Automated infection risks assessments (AIRa) for decision-making using a blockchain-based alert system: A case study in a representative building

Indoor air quality (IAQ) is an important parameter in protecting the occupants of an indoor environment. Previous studies have shown that an indoor environment with poor ventilation increases airborne virus transmission. Existing research has concluded that high ventilation rates can reduce the risk of individuals in indoor environments being infected. However, most existing ventilation systems are designed to be efficient under non-pandemic conditions. Ultimately, indoor environments will become hotspots for the transmission of airborne viruses. Current infection risk assessments can estimate virus transmission via airborne routes, but with limited information sharing among stakeholders. Our own research did not identify any systems that integrate risk assessments with smart sensors in order to support information sharing with experts in indoor environments in their decision-making process. To fill this gap, we designed a blockchain-based prototype (AIRa) that integrates CO₂ smart sensor data with infection risk assessments from a post-pandemic perspective. This system generates two types of alerts: (1) P-Alert and (2) R0-Alert for decision-making by building owners, such as increasing the ventilation rate or track and trace, as needed. AIRa shows various benefits over three existing infection-control alert systems. Our solution stores and shares information such as the timestamp and room number, instead of storing building user's personal information. Our approach does not require a QR code to be scanned or a mobile app to be downloaded in order to enable track and trace. However, AIRa is still an early prototype for evaluating the risks of airborne virus transmission in smart building environments. Multidisciplinary knowledge and technological research will be vital in formulating different alerts in the future.

A Framework for Online Document Verification Using Self-Sovereign Identity Technology

As the world is gradually moving towards digitization, forgery of vital digital documents has become relatively easy. Therefore, the need for efficient and secure verification and authentication practices of digital documents is also increasing. Self-sovereign identity (SSI) is a set of technologies that build on core concepts in identity management, blockchain technology, and cryptography. SSI enables entities to create fraud-proof verifiable credentials and instantly verify the authenticity of a digital credential. The online document verification solutions must deal with a myriad of issues in regard to privacy and security. Moreover, various challenging and tedious processes have made document verification overly complex and time-consuming which motivated us to conduct this research. This work presents a novel framework for online document verification based on SSI technology. The solution address the complexity and interoperability issues that are present in the current digital document verification systems. We look at a particular use case, i.e., document verification in online loan processing and evaluate how this proposed approach can make an impact on the existing system. Our solution based on SSI standards replaces the intermediary and enables trust between players in the ecosystem. The technology also holds the potential to make the system more efficient, interoperable, and privacy-preserving.

Decentralized Identity Management for E-Health Applications: State-of-the-Art and Guidance for Future Work

BACKGROUND

The increasing use of various online services requires an efficient digital identity management (DIM) approach. Unfortunately, the original Internet protocols were not designed with built-in identity management, which creates challenges related to privacy, security, and usability. There is an increasing societal concern regarding the management of these sensitive data, access to it, and where it is stored. Blockchain technology can potentially offer a secure solution to address these issues in a decentralized manner without centralized authority. This is important for e-health services where the patient and the healthcare provider often are required to prove their identity. Blockchain technology can be utilized for creating digital identities and making its management easier, thus giving a higher degree of control to the user than what current solutions offer. It can be used to create a digital identity on the blockchain, making it easier for individuals and entities to manage, giving them greater control over who has their personal information and how they handle it. In addition, it might be utilized to create a higher degree of trust and security for e-health applications.

OBJECTIVE

The aim of this research work was to review the state-of-the-art regarding blockchain-based decentralized identity management for healthcare applications. Based on this summary, we provide a viewpoint on how blockchain-based decentralized identity frameworks might be utilized for virtualized healthcare applications.

METHODS

This research study applied a scoping, semi-systematic review approach to summarize the state-of-the-art. Included identity management systems were evaluated based on seven criteria: autonomy, authority, availability, approval, confidentiality, tenacity, and Interoperability.

RESULTS

Seven blockchain-based identity management systems were included and evaluated in this work: these include solutions built with Ethereum, Hyperledger Indy, Hyperledger Fabric, Hedera, and Sovrin blockchains.

CONCLUSIONS

DIM is crucial for virtual health care. Decentralized identity management for healthcare purposes is currently being explored in both academia and the private sector. More work is needed with the aim of improving the efficiency of current DIM solutions and to fully understand what technical frameworks are best suited for e-health applications.

Blockchain-Based Digital Contact Tracing Apps for COVID-19 Pandemic Management: Issues, Challenges, Solutions, and Future Directions

The COVID-19 pandemic has caused substantial global disturbance by affecting more than 42 million people (as of the end of October 2020). Since there is no medication or vaccine available, the only way to combat it is to minimize transmission. Digital contact tracing is an effective technique that can be utilized for this purpose, as it eliminates the manual contact tracing process and could help in identifying and isolating affected people. However, users are reluctant to share their location and contact details due to concerns related to the privacy and security of their personal information, which affects its implementation and extensive adoption. Blockchain technology has been applied in various domains and has been proven to be an effective approach for handling data transactions securely, which makes it an ideal choice for digital contact tracing apps. The properties of blockchain such as time stamping and immutability of data may facilitate the retrieval of accurate information on the trail of the virus in a transparent manner, while data encryption assures the integrity of the information being provided. Furthermore, the anonymity of the user's identity alleviates some of the risks related to privacy and confidentiality concerns. In this paper, we provide readers with a detailed discussion on the digital contact tracing mechanism and outline the apps developed so far to combat the COVID-19 pandemic. Moreover, we present the possible risks, issues, and challenges associated with the available contact tracing apps and analyze how the adoption of a blockchain-based decentralized network for handling the app could provide users with privacy-preserving contact tracing without compromising performance and efficiency.

Reducing Alert Fatigue by Sharing Low-Level Alerts With Patients and Enhancing Collaborative Decision Making Using Blockchain Technology: Scoping Review and Proposed Framework (MedAlert)

Background

Clinical decision support (CDS) is a tool that helps clinicians in decision making by generating clinical alerts to supplement their previous knowledge and experience. However, CDS generates a high volume of irrelevant alerts, resulting in alert fatigue among clinicians. Alert fatigue is the mental state of alerts consuming too much time and mental energy, which often results in relevant alerts being overridden unjustifiably, along with clinically irrelevant ones. Consequently, clinicians become less responsive to important alerts, which opens the door to medication errors.

Objective

This study aims to explore how a blockchain-based solution can reduce alert fatigue through collaborative alert sharing in the health sector, thus improving overall health care quality for both patients and clinicians.

Methods

We have designed a 4-step approach to answer this research question. First, we identified five potential challenges based on the published literature through a scoping review. Second, a framework is designed to reduce alert fatigue by addressing the identified challenges with different digital components. Third, an evaluation is made by comparing MedAlert with other proposed solutions. Finally, the limitations and future work are also discussed.

Results

Of the 341 academic papers collected, 8 were selected and analyzed. MedAlert securely distributes low-level (nonlife-threatening) clinical alerts to patients, enabling a collaborative clinical decision. Among the solutions in our framework, Hyperledger (private permissioned blockchain) and BankID (federated digital identity management) have been selected to overcome challenges such as data integrity, user identity, and privacy issues.

Conclusions

MedAlert can reduce alert fatigue by attracting the attention of patients and clinicians, instead of solely reducing the total number of alerts. MedAlert offers other advantages, such as ensuring a higher degree of patient privacy and faster transaction times compared with other frameworks. This framework may not be suitable for elderly patients who are not technology savvy or in-patients. Future work in validating this framework based on real health care scenarios is needed to provide the performance evaluations of MedAlert and thus gain support for the better development of this idea.

Developing a smartphone 'app' for public health research: the example of measuring observed smoking in vehicles

BACKGROUND

We have developed manual methods to gather data on the point prevalence of observed smoking in road vehicles. To enable the widespread international collection of such data, we aimed to develop a smartphone application (app) for this work.

METHODS

We developed specifications for an app that described the: (1) variables that could be collected; (2) transfer of data to an online repository; (3) user interface (including visual schematics) and (4) processes to ensure the data authenticity from distant observers. The app functionality was trialled in roadside situations and the app was made publicly available.

RESULTS

The smartphone app and its accompanying website were developed, tested and released over a period of 6 months. Users (n=18) who have registered themselves (and who met authentication criteria), have reported no significant problems with this application to date (observing 20 535 vehicles as of 5 July 2012). The framework, methodology and source code for this project are now freely available online and can be easily adapted for other research purposes. The prevalence of smoking in vehicles was observed in: Poland 2.7% (95% CI 2.3% to 3.1%); Australia 1.0% (95% CI 0.7% to 1.3%); New Zealand 2.9% (95% CI 2.6% to 3.2%)-similar to results using preapp methods in 2011 (3.2%, 95% CI 3.1% to 3.3%).

CONCLUSIONS

This project indicates that it can be practical and feasible for health researchers to work together with information science researchers and software developers to create smartphone apps for field research in public health. Such apps may be used to collect observational data more widely, effectively and easily than through traditional (non-electronic) methods.