Blockchain Technology in Healthcare: A Systematic Review

Navigating Challenges and Opportunities in Multi-Omics Integration for Personalized Healthcare

The field of multi-omics has witnessed unprecedented growth, converging multiple scientific disciplines and technological advances. This surge is evidenced by a more than doubling in multi-omics scientific publications within just two years (2022-2023) since its first referenced mention in 2002, as indexed by the National Library of Medicine. This emerging field has demonstrated its capability to provide comprehensive insights into complex biological systems, representing a transformative force in health diagnostics and therapeutic strategies. However, several challenges are evident when merging varied omics data sets and methodologies, interpreting vast data dimensions, streamlining longitudinal sampling and analysis, and addressing the ethical implications of managing sensitive health information. This review evaluates these challenges while spotlighting pivotal milestones: the development of targeted sampling methods, the use of artificial intelligence in formulating health indices, the integration of sophisticated n-of-1 statistical models such as digital twins, and the incorporation of blockchain technology for heightened data security. For multi-omics to truly revolutionize healthcare, it demands rigorous validation, tangible real-world applications, and smooth integration into existing healthcare infrastructures. It is imperative to address ethical dilemmas, paving the way for the realization of a future steered by omics-informed personalized medicine.

Mobile Diagnostic Clinics

This article reviews the revolutionary impact of emerging technologies and artificial intelligence (AI) in reshaping modern healthcare systems, with a particular focus on the implementation of mobile diagnostic clinics. It presents an insightful analysis of the current healthcare challenges, including the shortage of healthcare workers, financial constraints, and the limitations of traditional clinics in continual patient monitoring. The concept of "Mobile Diagnostic Clinics" is introduced as a transformative approach where healthcare delivery is made accessible through the incorporation of advanced technologies. This approach is a response to the impending shortfall of medical professionals and the financial and operational burdens conventional clinics face. The proposed mobile diagnostic clinics utilize digital health tools and AI to provide a wide range of services, from everyday screenings to diagnosis and continual monitoring, facilitating remote and personalized care. The article delves into the potential of nanotechnology in diagnostics, AI's role in enhancing predictive analytics, diagnostic accuracy, and the customization of care. Furthermore, the article discusses the importance of continual, noninvasive monitoring technologies for early disease detection and the role of clinical decision support systems (CDSSs) in personalizing treatment guidance. It also addresses the challenges and ethical concerns of implementing these advanced technologies, including data privacy, integration with existing healthcare infrastructure, and the need for transparent and bias-free AI systems.

Adoption of blockchain as a step forward in orthopedic practice

Blockchain technology has gained popularity since the invention of Bitcoin in 2008. It offers a decentralized and secure system for managing and protecting data. In the healthcare sector, where data protection and patient privacy are crucial, blockchain has the potential to revolutionize various aspects, including patient data management, orthopedic registries, medical imaging, research data, and the integration of Internet of Things (IoT) devices. This manuscript explores the applications of blockchain in orthopedics and highlights its benefits. Furthermore, the combination of blockchain with artificial intelligence (AI), machine learning, and deep learning can enable more accurate diagnoses and treatment recommendations. AI algorithms can learn from large datasets stored on the blockchain, leading to advancements in automated clinical decision-making. Overall, blockchain technology has the potential to enhance data security, interoperability, and collaboration in orthopedics. While there are challenges to overcome, such as adoption barriers and data sharing willingness, the benefits offered by blockchain make it a promising innovation for the field.

Biomedical blockchain with practical implementations and quantitative evaluations: a systematic review

OBJECTIVE

Blockchain has emerged as a potential data-sharing structure in healthcare because of its decentralization, immutability, and traceability. However, its use in the biomedical domain is yet to be investigated comprehensively, especially from the aspects of implementation and evaluation, by existing blockchain literature reviews. To address this, our review assesses blockchain applications implemented in practice and evaluated with quantitative metrics.

MATERIALS AND METHODS

This systematic review adapts the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to review biomedical blockchain papers published by August 2023 from 3 databases. Blockchain application, implementation, and evaluation metrics were collected and summarized.

RESULTS

Following screening, 11 articles were included in this review. Articles spanned a range of biomedical applications including COVID-19 medical data sharing, decentralized internet of things (IoT) data storage, clinical trial management, biomedical certificate storage, electronic health record (EHR) data sharing, and distributed predictive model generation. Only one article demonstrated blockchain deployment at a medical facility.

DISCUSSION

Ethereum was the most common blockchain platform. All but one implementation was developed with private network permissions. Also, 8 articles contained storage speed metrics and 6 contained query speed metrics. However, inconsistencies in presented metrics and the small number of articles included limit technological comparisons with each other.

CONCLUSION

While blockchain demonstrates feasibility for adoption in healthcare, it is not as popular as currently existing technologies for biomedical data management. Addressing implementation and evaluation factors will better showcase blockchain's practical benefits, enabling blockchain to have a significant impact on the health sector.

[Blockchain in health: Transforming security and clinical data management]

INTRODUCTION

Technological advances continue to transform society, including the health sector. The decentralized and verifiable nature of blockchain technology presents great potential for addressing current challenges in healthcare data management.

DISCUSSION

This article reports on how the generalized adoption of blockchain faces important challenges and barriers that must be addressed, such as the lack of regulation, technical complexity, safeguarding privacy, and economic and technological costs. Collaboration between medical professionals, technologists and legislators is essential to establish a solid regulatory framework and adequate training.

CONCLUSION

Blockchain technology has the potential to revolutionize data management in the healthcare sector, improving the quality of medical care, empowering users, and promoting the secure sharing of data, but an important cultural change is needed, along with more evidence, to reveal its advantages in front of the existing technological alternative.

Blockchain integration in healthcare: a comprehensive investigation of use cases, performance issues, and mitigation strategies

Healthcare is a critical area where blockchain technology (BT) is being heralded as a potential game-changer for facilitating secure and efficient data sharing. The purpose of this review is to examine BT applications, performance challenges, and solutions in healthcare. To begin, This review paper explores popular blockchain networks for data exchange, encompassing both public and permissioned platforms, such as Ethereum and Hyperledger Fabric. This paper analyzes the potential applications of BT's decentralized, immutable, and smart contract capabilities in healthcare settings, including secure and interoperable health data exchange, patient consent management, drug supply chain oversight, and clinical trial management. The healthcare industry might greatly benefit from the increased privacy, transparency, and accessibility that these technologies provide. Despite BT's promising medical uses, the technology is not without its drawbacks. High energy consumption, throughput, and scalability are all concerns. We wrapped up by discussing the solutions that have been implemented, including consensus processes, scalability measures like sharding, and off-chain transactions that are designed to mitigate the drawbacks.

Moving Beyond Proof of Concept and Pilots to Mainstream: Discovery and Lessons from a Reference Framework and Implementation

Blockchain technology is a radical innovation with the potential to disrupt and re-imagine more collaborative established business structures and processes. Significant advances, particularly in the payments space, include newer, faster, and less costly options for moving money. The underlying blockchain technology can be used for broader use cases spanning several verticals, including healthcare - although its adoption here is less than complete. Numerous proofs-of-concept and pilots have been executed and are increasing, although enterprise blockchain applications in healthcare at the production scale enabling transformative constituent processes are limited. In this article, the authors analyze the blockchain in healthcare literature for critical success factors and add practitioner views on crossing the chasm from proof-of-concept and pilots to a transformational scale. We explore 24 articles for key inflections for scale and highlight the need for a multifaceted execution framework to resolve the practical barriers to enabling reimagined network-based blockchain use cases for efficiencies, particularly in disparate health systems such as the U.S. In addition, we introduce the blockchain discovery framework to make this emerging technology meet the mainstream operations at scale systematically and in a stair-stepped and future-proofed manner, addressing practical stakeholder concerns. Finally, the authors present a reference case study discovered through the framework of one such healthcare administrative process for a scaled reimagined implementation. Healthcare executives and portfolio managers will benefit from these insights and help to increase the enterprise adoption of this inevitable technology of the future.

Plan Language Summary

This article presents a practitioner's view of operating in emerging technology, exploring and advancing blockchain-based transformation in healthcare. Blockchain technology is maturing quickly, with financial technology (aka fintech) leading the way with efficient options for moving money, particularly in the public permissionless blockchain segment. The underlying technology allows for a broader set of capabilities, including provenance, data sharing, immutability, non-repudiation, and auditability, which provides for complete rethinking of existing business processes. These features can help to reimagine a more comprehensive set of use cases in many disciplines, including healthcare. However, enterprise adoption needs to catch up.

S3EF-HBCAs: Secure and Sustainable Software Engineering Framework for Healthcare Blockchain Applications

Blockchain applications in healthcare have grown rapidly. They include record-keeping, clinical trials, medical supply chains, patient monitoring, etc., where blockchain characteristics are needed to improve safety, privacy, and security. Blockchain technology is one of the most significant disruptive technologies today. However, Porru et al.1 reported that it lacks processes, tools, and techniques. Therefore, this paper provides a systematic framework for a secure and sustainable software engineering framework for healthcare blockchain applications (S3EF-HBCA). S3EF-HBCA is a significant contribution that includes requirements engineering for healthcare, business process modeling for healthcare, domain modeling for healthcare, a reference architecture for healthcare, and validation by a case study on electronic healthcare record management system (EHR), and simulation with business process modeling notation (BPMN) tools. The simulation shows it has taken 10.45 min to process 100 instances of real-time data and service requests. The overall result shows encouragement regarding process, tools, standards, and testing.

Privacy-Conflict Resolution for Integrating Personal and Electronic Health Records in Blockchain-Based Systems

Integrating personal health records (PHRs) and electronic health records (EHRs) facilitates the provision of novel services to individuals, researchers, and healthcare practitioners. Simultaneously, integrating healthcare data leads to complexities arising from the structural and semantic heterogeneity within the data. The subject of healthcare data evokes strong emotions due to concerns surrounding privacy breaches. Blockchain technology is employed to address the issue of patient data privacy in inter-organizational processes, as it facilitates patient data ownership and promotes transparency in its usage. At the same time, blockchain technology creates new challenges for e-healthcare systems, such as data privacy, observability, and online enforceability. This article proposes designing and formalizing automatic conflict resolution techniques in decentralized e-healthcare systems. The present study expounds upon our concepts by employing a running case study centered around preventive and personalized healthcare domains.

Plain Language Summary

This paper suggests using blockchain technology for privacy concerns in integrating personal health records and electronic health records in decentralized e-healthcare systems. This report focuses on designing automatic conflict resolution techniques to ensure patient data ownership, transparency, and privacy in inter-organizational processes. This paper proposes designing automatic conflict resolution techniques in decentralized e-healthcare systems, which can improve inter-organizational processes in healthcare. Using blockchain technology to integrate personal and electronic health records can ensure patient data ownership and promote transparency in data usage, addressing privacy concerns in healthcare systems. This paper emphasizes the importance of data privacy and protection in healthcare systems, highlighting the need for compliance with laws and regulations. The research results, including the proof-of-concept prototype, can provide practical insights into implementing conflict resolution techniques in decentralized e-healthcare systems.

A systematic review of privacy-preserving methods deployed with blockchain and federated learning for the telemedicine

The unexpected and rapid spread of the COVID-19 pandemic has amplified the acceptance of remote healthcare systems such as telemedicine. Telemedicine effectively provides remote communication, better treatment recommendation, and personalized treatment on demand. It has emerged as the possible future of medicine. From a privacy perspective, secure storage, preservation, and controlled access to health data with consent are the main challenges to the effective deployment of telemedicine. It is paramount to fully overcome these challenges to integrate the telemedicine system into healthcare. In this regard, emerging technologies such as blockchain and federated learning have enormous potential to strengthen the telemedicine system. These technologies help enhance the overall healthcare standard when applied in an integrated way. The primary aim of this study is to perform a systematic literature review of previous research on privacy-preserving methods deployed with blockchain and federated learning for telemedicine. This study provides an in-depth qualitative analysis of relevant studies based on the architecture, privacy mechanisms, and machine learning methods used for data storage, access, and analytics. The survey allows the integration of blockchain and federated learning technologies with suitable privacy techniques to design a secure, trustworthy, and accurate telemedicine model with a privacy guarantee.

Blockchain, Information Security, Control, and Integrity: Who Is in Charge?

SUMMARY

Blockchain technology has attracted substantial interest in recent years, most notably for its effect on global economics through the advent of cryptocurrency. Within the health care domain, blockchain technology has been actively explored as a tool for improving personal health data management, medical device security, and clinical trial management. Despite a strong demand for innovation and cutting-edge technology in plastic surgery, integration of blockchain technologies within plastic surgery is in its infancy. Recent advances and mainstream adoption of blockchain are gaining momentum and have shown significant promise for improving patient care and information management. In this article, the authors explain what defines a blockchain and discuss its history and potential applications in plastic surgery. Existing evidence suggests that blockchain can enable patient-centered data management, improve privacy, and provide additional safeguards against human error. Integration of blockchain technology into clinical practice requires further research and development to demonstrate its safety and efficacy for patients and providers.

Technology: A metaparadigm concept of nursing

Undoubtedly, technology continues to permeate the world at an unprecedented pace. The discipline of nursing is not alien to this phenomenon as nurses continue to employ various technological objects and applications in clinical practice, education, administration and research. Despite the centrality of technology in nursing, it has not been recognised as a metaparadigm domain of interest in the discipline of nursing. Thus, this paper sought to examine if technology truly reflected a metaparadigm domain using the four requirements posited by Fawcett. Using these requirements, we examined the onto-epistemology of technology in relation to nursing and conclude that technology potentially represents a distinct domain that intersects with nursing (particularly, from the humanities perspective). Also, technology encompasses some phenomena of interest to the discipline of nursing, demonstrates perspective-neutrality, and is international in scope and substance albeit with some nuances which do not fit well with nursing onto-epistemology. Put together, it is highlighted that technology intersects with the existing metaparadigm domains (person, health, environment and nursing) which positions it as a potential phenomenon of interest to the discipline of nursing requiring further work to articulate its position and role.

Secure Ring Signature Scheme for Privacy-Preserving Blockchain

Blockchain integrates peer-to-peer networks, distributed consensus, smart contracts, cryptography, etc. It has the unique advantages of weak centralization, anti-tampering, traceability, openness, transparency, etc., and is widely used in various fields, e.g., finance and healthcare. However, due to its open and transparent nature, attackers can analyze the ledger information through clustering techniques to correlate the identities between anonymous and real users in the blockchain system, posing a serious risk of privacy leakage. The ring signature is one of the digital signatures that achieves the unconditional anonymity of the signer. Therefore, by leveraging Distributed Key Generation (DKG) and Elliptic Curve Cryptography (ECC), a blockchain-enabled secure ring signature scheme is proposed. Under the same security parameters, the signature constructed on ECC has higher security in comparison to the schemes using bilinear pairing. In addition, the system master key is generated by using the distributed key agreement, which avoids the traditional method of relying on a trusted third authorizer (TA) to distribute the key and prevents the key leakage when the TA is not authentic or suffers from malicious attacks. Moreover, the performance analysis showed the feasibility of the proposed scheme while the security was ensured.

Blockchain Revolutionizing in Emergency Medicine: A Scoping Review of Patient Journey through the ED

BACKGROUND

Blockchain technology has revolutionized the healthcare sector, including emergency medicine, by integrating AI, machine learning, and big data, thereby transforming traditional healthcare practices. The increasing utilization and accumulation of personal health data also raises concerns about security and privacy, particularly within emergency medical settings.

METHOD

Our review focused on articles published in databases such as Web of Science, PubMed, and Medline, discussing the revolutionary impact of blockchain technology within the context of the patient journey through the ED.

RESULTS

A total of 33 publications met our inclusion criteria. The findings emphasize that blockchain technology primarily finds its applications in data sharing and documentation. The pre-hospital and post-discharge applications stand out as distinctive features compared to other disciplines. Among various platforms, Ethereum and Hyperledger Fabric emerge as the most frequently utilized options, while Proof of Work (PoW) and Proof of Authority (PoA) stand out as the most commonly employed consensus algorithms in this emergency care domain. The ED journey map and two scenarios are presented, exemplifying the most distinctive applications of emergency medicine, and illustrating the potential of blockchain. Challenges such as interoperability, scalability, security, access control, and cost could potentially arise in emergency medical contexts, depending on the specific scenarios.

CONCLUSION

Our study examines the ongoing research on blockchain technology, highlighting its current influence and potential future advancements in optimizing emergency medical services. This approach empowers frontline medical professionals to validate their practices and recognize the transformative potential of blockchain in emergency medical care, ultimately benefiting both patients and healthcare providers.

Implementation of Blockchain Technology Across Different Domains of Dentistry: A Systematic Review

Blockchain technology has gained attention as a potential solution for improving data security, privacy, and interoperability in various industries, including healthcare. In the field of dentistry, the implementation of blockchain holds promise for transforming dental practice and management. However, a comprehensive evaluation of the existing literature regarding the implementation of blockchain technology in dental practice is lacking. This systematic review aimed to assess the current evidence on the implementation of blockchain technology in dental practice and management. A systematic literature search was conducted using major databases to identify relevant studies. The search strategy included keywords related to blockchain technology and dentistry. The investigation was performed as per the PRISMA guidelines. Studies reporting on the implementation, adoption, and outcomes of blockchain technology in dental practice and management were included. Quality assessment and data extraction were performed following predefined criteria. The initial search yielded a multitude of articles, and after applying the inclusion and exclusion criteria, six studies were included in the systematic review. The studies explored various aspects of blockchain technology implementation in dental practice, including data security, interoperability, supply chain management, and patient consent management. Furthermore, the use of blockchain-based systems showed potential benefits in enhancing supply chain management efficiency and patient consent authentication. This systematic review provided insights into the current state of blockchain technology implementation in dental practice and management. The findings suggested that blockchain technology has the potential to enhance data security, privacy, and interoperability in dental practices. However, further research and real-world implementation studies are needed to fully understand the impact of blockchain technology on dental practice and to address the existing challenges.

Comparing Decentralized Learning Methods for Health Data Models to Nondecentralized Alternatives: Protocol for a Systematic Review

BACKGROUND

Considering the soaring health-related costs directed toward a growing, aging, and comorbid population, the health sector needs effective data-driven interventions while managing rising care costs. While health interventions using data mining have become more robust and adopted, they often demand high-quality big data. However, growing privacy concerns have hindered large-scale data sharing. In parallel, recently introduced legal instruments require complex implementations, especially when it comes to biomedical data. New privacy-preserving technologies, such as decentralized learning, make it possible to create health models without mobilizing data sets by using distributed computation principles. Several multinational partnerships, including a recent agreement between the United States and the European Union, are adopting these techniques for next-generation data science. While these approaches are promising, there is no clear and robust evidence synthesis of health care applications.

OBJECTIVE

The main aim is to compare the performance among health data models (eg, automated diagnosis and mortality prediction) developed using decentralized learning approaches (eg, federated and blockchain) to those using centralized or local methods. Secondary aims are comparing the privacy compromise and resource use among model architectures.

METHODS

We will conduct a systematic review using the first-ever registered research protocol for this topic following a robust search methodology, including several biomedical and computational databases. This work will compare health data models differing in development architecture, grouping them according to their clinical applications. For reporting purposes, a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 flow diagram will be presented. CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies)-based forms will be used for data extraction and to assess the risk of bias, alongside PROBAST (Prediction Model Risk of Bias Assessment Tool). All effect measures in the original studies will be reported.

RESULTS

The queries and data extractions are expected to start on February 28, 2023, and end by July 31, 2023. The research protocol was registered with PROSPERO, under the number 393126, on February 3, 2023. With this protocol, we detail how we will conduct the systematic review. With that study, we aim to summarize the progress and findings from state-of-the-art decentralized learning models in health care in comparison to their local and centralized counterparts. Results are expected to clarify the consensuses and heterogeneities reported and help guide the research and development of new robust and sustainable applications to address the health data privacy problem, with applicability in real-world settings.

CONCLUSIONS

We expect to clearly present the status quo of these privacy-preserving technologies in health care. With this robust synthesis of the currently available scientific evidence, the review will inform health technology assessment and evidence-based decisions, from health professionals, data scientists, and policy makers alike. Importantly, it should also guide the development and application of new tools in service of patients' privacy and future research.

TRIAL REGISTRATION

PROSPERO 393126; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=393126.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/45823.

Comprehensive review for healthcare data quality challenges in blockchain technology

There are several features inherent in blockchain, including decentralized storage, distributed ledger, immutability, security and authentication, and it has shifted away from the hype to be used practically in different industries, such as in the healthcare sector. The use of blockchain technology has allowed the provision of improved services to industries. The objective of this paper is to demonstrate how the use of blockchain is influenced by data quality issues in the healthcare industry. The article is structured as a systematic literature review study that uses several articles issued in various databases from 2016 onwards. In this review study, 65 articles were chosen and grouped into a single key aspect of the challenge in the healthcare sector. The findings obtained were analyzed based on factors in three domains, classified as issues pertinent to the adoption, operational and technological domains. This review study aims to use the findings to provide support to the practitioners, stakeholders and professionals, whose purpose is to carry out and manage transformation projects pertinent to blockchain in the field of healthcare. In addition, the organizations would be facilitated in their decision-making processes when the potential blockchain users are made to comprehend the implicit factors related to blockchain.

Dentistry in the Digital Age: Embracing Blockchain Technology

Blockchain technology can revolutionize the dental industry by offering secure and efficient data management and patient care solutions. This editorial explores how blockchain can benefit dentistry, including enhancing data security and privacy, streamlining interoperability, facilitating supply chain management, and empowering patients. Blockchain ensures tamper-proof and authorized access to patient data, enabling dentists and patients to have peace of mind regarding data security. Interoperability between dental systems can be improved through blockchain, allowing seamless data exchange and care coordination. By leveraging the transparency and immutability of blockchain, supply chain management in dentistry can be enhanced to ensure the authenticity of dental products. Moreover, blockchain empowers patients by granting them control over their healthcare data, promoting transparency and trust in the dental industry. However, challenges such as scalability, energy consumption, regulatory compliance, and data governance need to be addressed for successful implementation. Collaboration among stakeholders, education, and the development of regulatory frameworks are crucial for maximizing the benefits of blockchain technology in dentistry. By embracing blockchain, the dental industry can create a future where patient care is secure, efficient, and patient-centric.

Breaking Down Barriers and Paving the Way for Blockchain Adoption in Dentistry

Blockchain technology can potentially transform the dentistry sector by facilitating safe communication between dental practitioners and offering secure and efficient administration of patient information. Nevertheless, using this technology in dentistry confronts various barriers, including regulatory and legal obstacles, a lack of technical skills, and a lack of standardization. To overcome these challenges, dental practitioners, industry stakeholders, and regulators must work together to develop a legislative framework that encourages the use of blockchain technology in dentistry. Moreover, education and training programs must equip dental practitioners with the skills and expertise to properly incorporate and use blockchain technology. The use of blockchain technology in dentistry has the potential to greatly improve patient outcomes while also increasing the efficiency and security of the dental business.

The Potential of Blockchain Technology in Dental Healthcare: A Literature Review

Blockchain technology in the healthcare industry has potential to enable enhanced privacy, increased security, and an interoperable data record. Blockchain technology is being implemented in dental care systems to store and share medical information, improve insurance claims, and provide innovative dental data ledgers. Because the healthcare sector is a large and ever-growing industry, the use of blockchain technology would have many benefits. To improve dental care delivery, researchers advocate using blockchain technology and smart contracts due to their numerous advantages. In this research, we concentrate on blockchain-based dental care systems. In particular, we examine the current research literature, pinpoint issues with existing dental care systems, and consider how blockchain technology may be used to address these issues. Finally, the limitations of the proposed blockchain-based dental care systems are discussed which may be regarded as open issues.

Medical supply chain integrated with blockchain and IoT to track the logistics of medical products

Nowadays blockchain technology plays a vital role in creative developments and important discoveries in the world. Blockchain develops secure and trustworthy platforms for data sharing in various application areas such as secure sharing of medical data, Anti-money laundering, tracking systems, Supply chain, and logistics monitoring, Crypto-currency exchange, etc. Today's Supply chain in the healthcare sector faces many problems like security, transparency, tampering with medical products, counterfeit drugs, more paperwork, high cost, and more time-consuming process while transporting medical equipment from manufacture to end-users. To overcome these problems, we introduce Novel Approach for Integrated IoT (Internet of Things) With Blockchain in Health Supply Chain (NAIBHSC) approach. By using this approach, we can eliminate all supply chain-related issues between suppliers and end-users. The goal of this research is by combining Blockchain technology with IoT to develop a smart health supply chain management system. This approach provides security, privacy, trust, visibility, decentralized tracking and tracing of the medical product, avoids counterfeit drugs, avoids the damage to medical components, authentication, reduces the cost, and provides the status of the products during the shipment process between manufacturers to end-user. In this approach, we conduct a series of experiments on a different group of users. The experimental results show that compare to existing approaches our proposed NAIBHSC approach gives better response time that is the average Transaction Per Second (TPS) for a group of 500 users is 100 milliseconds, reduces the latency time that is average latency time for 500 users group has 403 milliseconds, and improves the overall performance of the smart health supply chain management system.

Abstracting Data in Distributed Ledger Systems for Higher Level Analytics and Visualizations

By design, distributed ledger technologies persist low-level data, which makes conducting complex business analysis of the recorded operations challenging. Existing blockchain visualization and analytics tools such as block explorers tend to rely on this low-level data and complex interfacing to provide an enriched level of analytics. The ability to derive richer analytics could be improved through the availability of a higher level abstraction of the data. This article proposes an abstraction layer architecture that enables the design of high-level analytics of distributed ledger systems and the decentralized applications that run on top. Based on the analysis of existing initiatives and identification of the relevant user requirements, this work aims to establish key insights and specifications to improve the auditability and intuitiveness of distributed ledger systems by leveraging the development of future user interfaces. To illustrate the benefits offered by the proposed abstraction layer architecture, a regulated sector use case is explored.

Sharing Health Information Using a Blockchain

Data sharing in the health sector represents a big problem due to privacy and security issues. Health data have tremendous value for organisations and criminals. The European Commission has classified health data as a unique resource owing to their ability to enable both retrospective and prospective research at a low cost. Similarly, the Organisation for Economic Co-operation and Development (OECD) encourages member nations to create and implement health data governance systems that protect individual privacy while allowing data sharing. This paper proposes adopting a blockchain framework to enable the transparent sharing of medical information among health entities in a secure environment. We develop a laboratory-based prototype using a design science research methodology (DSRM). This approach has its roots in the sciences of engineering and artificial intelligence, and its primary goal is to create relevant artefacts that add value to the fields in which they are used. We adopt a patient-centric approach, according to which a patient is the owner of their data and may allow hospitals and health professionals access to their data.

Enabling Value Co-Creation in Healthcare through Blockchain Technology

The COVID-19 pandemic highlighted the need to manage complex relations within the healthcare ecosystem. The role of new technologies in achieving this goal is a topic of current interest. Among them, blockchain technology is experiencing widespread application in the healthcare context. The present work investigates how this technology fosters value co-creation paths in the new digital healthcare ecosystems. To this end, a multiple case study has been conducted examining the development and application of blockchain by 32 healthcare tech companies. The results show blockchain technology adoption's current and potential impacts on value co-creation regarding data and resource sharing, patient participation, and collaboration between professionals. Three main areas of activity emerge from the case studies where blockchain implementation brings significant benefits for value co-creation: improving service interaction, impacting actors' engagement, and fostering ecosystem transparency.

Evaluation of competency and job satisfaction by positive human psychology among physical education teachers at the university level: A systematic review

The study aimed to determine how a teacher's competency at the university level related to professional commitment and job satisfaction. This systematic review intends to determine physical education teachers' competency and job satisfaction. One of the main objectives of physical education programs is to increase various activities of the student, especially physical activities and participation in it. Students who participate in physical activities feel a variety of emotions, and these may enhance their mental and physical well-being. The study concerns the teachers' satisfaction in effectively influencing and teaching the students. Job satisfaction refers to teachers' feelings and positive attitudes toward their work. The five components of job satisfaction are pay, promotion, supervision, co-workers, and work itself. Job satisfaction is broken down into these five components. Work as a teacher is one of the most important components of a teacher's or teacher's success at work and one of the key criteria for the school's achievement. Electronic libraries were explored, including Google Scholar, PubMed, Embase, Bing Academic, and Cochrane. Appropriate keywords were used for searching the literature. By applying certain inclusion and exclusion criteria, the final studies were selected for evaluation. The study's findings showed that physical education instructors had high levels of teaching competence and moderate levels of job satisfaction. The findings demonstrated that job satisfaction and competency rise when degree levels rise, and relatedness, skill, and autonomy self-motivation ensue. Students' motivation for physical education was greatly influenced by the teachers' support, motivation, and mastery climate. The self-determination theory positively enhances physical education from the teacher's perspective on PE, increasing instruction effectiveness.

Blockchain for Patient Safety: Use Cases, Opportunities and Open Challenges

Medical errors are recognized as major threats to patient safety worldwide. Lack of streamlined communication and an inability to share and exchange data are among the contributory factors affecting patient safety. To address these challenges, blockchain can be utilized to ensure a secure, transparent and decentralized data exchange among stakeholders. In this study, we discuss six use cases that can benefit from blockchain to gain operational effectiveness and efficiency in the patient safety context. The role of stakeholders, system requirements, opportunities and challenges are discussed in each use case in detail. Connecting stakeholders and data in complex healthcare systems, blockchain has the potential to provide an accountable and collaborative milieu for the delivery of safe care. By reviewing the potential of blockchain in six use cases, we suggest that blockchain provides several benefits, such as an immutable and transparent structure and decentralized architecture, which may help transform health care and enhance patient safety. While blockchain offers remarkable opportunities, it also presents open challenges in the form of trust, privacy, scalability and governance. Future research may benefit from including additional use cases and developing smart contracts to present a more comprehensive view on potential contributions and challenges to explore the feasibility of blockchain-based solutions in the patient safety context.

Digital innovations for retinal care in diabetic retinopathy

AIM

The purpose of this review is to examine the applications of novel digital technology domains for the screening and management of patients with diabetic retinopathy (DR).

METHODS

A PubMed engine search was performed, using the terms "Telemedicine", "Digital health", "Telehealth", "Telescreening", "Artificial intelligence", "Deep learning", "Smartphone", "Triage", "Screening", "Home-based", "Monitoring", "Ophthalmology", "Diabetes", "Diabetic Retinopathy", "Retinal imaging". Full-text English language studies from January 1, 2010, to February 1, 2022, and reference lists were considered for the conceptual framework of this review.

RESULTS

Diabetes mellitus and its eye complications, including DR, are particularly well suited to digital technologies, providing an ideal model for telehealth initiatives and real-world applications. The current development in the adoption of telemedicine, artificial intelligence and remote monitoring as an alternative to or in addition to traditional forms of care will be discussed.

CONCLUSIONS

Advances in digital health have created an ecosystem ripe for telemedicine in the field of DR to thrive. Stakeholders and policymakers should adopt a participatory approach to ensure sustained implementation of these technologies after the COVID-19 pandemic. This article belongs to the Topical Collection "Diabetic Eye Disease", managed by Giuseppe Querques.

Autoimmune haemolytic anaemia due to immunodeficiency

Autoimmune disorders are common presenting manifestations of immunodeficiency syndromes. We present a case of a woman in her late teens, with a history of frequent sinopulmonary tract infections during her childhood, who presented to our hospital with anaemia, jaundice and fatigue. She also had significant physical growth retardation for her age and sex. With this case report, we intend to present the diagnostic and therapeutic challenges faced by the patient and our healthcare system and propose a few feasible solutions to tackle these challenges.

Are FinTech, Robotics, and Blockchain index funds providing diversification opportunities with emerging markets?Lessons from pre and postoutbreak of COVID-19

The study has been inspired by the emergence of technology-based assets, namely, FinTech, Robotics, and Blockchain in the 4th Industrial Revolution. We are examining diversification opportunities with nonconventional technology funds based on FinTech, Robotics, and Blockchain while investing in MSCI Emerging Markets Index, and finally gauging the most resilient fund during the pre-and post-outbreak of COVID-19. The five technology-driven funds considered are ARK FinTech Innovation Exchange Traded Funds (ARKF), Global X FinTech Exchange Traded Funds (FINX), First Trust NASDAQ Artificial Intelligence and Robotics Exchange Traded Funds (ROBT), Global X Robotics and Artificial Intelligence (BOTZ), and Ishares Robotics and Artificial Intelligence (IRBO) to investigate diversification opportunities with MSCI Emerging Markets Index. The time-varying dynamic spillover using the Vector Auto Regression Model for average, low, and high volatility quantiles and the network of volatility connectedness based on quantile VAR have been applied to capture diversification and identifying the most resilient fund. The study found that ARKF and FINX provide diversification opportunities. In each quantile, these two funds are evidence of diversification, and BOTZ, also shows diversification evidence. Moreover, FINX is the throughout resilient fund, and ARKF is the most resilient in extreme quantiles. Throughout the quantiles, it is perceived a significant impact of COVID-19 on the total connectedness of Funds with the emerging market index.

Recent Advancements in Emerging Technologies for Healthcare Management Systems: A Survey

In recent times, the growth of the Internet of Things (IoT), artificial intelligence (AI), and Blockchain technologies have quickly gained pace as a new study niche in numerous collegiate and industrial sectors, notably in the healthcare sector. Recent advancements in healthcare delivery have given many patients access to advanced personalized healthcare, which has improved their well-being. The subsequent phase in healthcare is to seamlessly consolidate these emerging technologies such as IoT-assisted wearable sensor devices, AI, and Blockchain collectively. Surprisingly, owing to the rapid use of smart wearable sensors, IoT and AI-enabled technology are shifting healthcare from a conventional hub-based system to a more personalized healthcare management system (HMS). However, implementing smart sensors, advanced IoT, AI, and Blockchain technologies synchronously in HMS remains a significant challenge. Prominent and reoccurring issues such as scarcity of cost-effective and accurate smart medical sensors, unstandardized IoT system architectures, heterogeneity of connected wearable devices, the multidimensionality of data generated, and high demand for interoperability are vivid problems affecting the advancement of HMS. Hence, this survey paper presents a detailed evaluation of the application of these emerging technologies (Smart Sensor, IoT, AI, Blockchain) in HMS to better understand the progress thus far. Specifically, current studies and findings on the deployment of these emerging technologies in healthcare are investigated, as well as key enabling factors, noteworthy use cases, and successful deployments. This survey also examined essential issues that are frequently encountered by IoT-assisted wearable sensor systems, AI, and Blockchain, as well as the critical concerns that must be addressed to enhance the application of these emerging technologies in the HMS.

Securing federated learning with blockchain: a systematic literature review

Federated learning (FL) is a promising framework for distributed machine learning that trains models without sharing local data while protecting privacy. FL exploits the concept of collaborative learning and builds privacy-preserving models. Nevertheless, the integral features of FL are fraught with problems, such as the disclosure of private information, the unreliability of uploading model parameters to the server, the communication cost, etc. Blockchain, as a decentralized technology, is able to improve the performance of FL without requiring a centralized server and also solves the above problems. In this paper, a systematic literature review on the integration of Blockchain in federated learning was considered with the analysis of the existing FL problems that can be compensated. Through carefully screening, most relevant studies are included and research questions cover the potential security and privacy attacks in traditional federated learning that can be solved by blockchain as well as the characteristics of Blockchain-based FL. In addition, the latest Blockchain-based approaches to federated learning have been studied in-depth in terms of security and privacy, records and rewards, and verification and accountability. Furthermore, open issues related to the combination of Blockchain and FL are discussed. Finally, future research directions for the robust development of Blockchain-based FL systems are proposed.

Towards effective data sharing in ophthalmology: data standardization and data privacy

PURPOSE OF REVIEW

The purpose of this review is to provide an overview of updates in data standardization and data privacy in ophthalmology. These topics represent two key aspects of medical information sharing and are important knowledge areas given trends in data-driven healthcare.

RECENT FINDINGS

Standardization and privacy can be seen as complementary aspects that pertain to data sharing. Standardization promotes the ease and efficacy through which data is shared. Privacy considerations ensure that data sharing is appropriate and sufficiently controlled. There is active development in both areas, including government regulations and common data models to advance standardization, and application of technologies such as blockchain and synthetic data to help tackle privacy issues. These advancements have seen use in ophthalmology, but there are areas where further work is required.

SUMMARY

Information sharing is fundamental to both research and care delivery, and standardization/privacy are key constituent considerations. Therefore, widespread engagement with, and development of, data standardization and privacy ecosystems stand to offer great benefit to ophthalmology.

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

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

Analysis of Blockchain in the Healthcare Sector: Application and Issues

The emergence of blockchain technology makes it possible to address disparate distributed system security concerns in formerly ridiculous practices. A key factor of this ability is the decentralization of the symmetrically distributed ledgers of blockchain. Such decentralization has replaced several security functionalities of centralized authority with the use of cryptographic systems. That is, public or asymmetric cryptography is the key part of what makes blockchain technology possible. Recently, the blockchain experience introduces the chance for the healthcare field to implement these knowhows in their electronic records. This adoption supports retaining and sharing the symmetrical patient records with the appropriate alliance of hospitals and healthcare providers in a secure decentralized system, using asymmetric cryptography like hashing, digitally signed transactions, and public key infrastructure. These include specialized applications for drug tracking, applications for observing patients, or Electronic Health Records (EHR). Therefore, it is essential to notice that the principled awareness of the healthcare professionals is the leading point of the right perception ethics. In this work, we provide a thorough review of the issues and applications of utilizing blockchain in the healthcare and medical fields emphasizing the particular challenges and aspects. The study adopted a systematic review of secondary literature in answering the research question. Specifically, this paper aims to investigate how blockchain technology can be applied to improve the overall performance of the healthcare sector and to explore the various challenges and concerns of the application of blockchain in the healthcare system.

Lightweight blockchain fuzzy decision scheme through MQTT and Fibonacci for sustainable transport

The unprecedented progress in field of IoT enabled rapid developments in the vehicle intelligent transportation systems and most of these provide services in a centralized way. However, the centralized system architecture is vulnerable to the external attacks as a result both information and equipment are prone to eavesdropping and destruction. Therefore, there is a trend to apply blockchain technology to the vehicle intelligent transportation systems in order to achieve sustainable transportation. Nevertheless, the system is so great and very sophisticated and the ultimate task will be harder to implement. In view of this, an attempt is made in this paper to propose a lightweight fuzzy decision blockchain scheme through MQTT and Fibonacci, and through this scheme, the extent of blockchain server can be scaled and easy to deploy. Also through MQTT, reliable communication and transmission of blockchain can be realized. LF-BC is formed by using DH and Fibonacci transformation to enhance security, and F-PBFT consensus algorithm can reduce the communication overhead and improve the fault tolerance tremendously. Using LF-BC scheme, the experimental results show that the fault tolerance rate is significantly improved by 22.3%, and the sustainable safety and reliability of the vehicle intelligent transportation system is increased consumedly. At the same time, the feasibility of the scheme is also verified by taking specific cases.

Improving End-to-End Traceability and Pharma Supply Chain Resilience using Blockchain

Regulating and monitoring a traditionally fragmented pharma supply chain has been a global challenge for decades. Without a trusted system and strong collaboration between stakeholders, threats such as counterfeits can easily intercept the supply chain and cause monumental disruptions. Today, the COVID-19 pandemic has accelerated the need for greater data transparency, better deployment of technology, and improved ways of connecting stakeholder information along the supply chain. There is a need for improved ways of working to help build up supply chain resilience, and one way is by implementing better end-to-end traceability using blockchain technology such as Hyperledger Fabric. This paper will explore the business value that blockchain brings to the pharma supply chain with better end-to-end traceability, using the example of an industry-grade blockchain solution called eZTracker. Through six key features, pharmaceutical manufacturers, patients, and Healthcare Practitioners (HCPs) can now participate in data sharing, with extended use cases of integrating blockchain with warehouse platforms, a patient-facing mobile application, and an interactive dashboard for real-time verification and data transparency. Beyond anti-counterfeit verification, other potential use cases include effective product recall management, cold chain monitoring, e-product information, and more. The effectiveness of a traceability solution is heavily dependent on the amount of data collected and is affected by poor adoption and scalability. Existing limitations that need to be addressed include the lack of mandated serialization in Asia and blockchain interoperability. To maximize the value of blockchain, collaboration is the key. Pharmaceutical manufacturers need to invest in new technologies, such as blockchain, to help them break out of data silos and operationalize data to build supply chain resilience. Pharmaceutical supply chain is the backbone of a US$1.27 trillion industry,¹ but because of its highly complex and fragmented nature, it is hard to regulate and protect, and this makes it a valuable target for opportunistic parties such as counterfeiters looking to profit.² As a result of the COVID-19 pandemic, there has been greater emphasis on transparency of data and connecting stakeholders along the pharma supply chain in real-time in the last few years. With the introduction of blockchain technology, companies are now able to implement solutions with more effective track and trace results, providing quality assurance to pharmaceutical manufacturers, patients, and Healthcare Practitioners (HCPs), and even improving operational efficiencies. This paper seeks to explore the positive business impact of end-to-end traceability using blockchain technology, and the effects it brings about, such as improving supply chain resilience and combating counterfeits, as seen in successful live use cases in Asia.

Blockchain Technology and Artificial Intelligence Based Decentralized Access Control Model to Enable Secure Interoperability for Healthcare

Healthcare, one of the most important industries, is data-oriented, but most of the research in this industry focuses on incorporating the internet of things (IoT) or connecting medical equipment. Very few researchers are looking at the data generated in the healthcare industry. Data are very important tools in this competitive world, as they can be integrated with artificial intelligence (AI) to promote sustainability. Healthcare data include the health records of patients, drug-related data, clinical trials data, data from various medical equipment, etc. Most of the data management processes are manual, time-consuming, and error-prone. Even then, different healthcare industries do not trust each other to share and collaborate on data. Distributed ledger technology is being used for innovations in different sectors including healthcare. This technology can be incorporated to maintain and exchange data between different healthcare organizations, such as hospitals, insurance companies, laboratories, pharmacies, etc. Various attributes of this technology, such as its immutability, transparency, provenance etc., can bring trust and security to the domain of the healthcare sector. In this paper, a decentralized access control model is proposed to enable the secure interoperability of different healthcare organizations. This model uses the Ethereum blockchain for its implementation. This model interfaces patients, doctors, chemists, and insurance companies, empowering the consistent and secure exchange of data. The major concerns are maintaining a history of the transactions and avoiding unauthorized updates in health records. Any transaction that changes the state of the data is reflected in the distributed ledger and can be easily traced with this model. Only authorized entities can access their respective data. Even the administrator will not be able to modify any medical records.

HealthCare EHR

Blockchain technology is currently playing a significant role in providing a secure and effective means to share information in a variety of domains, including the financial sector, supply chain management (SCM) in various domains, IoT, and the field of health care systems (HCS). The HCS application's interoperability and security allow patients and vendors to communicate information seamlessly. The absence of such traits reveals the patient's difficulties in gaining access to his or her own health status. As a result, incorporating blockchain technology will eliminate this disadvantage, allowing the HCS to become more effective and efficient. These potential benefits provide a foundation for blockchain technology to be used in various aspects of HCS, such as maintain the patient electronic health record (EHR) and electronic medical records (EMR) for various medical devices, billing, and telemedicine systems, and so on.

METORY: Development of a Demand-Driven Blockchain-Based Dynamic Consent Platform Tailored for Clinical Trials

The recent advent of the dynamic consent concept intensified the data integrity issue in clinical trials. Incorporating blockchain technology into a dynamic consent platform can be a feasible solution. Due to various clinical trial settings, a demand-driven development strategy is required. We developed a blockchain-based dynamic consent platform named METORY tailored for clinical trials. The platform consisted of three parts: web and mobile application user interface, study management platform, and blockchain platform. Hyperledger Fabric, an enterprise-grade private blockchain framework, was used to integrate blockchain into the study consent platform. We conducted user acceptance tests and applied feedback to the improvement of the platform. Identity and role-based access control was constructed by combining mobile-application-based certificate system and access control functionalities in Hyperledger fabric. Data were encrypted using SHA-256 prior to transmission to blockchain server and TLS protocol was used for in-transit encryption. File-system level encryption was separated implemented within the security measures from Amazon RDS. Users' experience in the clinical trial was acceptable in the ease and usefulness of the platform.

A Systematic Review on Blockchain Adoption

Blockchain technologies have received considerable attention from academia and industry due to their distinctive characteristics, such as data integrity, security, decentralization, and reliability. However, their adoption rate is still scarce, which is one of the primary reasons behind conducting studies related to users’ satisfaction and adoption. Determining what impacts the use and adoption of Blockchain technologies can efficiently address their adoption challenges. Hence, this systematic review aimed to review studies published on Blockchain technologies to offer a thorough understanding of what impacts their adoption and discuss the main challenges and opportunities across various sectors. From 902 studies collected, 30 empirical studies met the eligibility criteria and were thoroughly analyzed. The results confirmed that the technology acceptance model (TAM) and technology–organization–environment (TOE) were the most common models for studying Blockchain adoption. Apart from the core variables of these two models, the results indicated that trust, perceived cost, social influence, and facilitating conditions were the significant determinants influencing several Blockchain applications. The results also revealed that supply chain management is the main domain in which Blockchain applications were adopted. Further, the results indicated inadequate exposure to studying the actual use of Blockchain technologies and their continued use. It is also essential to report that existing studies have examined the adoption of Blockchain technologies from the lens of the organizational level, with little attention paid to the individual level. This review is believed to improve our understanding by revealing the full potential of Blockchain adoption and opening the door for further research opportunities.

A Blockchain Framework to Secure Personal Health Record (PHR) in IBM Cloud-Based Data Lake

The health system in today's real world is significant but difficult and overcrowded. These hurdles can be diminished using improved health record management and blockchain technology. These technologies can handle medical data to provide security by monitoring and maintaining patient records. The processing of medical data and patient records is essential to analyze the earlier prescribed medicines and to understand the severity of diseases. Blockchain technology can improve the security, performance, and transparency of sharing the medical records of the current healthcare system. This paper proposed a novel framework for personal health record (PHR) management using IBM cloud data lake and blockchain platform for an effective healthcare management process. The problem in the blockchain-based healthcare management system can be minimized with the utilization of the proposed technique. Significantly, the traditional blockchain system usually decreases the latency. Therefore, the proposed technique focuses on improving latency and throughput. The result of the proposed system is calculated based on various matrices, such as F1 Score, Recall, and Confusion matrices. Therefore, the proposed work scored high accuracy and provided better results than existing techniques.

A Clinical Study on the Brain Protection Effect of Propofol Anesthesia on Patients Undergoing Acute Craniocerebral Trauma Surgery Based on Blockchain

In order to explore the effects of propofol anesthesia system based on block chain on brain tissue and brain function protection, 88 patients undergoing craniocerebral trauma surgery are selected for prospective study. The anesthetic dose of propofol during operation in the control group is determined according to general information and personal situation. The team uses blockchain to process the patient's clinical data and general information to calculate the optimal dose of propofol. The changes of hemodynamic indexes of patients in the two groups are compared, including dural incision (T1), 1 h after craniotomy (T2), end of surgery (T3), and 6 h after surgery (T4). The changes of neuron-specific enolase (NSE) and central neuron-specific protein (S100β) at T1, T2, T3, and T4 in 2 groups are observed and recorded. The changes of malondialdehyde (MDA) at T1, T2, T3, and T4 are compared between the two groups. Based on the analysis of clinical data and general information of patients on blockchain, the optimal intraoperative anesthetic dose of propofol for patients can effectively protect the brain function of patients, and the intraoperative anesthesia state is relatively stable, and the changes and improvements of intraoperative indicators are good.

Grid based blockchain framework for information management in surgical process proceedings

Numerous academic and industrial research studies have focused on the feasibility of implementing blockchain-based healthcare systems data management that can transform the way data systems functioning, usage, and development can be effective. In this manuscript, the focus is on the development of a Grid-based blockchain structure formanaging the surgical process-related information in integrated systems. Considering the implications, scope of human error in the surgical processes, and the quantum of records integral to such process, the need for having robust records of surgical data is imperative. Aiming at improving the security of the information, in this manuscript, the Grid-block structure constituting multiple grids framework is proposed, which can be optimal for transaction query processing, responsiveness for triggers, and security inheritance. The proposed system, if chosen for real-time implementation, can support interoperability of data among the distinct healthcare systems and support in minimizing the issues of human error inspections, prevention scope for errors whilst improving the quality of healthcare solutions.