How blockchain-timestamped protocols could improve the trustworthiness of medical science

Blockchained education: challenging the long-standing model of academic institutions

The model of higher education institutions has remained widely unchallenged over time. Although study topics keep evolving and the inclusion of increasingly sophisticated technologies have revolutionised the format of lectures and learning experiences. Their value chain remains unchanged, with institutions acting as intermediaries, between professors (knowledge) and students (recipients), and as central authorities granting and validating student knowledge. The work here presented is a review of blockchain technology and its application in education, emphasising the opportunities for disrupting the current value chain of academic institutions. Blockchain technology’s prime novelty constitutes an incorruptible digital ledger of transactions, capable of recording virtually any nature of value exchange. When coupled with other emerging technologies such as the internet of things and big data, new paths for the decentralised exchange of education and recording of knowledge and skills appear. The result is an extensive analysis of the evolution of blockchain technology for education applications, along with a forecast of plausible scenarios of disruption for academic institutions. Blockchain technology is steadily advancing at accelerating rates; applications aimed at decentralising educational institutions are already available. Meanwhile, the technology keeps gaining momentum in a growing base of adepts.

The HealthChain Blockchain for Electronic Health Records: Development Study

Background

Health care professionals are required to maintain accurate health records of patients. Furthermore, these records should be shared across different health care organizations for professionals to have a complete review of medical history and avoid missing important information. Nowadays, health care providers use electronic health records (EHRs) as a key to the implementation of these goals and delivery of quality care. However, there are technical and legal hurdles that prevent the adoption of these systems, such as concerns about performance and privacy issues.

Objective

This study aimed to build and evaluate an experimental blockchain for EHRs, named HealthChain, which overcomes the disadvantages of traditional EHR systems.

Methods

HealthChain is built based on consortium blockchain technology. Specifically, three organizations, namely hospitals, insurance providers, and governmental agencies, form a consortium that operates under a governance model, which enforces the business logic agreed by all participants. Every peer node hosts an instance of the distributed ledger consisting of EHRs and an instance of chaincode regulating the permissions of participants. Designated orderers establish consensus on the order of EHRs and then disseminate blocks to peers.

Results

HealthChain achieves functional and nonfunctional requirements. It can store EHRs in a distributed ledger and share them among different participants. Moreover, it demonstrates superior features, such as privacy preservation, security, and high throughput. These are the main reasons why HealthChain is proposed.

Conclusions

Consortium blockchain technology can help to build new EHR systems and solve the problems that prevent the adoption of traditional systems.

Privacy-Preserving in Healthcare Blockchain Systems Based on Lightweight Message Sharing

Electronic medical records (EMRs) are extremely important for patients’ treatment, doctors’ diagnoses, and medical technology development. In recent years, the distributed healthcare blockchain system has been researched for solving the information isolated island problem in centralized healthcare service systems. However, there still exists a series of important problems such as the patients’ sensitive information security, cross-institutional data sharing, medical quality, and efficiency. In this paper, we establish a lightweight privacy-preserving mechanism for a healthcare blockchain system. First, we apply an interleaving encoder to encrypt the original EMRs. This can hide the sensitive information of EMRs to protect the patient’s privacy security. Second, a (t,n)-threshold lightweight message sharing scheme is presented. The EMRs are mapped to n different short shares, and it can be reconstructed by at least t shares. The EMR shares rather than the original EMRs are stored in the blockchain nodes. This can guarantee high security for EMR sharing and improve the data reconstruction efficiency. Third, the indexes of the stored EMR shares are employed to generate blocks that are chained together and finally form a blockchain. The authorized data users or institutions can recover an EMR by requesting at least t shares of the EMR from the blockchain nodes. In this way, the healthcare blockchain system can not only facilitate the cross-institution sharing process, but also provide proper protections for the EMRs. The security proof and analysis indicate that the proposed scheme can protect the privacy and security of patients’ medical information. The simulation results show that our proposed scheme is more efficient than similar literature in terms of energy consumption and storage space, and the healthcare blockchain system is more stable with the proposed message sharing scheme.

A Decentralized Privacy-Preserving Healthcare Blockchain for IoT

Medical care has become one of the most indispensable parts of human lives, leading to a dramatic increase in medical big data. To streamline the diagnosis and treatment process, healthcare professionals are now adopting Internet of Things (IoT)-based wearable technology. Recent years have witnessed billions of sensors, devices, and vehicles being connected through the Internet. One such technology—remote patient monitoring—is common nowadays for the treatment and care of patients. However, these technologies also pose grave privacy risks and security concerns about the data transfer and the logging of data transactions. These security and privacy problems of medical data could result from a delay in treatment progress, even endangering the patient’s life. We propose the use of a blockchain to provide secure management and analysis of healthcare big data. However, blockchains are computationally expensive, demand high bandwidth and extra computational power, and are therefore not completely suitable for most resource-constrained IoT devices meant for smart cities. In this work, we try to resolve the above-mentioned issues of using blockchain with IoT devices. We propose a novel framework of modified blockchain models suitable for IoT devices that rely on their distributed nature and other additional privacy and security properties of the network. These additional privacy and security properties in our model are based on advanced cryptographic primitives. The solutions given here make IoT application data and transactions more secure and anonymous over a blockchain-based network.

Tamper-Resistant Mobile Health Using Blockchain Technology

Background

Digital health technologies, including telemedicine, mobile health (mHealth), and remote monitoring, are playing a greater role in medical practice. Safe and accurate management of medical information leads to the advancement of digital health, which in turn results in a number of beneficial effects. Furthermore, mHealth can help lower costs by facilitating the delivery of care and connecting people to their health care providers. Mobile apps help empower patients and health care providers to proactively address medical conditions through near real-time monitoring and treatment, regardless of the location of the patient or the health care provider. Additionally, mHealth data are stored in servers, and consequently, data management that prevents all forms of manipulation is crucial for both medical practice and clinical trials.

Objective

The aim of this study was to develop and evaluate a tamper-resistant mHealth system using blockchain technology, which enables trusted and auditable computing using a decentralized network.

Methods

We developed an mHealth system for cognitive behavioral therapy for insomnia using a smartphone app. The volunteer data collected with the app were stored in JavaScript Object Notation format and sent to the blockchain network. Thereafter, we evaluated the tamper resistance of the data against the inconsistencies caused by artificial faults.

Results

Electronic medical records collected using smartphones were successfully sent to a private Hyperledger Fabric blockchain network. We verified the data update process under conditions where all the validating peers were running normally. The mHealth data were successfully updated under network faults. We further ensured that any electronic health record registered to the blockchain network was resistant to tampering and revision. The mHealth data update was compatible with tamper resistance in the blockchain network.

Conclusions

Blockchain serves as a tamperproof system for mHealth. Combining mHealth with blockchain technology may provide a novel solution that enables both accessibility and data transparency without a third party such as a contract research organization.

Blockchain technology for improving clinical research quality

Reproducibility, data sharing, personal data privacy concerns and patient enrolment in clinical trials are huge medical challenges for contemporary clinical research. A new technology, Blockchain, may be a key to addressing these challenges and should draw the attention of the whole clinical research community.Blockchain brings the Internet to its definitive decentralisation goal. The core principle of Blockchain is that any service relying on trusted third parties can be built in a transparent, decentralised, secure "trustless" manner at the top of the Blockchain (in fact, there is trust, but it is hardcoded in the Blockchain protocol via a complex cryptographic algorithm). Therefore, users have a high degree of control over and autonomy and trust of the data and its integrity. Blockchain allows for reaching a substantial level of historicity and inviolability of data for the whole document flow in a clinical trial. Hence, it ensures traceability, prevents a posteriori reconstruction and allows for securely automating the clinical trial through what are called Smart Contracts. At the same time, the technology ensures fine-grained control of the data, its security and its shareable parameters, for a single patient or group of patients or clinical trial stakeholders.In this commentary article, we explore the core functionalities of Blockchain applied to clinical trials and we illustrate concretely its general principle in the context of consent to a trial protocol. Trying to figure out the potential impact of Blockchain implementations in the setting of clinical trials will shed new light on how modern clinical trial methods could evolve and benefit from Blockchain technologies in order to tackle the aforementioned challenges.

Improving data transparency in clinical trials using blockchain smart contracts

The scientific credibility of findings from clinical trials can be undermined by a range of problems including missing data, endpoint switching, data dredging, and selective publication. Together, these issues have contributed to systematically distorted perceptions regarding the benefits and risks of treatments. While these issues have been well documented and widely discussed within the profession, legislative intervention has seen limited success. Recently, a method was described for using a blockchain to prove the existence of documents describing pre-specified endpoints in clinical trials. Here, we extend the idea by using smart contracts - code, and data, that resides at a specific address in a blockchain, and whose execution is cryptographically validated by the network - to demonstrate how trust in clinical trials can be enforced and data manipulation eliminated. We show that blockchain smart contracts provide a novel technological solution to the data manipulation problem, by acting as trusted administrators and providing an immutable record of trial history.