/approach

A systematic review was conducted, and a total of 752 articles were analyzed.

Findings

Collaborative planning, forecasting and replenishment practices are under-researched in the HCSC literature. Similarly, a fragmented application of extant SC collaborative risk management capabilities undermines efforts to enhance resilience against systematic disruptions from medical stockouts. The paucity of HCSC articles in humanitarian logistics and SC journals indicates a need for more research interlinking two interdependent yet critical fields in responding to pandemics.

Research limitations/implications

Although based on an exhaustive search of academic articles addressing HCSCs, there is a possibility of having overlooked other studies due to search variations in language controls, differences in publication cycle time and database search engines.

Originality/value

The paper relies on COVID-19's uniqueness to highlight the limitations in optimization and individualistic approaches to managing medical inventory and stockout risks in HCSCs. The paper proposes a shift from a fragmented to holistic application of relevant collaboration practices and capabilities to enhance the resilience of HCSCs against stockout ripple effects during future pandemics. The study propositions and suggestion for an SC learning curve provide an interdisciplinary research agenda to trigger early preparation of a coordinated HCSC and humanitarian logistics response to future pandemics.

Barriers to blockchain adoption in health-care industry: an Indian perspective

Purpose

This paper aims to identify barriers toward the adoption of blockchain (BC) technology in Indian health-care industry and also examines the significant issues of BC applications in health-care industry.

Design/methodology/approach

The barriers of the study are identified by two phases including the review of literature and semistructured interviews with hospital staff and administration operating in India. The experts (N = 15) are being taken from top-level management, IT experts and patients from the hospitals. The study implemented integrated total interpretative structural modeling-FUZZY-Cross-impact matrix multiplication applied to classification (TISM-FUZZY-MICMAC) methods for identifying the interrelationship among the barriers.

Findings

A total of 15 barriers have been determined in the Indian health-care industry through discussion with the selected experts. TISM is applied to develop multilevel structure for BC barriers. Further, FUZZY-MICMAC has been used to compute driving and dependent barriers. The findings suggest that low awareness related to legal issues and low support from high level of management have maximum driving power.

Research limitations/implications

The present study applies multicriterion approach to identify the limited barriers in BC adoption in health care. Future studies may develop the relationship and mark down the steps for implementation of BC in health-care setting of a developing economy. Empirical study can be conducted to verify the results along with selected case studies.

Practical implications

The present study identifies the BC adoption barriers in health-care industry. The study examines the pertinent issues in context to major support required, bottlenecks in adoption, key benefits of adoption planning and activities. The technology adoption practices are expected to provide applications such as distributed, secured medical and clinical data and patient centric systems that will enhance the efficiency of the health-care industry.

Originality/value

The study is among few primary studies that identify and analyze the BC adoption in health-care industry.

Part 2: Blockchain technology in health care

Blockchain technology is one of the many disruptive technologies of the Fourth Industrial Revolution that will irrevocably change the way we live and work. These technologies are well embedded in the areas of global finance, health care and defence, to name a few. This review focuses on the relevance of blockchain technology to health care. Blockchain technology will be the unifying platform for sharing patient data currently inaccessible due to the siloed architecture of legacy software systems, and as a result potentially be the basis for precision or individualized patient treatment. It will also strengthen digital security of sensitive patient data that is presently a lucrative target for cyber criminals. In the current COVID-19 environment, clinicians will rely more on telehealth to reduce person-to-person contact. This service can be delivered by the clinical team with confidence in the veracity of the patient data made accessible through the blockchain platform. Smart contracts written on the blockchain platform will reduce the possibility of international humanitarian aid to low- and middle-income countries being misspent. The pharmaceutical supply chain industry is adopting blockchain technology to ensure supply chain provenance. Similarly, the health insurance industry recognizes how the blockchain ecosystem can improve services to its members and expedite reimbursements to clinicians.

Blockchain technology in supply chain operations: Applications, challenges and research opportunities

Blockchain is a technology with unique combination of features such as decentralized structure, distributed notes and storage mechanism, consensus algorithm, smart contracting, and asymmetric encryption to ensure network security, transparency and visibility. Blockchain has immense potential to transform supply chain (SC) functions, from SC provenance, business process reengineering to security enhancement. More and more studies exploring the use of blockchain in SCs have appeared in recent years. In this paper, we consider a total of 178 articles and examine all the relevant research done in the field associated with the use of blockchain integration in SC operations. We highlight the corresponding opportunities, possible societal impacts, current state-of-the-art technologies along with major trends and challenges. We examine several industrial sectors such as shipping, manufacturing, automotive, aviation, finance, technology, energy, healthcare, agriculture and food, e-commerce, and education among others that can be successfully revamped with blockchain based technologies through enhanced visibility and business process management. A future research agenda is established which lays the solid foundation for further studies on this important emerging research area.

The Current State of Research, Challenges, and Future Research Directions of Blockchain Technology in Patient Care: Systematic Review

Background

Blockchain offers a promising new distributed technology to address the challenges of data standardization, system interoperability, security, privacy, and accessibility of medical records.

Objective

The purpose of this review is to assess the research on the use of blockchain technology for patient care and the associated challenges and to provide a research agenda for future research.

Methods

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Excerpta Medica dataBASE (EMBASE), and Web of Science databases for peer-reviewed research articles published up to December 2019 that examined the implementation of blockchain technology in health care settings. We identified 800 articles from which we selected 70 empirical research articles for a detailed review.

Results

Blockchain-based patient care applications include medical information systems, personal health records, mobile health and telemedicine, data preservation systems and social networks, health information exchanges and remote monitoring systems, and medical research systems. These blockchain-based health care applications may improve patient engagement and empowerment, improve health care provider access to information, and enhance the use of health care information for medical research.

Conclusions

Blockchain health information technology (HIT) provides benefits such as ensuring data privacy and security of health data, facilitating interoperability of heterogeneous HIT systems, and improving the quality of health care outcomes. However, barriers to using blockchain technology to build HIT include security and privacy vulnerabilities, user resistance, high computing power requirements and implementation costs, inefficient consensus algorithms, and challenges of integrating blockchain with existing HIT. With 51% of the research focused on medical information systems such as electronic health record and electronic medical record, and 53% of the research focused on data security and privacy issues, this review shows that HIT research is primarily focused on the use of blockchain technologies to address the current challenges HIT faces. Although Blockchain presents significant potential for disrupting health care, most ideas are in their infancy.

Blockchain Technology: Principles and Applications in Medical Imaging

Blockchain is an immutable, encrypted, distributed ledger technology. While initially devised for and most commonly referenced with cryptocurrencies, there are an increasing number of applications outside finance, many of which are relevant to medical imaging. In this paper, the concepts and principles underlying the technology and applications relevant to medical imaging are discussed, in addition to potential challenges with implementations such as public versus private key access, distributed ledger size constraints, speed, complexity, and security pitfalls. Potential use cases for blockchain specifically relevant to medical imaging include image sharing including direct patient ownership of images, tracking of implanted medical devices, research, teleradiology, and artificial intelligence. While blockchain offers exciting ways to facilitate the storage and distribution of medical images, similar to the advent of picture archiving and communication systems decades ago, it does have several key limitations of which healthcare providers of medical imaging and imaging informatics professionals should be aware.

Evaluation of patient perception towards dynamic health data sharing using blockchain based digital consent with the Dovetail digital consent application: A cross sectional exploratory study

Background

New patient-centric integrated care models are enabled by the capability to exchange the patient’s data amongst stakeholders, who each specialise in different aspects of the patient’s care. This requires a robust, trusted and flexible mechanism for patients to offer consent to share their data. Furthermore, new IT technologies make it easier to give patients more control over their data, including the right to revoke consent. These characteristics challenge the traditional paper-based, single-organisation-led consent process. The Dovetail digital consent application uses a mobile application and blockchain based infrastructure to offer this capability, as part of a pilot allowing patients to have their data shared amongst digital tools, empowering patients to manage their condition within an integrated care setting.

Objective

To evaluate patient perceptions towards existing consent processes, and the Dovetail blockchain based digital consent application as a means to manage data sharing in the context of diabetes care.

Method

Patients with diabetes at a General Practitioner practice were recruited. Data were collected using focus groups and questionnaires. Thematic analysis of the focus group transcripts and descriptive statistics of the questionnaires was performed.

Results

There was a lack of understanding of existing consent processes in place, and many patients did not have any recollection of having previously given consent. The digital consent application received favourable feedback, with patients recognising the value of the capability offered by the application. Patients overwhelmingly favoured the digital consent application over existing practice.

Conclusions

Digital consent was received favourably, with patients recognising that it addresses the main limitations of the current process. Feedback on potential improvements was received. Future work includes confirmation of results in a broader demographic sample and across multiple conditions.

Towards a European health research and innovation cloud (HRIC)

The European Union (EU) initiative on the Digital Transformation of Health and Care (Digicare) aims to provide the conditions necessary for building a secure, flexible, and decentralized digital health infrastructure. Creating a European Health Research and Innovation Cloud (HRIC) within this environment should enable data sharing and analysis for health research across the EU, in compliance with data protection legislation while preserving the full trust of the participants. Such a HRIC should learn from and build on existing data infrastructures, integrate best practices, and focus on the concrete needs of the community in terms of technologies, governance, management, regulation, and ethics requirements. Here, we describe the vision and expected benefits of digital data sharing in health research activities and present a roadmap that fosters the opportunities while answering the challenges of implementing a HRIC. For this, we put forward five specific recommendations and action points to ensure that a European HRIC: i) is built on established standards and guidelines, providing cloud technologies through an open and decentralized infrastructure; ii) is developed and certified to the highest standards of interoperability and data security that can be trusted by all stakeholders; iii) is supported by a robust ethical and legal framework that is compliant with the EU General Data Protection Regulation (GDPR); iv) establishes a proper environment for the training of new generations of data and medical scientists; and v) stimulates research and innovation in transnational collaborations through public and private initiatives and partnerships funded by the EU through Horizon 2020 and Horizon Europe.

Opinions on Sustainability of Smart Cities in the Context of Energy Challenges Posed by Cryptocurrency Mining

Next to climate change on the list of challenges faced by humankind in today’s technological age is energy management. While “smart” ideas continue to gather momentum as some of the ways earmarked to combat the menace of a changing climate, coupled with efficient management of energy, research and development in the blockchain is not retracting, recently giving rise to digital currencies capable of fueling massive energy consumption via mining of “crypto-coins”. Given that sustainability is a crucial goal in the design of smart cities nowadays, there are currently no assurances of sustainable cities where cryptocurrency mining is at full scale. Nevertheless, alternative energy sources may come to the rescue in no distant time. In this paper, we contextualize energy-use in smart cities through mining of virtual currencies, in order to predict whether or not smart cities can truly be sustainable if crypto-mining is sustained. An attempt is also made to emphasize the possible ways of reducing energy use and all activities involving digital currencies by seeking to replace “Proof of Work” (PoW) with improved alternatives.

Attitudes Toward Blockchain Technology in Managing Medical Information: Survey Study

BACKGROUND

The recently developed blockchain technology uses a peer-to-peer network to distribute data to all participants for storage. This method enhances data safety, reliability, integrity, and transparency. To successfully introduce blockchain technology to medical data management, it is essential to obtain consent from medical doctors and patients.

OBJECTIVE

The aim of this study was to examine medical doctors' and patients' attitudes toward the use of blockchain technology and interpret the findings within the framework of expectancy theory.

METHODS

In this questionnaire survey, we examined medical doctors' (n=90) and patients' (n=90) attitudes toward the use of blockchain technology in the management and distribution of medical information. The questionnaire comprised 8 questions that assessed attitudes toward new means of managing and distributing medical information using blockchain technology. Responses were rated on a scale that ranged from 1 (very negative) to 7 (very positive).

RESULTS

Medical doctors (mean 3.7-5.0) reported significantly more negative attitudes than patients (mean 6.3-6.8). Furthermore, self-employed doctors reported more negative attitudes than employed doctors and university professors.

CONCLUSIONS

To successfully introduce blockchain technology to medical data management, it is necessary to promote positive attitudes toward this technology among medical doctors, especially self-employed doctors.