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Pham A, Edelson M, Nouri A, Kuo TT. Distributed management of patient data-sharing informed consents for clinical research. Comput Biol Med 2024; 180:108956. [PMID: 39121682 DOI: 10.1016/j.compbiomed.2024.108956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 07/21/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND The consent protocol is now a critical part in the overall orchestration of clinical research. We aimed to demonstrate the feasibility of an Ethereum-based informed consent system, which includes an immutable and automated channel of consent matching, to simultaneously assure patient privacy and increase the efficiency of researchers' data access. METHOD We simulated a multi-site scenario, each assigned 10000 consent records. A consent record contained one patient's data-sharing preference with regards to seven data categories. We developed a blockchain-based infrastructure with a smart contract to record consents on-chain, and to query consenting patients corresponding to specific criteria. We measured our system's recording efficiency against a baseline design and verified accuracy by testing an exhaustive list of possible queries. RESULTS Our method achieved ∼3-4% lead with an average insertion speed of ∼2 s per record per node on either a 3-, 4- or 5-node network, and 100 % accuracy. It also outperformed other solutions in external validation. DISCUSSION The speed we achieved is reasonable in a real-world system under the realistic assumption that patients may not change their minds too frequently, with the added benefit of immutability. Furthermore, the per-insertion time did improve slightly as the number of network nodes increased, attesting to the benefit of node parallelism as it suggests no attrition of insertion efficiency due to scale of nodes. CONCLUSIONS Our work confirms the technical feasibility of a blockchain-based consent mechanism, assuring patients with an immutable audit trail, and providing researchers with an efficient way to reach their cohorts.
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Affiliation(s)
- Anh Pham
- UCSD Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| | - Maxim Edelson
- UCSD Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, USA
| | - Armin Nouri
- Department of Biomedical Engineering, Fu Foundation School of Engineering, Columbia University, New York, NY, USA
| | - Tsung-Ting Kuo
- UCSD Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA; Department of Biomedical Informatics and Data Science, School of Medicine, Yale University, New Haven, CT, USA; Department of Surgery, School of Medicine, Yale University, New Haven, CT, USA.
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2
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Ghadi YY, Mazhar T, Shahzad T, Amir Khan M, Abd-Alrazaq A, Ahmed A, Hamam H. The role of blockchain to secure internet of medical things. Sci Rep 2024; 14:18422. [PMID: 39117650 PMCID: PMC11310483 DOI: 10.1038/s41598-024-68529-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024] Open
Abstract
This study explores integrating blockchain technology into the Internet of Medical Things (IoMT) to address security and privacy challenges. Blockchain's transparency, confidentiality, and decentralization offer significant potential benefits in the healthcare domain. The research examines various blockchain components, layers, and protocols, highlighting their role in IoMT. It also explores IoMT applications, security challenges, and methods for integrating blockchain to enhance security. Blockchain integration can be vital in securing and managing this data while preserving patient privacy. It also opens up new possibilities in healthcare, medical research, and data management. The results provide a practical approach to handling a large amount of data from IoMT devices. This strategy makes effective use of data resource fragmentation and encryption techniques. It is essential to have well-defined standards and norms, especially in the healthcare sector, where upholding safety and protecting the confidentiality of information are critical. These results illustrate that it is essential to follow standards like HIPAA, and blockchain technology can help ensure these criteria are met. Furthermore, the study explores the potential benefits of blockchain technology for enhancing inter-system communication in the healthcare industry while maintaining patient privacy protection. The results highlight the effectiveness of blockchain's consistency and cryptographic techniques in combining identity management and healthcare data protection, protecting patient privacy and data integrity. Blockchain is an unchangeable distributed ledger system. In short, the paper provides important insights into how blockchain technology may transform the healthcare industry by effectively addressing significant challenges and generating legal, safe, and interoperable solutions. Researchers, doctors, and graduate students are the audience for our paper.
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Affiliation(s)
- Yazeed Yasin Ghadi
- Department of Computer Science and Software Engineering, Al Ain University, Abu Dhabi, 15322, UAE
| | - Tehseen Mazhar
- Department of Computer Science, Virtual University of Pakistan, Lahore, 55150, Pakistan.
| | - Tariq Shahzad
- Department of Computer Science, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, 57000, Pakistan
| | - Muhammad Amir Khan
- School of Computing Sciences, College of Computing, Informatics and Mathematics, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
| | - Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar.
| | - Habib Hamam
- Faculty of Engineering, Université de Moncton, Moncton, NB, E1A3E9, Canada
- School of Electrical Engineering, Department of Electrical and Electronic Engineering Science, University of Johannesburg, Johannesburg, 2006, South Africa
- Hodmas University College, Taleh Area, Mogadishu, Somalia
- Bridges for Academic Excellence, Tunis, Tunisia
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3
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Lopez-Barreiro J, Alvarez-Sabucedo L, Garcia-Soidan JL, Santos-Gago JM. Use of Blockchain Technology in the Domain of Physical Exercise, Physical Activity, Sport, and Active Ageing: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8129. [PMID: 35805788 PMCID: PMC9265962 DOI: 10.3390/ijerph19138129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 02/05/2023]
Abstract
Blockchain technology provides a distributed support for information storage and traceability. Recently, it has been booming in a wide variety of domains: finance, food, energy, and health. In the field of physical activity, physical exercise, sport, and active ageing, this technology could also originate some interesting services introducing support for reliable repository of results, for gamification, or for secure data interchange. This systematic review explores the use of blockchain in this context. The objective is to determine to which extent this technology has fulfilled the potential of blockchain to bring these new added-value services. The authors explored 5 repositories in search of papers describing solutions applied to the above-mentioned frame. 17 papers were selected for full-text analysis, and they displayed diverse applications of blockchain, such as Fitness and healthcare, Sport, and Active ageing. A detailed analysis shows that the solutions found do not leverage all the possibilities of blockchain technology. Most of the solutions analyzed use blockchain for managing, sharing, and controlling access to data and do not exploit the possibilities of Smart Contracts or oracles. Additionally, the advantages of the blockchain model have not been fully exploited to engage users using approaches such as gamification.
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Affiliation(s)
- Juan Lopez-Barreiro
- Faculty of Education and Sport Sciences, Campus A Xunqueira, s/n, University of Vigo, 36005 Pontevedra, Spain;
| | - Luis Alvarez-Sabucedo
- AtlanTTic, Campus Lagoas-Marcosende, University of Vigo, Maxwell, s/n, 36310 Vigo, Spain; (L.A.-S.); (J.M.S.-G.)
| | - Jose Luis Garcia-Soidan
- Faculty of Education and Sport Sciences, Campus A Xunqueira, s/n, University of Vigo, 36005 Pontevedra, Spain;
| | - Juan M. Santos-Gago
- AtlanTTic, Campus Lagoas-Marcosende, University of Vigo, Maxwell, s/n, 36310 Vigo, Spain; (L.A.-S.); (J.M.S.-G.)
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Abstract
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.
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5
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Paganelli AI, Velmovitsky PE, Miranda P, Branco A, Alencar P, Cowan D, Endler M, Morita PP. A conceptual IoT-based early-warning architecture for remote monitoring of COVID-19 patients in wards and at home. INTERNET OF THINGS (AMSTERDAM, NETHERLANDS) 2022; 18:100399. [PMID: 38620637 PMCID: PMC8023791 DOI: 10.1016/j.iot.2021.100399] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 05/31/2023]
Abstract
Due to the COVID-19 pandemic, health services around the globe are struggling. An effective system for monitoring patients can improve healthcare delivery by avoiding in-person contacts, enabling early-detection of severe cases, and remotely assessing patients' status. Internet of Things (IoT) technologies have been used for monitoring patients' health with wireless wearable sensors in different scenarios and medical conditions, such as noncommunicable and infectious diseases. Combining IoT-related technologies with early-warning scores (EWS) commonly utilized in infirmaries has the potential to enhance health services delivery significantly. Specifically, the NEWS-2 has been showing remarkable results in detecting the health deterioration of COVID-19 patients. Although the literature presents several approaches for remote monitoring, none of these studies proposes a customized, complete, and integrated architecture that uses an effective early-detection mechanism for COVID-19 and that is flexible enough to be used in hospital wards and at home. Therefore, this article's objective is to present a comprehensive IoT-based conceptual architecture that addresses the key requirements of scalability, interoperability, network dynamics, context discovery, reliability, and privacy in the context of remote health monitoring of COVID-19 patients in hospitals and at home. Since remote monitoring of patients at home (essential during a pandemic) can engender trust issues regarding secure and ethical data collection, a consent management module was incorporated into our architecture to provide transparency and ensure data privacy. Further, the article details mechanisms for supporting a configurable and adaptable scoring system embedded in wearable devices to increase usefulness and flexibility for health care professions working with EWS.
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Affiliation(s)
- Antonio Iyda Paganelli
- Informatics Departament, Pontifical Catholic University, Rua Marquês de São Vicente 225-Gávea, Rio de Janeiro 22541-041, Brazil
| | - Pedro Elkind Velmovitsky
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Pedro Miranda
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Adriano Branco
- Informatics Departament, Pontifical Catholic University, Rua Marquês de São Vicente 225-Gávea, Rio de Janeiro 22541-041, Brazil
| | - Paulo Alencar
- David R. Cheriton School of Computer Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Donald Cowan
- David R. Cheriton School of Computer Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Markus Endler
- Informatics Departament, Pontifical Catholic University, Rua Marquês de São Vicente 225-Gávea, Rio de Janeiro 22541-041, Brazil
| | - Plinio Pelegrini Morita
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
- Research Institute for Aging, University of Waterloo, 250 Laurelwood Drive, Waterloo, ON N2J 0E2, Canada
- Department of Systems Design Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
- eHealth Innovation, Techna Institute, University Health Network, R. Fraser Elliott Building, 4th Floor, 190 Elizabeth St, Toronto, ON M5G 2C4, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Health Sciences Building 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
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6
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Huh KY, Moon SJ, Jeong SU, Kim MJ, Yang W, Jeong M, Kim MG, Lee S. Evaluation of a blockchain-based dynamic consent platform (METORY) in a decentralized and multicenter clinical trial using virtual drugs. Clin Transl Sci 2022; 15:1257-1268. [PMID: 35157788 PMCID: PMC9099134 DOI: 10.1111/cts.13246] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 12/15/2022] Open
Abstract
Blockchain is a novel data architecture characterized by a chronological sequence of blocks in a decentralized manner. We aimed to evaluate the real-world feasibility of a blockchain-based dynamic consent platform (METORY) in a decentralized and multicenter trial. The study consisted of three visits (i.e., screening and 2 follow-up visits) with a 2-week interval. Each subject was required to report the self-measured body temperatures and take a virtual investigational drug by entering the unique drug code on the application. To simulate real-world study settings, two major (i.e., changes in the schedule of body temperature measurement) and three minor protocol amendments (i.e., nonsignificant changes without any changes in the procedures) were set. Overall study completion rates, proportion of consent, and response time to each protocol amendment and adherence were evaluated. A total of 60 subjects (30 in each center) were enrolled in two study centers. All subjects completed the study, and the overall proportion of consent to each protocol amendment was 95.7 ± 13.7% (mean ± SD), with a median response time of 0.2 h. Overall, subjects took 90.8% ± 19.2% of the total drug, whereas compliance with the schedule was 69.1% ± 27.0%. Subjects reported 96.7% ± 4.2% of the total body temperature measurements whereas the adherence to the schedule was 59.0% ± 25.0%, which remarkably decreased after major protocol amendments. In conclusion, we evaluated a blockchain-based dynamic consent platform in real clinical trial settings. The results suggested that major changes should be avoided unless subjects' proper understanding is warranted.
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Affiliation(s)
- Ki Young Huh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Seol Ju Moon
- Center for Clinical Pharmacology and Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Korea
| | - Sang-Un Jeong
- Center for Clinical Pharmacology and Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Korea
| | - Min-Ji Kim
- Center for Clinical Pharmacology and Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Korea
| | - Wooseok Yang
- Clinical Trial Center, Seoul National University Hospital, Seoul, Korea
| | - Myeonggyu Jeong
- Clinical Trial Center, Seoul National University Hospital, Seoul, Korea
| | - Min-Gul Kim
- Center for Clinical Pharmacology and Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Korea.,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Korea.,Department of Pharmacology, School of Medicine, Jeonbuk National University, Jeonju, Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
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7
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Ng WY, Tan TE, Movva PVH, Fang AHS, Yeo KK, Ho D, Foo FSS, Xiao Z, Sun K, Wong TY, Sia ATH, Ting DSW. Blockchain applications in health care for COVID-19 and beyond: a systematic review. Lancet Digit Health 2021; 3:e819-e829. [PMID: 34654686 PMCID: PMC8510632 DOI: 10.1016/s2589-7500(21)00210-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/03/2021] [Accepted: 08/16/2021] [Indexed: 01/04/2023]
Abstract
The COVID-19 pandemic has had a substantial and global impact on health care, and has greatly accelerated the adoption of digital technology. One of these emerging digital technologies, blockchain, has unique characteristics (eg, immutability, decentralisation, and transparency) that can be useful in multiple domains (eg, management of electronic medical records and access rights, and mobile health). We conducted a systematic review of COVID-19-related and non-COVID-19-related applications of blockchain in health care. We identified relevant reports published in MEDLINE, SpringerLink, Institute of Electrical and Electronics Engineers Xplore, ScienceDirect, arXiv, and Google Scholar up to July 29, 2021. Articles that included both clinical and technical designs, with or without prototype development, were included. A total of 85 375 articles were evaluated, with 415 full length reports (37 related to COVID-19 and 378 not related to COVID-19) eventually included in the final analysis. The main COVID-19-related applications reported were pandemic control and surveillance, immunity or vaccine passport monitoring, and contact tracing. The top three non-COVID-19-related applications were management of electronic medical records, internet of things (eg, remote monitoring or mobile health), and supply chain monitoring. Most reports detailed technical performance of the blockchain prototype platforms (277 [66·7%] of 415), whereas nine (2·2%) studies showed real-world clinical application and adoption. The remaining studies (129 [31·1%] of 415) were themselves of a technical design only. The most common platforms used were Ethereum and Hyperledger. Blockchain technology has numerous potential COVID-19-related and non-COVID-19-related applications in health care. However, much of the current research remains at the technical stage, with few providing actual clinical applications, highlighting the need to translate foundational blockchain technology into clinical use.
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Affiliation(s)
- Wei Yan Ng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore,Duke-NUS Medical School, National University of Singapore, Singapore
| | - Tien-En Tan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore,Duke-NUS Medical School, National University of Singapore, Singapore
| | - Prasanth V H Movva
- Certis Commercial and Industrial Security Corporation Security, Singapore
| | - Andrew Hao Sen Fang
- Duke-NUS Medical School, National University of Singapore, Singapore,SingHealth Polyclinics, Singapore
| | - Khung-Keong Yeo
- Duke-NUS Medical School, National University of Singapore, Singapore,National Heart Centre Singapore, Singapore
| | - Dean Ho
- Institute for Digital Medicine and Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,N.1 Institute for Health, National University of Singapore, Singapore,Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Fuji Shyy San Foo
- Certis Commercial and Industrial Security Corporation Security, Singapore
| | - Zhe Xiao
- Institute of High Performance Computing, Agency for Science, Technology and Research, Singapore
| | - Kai Sun
- Data Science Institute, Imperial College London, London, UK
| | - Tien Yin Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore,Duke-NUS Medical School, National University of Singapore, Singapore
| | - Alex Tiong-Heng Sia
- Duke-NUS Medical School, National University of Singapore, Singapore,KK Women's and Children's Hospital, Singapore
| | - Daniel Shu Wei Ting
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore,Duke-NUS Medical School, National University of Singapore, Singapore,Correspondence to: Dr Daniel Ting, Duke-NUS Medical School, National University of Singapore, Singapore 168751
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8
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Calvillo-Arbizu J, Román-Martínez I, Reina-Tosina J. Internet of things in health: Requirements, issues, and gaps. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 208:106231. [PMID: 34186337 DOI: 10.1016/j.cmpb.2021.106231] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/02/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVES The Internet of Things (IoT) paradigm has been extensively applied to several sectors in the last years, ranging from industry to smart cities. In the health domain, IoT makes possible new scenarios of healthcare delivery as well as collecting and processing health data in real time from sensors in order to make informed decisions. However, this domain is complex and presents several technological challenges. Despite the extensive literature about this topic, the application of IoT in healthcare scarcely covers requirements of this sector. METHODS A literature review from January 2010 to February 2021 was performed resulting in 12,108 articles. After filtering by title, abstract, and content, 86 were eligible and examined according to three requirement themes: data lifecycle; trust, security, and privacy; and human-related issues. RESULTS The analysis of the reviewed literature shows that most approaches consider IoT application in healthcare merely as in any other domain (industry, smart cities…), with no regard of the specific requirements of this domain. CONCLUSIONS Future efforts in this matter should be aligned with the specific requirements and needs of the health domain, so that exploiting the capabilities of the IoT paradigm may represent a meaningful step forward in the application of this technology in healthcare.
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Affiliation(s)
- Jorge Calvillo-Arbizu
- Grupo de Ingeniería Biomédica, Universidad de Sevilla, Sevilla 41092, Spain; Departamento de Ingeniería Telemática, Universidad de Sevilla, Spain.
| | | | - Javier Reina-Tosina
- Grupo de Ingeniería Biomédica, Universidad de Sevilla, Sevilla 41092, Spain; Departamento de Teoría de la Señal y las Comunicaciones, Universidad de Sevilla, Spain
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Velmovitsky PE, Bublitz FM, Fadrique LX, Morita PP. Blockchain Applications in Health Care and Public Health: Increased Transparency. JMIR Med Inform 2021; 9:e20713. [PMID: 34100768 PMCID: PMC8409015 DOI: 10.2196/20713] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/21/2020] [Accepted: 04/24/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Although big data and smart technologies allow for the development of precision medicine and predictive models in health care, there are still several challenges that need to be addressed before the full potential of these data can be realized (eg, data sharing and interoperability issues, lack of massive genomic data sets, data ownership, and security and privacy of health data). Health companies are exploring the use of blockchain, a tamperproof and distributed digital ledger, to address some of these challenges. OBJECTIVE In this viewpoint, we aim to obtain an overview of blockchain solutions that aim to solve challenges in health care from an industry perspective, focusing on solutions developed by health and technology companies. METHODS We conducted a literature review following the protocol defined by Levac et al to analyze the findings in a systematic manner. In addition to traditional databases such as IEEE and PubMed, we included search and news outlets such as CoinDesk, CoinTelegraph, and Medium. RESULTS Health care companies are using blockchain to improve challenges in five key areas. For electronic health records, blockchain can help to mitigate interoperability and data sharing in the industry by creating an overarching mechanism to link disparate personal records and can stimulate data sharing by connecting owners and buyers directly. For the drug (and food) supply chain, blockchain can provide an auditable log of a product's provenance and transportation (including information on the conditions in which the product was transported), increasing transparency and eliminating counterfeit products in the supply chain. For health insurance, blockchain can facilitate the claims management process and help users to calculate medical and pharmaceutical benefits. For genomics, by connecting data buyers and owners directly, blockchain can offer a secure and auditable way of sharing genomic data, increasing their availability. For consent management, as all participants in a blockchain network view an immutable version of the truth, blockchain can provide an immutable and timestamped log of consent, increasing transparency in the consent management process. CONCLUSIONS Blockchain technology can improve several challenges faced by the health care industry. However, companies must evaluate how the features of blockchain can affect their systems (eg, the append-only nature of blockchain limits the deletion of data stored in the network, and distributed systems, although more secure, are less efficient). Although these trade-offs need to be considered when viewing blockchain solutions, the technology has the potential to optimize processes, minimize inefficiencies, and increase trust in all contexts covered in this viewpoint.
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Affiliation(s)
| | - Frederico Moreira Bublitz
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.,Center for Strategic Technologies in Health (NUTES), State University of Paraiba (UEPB), Campina Grande, Brazil
| | - Laura Xavier Fadrique
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Plinio Pelegrini Morita
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,Research Institute for Aging, University of Waterloo, Waterloo, ON, Canada.,Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada.,eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
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10
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Velmovitsky PE, Bevilacqua T, Alencar P, Cowan D, Morita PP. Convergence of Precision Medicine and Public Health Into Precision Public Health: Toward a Big Data Perspective. Front Public Health 2021; 9:561873. [PMID: 33889555 PMCID: PMC8055845 DOI: 10.3389/fpubh.2021.561873] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 03/10/2021] [Indexed: 12/23/2022] Open
Abstract
The field of precision medicine explores disease treatments by looking at genetic, socio-environmental, and clinical factors, thus trying to provide a holistic view of a person's health. Public health, on the other hand, is focused on improving the health of populations through preventive strategies and timely interventions. With recent advances in technology, we are able to collect, analyze and store for the first-time large volumes of real-time, diverse and continuous health data. Typically, the field of precision medicine deals with a huge amount of data from few individuals; public health, on the other hand, deals with limited data from a population. With the coming of Big Data, the fields of precision medicine and public health are converging into precision public health, the study of biological and genetic factors supported by large amounts of population data. In this paper, we explore through a comprehensive review the data types and use cases found in precision medicine and public health. We also discuss how these data types and use cases can converge toward precision public health, as well as challenges and opportunities provided by research and analyses of health data.
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Affiliation(s)
| | - Tatiana Bevilacqua
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Paulo Alencar
- David R. Cheriton School of Computer Science, University of Waterloo, Waterloo, ON, Canada.,Waterloo Artificial Intelligence Institute (Waterloo.ai), Waterloo, ON, Canada
| | - Donald Cowan
- David R. Cheriton School of Computer Science, University of Waterloo, Waterloo, ON, Canada.,Waterloo Artificial Intelligence Institute (Waterloo.ai), Waterloo, ON, Canada
| | - Plinio Pelegrini Morita
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
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