Opportunities for Use of Blockchain Technology in Medicine

Healthcare 5.0: A secure and distributed network for system informatics in medical surgery

INTRODUCTION

Health records serve not only as a database of a patient's health history and treatment process but also as a crucial tool for doctors to diagnose and treat patients. However, the storage and sharing of these records are sensitive issues as they involve maintaining patient privacy and ensuring data transparency, security, and interoperability between different parties. Challenges to achieving these goals in the current surgical process can impact the allocation of medical resources and surgical outcomes.

METHODS

This article proposes a healthcare 5.0 framework for medical surgery that deploys a secure and distributed network using Blockchain to demonstrate transactions between different parties in the orthopedic surgery process. The proposed network uses the Hyperledger Composer platform for deployment, and a patient-doctor-supplier orthopedic surgery network is designed and implemented to enable the safe sharing of medical records.

RESULTS

A benchmarking tool was implemented for analyzing different scenarios of applying blockchain technology to orthopedic surgery. The application of blockchain technology to orthopedic surgery presents a promising solution for data sharing and supply chain management in the field. The integration of blockchain with cloud storage and hybrid encryption ensures secure and efficient storage of Electronic Health Record (EHR) and Personal Health Record (PHR) data. By leveraging the tamper-proof nature of blockchain and addressing concerns regarding centralized data storage, this scenario demonstrates enhanced security, improved access efficiency, and privacy protection in medical data sharing.

CONCLUSIONS

The article demonstrates the feasibility of using an IoT-based blockchain network in orthopedic surgery, which can reduce medical errors and improve data interoperability among different parties. This unique application of blockchain enables secure sharing of medical records, ensuring transparency, security, and interoperability. The network design may also be applicable to other surgeries and medical applications in the future.

Blockchain: What is the use case for physicians in 2024? A rapid review of the literature

Blockchain is topical in many areas of science. The impact on clinical care of physicians is not known. We undertook a rapid review of the literature to identify areas of interest for clinicians in active practice focusing on evidence relevant to clinical care. We found limited evidence for use blockchain in clinical practice with most studies focusing on technical aspects of prototypes and implementation with no evidence of standardised metric to measure impact for patients, clinicians, and organisations. Personal Health Records for use across organisational and geographic boundaries emerged as the strongest clinical use-case. Defined metrics by professional bodies might aid research, development, and future impact.

Blockchain technology in Cardiovascular Medicine: a glance to the future? Results from a social media survey and future perspectives

The leverage of digital facilities in medicine for disease diagnosis, monitoring, and medical history recording has become increasingly pivotal. However, the advancement of these technologies poses a significant challenge regarding data privacy, given the highly sensitive nature of medical information. In this context, the application of Blockchain technology, a digital system where information is stored in blocks and each block is linked to the one before, has the potential to enhance existing technologies through its exceptional security and transparency. This paradigm is of particular importance in cardiovascular medicine, where the prevalence of chronic conditions leads to the need for secure remote monitoring, secure data storage and secure medical history updating. Indeed, digital support for chronic cardiovascular pathologies is getting more and more crucial. This paper lays its rationale in three primary aims: 1) to scrutinize the existing literature for tangible applications of blockchain technology in the field of cardiology; 2) to report results from a survey aimed at gauging the reception of blockchain technology within the cardiovascular community, conducted on social media; 3) to conceptualize a web application tailored specifically to cardiovascular care based on blockchain technology. We believe that Blockchain technology may contribute to a breakthrough in healthcare digitalization, especially in the field of cardiology; in this context, we hope that the present work may be inspiring for physicians and healthcare stakeholders.

TrackChain: Hyperledger based pharmaceutical supply chain - Resource utilization perspective

A distributed and decentralised ledger system shared by a variety of users in a peer-to-peer network is defined as a blockchain. Through its decentralised approach, it makes pharmaceutical products more accessible and secure for vendors, while they can maintain and access their inventories themselves. Between a company and its suppliers, a supply chain is used to produce and distribute a specific product or service, whose efficiency is increased with its integration in the supply chain. For efficient and transparent tracking of products, blockchain will be the right choice. In view of blockchain being incorporated into the supply chain system, it solves many logistical issues that supply chains face, such as appropriate data access, ensuring data quality, and many more. This can increase the traceability of the material supply chain and improve the maintenance of the list when there are several products to be supplied. Therefore, the concept of supply chain was developed in two platforms namely, Hyperledger Fabric and Hyperledger Sawtooth. Finally, Hyperledger Sawtooth was found to be well suited for creating decentralised apps or platforms with respect to resource utilization It enables developers to separate their application domain from the core system so that business rules for apps can exist without requiring knowledge of the primary platform's underlying architecture. The proposed system shows that Hyperledger Sawtooth framework consumes lower CPU than Fabric which helps in increasing the number of transactions.

"Blockchain technology in food safety and traceability concern to livestock products"

Livestock products share more than fifteen percent of total agri-foods traded worldwide. A global increase in food demand has increased the risk to food safety. Improvements in food quality, cold chain transit, and preservation are required for safe livestock products. Though, the food safety and regulation authorities demand complete food traceability from farm to fork, but in traditional supply chain it is ignored by fiddling with the transit paperwork and bill invoices. The process of supply chain reformation and activities linked to food recalls during food safety issues are insanely expensive and challenging. Traceability-driven food supply chain management is likely to implement novel technologies like the Internet of Things (IoT). The capability of the Blockchain era within the food sector is emerging with use cases across different regions, as shown via the growing number of studies. Credibility, efficiency, and safety are all improved when food products can be instantly traced from their point of origin through all points of contact on their way to the consumer. Blockchain assures a tamper-proof and transparent system that allows an innovative business solution, together with smart contracts. However, there are significant difficulties with the implementation of blockchain technology for food traceability. It necessitates more and more training platforms as well as trainers, who can make understanding and operability of this technology easy among ground-level participants and food entities. For the tactical application of this technology, it is essential to comprehend the legal and regulatory framework.

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.

Blockchain and COVID-19 pandemic: applications and challenges

The year 2020 has witnessed the emergence of coronavirus (COVID-19) that has rapidly spread and adversely affected the global economy, health, and human lives. The COVID-19 pandemic has exposed the limitations of existing healthcare systems regarding their inadequacy to timely and efficiently handle public health emergencies. A large portion of today's healthcare systems are centralized and fall short in providing necessary information security and privacy, data immutability, transparency, and traceability features to detect fraud related to COVID-19 vaccination certification, and anti-body testing. Blockchain technology can assist in combating the COVID-19 pandemic by ensuring safe and reliable medical supplies, accurate identification of virus hot spots, and establishing data provenance to verify the genuineness of personal protective equipment. This paper discusses the potential blockchain applications for the COVID-19 pandemic. It presents the high-level design of three blockchain-based systems to enable governments and medical professionals to efficiently handle health emergencies caused by COVID-19. It discusses the important ongoing blockchain-based research projects, use cases, and case studies to demonstrate the adoption of blockchain technology for COVID-19. Finally, it identifies and discusses future research challenges, along with their key causes and guidelines.

Risk control drives risk assessment and risk review: A cause and effect model of pharmaceutical drug recall on patient safety

Background

Pharmaceutical drug recall is a relentless issue that is composed of multidimensional criteria. The distinct criteria that contributed to drug recalls have been identified in previous literature; however, there is limited information regarding the causal relationships between each criterion. Highlighting key influential aspects and criteria of pharmaceutical drug recall is critical in addressing this ongoing issue and promoting patient safety.

Objective

The objective of this study is as follows: (1) identify critical criteria of pharmaceutical drug recalls for improvements, (2) determine the interrelationships among the criteria, and (3) define the causal relationships of pharmaceutical drug recall and provide theoretical insights and practice recommendations to minimize risks associated with pharmaceutical recalls and maximize patient safety.

Design

This study proposes five aspects and 42 criteria to identify the impact of pharmaceutical drug recalls on patient safety by evaluating the interrelationships between the criteria by employing the fuzzy decision-making trial and evaluation laboratory method.

Methods

A group of 11 professionals across the pharmaceutical industry, hospitals, ambulatory care, regulatory authority, and community care settings were selected for interviews.

Results

Risk control is the influencing aspect of pharmaceutical drug recalls that has the most substantial impact on risk assessment and risk review; it generates medium effects on risk communication and technology. Risk assessment, risk communication, and risk review demonstrated comparative weak interrelationships, while risk communication exhibits a weak unidirectional effect on risk review. Finally, risk assessment exerts a weak influence on technology application and development. Product contamination, product subpotent or superpotent, injury to patients, product not sterile or impure, and system detectability of hazards have the strongest influence in the causal group of pharmaceutical drug recalls.

Conclusion

The study shows that risk control drives risk assessment and risk review in the pharmaceutical industry manufacturing process. To achieve patient safety, this study suggests focusing on risk control strategies, as this aspect displays the most substantial effect on influencing other critical risk management aspects such as risk assessment and risk review.

Priority evaluation factors for blockchain application services in public sectors

Blockchain is rapidly becoming established as the core technology of the Fourth Industrial Revolution. By combining blockchain to improve processes in existing industries, innovative new services will emerge, but services not effectively applied by blockchain will also develop. This study investigated the factors to be considered when applying the characteristics of blockchain technology to business. We developed a framework of blockchain service utility evaluation indexes using the analytic hierarchy process method. The Delphi method is used to identify highly effective blockchain application service cases by applying the evaluation framework to actual use cases in the public sector. By proposing a framework of utility evaluation factors for blockchain application services, this study provides a systematic foundation for blockchain business review. We address the question of "why blockchain should be applied to this service" by providing a more comprehensive approach than existing research, such as a fragmentary decision tree. Blockchains are expected to become more active along with the full-scale digital transformation of industries, and thus, we must examine the ways to broadly use blockchain as a base technology in a form applicable to the diverse industries and societies constituting the digital economy. Accordingly, this study presents an evaluation solution for promoting efficient policies and developing successful blockchain application services.

Future of industry 5.0 in society: human-centric solutions, challenges and prospective research areas

Industry 4.0 has been provided for the last 10 years to benefit the industry and the shortcomings; finally, the time for industry 5.0 has arrived. Smart factories are increasing the business productivity; therefore, industry 4.0 has limitations. In this paper, there is a discussion of the industry 5.0 opportunities as well as limitations and the future research prospects. Industry 5.0 is changing paradigm and brings the resolution since it will decrease emphasis on the technology and assume that the potential for progress is based on collaboration among the humans and machines. The industrial revolution is improving customer satisfaction by utilizing personalized products. In modern business with the paid technological developments, industry 5.0 is required for gaining competitive advantages as well as economic growth for the factory. The paper is aimed to analyze the potential applications of industry 5.0. At first, there is a discussion of the definitions of industry 5.0 and advanced technologies required in this industry revolution. There is also discussion of the applications enabled in industry 5.0 like healthcare, supply chain, production in manufacturing, cloud manufacturing, etc. The technologies discussed in this paper are big data analytics, Internet of Things, collaborative robots, Blockchain, digital twins and future 6G systems. The study also included difficulties and issues examined in this paper head to comprehend the issues caused by organizations among the robots and people in the assembly line.

Blockchain technology-based sustainable management research: the status quo and a general framework for future application

The problems of data leakage and unreliable information transfer in the management process make sustainability management an inevitable need for future development. Globally, there is increasing attention paid to blockchain technology and particularly its application in addressing sustainable management issues, both from academia and industry. Aiming to deepen the understanding of how blockchain technology could deal with sustainable management issues across different disciplines, this paper investigates the latest research on the application of blockchain technology in sustainable management published from 2017 to 2021. It is found that there is a drastic surge of publications in the recent 2 years. The analysis focuses on authors' origins, the collaboration network of the keywords, countries, and research topics covered. The application of blockchain technology in five key sectors of sustainable management, encompassing energy management, construction management, supply chain management, environmental management, and e-government management, is selected for further analysis detail. Also, a general framework for applying blockchain technology is proposed for broadening its use and dealing with sustainable management issues. The findings show that the identified 108 publications are distributed in 75 different journals, and scholars from China, the UK, and the USA have been working closely in BT-based sustainable management research. Blockchain technology is just emerging in sustainable management, and there is a great potential for applying blockchain technology to improve sustainable management performance and, more importantly, to provide solutions to quite a few long-lasting problems in these sectors. Opportunities for future research are also presented and discussed.

Blockchain Smart Contract to Prevent Forgery of Degree Certificates: Artificial Intelligence Consensus Algorithm

Certificates are often falsified, such as fake diplomas and forged transcripts. As such, many schools and educational institutions have begun to issue diplomas online. Although diplomas can be issued conveniently anytime, anywhere, there are many cases wherein diplomas are forged through hacking and forgery. This paper deals with the required Blockchain diploma. In addition, we use an automatic translation system, which incorporates natural language processing, to perform verification work that does not require an existing public certificate. The hash algorithm is used to authenticate security. This paper also proposes the use of these security protocols to provide more secure data protection. In addition, each transaction history, whether a diploma is true or not, may be different in length if it is presented in text, but converting it into a hash function means that it is always more than a certain length of SHA-512 or higher. It is then verified using the time stamp values. These chaining codes are designed. This paper also provides the necessary experimental environment. At least 10 nodes are constructed. Blockchain platform development applies and references Blockchain standardization, and a platform test, measurement test, and performance measurement test are conducted to assess the smart contract development and performance measurement. A total of 500 nodes were obtained by averaging 200 times, and a Blockchain-based diploma file was agreed upon at the same time. It shows performance information of about 4100 TPS. In addition, the analysis of artificial intelligence distribution diagram was conducted using a four-point method, and the distribution chart was evenly distributed, confirming the diploma with the highest similarity. The verified values were then analyzed. This paper proposes these natural language processing-based Blockchain algorithms.

A systematic review of digital technology and innovation and its potential to address anti-corruption, transparency, and accountability in the pharmaceutical supply chain

INTRODUCTION

The urgent need to acquire medical supplies amidst the COVID-19 pandemic has led to bypassing of controls that govern the global pharmaceutical supply chain, increasing the risk of corruption. Hence, promoting anti-corruption, transparency, and accountability (ACTA) in supply chain and procurement has never been more important. The adoption of digital tools, if designed and implemented appropriately, can reduce the risks of corruption.

AREAS COVERED

Following PRISMA guidelines, we conducted an interdisciplinary systematic review of health/medicine, humanities/social sciences, engineering, and computer science literature, with the aims of identifying technologies used for pharmaceutical supply chain and procurement optimization and reviewing whether they address ACTA mechanisms to strengthen pharmaceutical governance. Our review identified four distinct categories of digital solutions: e-procurement and open contracting; track-and-trace technology; anti-counterfeiting technology; and blockchain technology.

EXPERT OPINION

Findings demonstrate an increase in research of technologies to improve pharmaceutical supply chain and procurement functions; however, most technologies are not being leveraged to directly address ACTA or global health outcomes. Some blockchain and RFID technologies incorporated ACTA mechanisms and mentioned specific policy/governance frameworks, but more purposeful linkage is needed. Findings point to the need for targeted policy development and governance to activate these innovative technologies to improve global health .

Information and communications technology, health, and gender equality: Empirical evidence from a panel of Pacific developing economies

Information and communications technology (ICT) has been widely embraced in many developing economies in recent times. Extant research reveals that ICT increases economic growth. Beyond economic growth, improved access to information, markets and economic opportunities via information and communications technology have the potential to influence other dimensions of public welfare. This study quantitatively examines the effects of ICT on selected health and gender dimensions of Pacific Island developing countries’ populations. The results show a statistically significant and positive impact of ICT on health and gender outcomes. Our results are robust with an alternative modeling approach, different control variables, and different measures of health and gender outcomes. We further establish that the health outcome of technology has a valid pass-through of income. The study suggests policy implications for the Pacific and other developing countries striving to enhance the health and gender outcomes of SGDs.

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

Purpose

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

Design/methodology/approach

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

Findings

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

Originality/value

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

A Review of Blockchain Technology Applications in Ambient Assisted Living

The adoption of remote assisted care was accelerated by the COVID-19 pandemic. This type of system acquires data from various sensors, runs analytics to understand people’s activities, behavior, and living problems, and disseminates information with healthcare stakeholders to support timely follow-up and intervention. Blockchain technology may offer good technical solutions for tackling Internet of Things monitoring, data management, interventions, and privacy concerns in ambient assisted living applications. Even though the integration of blockchain technology with assisted care is still at the beginning, it has the potential to change the health and care processes through a secure transfer of patient data, better integration of care services, or by increasing coordination and awareness across the continuum of care. The motivation of this paper is to systematically review and organize these elements according to the main problems addressed. To the best of our knowledge, there are no studies conducted that address the solutions for integrating blockchain technology with ambient assisted living systems. To conduct the review, we have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology with clear criteria for including and excluding papers, allowing the reader to effortlessly gain insights into the current state-of-the-art research in the field. The results highlight the advantages and open issues that would require increased attention from the research community in the coming years. As for directions for further research, we have identified data sharing and integration of care paths with blockchain, storage, and transactional costs, personalization of data disclosure paths, interoperability with legacy care systems, legal issues, and digital rights management.

The Security of Student Information Management System Based upon Blockchain

In recent years, with the development of science and technology, as an emerging data security technology, blockchain has been widely used in all walks of life by virtue of its immutability, uniqueness, smart contract, and decentralized organization. Examples include industry, services, and education. With the progress of China's education, the application of blockchain technology in the field of education has also been further expanded. At present, the application of blockchain in China's education field is mainly concentrated in three areas: education resource management, teaching information management, and education basic platform construction. This article aims to study the security of the student information management system based on the blockchain. The security test experiment of the student information management system is carried out based on the encryption algorithm of the blockchain, and conclusions are drawn. The security of the student information management system based on the encryption algorithm of blockchain technology has increased by 87%, which also shows that the blockchain technology has a better effect on improving the security of the student information management system.

CertificateChain: decentralized healthcare training certificate management system using blockchain and smart contracts

Objective

Managing training certificates is an important issue in research that can lead to serious issues if not addressed properly. For institutions that currently do not have a dedicated management system for these training certificates, a central database is the most typical solution. However, such a system suffers from several risks, such as a single-point-of-failure.

Materials and Methods

To address this issue, we developed and evaluated CertificateChain, a decentralized training certificate management system by using peer-to-peer blockchain and automated smart contracts. We developed an efficient certificate dividing-and-merging algorithm to overcome the transaction size limit on blockchain.

Results

We performed experiments on the system to evaluate its performance, then created a web app and tested the system in a real-world scenario. CertificateChain scaled linearly in terms of time compared with the total number of certificates added and could be quickly queried for existing data stored on-chain.

Discussion

CertificateChain was able to store and retrieve the training certificates on the blockchain network, with limitations including a comparative analysis of other systems, evaluation of different consensus protocols, examining certificates off-chain, a thorough comparison with a centralized system, and the extension to the main public Ethereum network.

Conclusion

We believe that these results indicate that blockchain technology could be a viable decentralized alternative to traditional databases in this use case. Our software is publicly available at: https://doi.org/10.5281/zenodo.6257094.

In many research scenarios, certifications are required for data access requests. Institutions must manage the relevant certificates to avoid potentially serious scenarios that could impede research. Most existing systems suffer from risks such as single-point-of-failure, a scenario in which an entire system can be rendered ineffective with the failure of only one node in the network. To solve this problem, we developed CertificateChain, a decentralized certificate management system that adopted blockchain and smart contract (programs running on blockchain) technology and stores the certificates on-chain. To evaluate the system’s performance, we performed experiments on it by storing Collaborative Institutional Training Initiative (CITI) certificate files to test its scalability and speed, as well as real-world testing using an accompanying web app. We found that in terms of time, the system scaled linearly, and could quickly be searched for any existing certificates. The limitations include the evaluation of other blockchain consensus protocols, verification of certificate authenticity before and after uploading, the scalability of upload file size, as well as an in-depth comparison to existing centralized systems. After developing and evaluating the system, we believe that CertificateChain shows potential to be a viable decentralized alternative for existing centralized systems.

PRISED tangle: a privacy-aware framework for smart healthcare data sharing using IOTA tangle

Healthcare has evolved significantly in recent years primarily due to the advancements in and increasing adoption of technology in healthcare processes such as data collection, storage, diagnostics, and treatment. The emergence of the industrial internet of things (IIoT) has further evolved e-Health by facilitating the development of connected healthcare systems which can significantly improve data connectivity, visibility, and interoperability leading to improved quality of service delivered to patients. However, such technological advancements come with their perils—there are growing concerns with regards to the security and privacy of healthcare data especially when collected, shared, and processed using cutting-edge connected sensor devices affecting the adoption of next-generation e-healthcare systems. In particular, during the front-end and back-end data transfer in health information exchange (HIE) there exist a security risk in term of confidentiality, integrity, authentication and access control of the data due to the limited capabilities of IoT devices involved. In this paper, we investigate the use of distributed ledger technologies (DLT) to address such security concerns for emerging healthcare systems. In particular, we use masked authenticated messaging (MAM) over the Tangle to achieve secure data sharing within a healthcare system and provide a proof-of-concept of applying the proposed approach for securing healthcare data in a connected IIoT environment. Further, we have performed the evaluation and analysis of data communication against the metrics of encryption and efficiency in transaction time.

Model to Program and Blockchain Approaches for Business Processes and Workflows in Finance

Business process modeling and verification have become an essential way to control and assure organizational evolution. We overview the opportunities for the application of blockchain in Business Process Management and Modeling in Finance and we focus on in-depth analysis of claim process in insurance as a use case. We investigate the utilization of blockchain technology for model checking of Workflow, Business Processes to ensure consistency, integrity, and security in a dynamically changing business environment. We create a UML profile for the blockchain, then we combine it with a UML activity diagram followed by a verification using Petri nets to guarantee a distributed computing system and scalable with mutable data. Our paper creates a unified picture of the approaches towards business processes modeling used in the financial industry organized around the set of premises intending to develop a future research agenda for blockchain business process modeling, specifically for the financial industry domain.

Intelligent Information Network Security Management Strategy for Service Innovation of Manufacturing Enterprises Under Blockchain

Since the beginning of the new century, all manufacturing enterprises have been seeking ways to transform and upgrade the systems to maintain their competitive advantages. In the process of transformation and upgrading, service innovation has become more vital. In the service innovation mode, customers and suppliers are mainly involved in the manufacture of products. In the process of communication, these suppliers and customers need to rely on public key infrastructure (PKI) for data encryption and identity authentication operations, thereby achieving reliable information exchange and identity authentication in an untrusted environment. Therefore, ensuring the security of network communication for various types of users is crucial. The purpose of this paper is to solve the problem that results when a tampered certificate is difficult to trace due to the single point of failure and vulnerability of the current settlement and authentication system. In this scenario, the user's identity information is leaked in the certificate application. Resolving this problem is necessary to ensure the security of the information network.

Legal and Regulatory Framework for AI Solutions in Healthcare in EU, US, China, and Russia: New Scenarios after a Pandemic

The COVID-19 crisis has exposed some of the most pressing challenges affecting healthcare and highlighted the benefits that robust integration of digital and AI technologies in the healthcare setting may bring. Although medical solutions based on AI are growing rapidly, regulatory issues and policy initiatives including ownership and control of data, data sharing, privacy protection, telemedicine, and accountability need to be carefully and continually addressed as AI research requires robust and ethical guidelines, demanding an update of the legal and regulatory framework all over the world. Several recently proposed regulatory frameworks provide a solid foundation but do not address a number of issues that may prevent algorithms from being fully trusted. A global effort is needed for an open, mature conversation about the best possible way to guard against and mitigate possible harms to realize the potential of AI across health systems in a respectful and ethical way. This conversation must include national and international policymakers, physicians, digital health and machine learning leaders from industry and academia. If this is done properly and in a timely fashion, the potential of AI in healthcare will be realized.

Threats to Global Mental Health From Unregulated Digital Phenotyping and Neuromarketing: Recommendations for COVID-19 Era and Beyond

The new era of digitalized knowledge and information technology (IT) has improved efficiency in all medical fields, and digital health solutions are becoming the norm. There has also been an upsurge in utilizing digital solutions during the COVID-19 pandemic to address the unmet mental healthcare needs, especially for those unable to afford in-person office-based therapy sessions or those living in remote rural areas with limited access to mental healthcare providers. Despite these benefits, there are significant concerns regarding the widespread use of such technologies in the healthcare system. A few of those concerns are a potential breach in the patients' privacy, confidentiality, and the agency of patients being at risk of getting used for marketing or data harnessing purposes. Digital phenotyping aims to detect and categorize an individual's behavior, activities, interests, and psychological features to properly customize future communications or mental care for that individual. Neuromarketing seeks to investigate an individual's neuronal response(s) (cortical and subcortical autonomic) characteristics and uses this data to direct the person into purchasing merchandise of interest, or shaping individual's opinion in consumer, social or political decision making, etc. This commentary's primary concern is the intersection of these two concepts that would be an inevitable threat, more so, in the post-COVID era when disparities would be exaggerated globally. We also addressed the potential "dark web" applications in this intersection, worsening the crisis. We intend to raise attention toward this new threat, as the impacts might be more damming in low-income settings or/with vulnerable populations. Legal, health ethics, and government regulatory processes looking at broader impacts of digital marketing need to be in place.

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.

Steganographic Analysis of Blockchains

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

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.

Blockchain research in healthcare: a bibliometric review and current research trends

The literature on blockchain-enabled use cases has grown exponentially over recent years. Yet, studies are missing that apply bibliometrics and visualization techniques to unravel the dynamics and current discussions pertaining to the nexus of blockchain technology (BCT) and the healthcare field. To close this knowledge gap, we examine the knowledge base and research hotspots of BCT research in the field of healthcare. We carry out a series of bibliometric analyses on the extant literature, including the scholarly production, developmental pattern of the annual total number of authors, and identification of productive academic institutions, countries, and leading authors. Additionally, we conduct a keyword co-occurrence analysis and identify the major research hotspots and trends for the future. The findings of this research are valuable for scholars and practitioners who seek to better understand the development status, dynamics, and trends pertaining to BCT in healthcare.

The role of blockchain technology in telehealth and telemedicine

OBJECTIVE

Telehealth and telemedicine systems aim to deliver remote healthcare services to mitigate the spread of COVID-9. Also, they can help to manage scarce healthcare resources to control the massive burden of COVID-19 patients in hospitals. However, a large portion of today's telehealth and telemedicine systems are centralized and fall short of providing necessary information security and privacy, operational transparency, health records immutability, and traceability to detect frauds related to patients' insurance claims and physician credentials.

METHODS

The current study has explored the potential opportunities and adaptability challenges for blockchain technology in telehealth and telemedicine sector. It has explored the key role that blockchain technology can play to provide necessary information security and privacy, operational transparency, health records immutability, and traceability to detect frauds related to patients' insurance claims and physician credentials.

RESULTS

Blockchain technology can improve telehealth and telemedicine services by offering remote healthcare services in a manner that is decentralized, tamper-proof, transparent, traceable, reliable, trustful, and secure. It enables health professionals to accurately identify frauds related to physician educational credentials and medical testing kits commonly used for home-based diagnosis.

CONCLUSIONS

Wide deployment of blockchain in telehealth and telemedicine technology is still in its infancy. Several challenges and research problems need to be resolved to enable the widespread adoption of blockchain technology in telehealth and telemedicine systems.

An Overview of Existing Publications and Most Relevant Projects/Platforms on the Use of Blockchain in Medicine and Neurology

Background

Blockchain is a new methodology involving a data structure with list of records, called blocks, which are linked using cryptography. The aim of the review is to overview the existing publication, projects, and platforms on the use of blockchain in Medicine and Neurology.

Methods

We searched the bibliographic database of MEDLINE and BASE. We also accessed ICObench, Coinmarketcap, and Mobihealthnews databases to explore upcoming, ongoing, and ended projects.

Results

In medicine, there are many projects related to health care, disease prevention, and promotion of healthy life style. In neurology, only one project looks promising: Neuro, an ongoing scientific-technical project uniting scientists, engineers, and programmers for development of new architectures and algorithms of neural networks. Bibliographic searches found 117 publications on Medline and 203 publications on BASE referring to the use of blockchain technology in medicine. Most of them are presented as reviews (narrative, systematic, or minireview), opinions and hypotheses, commentaries, or perspectives. As for Neurology, only one publication refers to the use of blockchain, specifically to Parkinson’s disease.

Discussion

Among the problems related to medicine, there is the lack of information on the patient’s clinical history that could allow accurate diagnosis and treatment. The possibility of having a register based on blockchain technology could help doctors in many ways, including patient management, choosing and monitoring treatments, and standardization of clinical trials.

Conclusion

The use of the blockchain technology in medicine has been repetitively proposed to solve different problems. In this article, we highlight the possible benefits of this technology, with attention to Neurology. Blockchain use can lead to quantifiable benefits in the treatment of neurodegenerative diseases, especially in clinical trials that can fail because of an incorrect patient recruitment.

Blockchain technology in financial services: a comprehensive review of the literature

Purpose

The purpose of this study is to thoroughly review studies that have used blockchain technology in financial services. This study will help provide a holistic framework that would highlight the current state and challenges of the blockchain in the financial services sector.

Design/methodology/approach

The objective of this study is to systematically examine and organize the current body of research literature that either quantitatively or qualitatively explored the use of blockchain technology in financial services. The study uses PRISMA-guided systematic review along with bibliometric analysis to achieve the purpose.

Findings

This study contributes to the existing literature by exploring and analyzing systematic studies available on blockchain with special reference to financial services sector. With blockchain based on five principles, namely, computational logic, peer-to-peer transmission, irreversibility of records, distributed database and transparency with pseudonym has immense potential to unleash and transform the financial service industry. With increasing blockchain-based operations of decentralized banking, insurance, trade finance, financial markets and cryptocurrency market, the subject is rapidly growing and seeking considerable contribution from scholars from around the world.

Research limitations/implications

This study uses systematic literature review approach, which has its own demerits. Like other studies based on Systematic Literature Review, this study also suffers from a certain bias such as sample selection bias, publication bias, data interpretation and the combination of quantitative and qualitative studies in the population. Further, the adoption and resultant benefits of blockchain have not been empirically tested.

Practical implications

This study can help policymakers and institutions in determining their future course of action, as it highlights the state of research in the area of blockchain technology and financial services.

Originality/value

Very few studies have done a comprehensive review of literature on blockchain in financial services.

Transformative dynamism in pharmaceutical and biomedical research: Complexity of integration of innovative R & D hubs

Introduction: To be fully functional, pharmaceutical, and biomedical research centers need to be transformed to become innovative research and development (R & D) hubs. Such transformation, however, is a dynamic complex matter.

Methods: To establish an innovative R & D hub, a simple and concise manifesto is conceptualized for the nonlinear dynamic transformation towards an innovative research hub to reinforce the transition of the 2nd generation R & D centers.

Results: Interdisciplinary research is the most demanded field of research to overcome various multi-sided health issues. To become an innovative R & D hub, pharmaceutical centers must function as a small-scale physical infrastructure to support the inter-communication of scientists and provide specific technological needs to promote the related innovation and entrepreneurship with advanced business plans and prototypes. Given that a success paradigm within an unorderly surrounding setting has already been condemned to fail, the orderly integration of nested systems and groups should be carefully implemented towards a shared vision with formal and tacit agreements among all parties, including academia, industry, and finance team.

Conclusion: To achieve a fully functional innovative R & D hub, a "know-how" approach with the systems thinking mindset within all the parties is of paramount necessity. The healthier the order of the whole working system is, the more effective will be the encompassed entitles and players. However, systems should have several checkpoints to enhance clarity and evade discrepancy and divergence. Since the medication is a highly trusted and needed public enterprise, the drug discovery and development paradigm should be practiced at the highest speed with maximum transparency and accountability.

Research on the Application of Blockchain in Smart Healthcare: Constructing a Hierarchical Framework

This study aims to explore the application of blockchain technology in smart healthcare, establish a hierarchical theoretical framework of smart healthcare, reveal the impact of blockchain on smart healthcare, and finally, construct a development application system of smart healthcare under the blockchain based on stakeholder theory. However, such a hierarchical theoretical framework should consider not only the necessary attributes and the interrelationship among various aspects and attributes but also the role of multiple stakeholders. Therefore, the paper uses fuzzy set theory to filter unnecessary attributes, proposes a decision-making and experimental evaluation laboratory (DEMATEL) to manage the complex interrelationships between various aspects and attributes, and uses Interpretive Structure Modeling (ISM) to divide the hierarchy and construct a hierarchical theoretical framework. The results show that (1) the top-level design, the medical record management, and the doctor management are the root causes of system. (2) The specific application of blockchain in the field of smart healthcare is mainly carried out around the intelligent contract, which relies on the medical record management and is constrained by the system, and optimization of application is the key to system upgrading. (3) The internal and external regulation, the medical insurance, and the environmental governance play a guaranteed role for the development of the system and effectively safeguard the interests of stakeholders. (4) The application system of smart healthcare under the blockchain needs to be built based on three layers: the transaction layer, information layer, and stakeholder layer. The theoretical hierarchical framework is intended to guide smart healthcare towards blockchain applications, and stakeholders are suggested to participate in the development application systems.

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.

Blockchain-based health care monitoring for privacy preservation of COVID-19 medical records

The explosion and unpredictable global spread of COVID-19 has revealed the shortcomings of conventional health care systems in dealing with public health emergencies in a timely manner. The health care system enabled by the Internet of Things (IoT) is competent for tracking COVID-19 patients efficiently through an integrated network. The popular technologies in digital health care monitoring pose serious risks in terms of privacy and security issues such as data transfer and data transaction logging. Such medical data confidentiality and privacy issues could result in a delay in the advancement of treatment, thus endangering the patient's life. This chapter aims to assist infected people online by smart devices using IoT and Blockchain technologies. IoT-based health care smart devices gather valuable information and provide additional perceptions into symptoms and behaviors. Blockchain facilitates the secure exchange of information concerning patient health and it controls the medical delivery network. Blockchains are computationally expensive and require a high bandwidth with extra computing power, and therefore they are not completely suitable for most resource-constrained IoT devices intended for smart cities. Here, a customized blockchain model framework is proposed that is appropriate for the dispersed IoT devices, which are added with enhanced network confidentiality characteristics. Here, proxy reencryption and advanced cryptographic primitives are used to satisfy the additional privacy and security properties. This study provides a structure for COVID-19 infectious disease patients, and discusses electronic medical record issues and diagnostics. The work also highlights the data and transactions over a blockchain-based network that is more secure and anonymous. A widespread security analysis demonstrates that the model being introduced is certifiably successful for ensuring the privacy and resistance to intrusion. Finally, the performance assessment signifies that the projected model realizes superior overall efficiency as compared to other techniques.

Blockchain technologies to mitigate COVID-19 challenges: A scoping review

Background: As public health strategists and policymakers explore different approaches to lessen the devastating effects of novel coronavirus disease (COVID-19), blockchain technology has emerged as a resource that can be utilized in numerous ways. Many blockchain technologies have been proposed or implemented during the COVID-19 pandemic; however, to the best of our knowledge, no comprehensive reviews have been conducted to uncover and summarise the main feature of these technologies. Objective: This study aims to explore proposed or implemented blockchain technologies used to mitigate the COVID-19 challenges as reported in the literature. Methods: We conducted a scoping review in line with guidelines of PRISMA Extension for Scoping Reviews (PRISMA-ScR). To identify relevant studies, we searched 11 bibliographic databases (e.g., EMBASE and MEDLINE) and conducted backward and forward reference list checking of the included studies and relevant reviews. The study selection and data extraction were conducted by 2 reviewers independently. Data extracted from the included studies was narratively summarised and described. Results: 19 of 225 retrieved studies met eligibility criteria in this review. The included studies reported 10 used cases of blockchain to mitigate COVID-19 challenges; the most prominent use cases were contact tracing and immunity passports. While the blockchain technology was developed in 10 studies, its use was proposed in the remaining 9 studies. The public blockchain technology was the most commonly utilized type in the included studies. All together, 8 different consensus mechanisms were used in the included studies. Out of 10 studies that identified the used platform, 9 studies used Ethereum to run the blockchain. Solidity was the most prominent programming language used in developing blockchain technology in the included studies. The transaction cost was reported in only 4 of the included studies and varied between USD 10-10 and USD 5. The expected latency and expected scalability were not identified in the included studies. Conclusion: Blockchain technologies are expected to play an integral role in the fight against the COVID-19 pandemic. Many possible applications of blockchain were found in this review; however, most of them are not mature enough to reveal their expected impact in the fight against COVID-19. We encourage governments, health authorities, and policymakers to consider all blockchain applications suggested in the current review to combat COVID-19 challenges. There is a pressing need to empirically examine how effective blockchain technologies are in mitigating COVID-19 challenges. Further studies are required to assess the performance of blockchain technologies' fight against COVID-19 in terms of transaction cost, scalability, and/or latency when using different consensus algorithms, platforms, and access types.

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.

Understanding the Blockchain Oracle Problem: A Call for Action

Scarce and niche in the literature just a few years ago, the blockchain topic is now the main subject in conference papers and books. However, the hype generated by the technology and its potential implications for real-world applications is flawed by many misconceptions about how it works and how it is implemented, creating faulty thinking or overly optimistic expectations. Too often, characteristics such as immutability, transparency, and censorship resistance, which mainly belong to the bitcoin blockchain, are sought in regular blockchains, whose potential is barely comparable. Furthermore, critical aspects such as oracles and their role in smart contracts receive few literature contributions, leaving results and theoretical implications highly questionable. This literature review of the latest papers in the field aims to give clarity to the blockchain oracle problem by discussing its effects in some of the most promising real-world applications. The analysis supports the view that the more trusted a system is, the less the oracle problem impacts.

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.