A Proposed Solution and Future Direction for Blockchain-Based Heterogeneous Medicare Data in Cloud Environment

Securing patient data in the healthcare industry: A blockchain-driven protocol with advanced encryption

BACKGROUND

Ensuring the security and privacy of patient data is a critical concern in the healthcare industry. The growing utilization of electronic data transmission and storage in medical records has amplified apprehensions about data security. However, due to varying stakeholder interests, not all data can be freely shared, necessitating the development of secure protocols.

MATERIALS AND METHODS

This study presents a highly secure protocol that integrates blockchain technology, patient biometric information, and robust cryptographic algorithms (elliptic curve cryptography (ECC) and advanced encryption algorithm (AEC)) to facilitate data encryption and decryption. The protocol encompasses secure login, secure key sharing, and data sharing mechanisms among miners, offering comprehensive security measures. To validate the effectiveness of the proposed protocol, both informal and formal security analyses are conducted. The security protocol description language in Scyther is utilized to evaluate the protocol's resilience against attacks.

RESULTS

The culmination of this research is a secure protocol that leverages blockchain technology and ECC for the secure storage and sharing of medical records. The protocol covers all stages, including system setup, user registration, login mechanisms, key exchange between users and blockchain, communication between blockchains, and interaction with other miners, with a steadfast emphasis on security. Furthermore, the protocol's communication and computation costs are assessed, with a comparison to existing blockchain-based schemes. Informal proofs establish the protocol's security against common attacks faced by medical institutions. Formal simulation of the protocol using the Scyther tool provides definitive evidence of its resistance to attacks.

CONCLUSIONS

As a result, this protocol presents a viable real-time implementation solution for safeguarding patient data within the healthcare domain, representing a significant contribution to data security.

Blockchain based medical image encryption using Arnold's cat map in a cloud environment

Improved software for processing medical images has inspired tremendous interest in modern medicine in recent years. Modern healthcare equipment generates huge amounts of data, such as scanned medical images and computerized patient information, which must be secured for future use. Diversity in the healthcare industry, namely in the form of medical data, is one of the largest challenges for researchers. Cloud environment and the Block chain technology have both demonstrated their own use. The purpose of this study is to combine both technologies for safe and secure transaction. Storing or sending medical data through public clouds exposes information into potential eavesdropping, data breaches and unauthorized access. Encrypting data before transmission is crucial to mitigate these security risks. As a result, a Blockchain based Chaotic Arnold's cat map Encryption Scheme (BCAES) is proposed in this paper. The BCAES first encrypts the image using Arnold's cat map encryption scheme and then sends the encrypted image into Cloud Server and stores the signed document of plain image into blockchain. As blockchain is often considered more secure due to its distributed nature and consensus mechanism, data receiver will ensure data integrity and authenticity of image after decryption using signed document stored into the blockchain. Various analysis techniques have been used to examine the proposed scheme. The results of analysis like key sensitivity analysis, key space analysis, Information Entropy, histogram correlation of adjacent pixels, Number of Pixel Change Rate, Peak Signal Noise Ratio, Unified Average Changing Intensity, and similarity analysis like Mean Square Error, and Structural Similarity Index Measure illustrated that our proposed scheme is an efficient encryption scheme as compared to some recent literature. Our current achievements surpass all previous endeavors, setting a new standard of excellence.

Unraveling a blockchain-based framework towards patient empowerment: A scoping review envisioning future smart health technologies

The COVID-19 pandemic shows us how crucial patient empowerment can be in the healthcare ecosystem. Now, we know that scientific advancement, technology integration, and patient empowerment need to be orchestrated to realize future smart health technologies. In that effort, this paper unravels the Good (advantages), Bad (challenges/limitations), and Ugly (lacking patient empowerment) of the blockchain technology integration in the Electronic Health Record (EHR) paradigm in the existing healthcare landscape. Our study addresses four methodically-tailored and patient-centric Research Questions, primarily examining 138 relevant scientific papers. This scoping review also explores how the pervasiveness of blockchain technology can help to empower patients in terms of access, awareness, and control. Finally, this scoping review leverages the insights gleaned from this study and contributes to the body of knowledge by proposing a patient-centric blockchain-based framework. This work will envision orchestrating three essential elements with harmony: scientific advancement (Healthcare and EHR), technology integration (Blockchain Technology), and patient empowerment (access, awareness, and control).

State-of-the-Art Research in Blockchain of Things for HealthCare

Existing blockchain approaches exhibit a diverse set of dimensions, and on the other hand, IoT-based health care applications manifest a wide variety of requirements. The state-of-the-art analysis of blockchain concerning existing IoT-based approaches for the healthcare domain has been investigated to a limited extend. The purpose of this survey paper is to analyze current state-of-the-art blockchain work in several IoT disciplines, with a focus on the health sector. This study also attempts to demonstrate the prospective use of blockchain in healthcare, as well as the obstacles and future paths of blockchain development. Furthermore, the fundamentals of blockchain have been thoroughly explained to appeal to a diverse audience. On the contrary, we analyzed state-of-the-art studies from several IoT disciplines for eHealth, and also the study deficit but also the obstacles when considering blockchain to IoT, which are highlighted and explored in the paper with suggested alternatives.

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.

Blockchain Technology: Benefits, Challenges, Applications, and Integration of Blockchain Technology with Cloud Computing

The real-world use cases of blockchain technology, such as faster cross-border payments, identity management, smart contracts, cryptocurrencies, and supply chain–blockchain technology are here to stay and have become the next innovation, just like the Internet. There have been attempts to formulate digital money, but they have not been successful due to security and trust issues. However, blockchain needs no central authority, and its operations are controlled by the people who use it. Furthermore, it cannot be altered or forged, resulting in massive market hype and demand. Blockchain has moved past cryptocurrency and discovered implementations in other real-life applications; this is where we can expect blockchain technology to be simplified and not remain a complex concept. Blockchain technology’s desirable characteristics are decentralization, integrity, immutability, verification, fault tolerance, anonymity, audibility, and transparency. We first conduct a thorough analysis of blockchain technology in this paper, paying particular attention to its evolution, applications and benefits, the specifics of cryptography in terms of public key cryptography, and the challenges of blockchain in distributed transaction ledgers, as well as the extensive list of blockchain applications in the financial transaction system. This paper presents a detailed review of blockchain technology, the critical challenges faced, and its applications in different fields. Blockchain in the transaction system is explained in detail with a summary of different cryptocurrencies. Some of the suggested solutions are given in the overall study of the paper.

Blockchain technology applications in the health domain: a multivocal literature review

Blockchain technology has been changing the nature of several businesses, from supply chain management to electronic record management systems and copyright management to healthcare applications. It provides a resilient and secure platform for modifications due to its distributed and shared nature and cryptographic functions. Each new technology, however, comes with its challenges alongside its opportunities. Previously, we performed a systematic literature review (SLR) to explore how blockchain technology potentially benefits health domain applications. The previous SLR included 27 formal literature papers from 2016 to 2020. Noticing that blockchain technology is rapidly growing, we extended the previous SLR with a multivocal literature review (MLR) approach to present the state of the art in this study. We focused on understanding to what degree blockchain could answer the challenges inherited in the health domain and whether blockchain technology may bring new challenges to health applications. The MLR consists of 78 sources of formal literature and 23 sources of gray literature from 2016 to 2021. As a result of this study, we specified 17 health domain challenges that can be categorized into four groups: (i) meeting regulatory requirements and public health surveillance, (ii) ensuring security and privacy, (iii) ensuring interoperability, and (iv) preventing waste of resources. The analysis shows that blockchain makes significant contributions to the solutions of these challenges. However, 10 new pitfalls come with adopting the technology in the health domain: the inability to delete sensitive data once it is added to a chain, limited ability to keep large-scale data in a blockchain, and performance issues. The data we extracted during the MLR is available in a publicly accessible online repository.

Blockchain technology in healthcare: A systematic review

Blockchain technology (BCT) has emerged in the last decade and added a lot of interest in the healthcare sector. The purpose of this systematic literature review (SLR) is to explore the potential paradigm shift in healthcare utilizing BCT. The study is compiled by reviewing research articles published in nine well-reputed venues such as IEEE Xplore, ACM Digital Library, Springs Link, Scopus, Taylor & Francis, Science Direct, PsycINFO, Ovid Medline, and MDPI between January 2016 to August 2021. A total of 1,192 research studies were identified out of which 51 articles were selected based on inclusion criteria for this SLR that presents the modern information on the recent implications and gaps in the use of BCT for enhancing the healthcare procedures. According to the outcomes, BCT is being applied to design the novel and advanced interventions to enrich the current protocol of managing, distributing, and processing clinical records and personal medical information. BCT is enduring the conceptual development in the healthcare domain, where it has summed up the substantial elements through better and enhanced efficiency, technological innovation, access control, data privacy, and security. A framework is developed to address the probable field where future researchers can add considerable value, such as data protection, system architecture, and regulatory compliance. Finally, this SLR concludes that the upcoming research can support the pervasive implementation of BCT to address the critical dilemmas related to health diagnostics, enhancing the patient healthcare process in remote monitoring or emergencies, data integrity, and avoiding fraud.

CrowdMed-II: a blockchain-based framework for efficient consent management in health data sharing

The healthcare industry faces serious problems with health data. Firstly, health data is fragmented and its quality needs to be improved. Data fragmentation means that it is difficult to integrate the patient data stored by multiple health service providers. The quality of these heterogeneous data also needs to be improved for better utilization. Secondly, data sharing among patients, healthcare service providers and medical researchers is inadequate. Thirdly, while sharing health data, patients' right to privacy must be protected, and patients should have authority over who can access their data. In traditional health data sharing system, because of centralized management, data can easily be stolen, manipulated. These systems also ignore patient's authority and privacy. Researchers have proposed some blockchain-based health data sharing solutions where blockchain is used for consensus management. Blockchain enables multiple parties who do not fully trust each other to exchange their data. However, the practice of smart contracts supporting these solutions has not been studied in detail. We propose CrowdMed-II, a health data management framework based on blockchain, which could address the above-mentioned problems of health data. We study the design of major smart contracts in our framework and propose two smart contract structures. We also introduce a novel search contract for searching patients in the framework. We evaluate their efficiency based on the execution costs on Ethereum. Our design improves on those previously proposed, lowering the computational costs of the framework. This allows the framework to operate at scale and is more feasible for widespread adoption.

A blockchain and smart contract-based data provenance collection and storing in cloud environment

Data uploading needs security and privacy in the cloud. But there are some problems like centralized provenance data (PD) collection, storage, lack of security, integrity, and more time consumption. There are methods like Rabin, Knapsack, McEliece, Elagamal, and Rivest–Shamir–Adleman for the generation of keys but it increases the encryption and decryption time and less security. Therefore, the blockchain and smart contract-based data provenance (BSCDP) Architecture is proposed for providing secure storage in the cloud environment. Initially, the fingerprint biometrics and physically uncloneable functions (PUF) have been used in verification process. The combination of PUF and fingerprint biometrics is used for secure data transmission. To protect privacy and strengthen the security, the fuzzy extractor is employed. Secondly, we use an elliptic-curve key based cyclic shift transposition cryptography algorithm for enhancing the security when sharing the key. Thirdly, we introduce the blockchain and the interplanetary file system (IPFS) for PD collection, hash computation, and storing with reduced computational overhead (CO). The integrity of data is maintained by using blockchain based secure hashing algorithm-3. By arranging fuzzy based smart contracts (FSC), the data user (DU) tracks their data. FSC is employed for tracking the history of data. The data collected is directly stored in IPFS and the DU gets a hash from IPFS to retrieve the data in the future. Finally, the data verification is done by the provenance auditor. When comparing our proposed BSCDP method with existing methods, the proposed BSCDP method achieves high security in the cloud environment for 2 K users in terms of evidence insertion time (30 ms), verification time (30 ms), response time (40 ms), total change rate (5%), CO (5.8 Kb), encryption (50 ms) and decryption time (52 ms).

Blockchain-Based Healthcare Information Preservation Using Extended Chaotic Maps for HIPAA Privacy/Security Regulations

A healthcare information system allows patients and other users to remotely login to medical services to access health data through the Internet. To protect the privacy of patients and security over the public network, secure communication is required. Therefore, the security of data in transmission has been attracting increasing attention. In recent years, blockchain technology has also attracted more attention. Relevant research has been published at a high rate. Most methods of satisfying relevant security-related regulations use modular and exponential calculation. This study proposes a medical care information preservation mechanism that considers the entire process of data storage in devices from wearable devices to mobile devices to medical center servers. The entire process is protected and complies with HIPAA privacy and security regulations. The proposed scheme uses extended chaotic map technology to develop ID-based key negotiation for wearable devices, and thereby reduces the amount of computing that must be carried out by wearable devices and achieve lightness quantify. It also uses the non-tamperability of the blockchain to ensure that the data have not been tampered with, improving data security. The proposed mechanism can resist a variety of attacks and is computationally lighter than the elliptic curve point multiplication that has been used elsewhere, while retaining its security characteristics.

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.

A Systematic Literature Review of Blockchain Technology for Smart Villages

According to the United Nations, Sustainable Development Goals are framed for improving rural health, hunger, poverty issues, environmental conditions, and illiteracy globally. With the upcoming technology, there have been many advances in the lifestyle of people all around the world. Comparatively, more emphasis has been given to the development of urban areas than rural. The sustainable development of a country depends on the growth of its rural areas. Countless technological and theoretical models, projects, and frameworks have been proposed and implemented to help overcome sundry issues and challenges faced by rural people in quotidian life. New technological methods are deemed to be the future of livability, therefore; a technologically advanced solution for sustainable rural development is called for. Blockchain Technology is the next step for innovation and development and it has far many applications in sustainable rural development that are yet to be discovered. The objective of this paper is to explicitly review research conducted in rural development to fill the undone work in the future with better research ideas, to make rural areas a livable and advanced place while also maintaining their integrity leading to sustainable development. To conduct such a review, a systematic research methodology is applied following regulations in the conduction of standardized but explorative analysis. Within the timeline of 2010-2021, 112 papers are carefully selected to perform the systematic review. This review will provide a comprehensible as well as concise research compendium for all applications proposed, implemented, and possible in the future to realize the concept of smart villages for the development of rural areas using blockchain technology.

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.

The role of 5G for digital healthcare against COVID-19 pandemic: Opportunities and challenges

COVID-19 pandemic caused a massive impact on healthcare, social life, and economies on a global scale. Apparently, technology has a vital role to enable ubiquitous and accessible digital health services in pandemic conditions as well as against “re-emergence” of COVID-19 disease in a post-pandemic era. Accordingly, 5G systems and 5G-enabled e-health solutions are paramount. This paper highlights methodologies to effectively utilize 5G for e-health use cases and its role to enable relevant digital services. It also provides a comprehensive discussion of the implementation issues, possible remedies and future research directions for 5G to alleviate the health challenges related to COVID-19.

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.

MedShard: Electronic Health Record Sharing Using Blockchain Sharding

Electronic health records (EHRs) are important assets of the healthcare system and should be shared among medical practitioners to improve the accuracy and efficiency of diagnosis. Blockchain technology has been investigated and adopted in healthcare as a solution for EHR sharing while preserving privacy and security. Blockchain can revolutionize the healthcare system by providing a decentralized, distributed, immutable, and secure architecture. However, scalability has always been a bottleneck in blockchain networks due to the consensus mechanism and ledger replication to all network participants. Sharding helps address this issue by artificially partitioning the network into small groups termed shards and processing transactions parallelly while running consensus within each shard with a subset of blockchain nodes. Although this technique helps resolve issues related to scalability, cross-shard communication overhead can degrade network performance. This study proposes a transaction-based sharding technique wherein shards are formed on the basis of a patient’s previously visited health entities. Simulation results show that the proposed technique outperforms standard-based healthcare blockchain techniques in terms of the number of appointments processed, consensus latency, and throughput. The proposed technique eliminates cross-shard communication by forming complete shards based on “the need to participate” nodes per patient.

Data sharing: using blockchain and decentralized data technologies to unlock the potential of artificial intelligence: What can assisted reproduction learn from other areas of medicine?

The extension of blockchain use for nonfinancial domains has revealed opportunities to the health care sector that answer the need for efficient and effective data and information exchanges in a secure and transparent manner. Blockchain is relatively novel in health care and particularly for data analytics, although there are examples of improvements achieved. We provide a systematic review of blockchain uses within the health care industry, with a particular focus on the in vitro fertilization (IVF) field. Blockchain technology in the fertility sector, including data sharing collaborations compliant with ethical data handling within confines of international law, allows for large-scale prospective cohort studies to proceed at an international scale. Other opportunities include gamete donation and matching, consent sharing, and shared resources between different clinics.

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.

DynamiChain: Development of Medical Blockchain Ecosystem Based on Dynamic Consent System

Although blockchain is acknowledged as one of the most important technologies to lead the fourth industrial revolution, major technical challenges regarding security breach and privacy issues remain. This issue is particularly sensitive in applied medical fields where personal health information is handled within the network. In addition, contemporary blockchain-converged solutions do not consider restricted medical data regulations that are still obstacles in many countries worldwide. This implies a crucial need for a system or solution that is suitable for the healthcare sector. Therefore, this article proposes the development of a dynamic consent medical blockchain system called DynamiChain, based on a ruleset management algorithm for handling health examination data. Moreover, medical blockchain-related studies were systematically reviewed to prove the novelty of DynamiChain. The proposed system was implemented in a scenario where the exercise management healthcare company provided health management services based on data obtained from the data provider’s hospital. The proposed research is envisioned to provide a widely compatible blockchain medical system that could be applied in future healthcare fields.

Peace engineering: The contribution of blockchain systems to the e-voting process

In recent decades, several countries have faced political tensions due to citizens' perceptions that their elections are fraudulent; some electors have even chosen not to vote because they believe that the results may be falsified. Thus, electoral fraud is a major issue. E-governance and e-voting are now being used in many countries, some of which are investigating blockchain solutions. The aim of this study is to investigate the potential contributions of blockchain technology to peace on a worldwide level by securing voting systems. Unfortunately, this technology is complex and could potentially generate conflict between actors in elections. Taking an exploratory approach, the authors chose a qualitative method to address this specific topic. Election observers and blockchain experts were interviewed to identify the technology's strengths and weaknesses. Our results emphasize the importance of trust and human factors in the voting process.

A Proposed Sentiment Analysis Deep Learning Algorithm for Analyzing COVID-19 Tweets

With the rise in cases of COVID-19, a bizarre situation of pressure was mounted on each country to make arrangements to control the population and utilize the available resources appropriately. The swiftly rising of positive cases globally created panic, anxiety and depression among people. The effect of this deadly disease was found to be directly proportional to the physical and mental health of the population. As of 28 October 2020, more than 40 million people are tested positive and more than 1 million deaths have been recorded. The most dominant tool that disturbed human life during this time is social media. The tweets regarding COVID-19, whether it was a number of positive cases or deaths, induced a wave of fear and anxiety among people living in different parts of the world. Nobody can deny the truth that social media is everywhere and everybody is connected with it directly or indirectly. This offers an opportunity for researchers and data scientists to access the data for academic and research use. The social media data contains many data that relate to real-life events like COVID-19. In this paper, an analysis of Twitter data has been done through the R programming language. We have collected the Twitter data based on hashtag keywords, including COVID-19, coronavirus, deaths, new case, recovered. In this study, we have designed an algorithm called Hybrid Heterogeneous Support Vector Machine (H-SVM) and performed the sentiment classification and classified them positive, negative and neutral sentiment scores. We have also compared the performance of the proposed algorithm on certain parameters like precision, recall, F1 score and accuracy with Recurrent Neural Network (RNN) and Support Vector Machine (SVM).

Experimental Setup for Investigating the Efficient Load Balancing Algorithms on Virtual Cloud

Cloud computing has emerged as the primary choice for developers in developing applications that require high-performance computing. Virtualization technology has helped in the distribution of resources to multiple users. Increased use of cloud infrastructure has led to the challenge of developing a load balancing mechanism to provide optimized use of resources and better performance. Round robin and least connections load balancing algorithms have been developed to allocate user requests across a cluster of servers in the cloud in a time-bound manner. In this paper, we have applied the round robin and least connections approach of load balancing to HAProxy, virtual machine clusters and web servers. The experimental results are visualized and summarized using Apache Jmeter and a further comparative study of round robin and least connections is also depicted. Experimental setup and results show that the round robin algorithm performs better as compared to the least connections algorithm in all measuring parameters of load balancer in this paper.

Application of blockchain technology in food safety control：current trends and future prospects

Blockchain technology is a distributed ledger technology and is expected to face some difficulties and challenges in various industries due to its transparency, decentralization, tamper-proof nature, and encryption security. Food safety has been paid increasing attention in recent years with economic development. Based on a systematic literature critical analysis, the causes of food safety problems and the state-of-the-art blockchain technology overview, including the definition of blockchain, development history, classification, structure, characteristics, and main applications, the feasibility and application prospects of blockchain technology in plant food safety, animal food safety, and processed food safety were proposed in this review. Finally, the challenges of the blockchain technology itself and the difficulties in the application of food safety were analyzed. This study contributes to the extant literature in the field of food safety by discovering the excellent potential of blockchain technology and its implications for food safety control. Our results indicated that blockchain is a promising technology toward a food safety control, with many ongoing initiatives in food products, but many food-related issues, barriers, and challenges still exist. Nevertheless, it is expected to provide a feasible solution for controlling food safety risks.

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 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.

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.

IoT based Clinical Sensor Data Management and Transfer using Blockchain Technology

There has been revolutionary developments in the healthcare industry with the advancement of technology over the past years. Internet of Things, Cloud Computing, Blockchain technology, lab-on-chip, non-invasive and minimally invasive surgeries and so on has simplified several dreadful diseases. The research as well as healthcare industry have been greatly impacted by these new technologies. Clinical exams and self-health tracking can be done by means of miniaturized healthcare sensors that are powered by IoT. They help in early diagnosis and treatment guidance by clinicians at remote locations without directly being in contact with the users. The access control structures and inconsistent security policies have been a hinderance in meeting the security requirements of these data. Blockchain based smart contracts and enterprise-distributed ledger framework can be used for monitoring the vital signs of the patient. This enables accessing medical information of patients globally at any time along with immutable and extensive history log. In comparison with the traditional patient monitoring system, the proposed system offers better monitoring, improved connectivity and enhanced data security.

Blockchain in Healthcare

Blockchain, an immutable ledger or database shared by peers in a network, is comprised of records of events or transactions that are appended chronologically. Introduced via Bitcoin to the world, blockchain is increasingly being accepted and adopted in different industries and for diverse use cases. Among key industries, health care offers several significant opportunities for applying blockchain conceptualization. Chief areas for health care blockchain applications include electronic medical records management, pharmaceutical supply chain management, biomedical research and education, remote patient monitoring, health insurance claim processing, and health data analytics. Even so, applying blockchain concepts in health care is not without challenges, including interoperability, security-privacy, scalability-speed, and stakeholders' engagement issues. While these challenges may militate against blockchain applications in health care, there are possible countermeasures and implementation techniques, which if adhered to, can reasonably contain many aspects of such challenges.

Design of Secure Protocol for Cloud-Assisted Electronic Health Record System Using Blockchain

In the traditional electronic health record (EHR) management system, each medical service center manages their own health records, respectively, which are difficult to share on the different medical platforms. Recently, blockchain technology is one of the popular alternatives to enable medical service centers based on different platforms to share EHRs. However, it is hard to store whole EHR data in blockchain because of the size and the price of blockchain. To resolve this problem, cloud computing is considered as a promising solution. Cloud computing offers advantageous properties such as storage availability and scalability. Unfortunately, the EHR system with cloud computing can be vulnerable to various attacks because the sensitive data is sent over a public channel. We propose the secure protocol for cloud-assisted EHR system using blockchain. In the proposed scheme, blockchain technology is used to provide data integrity and access control using log transactions and the cloud server stores and manages the patient’s EHRs to provide secure storage resources. We use an elliptic curve cryptosystems (ECC) to provide secure health data sharing with cloud computing. We demonstrate that the proposed EHR system can prevent various attacks by using informal security analysis and automated validation of internet security protocols and applications (AVISPA) simulation. Furthermore, we prove that the proposed EHR system provides secure mutual authentication using BAN logic analysis. We then compare the computation overhead, communication overhead, and security properties with existing schemes. Consequently, the proposed EHR system is suitable for the practical healthcare system considering security and efficiency.

Merging RFID and Blockchain Technologies to Accelerate Big Data Medical Research Based on Physiological Signals

The proliferation of physiological signals acquisition and monitoring system, has led to an explosion in physiological signals data. Additionally, RFID systems, blockchain technologies, and the fog computing mechanisms have significantly increased the availability of physiological signal information through big data research. The driver for the development of hybrid systems is the continuing effort in making health-care services more efficient and sustainable. Implantable medical devices (IMD) are therapeutic devices that are surgically implanted into patients' body to continuously monitor their physiological parameters. Patients treat cardiac arrhythmia due to IMD therapeutic and life-saving benefits. We focus on hybrid systems developed for patient physiological signals for collection, storage protection, and monitoring in critical care and clinical practice. In order to provide medical data privacy protection and medical decision support, the hybrid systems are presented, and RFID, blockchain, and big data technologies are used to analyse physiological signals.

Engineering Approaches for Addressing Opioid Use Disorder in the Community

Many communities in the United States are struggling to deal with the negative consequences of illicit opioid use. Effectively addressing this epidemic requires the coordination and support of community stakeholders in a change process with common goals and objectives, continuous engagement with individuals with opioid use disorder (OUD) through their treatment and recovery journeys, application of systems engineering principles to drive process change and sustain it, and use of a formal evaluation process to support a learning community that continuously adapts. This review presents strategies to improve OUD treatment and recovery with a focus on engineering approaches grounded in systems thinking.

Fair compute loads enabled by blockchain: sharing models by alternating client and server roles

Objective

Decentralized privacy-preserving predictive modeling enables multiple institutions to learn a more generalizable model on healthcare or genomic data by sharing the partially trained models instead of patient-level data, while avoiding risks such as single point of control. State-of-the-art blockchain-based methods remove the “server” role but can be less accurate than models that rely on a server. Therefore, we aim at developing a general model sharing framework to preserve predictive correctness, mitigate the risks of a centralized architecture, and compute the models in a fair way

Materials and Methods

We propose a framework that includes both server and “client” roles to preserve correctness. We adopt a blockchain network to obtain the benefits of decentralization, by alternating the roles for each site to ensure computational fairness. Also, we developed GloreChain (Grid Binary LOgistic REgression on Permissioned BlockChain) as a concrete example, and compared it to a centralized algorithm on 3 healthcare or genomic datasets to evaluate predictive correctness, number of learning iterations and execution time

Results

GloreChain performs exactly the same as the centralized method in terms of correctness and number of iterations. It inherits the advantages of blockchain, at the cost of increased time to reach a consensus model

Discussion

Our framework is general or flexible and can also address intrinsic challenges of blockchain networks. Further investigations will focus on higher-dimensional datasets, additional use cases, privacy-preserving quality concerns, and ethical, legal, and social implications

Conclusions

Our framework provides a promising potential for institutions to learn a predictive model based on healthcare or genomic data in a privacy-preserving and decentralized way.

A Systematic Review for Enabling of Develop a Blockchain Technology in Healthcare Application: Taxonomy, Substantially Analysis, Motivations, Challenges, Recommendations and Future Direction

Blockchain in healthcare applications requires robust security and privacy mechanism for high-level authentication, interoperability and medical records sharing to comply with the strict legal requirements of the Health Insurance Portability and Accountability Act of 1996. Blockchain technology in the healthcare industry has received considerable research attention in recent years. This study conducts a review to substantially analyse and map the research landscape of current technologies, mainly the use of blockchain in healthcare applications, into a coherent taxonomy. The present study systematically searches all relevant research articles on blockchain in healthcare applications in three accessible databases, namely, ScienceDirect, IEEE and Web of Science, by using the defined keywords 'blockchain', 'healthcare' and 'electronic health records' and their variations. The final set of collected articles related to the use of blockchain in healthcare application is divided into three categories. The first category includes articles (i.e. 43/58 scientific articles) that attempted to develop and design healthcare applications integrating blockchain, particularly those on new architecture, system designs, framework, scheme, model, platform, approach, protocol and algorithm. The second category includes studies (i.e., 6/58 scientific articles) that attempted to evaluate and analyse the adoption of blockchain in the healthcare system. Finally, the third category comprises review and survey articles (i.e., 6/58 scientific articles) related to the integration of blockchain into healthcare applications. The final articles for review are discussed on the basis of five aspects: (1) year of publication, (2) nationality of authors, (3) publishing house or journal, (4) purpose of using blockchain in health applications and the corresponding contributions and ⁽⁵⁾ problem types and proposed solutions. Additionally, this study provides identified motivations, open challenges and recommendations on the use of blockchain in healthcare applications. The current research contributes to the literature by providing a detailed review of feasible alternatives and identifying the research gaps. Accordingly, researchers and developers are provided with appealing opportunities to further develop decentralised healthcare applications through a comprehensive discussion of about the importance of blockchain and its integration into various healthcare applications.

Secure and Scalable mHealth Data Management Using Blockchain Combined With Client Hashchain: System Design and Validation

Background

Blockchain is emerging as an innovative technology for secure data management in many areas, including medical practice. A distributed blockchain network is tolerant against network fault, and the registered data are resistant to tampering and revision. The technology has a high affinity with digital medicine like mobile health (mHealth) and provides reliability to the medical data without labor-intensive third-party contributions. On the other hand, the reliability of the medical data is not insured before registration to the blockchain network. Furthermore, there are issues with regard to how the clients' mobile devices should be dealt with and authenticated in the blockchain network in order to avoid impersonation.

Objective

The aim of the study was to design and validate an mHealth system that enables the compatibility of the security and scalability of the medical data using blockchain technology.

Methods

We designed an mHealth system that sends medical data to the blockchain network via relay servers. The architecture provides scalability and convenience of operation of the system. In order to ensure the reliability of the data from clients' mobile devices, hash values with chain structure (client hashchain) were calculated in the clients' devices and the results were registered on the blockchain network.

Results

The system was applied and deployed in mHealth for insomnia treatment. Clinical trials for mHealth were conducted with insomnia patients. Medical data of the recruited patients were successfully registered with the blockchain network via relay servers along with the hashchain calculated on the clients' mobile devices. The correctness of the data was validated by identifying illegal data, which were made by simulating fraudulent access.

Conclusions

Our proposed mHealth system, blockchain combined with client hashchain, ensures compatibility of security and scalability in the data management of mHealth medical practice.

Trial Registration

UMIN Clinical Trials Registry UMIN000032951; https://upload.umin.ac.jp/cgi-open- bin/ctr_e/ctr_view.cgi?recptno=R000037564 (Archived by WebCite at http://www.webcitation.org/78HP5iFIw)

Blockchain Technology in Healthcare: A Comprehensive Review and Directions for Future Research

One of the most important discoveries and creative developments that is playing a vital role in the professional world today is blockchain technology. Blockchain technology moves in the direction of persistent revolution and change. It is a chain of blocks that covers information and maintains trust between individuals no matter how far they are. In the last couple of years, the upsurge in blockchain technology has obliged scholars and specialists to scrutinize new ways to apply blockchain technology with a wide range of domains. The dramatic increase in blockchain technology has provided many new application opportunities, including healthcare applications. This survey provides a comprehensive review of emerging blockchain-based healthcare technologies and related applications. In this inquiry, we call attention to the open research matters in this fast-growing field, explaining them in some details. We also show the potential of blockchain technology in revolutionizing healthcare industry.

Blockchain Technology in Healthcare: A Systematic Review

Since blockchain was introduced through Bitcoin, research has been ongoing to extend its applications to non-financial use cases. Healthcare is one industry in which blockchain is expected to have significant impacts. Research in this area is relatively new but growing rapidly; so, health informatics researchers and practitioners are always struggling to keep pace with research progress in this area. This paper reports on a systematic review of the ongoing research in the application of blockchain technology in healthcare. The research methodology is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and a systematic mapping study process, in which a well-designed search protocol is used to search four scientific databases, to identify, extract and analyze all relevant publications. The review shows that a number of studies have proposed different use cases for the application of blockchain in healthcare; however, there is a lack of adequate prototype implementations and studies to characterize the effectiveness of these proposed use cases. The review further highlights the state-of-the-art in the development of blockchain applications for healthcare, their limitations and the areas for future research. To this end, therefore, there is still the need for more research to better understand, characterize and evaluate the utility of blockchain in healthcare.

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.

Proposing New Blockchain Challenges in eHealth

The blockchain technology has reached a great boom in the health sector, due to its importance to overcome interoperability and security challenges of the EHR and EMR systems in eHealth. The main objective of this work is to show a review of the existing research works in the literature, referring to the new blockchain technology applied in ehealth and exposing the possible research lines and trends in which this technology can be focused. The search for blockchain studies in eHealth field was carried out in the following databases: IEEE Xplore, Google Scholar, Science Direct, PubMed, Web of Science and ResearchGate from 2010 to the present. Different search criteria were established such as: "Blockchain" AND ("eHealth" OR "EHR" OR "electronic health records" OR "medicine") selecting the papers considered of most interest. A total of 84 publications on blockchain in eHealth were found, of which 18 have been identified as relevant works, 5.56% correspond to the year 2016, 22.22% to 2017 and 72.22% to 2018. Many of the publications found show how this technology is being developed and applied in the health sector and the benefits it provides. The new blockchain technology applied in eHealth identifies new ways to share the distributed view of health data and promotes the advancement of precision medicine, improving health and preventing diseases.