Blockchain Paradigm for Healthcare: Performance Evaluation

System interoperability and data linkage in the era of health information management: A bibliometric analysis

Background: Across the world, health data generation is growing exponentially. The continuous rise of new and diversified technology to obtain and handle health data places health information management and governance under pressure. Lack of data linkage and interoperability between systems undermines best efforts to optimise integrated health information technology solutions. Objective: This research aimed to provide a bibliometric overview of the role of interoperability and linkage in health data management and governance. Method: Data were acquired by entering selected search queries into Google Scholar, PubMed, and Web of Science databases and bibliometric data obtained were then imported to Endnote and checked for duplicates. The refined data were exported to Excel, where several levels of filtration were applied to obtain the final sample. These sample data were analysed using Microsoft Excel (Microsoft Corporation, Washington, USA), WORDSTAT (Provalis Research, Montreal, Canada) and VOSviewer software (Leiden University, Leiden, Netherlands). Results: The literature sample was retrieved from 3799 unique results and consisted of 63 articles, present in 45 different publications, both evaluated by two specific in-house global impact rankings. Through VOSviewer, three main clusters were identified: (i) e-health information stakeholder needs; (ii) e-health information quality assessment; and (iii) e-health information technological governance trends. A residual correlation between interoperability and linkage studies in the sample was also found. Conclusion: Assessing stakeholders' needs is crucial for establishing an efficient and effective health information system. Further and diversified research is needed to assess the integrated placement of interoperability and linkage in health information management and governance. Implications: This research has provided valuable managerial and theoretical contributions to optimise system interoperability and data linkage within health information research and information technology solutions.

A Novel Blockchain-Based Healthcare System Design and Performance Benchmarking on a Multi-Hosted Testbed

As a result of the proliferation of digital and network technologies in all facets of modern society, including the healthcare systems, the widespread adoption of Electronic Healthcare Records (EHRs) has become the norm. At the same time, Blockchain has been widely accepted as a potent solution for addressing security issues in any untrusted, distributed, decentralized application and has thus seen a slew of works on Blockchain-enabled EHRs. However, most such prototypes ignore the performance aspects of proposed designs. In this paper, a prototype for a Blockchain-based EHR has been presented that employs smart contracts with Hyperledger Fabric 2.0, which also provides a unified performance analysis with Hyperledger Caliper 0.4.2. The additional contribution of this paper lies in the use of a multi-hosted testbed for the performance analysis in addition to far more realistic Gossip-based traffic scenario analysis with Tcpdump tools. Moreover, the prototype is tested for performance with superior transaction ordering schemes such as Kafka and RAFT, unlike other literature that mostly uses SOLO for the purpose, which accounts for superior fault tolerance. All of these additional unique features make the performance evaluation presented herein much more realistic and hence adds hugely to the credibility of the results obtained. The proposed framework within the multi-host instances continues to behave more successfully with high throughput, low latency, and low utilization of resources for opening, querying, and transferring transactions into a healthcare Blockchain network. The results obtained in various rounds of evaluation demonstrate the superiority of the proposed framework.

Towards an internet-scale overlay network for latency-aware decentralized workflows at the edge

Small-scale data centers at the edge are becoming prominent in offering various services to the end-users following the cloud model while avoiding the high latency inherent to the classic cloud environments when accessed from remote Internet regions. However, we should address several challenges to facilitate the end-users finding and consuming the relevant services from the edge at the Internet scale. First, the scale and diversity of the edge hinder seamless access. Second, a framework where researchers openly share their services and data in a secured manner among themselves and with external consumers over the Internet does not exist. Third, the lack of a unified interface and trust across the service providers hinder their interchangeability in composing workflows by chaining the services. Thus, creating a workflow from the services deployed on the various edge nodes is presently impractical. This paper designs Viseu, a latency-aware blockchain framework to provide Virtual Internet Services at the Edge. Viseu aims to solve the puzzle of network service discovery at the edge, considering the peers' reputation and latency when choosing the service instances. Viseu enables peers to share their computational resources, services, and data among each other in an untrusted environment, rather than relying on a set of trusted service providers. By composing workflows from the peers' services, rather than confining them to the pre-established service provider and consumer roles, Viseu aims to facilitate scientific collaboration across the peers natively. Furthermore, by offering services from multiple peers close to the end-users, Viseu also minimizes end-to-end latency and data loss in the service execution at the Internet scale.

Blockchain for 5G-enabled networks in healthcare service based on several aspects

The pandemic crisis caused by COVID-19 is having a significant impact on our daily work and lives. 5G networks are ready to roll out across the world. This 5G technology helps by interconnecting devices with high quality-of-services (QoS) and efficient system capacity expansion. Aside from this, 5G offers other benefits regarding privacy, decentralization, visibility, and data interoperability. Blockchain technology is used in various industries, including electronic banking, health, and consensus mechanism. Blockchain is a new field based on the idea of a digitally distributed network and smart contract that eliminate all intermediary risks. Extending blockchain technology to the Internet of things (IoT) can provide further benefits. Because millions of IoT devices are connected, and more personal data are shared, one of the most critical challenges with 5G technology is authentication. While using blockchain technology, this data should be more secure. Electronic health records (EHRs) have become a common way to store and manage patient data in hospitals. Sharing these records improves the accuracy and efficiency of the current healthcare database management system. This study was conducted by gathering data and implementing applications regularly. In a blockchain, encryption algorithms know to obtain high-quality confidentiality of individual and organizational data. Healthcare knowledge and analysis are indeed essential to all parties, and privacy should still be retained and developed as technology advances. This proposed method provides a distributed ledger in 5G networks to encrypt information in intelligent healthcare systems.

An Experimental Performance Evaluation of Cloud-API-Based Applications

Cloud Application Programming Interfaces (APIs) have been developed to link several cloud computing applications together. API-based applications are widely used to provide flexible and reliable services over cloud platforms. Recently, a huge number of services have been attached to cloud platforms and widely utilized during a very short period of time. This is due to the COVID-19 lockdowns, which forced several businesses to switch to online services instantly. Several cloud platforms have failed to support adequate services, especially for extended and real-time-based applications. Early testing of the available platforms guarantees a level of suitability and reliability for the uploaded services. In this work, we first selected two different API-based applications from education and professional taxonomies, the two most recently used applications that have switched to the cloud environment. Then, we aimed to evaluate the performance of different API-based applications under different cloud platforms, in order to measure and validate the ability of these platforms to support these services. The advantages and drawbacks of each platform were experimentally investigated for each application.

BlockPres: A Novel Blockchain-Based Incentive Mechanism to Mitigate Inequalities for Prescription Management System

The study presents a blockchain-based incentive mechanism intended to encourage those in underserved communities to engage with healthcare services. The smart healthcare system, which is the result of the amalgamation of advanced technologies, has emerged recently and is increasingly seen as essential to meet the needs of modern society. An important part of the healthcare system is the prescription management system, but studies show that prescription affordability and accessibility play a part in creating unequal access for underserved communities. This is a form of unequal access that results in those living in underserved communities to become disengaged from accessing healthcare services. In New Zealand, the prescription management system plays a crucial role and this study seeks to address the issue by presenting the BlockPres framework, which uses a novel incentive mechanism to encourage patients to participate and engage with services in order to be rewarded. The blockchain attribute of immutability in BlockPres enhances equality and participation by providing sophisticated authorisation and authentication capabilities for healthcare providers and patients. BlockPres empowers the patient by assigning ownership or control of some patient information to the patient. A simulation is carried out using the Ethereum blockchain and the evaluation of successful transaction completion and superficial performance assessment demonstrates that the blockchain would be sufficient to cope with the needs of a prescription management system. Furthermore, for the simulation, a BlockPres Smart Contract is developed using solidity and implemented in Remix. The Ropsten network is used as the simulation environment and the initial results show that the proposed incentive mechanism mitigates unequal access.

A Scoping Review of Integrated Blockchain-Cloud (BcC) Architecture for Healthcare: Applications, Challenges and Solutions

Blockchain is a disruptive technology for shaping the next era of a healthcare system striving for efficient and effective patient care. This is thanks to its peer-to-peer, secure, and transparent characteristics. On the other hand, cloud computing made its way into the healthcare system thanks to its elasticity and cost-efficiency nature. However, cloud-based systems fail to provide a secured and private patient-centric cohesive view to multiple healthcare stakeholders. In this situation, blockchain provides solutions to address security and privacy concerns of the cloud because of its decentralization feature combined with data security and privacy, while cloud provides solutions to the blockchain scalability and efficiency challenges. Therefore a novel paradigm of blockchain-cloud integration (BcC) emerges for the domain of healthcare. In this paper, we provide an in-depth analysis of the BcC integration for the healthcare system to give the readers the motivations behind the emergence of this new paradigm, introduce a classification of existing architectures and their applications for better healthcare. We then review the development platforms and services and highlight the research challenges for the integrated BcC architecture, possible solutions, and future research directions. The results of this paper will be useful for the healthcare industry to design and develop a data management system for better patient care.

MedShard: Electronic Health Record Sharing Using Blockchain Sharding

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

Security and Privacy in Cloud-Based E-Health System

Cloud based healthcare computing have changed the face of healthcare in many ways. The main advantages of cloud computing in healthcare are scalability of the required service and the provision to upscale or downsize the data storge, collaborating Artificial Intelligence (AI) and machine learning. The current paper examined various research studies to explore the utilization of intelligent techniques in health systems and mainly focused into the security and privacy issues in the current technologies. Despite the various benefits related to cloud-computing applications for healthcare, there are different types of management, technology handling, security measures, and legal issues to be considered and addressed. The key focus of this paper is to address the increased demand for cloud computing and its definition, technologies widely used in healthcare, their problems and possibilities, and the way protection mechanisms are organized and prepared when the company chooses to implement the latest evolving service model. In this paper, we focused on a thorough review of current and existing literature on different approaches and mechanisms used in e-Health to deal with security and privacy issues. Some of these approaches have strengths and weaknesses. After selecting original articles, the literature review was carried out, and we identified several models adopted in their solutions. We arrived at the reviewed articles after comparing the models used.