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Lacson R, Yu Y, Kuo TT, Ohno-Machado L. Biomedical blockchain with practical implementations and quantitative evaluations: a systematic review. J Am Med Inform Assoc 2024; 31:1423-1435. [PMID: 38726710 PMCID: PMC11105130 DOI: 10.1093/jamia/ocae084] [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: 01/16/2024] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
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.
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Affiliation(s)
- Roger Lacson
- Department of Biomedical Informatics & Data Science, Yale School of Medicine, New Haven, CT 06510, United States
| | - Yufei Yu
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA 92093, United States
- Department of Biomedical Informatics, University of California San Diego Health, La Jolla, CA 92093, United States
| | - Tsung-Ting Kuo
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA 92093, United States
- Department of Biomedical Informatics, University of California San Diego Health, La Jolla, CA 92093, United States
| | - Lucila Ohno-Machado
- Department of Biomedical Informatics & Data Science, Yale School of Medicine, New Haven, CT 06510, United States
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA 92093, United States
- Department of Biomedical Informatics, University of California San Diego Health, La Jolla, CA 92093, United States
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Charles WM, van der Waal MB, Flach J, Bisschop A, van der Waal RX, Es-Sbai H, McLeod CJ. Blockchain-Based Dynamic Consent and its Applications for Patient-Centric Research and Health Information Sharing: Protocol for an Integrative Review. JMIR Res Protoc 2024; 13:e50339. [PMID: 38315514 PMCID: PMC10877491 DOI: 10.2196/50339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Blockchain has been proposed as a critical technology to facilitate more patient-centric research and health information sharing. For instance, it can be applied to coordinate and document dynamic informed consent, a procedure that allows individuals to continuously review and renew their consent to the collection, use, or sharing of their private health information. Such has been suggested to facilitate ethical, compliant longitudinal research, and patient engagement. However, blockchain-based dynamic consent is a relatively new concept, and it is not yet clear how well the suggested implementations will work in practice. Efforts to critically evaluate implementations in health research contexts are limited. OBJECTIVE The objective of this protocol is to guide the identification and critical appraisal of implementations of blockchain-based dynamic consent in health research contexts, thereby facilitating the development of best practices for future research, innovation, and implementation. METHODS The protocol describes methods for an integrative review to allow evaluation of a broad range of quantitative and qualitative research designs. The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) framework guided the review's structure and nature of reporting findings. We developed search strategies and syntax with the help of an academic librarian. Multiple databases were selected to identify pertinent academic literature (CINAHL, Embase, Ovid MEDLINE, PubMed, Scopus, and Web of Science) and gray literature (Electronic Theses Online Service, ProQuest Dissertations and Theses, Open Access Theses and Dissertations, and Google Scholar) for a comprehensive picture of the field's progress. Eligibility criteria were defined based on PROSPERO (International Prospective Register of Systematic Reviews) requirements and a criteria framework for technology readiness. A total of 2 reviewers will independently review and extract data, while a third reviewer will adjudicate discrepancies. Quality appraisal of articles and discussed implementations will proceed based on the validated Mixed Method Appraisal Tool, and themes will be identified through thematic data synthesis. RESULTS Literature searches were conducted, and after duplicates were removed, 492 articles were eligible for screening. Title and abstract screening allowed the removal of 312 articles, leaving 180 eligible articles for full-text review against inclusion criteria and confirming a sufficient body of literature for project feasibility. Results will synthesize the quality of evidence on blockchain-based dynamic consent for patient-centric research and health information sharing, covering effectiveness, efficiency, satisfaction, regulatory compliance, and methods of managing identity. CONCLUSIONS The review will provide a comprehensive picture of the progress of emerging blockchain-based dynamic consent technologies and the rigor with which implementations are approached. Resulting insights are expected to inform best practices for future research, innovation, and implementation to benefit patient-centric research and health information sharing. TRIAL REGISTRATION PROSPERO CRD42023396983; http://tinyurl.com/cn8a5x7t. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50339.
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Affiliation(s)
- Wendy M Charles
- Health Administration Program, Business School, University of Colorado, Denver, Denver, CO, United States
- Healthcare Informatics Program, University of Denver, Denver, CO, United States
| | - Mark B van der Waal
- Triall, Maarssen, Netherlands
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | | | | | - Christopher J McLeod
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
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Allareddy V, Rampa S, Venugopalan SR, Elnagar MH, Lee MK, Oubaidin M, Yadav S. Blockchain technology and federated machine learning for collaborative initiatives in orthodontics and craniofacial health. Orthod Craniofac Res 2023; 26 Suppl 1:118-123. [PMID: 37036565 DOI: 10.1111/ocr.12662] [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: 02/23/2023] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 04/11/2023]
Abstract
There is a paucity of largescale collaborative initiatives in orthodontics and craniofacial health. Such nationally representative projects would yield findings that are generalizable. The lack of large-scale collaborative initiatives in the field of orthodontics creates a deficiency in study outcomes that can be applied to the population at large. The objective of this study is to provide a narrative review of potential applications of blockchain technology and federated machine learning to improve collaborative care. We conducted a narrative review of articles published from 2018 to 2023 to provide a high level overview of blockchain technology, federated machine learning, remote monitoring, and genomics and how they can be leveraged together to establish a patient centered model of care. To strengthen the empirical framework for clinical decision making in healthcare, we suggest use of blockchain technology and integrating it with federated machine learning. There are several challenges to adoption of these technologies in the current healthcare ecosystem. Nevertheless, this may be an ideal time to explore how best we can integrate these technologies to deliver high quality personalized care. This article provides an overview of blockchain technology and federated machine learning and how they can be leveraged to initiate collaborative projects that will have the patient at the center of care.
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Affiliation(s)
- Veerasathpurush Allareddy
- Department of Orthodontics, University of Illinois Chicago College of Dentistry, Chicago, Illinois, USA
| | | | | | - Mohammed H Elnagar
- University of Illinois Chicago College of Dentistry, Chicago, Illinois, USA
| | - Min Kyeong Lee
- University of Illinois Chicago College of Dentistry, Chicago, Illinois, USA
| | - Maysaa Oubaidin
- University of Illinois Chicago College of Dentistry, Chicago, Illinois, USA
| | - Sumit Yadav
- UNMC College of Dentistry, Lincoln, Nebraska, USA
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4
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Barrera JA, Trotsyuk AA, Henn D, Sivaraj D, Chen K, Mittal S, Mermin-Bunnell AM, Larson MR, Padmanabhan J, Kinney B, Nachbar J, Sacks J, Terkonda SP, Jeffers L, Gurtner GC. Blockchain, Information Security, Control, and Integrity: Who Is in Charge? Plast Reconstr Surg 2023; 152:751e-758e. [PMID: 36917745 DOI: 10.1097/prs.0000000000010409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
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.
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Affiliation(s)
- Janos A Barrera
- From the Department of Surgery, Stanford University School of Medicine
| | - Artem A Trotsyuk
- From the Department of Surgery, Stanford University School of Medicine
| | - Dominic Henn
- From the Department of Surgery, Stanford University School of Medicine
- Department of Hand, Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Ruprecht-Karls-University of Heidelberg
| | - Dharshan Sivaraj
- From the Department of Surgery, Stanford University School of Medicine
| | - Kellen Chen
- From the Department of Surgery, Stanford University School of Medicine
| | - Smiti Mittal
- From the Department of Surgery, Stanford University School of Medicine
| | | | - Madelyn R Larson
- From the Department of Surgery, Stanford University School of Medicine
| | | | | | | | - Justin Sacks
- Department of Surgery, Washington University School of Medicine
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Pietris J, Bacchi S, Wiech S, Tan Y, Kovoor J, Gupta A, Casson R, Chan W. Non-fungible tokens in ophthalmology: what is it good for? Eye (Lond) 2023; 37:2434-2435. [PMID: 36564577 PMCID: PMC10397237 DOI: 10.1038/s41433-022-02371-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 11/30/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- James Pietris
- University of Queensland, Herston, QLD, 4006, Australia.
- Health and Information, Adelaide, SA, 5000, Australia.
| | - Stephen Bacchi
- Health and Information, Adelaide, SA, 5000, Australia
- University of Adelaide, Adelaide, SA, 5005, Australia
- Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
- Flinders University, Bedford Park, SA, 5042, Australia
| | | | - Yiran Tan
- Health and Information, Adelaide, SA, 5000, Australia
- University of Adelaide, Adelaide, SA, 5005, Australia
- Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
- Flinders University, Bedford Park, SA, 5042, Australia
| | - Joshua Kovoor
- Health and Information, Adelaide, SA, 5000, Australia
- University of Adelaide, Adelaide, SA, 5005, Australia
- Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
| | - Aashray Gupta
- Health and Information, Adelaide, SA, 5000, Australia
- University of Adelaide, Adelaide, SA, 5005, Australia
| | - Robert Casson
- Health and Information, Adelaide, SA, 5000, Australia
- University of Adelaide, Adelaide, SA, 5005, Australia
- Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
| | - Weng Chan
- Health and Information, Adelaide, SA, 5000, Australia
- University of Adelaide, Adelaide, SA, 5005, Australia
- Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
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6
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Abstract
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.
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Panigrahi A, Nayak AK, Paul R. HealthCare EHR. INTERNATIONAL JOURNAL OF INFORMATION SYSTEMS AND SUPPLY CHAIN MANAGEMENT 2022. [DOI: 10.4018/ijisscm.290017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
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.
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Ho LS, Zhang T, Kwok TCT, Wat KP, Lai FTT, Li S. Financing Orphan Drugs Through a Blockchain-Supported Insurance Model. FRONTIERS IN BLOCKCHAIN 2022. [DOI: 10.3389/fbloc.2022.818807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The cost of treatment for rare diseases is notoriously high imposing threats to the global healthcare system. Existing market-based tools for orphan drugs are not designed to reduce drug prices and could be hampered by adverse selection. We propose an alternative insurance mechanism, Massive Group Insurance (MGI), which aims at reducing the prices of orphan drugs through offering separate Intellectual Property Right (IPR) Fees to the drug company from an MGI Agency, which will collect insurance premiums from each country on each orphan drug that the country wants all its citizens to enjoy access to. The premiums will be calculated so as to ensure that the drug company will collect a profit no smaller than what it enjoys under the traditional model. The plan uses the group insurance concept and will generate a significant increase in drug use. Blockchain technology is used to facilitate authentication and effective IPR payments and ensure data security and low administrative cost. This model can potentially be extended to other categories of expensive drugs and vaccines.
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Abstract
Since blockchain technology has proven to be effective in the development of a wide range of industries, its use in other fields is also being expanded. Agriculture is one such sector, where blockchain technology is being used to improve farm business operations. Today, several agribusiness firms are utilizing technology to improve food supply chain tracking. For example, Farmers Edge, the world’s leading company that revolutionized the field of digital agriculture through its work in providing advanced artificial intelligence solutions, as well as new opportunities that give agriculture a globally advanced future for all stakeholders, has taken a significant step forward. The issue of blockchain network technology and its applications in agriculture will be discussed in this study, as well as the key advantages that this technology can provide, when employed to make the lives of both producers and consumers easier. In addition, a total of 79 research papers were evaluated, with a focus on the state of blockchain technology in agriculture, related issues, and its future importance, as well as relevant contributions to this new technology and the distributions of this study by different countries.
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10
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Beyene M, Toussaint PA, Thiebes S, Schlesner M, Brors B, Sunyaev A. OUP accepted manuscript. J Am Med Inform Assoc 2022; 29:1433-1444. [PMID: 35595301 PMCID: PMC9277639 DOI: 10.1093/jamia/ocac077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Rising interests in distributed ledger technology (DLT) and genomics have sparked various interdisciplinary research streams with a proliferating number of scattered publications investigating the application of DLT in genomics. This review aims to uncover the current state of research on DLT in genomics, in terms of focal research themes and directions for future research. Materials and Methods We conducted a scoping review and thematic analysis. To identify the 60 relevant papers, we queried Scopus, Web of Science, PubMed, ACM Digital Library, IEEE Xplore, arXiv, and BiorXiv. Results Our analysis resulted in 7 focal themes on DLT in genomics discussed in literature, namely: (1) Data economy and sharing; (2) Data management; (3) Data protection; (4) Data storage; (5) Decentralized data analysis; (6) Proof of useful work; and (7) Ethical, legal, and social implications. Discussion Based on the identified themes, we present 7 future research directions: (1) Investigate opportunities for the application of DLT concepts other than Blockchain; (2) Explore people’s attitudes and behaviors regarding the commodification of genetic data through DLT-based genetic data markets; (3) Examine opportunities for joint consent management via DLT; (4) Investigate and evaluate data storage models appropriate for DLT; (5) Research the regulation-compliant use of DLT in healthcare information systems; (6) Investigate alternative consensus mechanisms based on Proof of Useful Work; and (7) Explore DLT-enabled approaches for the protection of genetic data ensuring user privacy. Conclusion While research on DLT in genomics is currently growing, there are many unresolved problems. This literature review outlines extant research and provides future directions for researchers and practitioners.
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Affiliation(s)
- Mikael Beyene
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
- HIDSS4Health—Helmholtz Information and Data Science School for Health, Karlsruhe/Heidelberg, Germany
| | - Philipp A Toussaint
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
- HIDSS4Health—Helmholtz Information and Data Science School for Health, Karlsruhe/Heidelberg, Germany
| | - Scott Thiebes
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Matthias Schlesner
- Biomedical Informatics, Data Mining and Data Analytics, Faculty of Applied Computer Science and Medical Faculty, University of Augsburg, Augsburg, Germany
- Bioinformatics and Omics Data Analytics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Benedikt Brors
- Division of Applied Bioinformatics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ali Sunyaev
- Corresponding Author: Ali Sunyaev, Department of Economics and Management, Karlsruhe Institute of Technology, Kaiserstr. 89, 76133 Karlsruhe, Germany;
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11
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Xie Y, Zhang J, Wang H, Liu P, Liu S, Huo T, Duan YY, Dong Z, Lu L, Ye Z. Applications of Blockchain in the Medical Field: Narrative Review. J Med Internet Res 2021; 23:e28613. [PMID: 34533470 PMCID: PMC8555946 DOI: 10.2196/28613] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/12/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
Background As a distributed technology, blockchain has attracted increasing attention from stakeholders in the medical industry. Although previous studies have analyzed blockchain applications from the perspectives of technology, business, or patient care, few studies have focused on actual use-case scenarios of blockchain in health care. In particular, the outbreak of COVID-19 has led to some new ideas for the application of blockchain in medical practice. Objective This paper aims to provide a systematic review of the current and projected uses of blockchain technology in health care, as well as directions for future research. In addition to the framework structure of blockchain and application scenarios, its integration with other emerging technologies in health care is discussed. Methods We searched databases such as PubMed, EMBASE, Scopus, IEEE, and Springer using a combination of terms related to blockchain and health care. Potentially relevant papers were then compared to determine their relevance and reviewed independently for inclusion. Through a literature review, we summarize the key medical scenarios using blockchain technology. Results We found a total of 1647 relevant studies, 60 of which were unique studies that were included in this review. These studies report a variety of uses for blockchain and their emphasis differs. According to the different technical characteristics and application scenarios of blockchain, we summarize some medical scenarios closely related to blockchain from the perspective of technical classification. Moreover, potential challenges are mentioned, including the confidentiality of privacy, the efficiency of the system, security issues, and regulatory policy. Conclusions Blockchain technology can improve health care services in a decentralized, tamper-proof, transparent, and secure manner. With the development of this technology and its integration with other emerging technologies, blockchain has the potential to offer long-term benefits. Not only can it be a mechanism to secure electronic health records, but blockchain also provides a powerful tool that can empower users to control their own health data, enabling a foolproof health data history and establishing medical responsibility.
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Affiliation(s)
- Yi Xie
- Department of Orthopedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Laboratory of Intelligent Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiayao Zhang
- Department of Orthopedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Laboratory of Intelligent Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Honglin Wang
- Department of Orthopedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Laboratory of Intelligent Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pengran Liu
- Department of Orthopedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Laboratory of Intelligent Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Songxiang Liu
- Department of Orthopedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Laboratory of Intelligent Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tongtong Huo
- Laboratory of Intelligent Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, China
| | - Yu-Yu Duan
- Laboratory of Intelligent Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei University of Chinese Medicine, Wuhan, China
| | - Zhe Dong
- Wuhan Academy of Intelligent Medicine, Wuhan, China
| | - Lin Lu
- Department of Orthopedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Laboratory of Intelligent Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhewei Ye
- Department of Orthopedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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12
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Khurshid A, Holan C, Cowley C, Alexander J, Harrell DT, Usman M, Desai I, Bautista JR, Meyer E. Designing and testing a blockchain application for patient identity management in healthcare. JAMIA Open 2021; 4:ooaa073. [PMID: 34505001 PMCID: PMC7928860 DOI: 10.1093/jamiaopen/ooaa073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/25/2020] [Accepted: 12/23/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Healthcare systems suffer from a lack of interoperability that creates "data silos," causing patient linkage and data sharing problems. Blockchain technology's unique architecture provides individuals greater control over their information and may help address some of the problems related to health data. A multidisciplinary team designed and tested a blockchain application, MediLinker, as a patient-centric identity management system. METHODS The study used simulated data of "avatars" representing different types of patients. Thirty study participants were enrolled to visit simulated clinics, and perform various activities using MediLinker. Evaluation was based on Bouras' criteria for patient-centric identity management and on the number of errors in entry and sharing of data by participants. RESULTS Twenty-nine of the 30 participants completed all study activities. MediLinker fulfilled all of Bouras' criteria except for one which was not testable. A majority of data errors were due to user error, such as wrong formatting and misspellings. Generally, the number of errors decreased with time. Due to COVID-19, sprint 2 was completed using "virtual" clinic visits. The number of user errors were less in virtual visits than in personal visits. DISCUSSION The evaluation of MediLinker provides some evidence of the potential of a patient-centric identity management system using blockchain technology. The results showed a working system where patients have greater control over their information and can also easily provide consent for use of their data. CONCLUSION Blockchain applications for identity management hold great promise for use in healthcare but further research is needed before real-world adoption.
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Affiliation(s)
- Anjum Khurshid
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Cole Holan
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Cody Cowley
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Jeremiah Alexander
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Daniel Toshio Harrell
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Muhammad Usman
- Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Ishav Desai
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | | | - Eric Meyer
- School of Information, The University of Texas at Austin, Austin, Texas, USA
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13
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Ng WY, Tan TE, Xiao Z, Movva PVH, Foo FSS, Yun D, Chen W, Wong TY, Lin HT, Ting DSW. Blockchain Technology for Ophthalmology: Coming of Age? Asia Pac J Ophthalmol (Phila) 2021; 10:343-347. [PMID: 34415244 DOI: 10.1097/apo.0000000000000399] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Wei Yan Ng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-National University of Singapore Medical School, Singapore
| | - Tien-En Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-National University of Singapore Medical School, Singapore
| | - Zhe Xiao
- Institute of High Performance Computing, Agency for Science, Technology and Research (A∗STAR), Singapore
| | - Prasanth V H Movva
- Certis Commercial and Industrial Security Corporation Security Private Limited, Singapore
| | - Fuji S S Foo
- Certis Commercial and Industrial Security Corporation Security Private Limited, Singapore
| | - Dongyuan Yun
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, People's Republic of China
| | - Wenben Chen
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, People's Republic of China
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-National University of Singapore Medical School, Singapore
| | - Hao Tian Lin
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, People's Republic of China
| | - Daniel S W Ting
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-National University of Singapore Medical School, Singapore
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Pereira T, Morgado J, Silva F, Pelter MM, Dias VR, Barros R, Freitas C, Negrão E, Flor de Lima B, Correia da Silva M, Madureira AJ, Ramos I, Hespanhol V, Costa JL, Cunha A, Oliveira HP. Sharing Biomedical Data: Strengthening AI Development in Healthcare. Healthcare (Basel) 2021; 9:healthcare9070827. [PMID: 34208830 PMCID: PMC8303863 DOI: 10.3390/healthcare9070827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/11/2021] [Accepted: 06/22/2021] [Indexed: 01/17/2023] Open
Abstract
Artificial intelligence (AI)-based solutions have revolutionized our world, using extensive datasets and computational resources to create automatic tools for complex tasks that, until now, have been performed by humans. Massive data is a fundamental aspect of the most powerful AI-based algorithms. However, for AI-based healthcare solutions, there are several socioeconomic, technical/infrastructural, and most importantly, legal restrictions, which limit the large collection and access of biomedical data, especially medical imaging. To overcome this important limitation, several alternative solutions have been suggested, including transfer learning approaches, generation of artificial data, adoption of blockchain technology, and creation of an infrastructure composed of anonymous and abstract data. However, none of these strategies is currently able to completely solve this challenge. The need to build large datasets that can be used to develop healthcare solutions deserves special attention from the scientific community, clinicians, all the healthcare players, engineers, ethicists, legislators, and society in general. This paper offers an overview of the data limitation in medical predictive models; its impact on the development of healthcare solutions; benefits and barriers of sharing data; and finally, suggests future directions to overcome data limitations in the medical field and enable AI to enhance healthcare. This perspective is dedicated to the technical requirements of the learning models, and it explains the limitation that comes from poor and small datasets in the medical domain and the technical options that try or can solve the problem related to the lack of massive healthcare data.
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Affiliation(s)
- Tania Pereira
- INESC TEC—Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal; (J.M.); (F.S.); (V.R.D.); (R.B.); (A.C.); (H.P.O.)
- Correspondence:
| | - Joana Morgado
- INESC TEC—Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal; (J.M.); (F.S.); (V.R.D.); (R.B.); (A.C.); (H.P.O.)
- FCUP—Faculty of Science, University of Porto, 4169-007 Porto, Portugal
| | - Francisco Silva
- INESC TEC—Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal; (J.M.); (F.S.); (V.R.D.); (R.B.); (A.C.); (H.P.O.)
| | - Michele M. Pelter
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA 94143, USA;
| | - Vasco Rosa Dias
- INESC TEC—Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal; (J.M.); (F.S.); (V.R.D.); (R.B.); (A.C.); (H.P.O.)
| | - Rita Barros
- INESC TEC—Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal; (J.M.); (F.S.); (V.R.D.); (R.B.); (A.C.); (H.P.O.)
| | - Cláudia Freitas
- CHUSJ—Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal; (C.F.); (E.N.); (B.F.d.L.); (M.C.d.S.); (A.J.M.); (I.R.); (V.H.)
- FMUP—Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Eduardo Negrão
- CHUSJ—Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal; (C.F.); (E.N.); (B.F.d.L.); (M.C.d.S.); (A.J.M.); (I.R.); (V.H.)
| | - Beatriz Flor de Lima
- CHUSJ—Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal; (C.F.); (E.N.); (B.F.d.L.); (M.C.d.S.); (A.J.M.); (I.R.); (V.H.)
| | - Miguel Correia da Silva
- CHUSJ—Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal; (C.F.); (E.N.); (B.F.d.L.); (M.C.d.S.); (A.J.M.); (I.R.); (V.H.)
| | - António J. Madureira
- CHUSJ—Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal; (C.F.); (E.N.); (B.F.d.L.); (M.C.d.S.); (A.J.M.); (I.R.); (V.H.)
- FMUP—Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Isabel Ramos
- CHUSJ—Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal; (C.F.); (E.N.); (B.F.d.L.); (M.C.d.S.); (A.J.M.); (I.R.); (V.H.)
- FMUP—Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Venceslau Hespanhol
- CHUSJ—Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal; (C.F.); (E.N.); (B.F.d.L.); (M.C.d.S.); (A.J.M.); (I.R.); (V.H.)
- FMUP—Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - José Luis Costa
- FMUP—Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- i3S—Institute for Research and Innovation in Health of the University of Porto, 4200-135 Porto, Portugal
- IPATIMUP—Institute of Molecular Pathology and Immunology of the University of Porto, 4200-135 Porto, Portugal
| | - António Cunha
- INESC TEC—Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal; (J.M.); (F.S.); (V.R.D.); (R.B.); (A.C.); (H.P.O.)
- UTAD—University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| | - Hélder P. Oliveira
- INESC TEC—Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal; (J.M.); (F.S.); (V.R.D.); (R.B.); (A.C.); (H.P.O.)
- FCUP—Faculty of Science, University of Porto, 4169-007 Porto, Portugal
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Hussien HM, Yasin SM, Udzir NI, Ninggal MIH. Blockchain-Based Access Control Scheme for Secure Shared Personal Health Records over Decentralised Storage. SENSORS 2021; 21:s21072462. [PMID: 33918266 PMCID: PMC8038200 DOI: 10.3390/s21072462] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 12/04/2022]
Abstract
Blockchain technology provides a tremendous opportunity to transform current personal health record (PHR) systems into a decentralised network infrastructure. However, such technology possesses some drawbacks, such as issues in privacy and storage capacity. Given its transparency and decentralised features, medical data are visible to everyone on the network and are inappropriate for certain medical applications. By contrast, storing vast medical data, such as patient medical history, laboratory tests, X-rays, and MRIs, significantly affect the repository storage of blockchain. This study bridges the gap between PHRs and blockchain technology by offloading the vast medical data into the InterPlanetary File System (IPFS) storage and establishing an enforced cryptographic authorisation and access control scheme for outsourced encrypted medical data. The access control scheme is constructed on the basis of the new lightweight cryptographic concept named smart contract-based attribute-based searchable encryption (SC-ABSE). This newly cryptographic primitive is developed by extending ciphertext-policy attribute-based encryption (CP-ABE) and searchable symmetric encryption (SSE) and by leveraging the technology of smart contracts to achieve the following: (1) efficient and secure fine-grained access control of outsourced encrypted data, (2) confidentiality of data by eliminating trusted private key generators, and (3) multikeyword searchable mechanism. Based on decisional bilinear Diffie–Hellman hardness assumptions (DBDH) and discrete logarithm (DL) problems, the rigorous security indistinguishability analysis indicates that SC-ABSE is secure against the chosen-keyword attack (CKA) and keyword secrecy (KS) in the standard model. In addition, user collusion attacks are prevented, and the tamper-proof resistance of data is ensured. Furthermore, security validation is verified by simulating a formal verification scenario using Automated Validation of Internet Security Protocols and Applications (AVISPA), thereby unveiling that SC-ABSE is resistant to man-in-the-middle (MIM) and replay attacks. The experimental analysis utilised real-world datasets to demonstrate the efficiency and utility of SC-ABSE in terms of computation overhead, storage cost and communication overhead. The proposed scheme is also designed and developed to evaluate throughput and latency transactions using a standard benchmark tool known as Caliper. Lastly, simulation results show that SC-ABSE has high throughput and low latency, with an ultimate increase in network life compared with traditional healthcare systems.
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Affiliation(s)
- Hassan Mansur Hussien
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Serdang 43400, Malaysia; (N.I.U.); (M.I.H.N.)
- Correspondence: (H.M.H.); (S.M.Y.); Tel.: +60-182015604 (H.M.H.)
| | - Sharifah Md Yasin
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Serdang 43400, Malaysia; (N.I.U.); (M.I.H.N.)
- Institute for Mathematical Research (INSPEM), Universiti Putra Malaysia, Serdang 43400, Malaysia
- Correspondence: (H.M.H.); (S.M.Y.); Tel.: +60-182015604 (H.M.H.)
| | - Nur Izura Udzir
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Serdang 43400, Malaysia; (N.I.U.); (M.I.H.N.)
| | - Mohd Izuan Hafez Ninggal
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Serdang 43400, Malaysia; (N.I.U.); (M.I.H.N.)
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Binkheder S, Aldekhyyel R, Almulhem J. Health informatics publication trends in Saudi Arabia: a bibliometric analysis over the last twenty-four years. J Med Libr Assoc 2021; 109:219-239. [PMID: 34285665 PMCID: PMC8270356 DOI: 10.5195/jmla.2021.1072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Understanding health informatics (HI) publication trends in Saudi Arabia may serve as a framework for future research efforts and contribute toward meeting national "e-Health" goals. The authors' intention was to understand the state of the HI field in Saudi Arabia by exploring publication trends and their alignment with national goals. METHODS A scoping review was performed to identify HI publications from Saudi Arabia in PubMed, Embase, and Web of Science. We analyzed publication trends based on topics, keywords, and how they align with the Ministry of Health's (MOH's) "digital health journey" framework. RESULTS The total number of publications included was 242. We found 1 (0.4%) publication in 1995-1999, 11 (4.5%) publications in 2000-2009, and 230 (95.0%) publications in 2010-2019. We categorized publications into 3 main HI fields and 4 subfields: 73.1% (n=177) of publications were in clinical informatics (85.1%, n=151 medical informatics; 5.6%, n=10 pharmacy informatics; 6.8%, n=12 nursing informatics; 2.3%, n=4 dental informatics); 22.3% (n=54) were in consumer health informatics; and 4.5% (n=11) were in public health informatics. The most common keyword was "medical informatics" (21.5%, n=52). MOH framework-based analysis showed that most publications were categorized as "digitally enabled care" and "digital health foundations." CONCLUSIONS The years of 2000-2009 may be seen as an infancy stage of the HI field in Saudi Arabia. Exploring how the Saudi Arabian MOH's e-Health initiatives may influence research is valuable for advancing the field. Data exchange and interoperability, artificial intelligence, and intelligent health enterprises might be future research directions in Saudi Arabia.
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Affiliation(s)
- Samar Binkheder
- , Assistant Professor of Biomedical and Health Informatics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Raniah Aldekhyyel
- , Assistant Professor of Biomedical and Health Informatics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Jwaher Almulhem
- , Assistant Professor of Biomedical and Health Informatics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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17
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The case for establishing a blockchain research and development program at an academic medical center. BLOCKCHAIN IN HEALTHCARE TODAY 2021; 4:161. [PMID: 36777480 PMCID: PMC9907427 DOI: 10.30953/bhty.v4.161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/26/2021] [Accepted: 01/19/2021] [Indexed: 11/17/2022]
Abstract
Objective To develop a research and development program to study factors that will support research, education and innovation using blockchain technology for health in an effective and sustainable manner. We proposed to conduct qualitative research to generate insights for developing a market strategy to build a research lab for the promotion of blockchain technologies in health in academic environments. The team aimed to identify the key barriers and opportunities for developing a sustainable research lab that generates research, education, and application of blockchain in healthcare at an academic medical institution and test those strategies in a real-world scenario. Methods The research team identified potential customers and stakeholders through interviews and snowball sampling. The team conducted semi-structured interviews with 4 faculty researchers, 10 industry leaders, and 6 students from a variety of disciplines and organizations. The findings of these research activities informed our understanding of the needs of stratified customers and helped identify key assets and activities the lab will have to offer to meet those needs. Results The research insights from data analysis were used to build the business model for establishing a blockchain in health impact lab. This systematic study of areas where blockchain technology can impact health will guide the future development of research agenda for the researchers on campus. Conclusion Based on our learnings, we hope to design a Blockchain in Health Impact Lab to serve as a platform for students and faculty to come together with industry partners and explore current challenges of blockchain in healthcare. The academic medical center's partnership with other healthcare providers will help create real-world opportunities to demonstrate and implement new technologies.
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18
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Sánchez López JD, Cambil Martín J, Luque Martínez F. [Blockchain. A new approach in patient safety]. J Healthc Qual Res 2021; 37:193-195. [PMID: 33642200 DOI: 10.1016/j.jhqr.2020.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 03/24/2020] [Accepted: 03/26/2020] [Indexed: 11/27/2022]
Affiliation(s)
- J D Sánchez López
- Facultativo Especialista de Área de Cirugía Oral y Maxilofacial, Hospital Universitario Virgen de las Nieves, Granada, España; Presidente del Comité Ético de Investigación de Granada, Granada, España.
| | - J Cambil Martín
- Doctor en Enfermería, Profesor del Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Granada, Granada, España
| | - F Luque Martínez
- Doctor en Farmacia, Responsable de Formación, Hospital Universitario Virgen de las Nieves, Granada, España; Vicepresidente del Comité Ético de Investigación de Granada, Granada, España
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Bansal A, Garg C, Padappayil RP, Gupta S, Jain V, Nadeem M, Kapadia SR. How Blockchain Technology Can Transform the Systematic Review/Meta-analysis Process? Am J Cardiol 2021; 139:136-138. [PMID: 33228947 DOI: 10.1016/j.amjcard.2020.10.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
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