A Distributed and Secure Self-Sovereign-Based Framework for Systems of Systems

Security and privacy are among the main challenges in the systems of systems. The distributed ledger technology and self-sovereign identity pave the way to empower systems and users' security and privacy. By utilizing both technologies, this paper proposes a distributed and self-sovereign-based framework for systems of systems to increase the security of such a system and maintain users' privacy. We conducted an extensive security analysis of the proposed framework using a threat model based on the STRIDE framework, highlighting the mitigation provided by the proposed framework compared to the traditional SoS security. The analysis shows the feasibility of the proposed framework, affirming its capability to establish a secure and privacy-preserving identity management system for systems of systems.

Widening Blockchain Technology toward Access Control for Service Provisioning in Cellular Networks

The attention on blockchain technology (BCT) to create new forms of relational reliance has seen an explosion of new applications and initiatives, to assure decentralized security and trust. Its potential as a game-changing technology relates to how data gets distributed and replicated over several organizations and countries. This paper provides an introduction to BCT, as well as a review of its technological aspects. A concrete application of outsource access control and pricing procedures in cellular networks, based on a decentralized access control-as-a-service solution for private cellular networks, is also presented. The application can be used by service and content providers, to provide new business models. The proposed method removes the single point of failure from conventional centralized access control systems, increasing scalability while decreasing operational complexity, regarding access control and pricing procedures. Design and implementation details of the new method in a real-world scenario using a private cellular network and a BCT system that enables smart contracts are also provided.

BlockEdge: A Privacy-Aware Secured Edge Computing Framework Using Blockchain for Industry 4.0

Edge computing has its application in a lot of areas now, but with the increasing popularity and benefits, it suffers from some challenges such as data privacy and security. Intruder attacks should be prevented and only authentic users should have access to data storage. Most of the authentication techniques apply some trusted entity to undergo the process. Users and servers both have to be registered in the trusted entity to get permission of authenticating other users. In this scenario, the entire system depends on a single trusted entity; so, a single point of failure can cause the failure of the total system, and scalability issues are there also. To address these issues remaining in the existing systems, in this paper, a decentralized approach has been discussed which is capable of eliminating the concept of a single trusted entity by introducing a blockchain paradigm in edge computing where every time a user or server wants to enter the system, it does not have to register itself manually, but the authentication process is carried out throughout the scheme automatically. Experimental results and performance analysis prove that the proposed architecture is definitely beneficial and it outperforms the existing ones in the concerned domain.

Implementation of a Distributed Framework for Permissioned Blockchain-Based Secure Automotive Supply Chain Management

An automotive supply chain includes a range of activities from the concept of the product to its final transfer to a customer and subsequent vehicle maintenance. The three distinct stages of this chain are production, sales, and maintenance. In many countries, automobile records are not available to the public and anyone who has access to the central database or government systems can tamper with these records. In addition, used vehicle maintenance and transfer histories remain unavailable or inaccessible. These issues can be overcome by incorporating state-of-the-art blockchain technology into automotive supply chain management. Blockchain technology uses a chain of blocks for distributed transfer and storage of information, creating a decentralized data register that makes records of any digital asset tamper-proof and transparent. In this paper, we implement a permissioned blockchain-based framework for secure and efficient supply chain management of the automobile industry. We employed Hyperledger Fabric; an enterprise-grade distributed ledger platform for developing solutions. In our solution, the blockchain is customized and private in order to ensure system security. We evaluated our system in terms of memory cost, monetary cost, and speed of execution. Our results demonstrate that only 346 MB of extra memory space is required for storing the automotive data of 1 million users, thus rendering the memory cost negligible. The monetary cost is insignificant as all open source blockchain resources are employed, and the speed of record update is also fast. Our results also show that the decentralization of the automotive supply chain using blockchain can implement system security with minor modifications in the established configuration of the web application database.

GLASS: A Citizen-Centric Distributed Data-Sharing Model within an e-Governance Architecture

E-governance is a process that aims to enhance a government’s ability to simplify all the processes that may involve government, citizens, businesses, and so on. The rapid evolution of digital technologies has often created the necessity for the establishment of an e-Governance model. There is often a need for an inclusive e-governance model with integrated multiactor governance services and where a single market approach can be adopted. e-Governance often aims to minimise bureaucratic processes, while at the same time including a digital-by-default approach to public services. This aims at administrative efficiency and the reduction of bureaucratic processes. It can also improve government capabilities, and enhances trust and security, which brings confidence in governmental transactions. However, solid implementations of a distributed data sharing model within an e-governance architecture is far from a reality; hence, citizens of European countries often go through the tedious process of having their confidential information verified. This paper focuses on the sinGLe sign-on e-GovernAnce Paradigm based on a distributed file-exchange network for security, transparency, cost-effectiveness and trust (GLASS) model, which aims to ensure that a citizen can control their relationship with governmental agencies. The paper thus proposes an approach that integrates a permissioned blockchain with the InterPlanetary File System (IPFS). This method demonstrates how we may encrypt and store verifiable credentials of the GLASS ecosystem, such as academic awards, ID documents and so on, within IPFS in a secure manner and thus only allow trusted users to read a blockchain record, and obtain the encryption key. This allows for the decryption of a given verifiable credential that stored on IPFS. This paper outlines the creation of a demonstrator that proves the principles of the GLASS approach.

Use of Blockchain Technology for Electronic Prescriptions

Objective

Distributed ledger technology can be used as a transparent, shareable ledger, that can record transactions between two parties efficiently and in a more secure, verifiable, and permanent way than the current electronic prescribing systems. We studied the use of a distributed ledger electronic prescribing programme, Prescription Abuse Greatly Reduced (PAGR) Prescriptions, to examine the effect of blockchain on provider prescribing efficiency at three family medicine clinics.

Design

The PAGR was installed side-by-side to the electronic health record at three family medicine practice clinics in middle Tennessee. A prospective, convenience sample of patients at all three clinics was used for analysis. Trained observers were used in each clinic to document the side-by-side use of current prescribing practice versus the use of the PAGR electronic prescribing system by the individual providers.The primary outcome was total time to write the prescription. Secondary metrics included compliance with checking the state's Physician Drug Monitoring Program (PDMP.) , accuracy of medicine reconciliation, use of patient's eligibility on insurance, prescription benefits, and change in prescription caused by benefits analysis or drug-interactions. Provider satisfaction was measure on a 4-point Likert scale.Data were analysed using two-tailed, paired Student T-tests with alpha set at 0.05. A sample size of 107 patients was calculated to have a power of 80% to detect a 50% change in the prescription writing time.

Results

The primary outcome of total prescription writing time was 171 ± 41 sec for current prescribing practice versus 63 ± 15 sec for the PAGR system (p = 0.0006). All providers were extremely satisfied with the use of the PAGR programme.

Conclusion

Use of the PAGR electronic prescription programme significantly saved a mean of 1 min 48 sec per written prescription at the three Family Medicine Clinics. The PAGR also provided accurate medicine reconciliation and complete PDMP checks for controlled substance prescriptions. The patient real-time benefits check and drug-drug and allergy-drug reviews resulted in the provider changing the prescription 28% of the time, enhancing safety and out-of-pocket patient expenses. Future enhancements include expanding the insurance benefits analysis and developing provider notifications when patients are non-compliant with filling their prescriptions.

A Blockchain-Based Distributed Paradigm to Secure Localization Services

In recent decades, modern societies are experiencing an increasing adoption of interconnected smart devices. This revolution involves not only canonical devices such as smartphones and tablets, but also simple objects like light bulbs. Named the Internet of Things (IoT), this ever-growing scenario offers enormous opportunities in many areas of modern society, especially if joined by other emerging technologies such as, for example, the blockchain. Indeed, the latter allows users to certify transactions publicly, without relying on central authorities or intermediaries. This work aims to exploit the scenario above by proposing a novel blockchain-based distributed paradigm to secure localization services, here named the Internet of Entities (IoE). It represents a mechanism for the reliable localization of people and things, and it exploits the increasing number of existing wireless devices and blockchain-based distributed ledger technologies. Moreover, unlike most of the canonical localization approaches, it is strongly oriented towards the protection of the users’ privacy. Finally, its implementation requires minimal efforts since it employs the existing infrastructures and devices, thus giving life to a new and wide data environment, exploitable in many domains, such as e-health, smart cities, and smart mobility.

Potential Uses of Blockchain Technology for Outcomes Research on Opioids

The scale and severity of the opioid epidemic call for innovative, multipronged solutions. Research and development is key to accelerate the discovery and evaluation of interventions that support pain and substance use disorder management. In parallel, the use and integration of blockchain technology within research networks holds the potential to address some of the unique challenges facing opioid research. This paper discusses the applications of blockchain technology and illustrates potential ways in which it could be applied to strengthen the validity of outcomes research on the opioid epidemic. We reviewed published and gray literature to identify useful applications of blockchain, specifically those that address the challenges faced by opioid research networks and programs. We then convened a panel of experts to discuss the strengths, limitations, and feasibility of each application. Blockchain has the potential to address some of the issues surrounding health data management, including data availability, data sharing and interoperability, and privacy and security. We identified five primary applications of blockchain to opioids: clinical trials and pharmaceutical research, incentivizing data donation and behavior change, secure exchange and management of e-prescriptions, supply chain management, and secondary use of clinical data for research and public health surveillance. The published literature was limited, leading us to rely on gray literature, which was also limited in its discussion of the technical aspects of implementation. The technical expert panel provided additional context and an assessment of feasibility that was lacking in the literature. Research on opioid use and misuse is challenging because of disparate data stored across different systems, data and system interoperability issues, and legal requirements. These areas must be navigated to make data accessible, timely, and useful to researchers. Blockchain technologies have the potential to act as a facilitator in this process, offering a more efficient, secure, and privacy-preserving solution for data exchange. Among the 5 primary applications, we found that clinical trial research, supply chain management, and secondary use of data had the most examples in practice and the potential effectiveness of blockchain. More discussions and studies should focus on addressing technical questions concerning scalability and tackling practical concerns such as cost, standards, and governance around the implementation of blockchain in health care. Policy concerns related to balancing the need for data accessibility that also protects patient privacy and autonomy in revoking consent should also be examined.

Blockchain Technology Projects to Provide Telemedical Services: Systematic Review

BACKGROUND

One of the most promising health care development areas is introducing telemedicine services and creating solutions based on blockchain technology. The study of systems combining both these domains indicates the ongoing expansion of digital technologies in this market segment.

OBJECTIVE

This paper aims to review the feasibility of blockchain technology for telemedicine.

METHODS

The authors identified relevant studies via systematic searches of databases including PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar. The suitability of each for inclusion in this review was assessed independently. Owing to the lack of publications, available blockchain-based tokens were discovered via conventional web search engines (Google, Yahoo, and Yandex).

RESULTS

Of the 40 discovered projects, only 18 met the selection criteria. The 5 most prevalent features of the available solutions (N=18) were medical data access (14/18, 78%), medical service processing (14/18, 78%), diagnostic support (10/18, 56%), payment transactions (10/18, 56%), and fundraising for telemedical instrument development (5/18, 28%).

CONCLUSIONS

These different features (eg, medical data access, medical service processing, epidemiology reporting, diagnostic support, and treatment support) allow us to discuss the possibilities for integration of blockchain technology into telemedicine and health care on different levels. In this area, a wide range of tasks can be identified that could be accomplished based on digital technologies using blockchains.

Commercially Successful Blockchain Healthcare Projects: A Scoping Review

Background

The healthcare industry is the new frontier for blockchain technology. Given its properties of immutability and decentralization, blockchain represents an opportunity for unprecedented level of privacy and security for all stakeholders by ensuring data integrity while giving patients control over their own health data. On a backdrop of rising interest in blockchain in general and blockchain healthcare applications in particular, there has been a proliferation of blockchain healthcare projects over the past few years. The aim of this review is to identify and understand real-world blockchain healthcare projects that have attained commercial success in the highly competitive blockchain market.

Methods and findings

A scoping review was performed in January 2021 on all projects in the CoinMarketCap database. Following a pre-defined inclusion and exclusion criteria, eligible projects were selected. A single reviewer then reviewed each project's official website and whitepaper (where available) and performed data abstraction; 10 blockchain healthcare projects fulfilled the selection criteria. The review found that these projects made up 0.24% of the total number of actively tracked projects on CoinMarketCap. In terms of market capitalization, the total market capitalization for the projects was US$65,078,849, comprising less than 0.01% of the total market capitalization of all projects. Among the projects, the most frequent type was for personal health tracking.

Conclusions

This review revealed that blockchain health projects currently comprise a small fraction of the overall number of commercially successful blockchain projects. However, because this sub-industry is still in its early stages, there are reasons to be optimistic that many more blockchain health projects will emerge and attain commercial success in future. Findings from this review done from an entrepreneurial perspective should help with the identification of future projects most likely to succeed.

Blockchain Personal Health Records: Systematic Review

Background

Blockchain technology has the potential to enable more secure, transparent, and equitable data management. In the health care domain, it has been applied most frequently to electronic health records. In addition to securely managing data, blockchain has significant advantages in distributing data access, control, and ownership to end users. Due to this attribute, among others, the use of blockchain to power personal health records (PHRs) is especially appealing.

Objective

This review aims to examine the current landscape, design choices, limitations, and future directions of blockchain-based PHRs.

Methods

Adopting the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, a cross-disciplinary systematic review was performed in July 2020 on all eligible articles, including gray literature, from the following 8 databases: ACM, IEEE Xplore, MEDLINE, ScienceDirect, Scopus, SpringerLink, Web of Science, and Google Scholar. Three reviewers independently performed a full-text review and data abstraction using a standardized data collection form.

Results

A total of 58 articles met the inclusion criteria. In the review, we found that the blockchain PHR space has matured over the past 5 years, from purely conceptual ideas initially to an increasing trend of publications describing prototypes and even implementations. Although the eventual application of blockchain in PHRs is intended for the health care industry, the majority of the articles were found in engineering or computer science publications. Among the blockchain PHRs described, permissioned blockchains and off-chain storage were the most common design choices. Although 18 articles described a tethered blockchain PHR, all of them were at the conceptual stage.

Conclusions

This review revealed that although research interest in blockchain PHRs is increasing and that the space is maturing, this technology is still largely in the conceptual stage. Being the first systematic review on blockchain PHRs, this review should serve as a basis for future reviews to track the development of the space.

The HealthChain Blockchain for Electronic Health Records: Development Study

Background

Health care professionals are required to maintain accurate health records of patients. Furthermore, these records should be shared across different health care organizations for professionals to have a complete review of medical history and avoid missing important information. Nowadays, health care providers use electronic health records (EHRs) as a key to the implementation of these goals and delivery of quality care. However, there are technical and legal hurdles that prevent the adoption of these systems, such as concerns about performance and privacy issues.

Objective

This study aimed to build and evaluate an experimental blockchain for EHRs, named HealthChain, which overcomes the disadvantages of traditional EHR systems.

Methods

HealthChain is built based on consortium blockchain technology. Specifically, three organizations, namely hospitals, insurance providers, and governmental agencies, form a consortium that operates under a governance model, which enforces the business logic agreed by all participants. Every peer node hosts an instance of the distributed ledger consisting of EHRs and an instance of chaincode regulating the permissions of participants. Designated orderers establish consensus on the order of EHRs and then disseminate blocks to peers.

Results

HealthChain achieves functional and nonfunctional requirements. It can store EHRs in a distributed ledger and share them among different participants. Moreover, it demonstrates superior features, such as privacy preservation, security, and high throughput. These are the main reasons why HealthChain is proposed.

Conclusions

Consortium blockchain technology can help to build new EHR systems and solve the problems that prevent the adoption of traditional systems.

P4UIoT: Pay-Per-Piece Patch Update Delivery for IoT Using Gradual Release

P 4 UIoT-pay-per-piece patch update delivery for IoT using gradual release-introduces a distributed framework for delivering patch updates to IoT devices. The framework facilitates distribution via peer-to-peer delivery networks and incentivizes the distribution operation. The peer-to-peer delivery network reduces load by delegating the patch distribution to the nodes of the network, thereby protecting against a single point of failure and reducing costs. Distributed file-sharing solutions currently available in the literature are limited to sharing popular files among peers. In contrast, the proposed protocol incentivizes peers to distribute patch updates, which might be relevant only to IoT devices, using a blockchain-based lightning network. A manufacturer/owner named vendor of the IoT device commits a bid on the blockchain, which can be publicly verified by the members of the network. The nodes, called distributors, interested in delivering the patch update, compete among each other to exchange a piece of patch update with cryptocurrency payment. The pay-per-piece payments protocol addresses the problem of misbehavior between IoT devices and distributors as either of them may try to take advantage of the other. The pay-per-piece protocol is a form of a gradual release of a commodity like a patch update, where the commodity can be divided into small pieces and exchanged between the sender and the receiver building trust at each step as the transactions progress into rounds. The permissionless nature of the framework enables the proposal to scale as it incentivizes the participation of individual distributors. Thus, compared to the previous solutions, the proposed framework can scale better without any overhead and with reduced costs. A combination of the Bitcoin lightning network for cryptocurrency incentives with the BitTorrent delivery network is used to present a prototype of the proposed framework. Finally, a financial and scalability evaluation of the proposed framework is presented.

Using Blockchain to Create Transaction Identity for Persons Experiencing Homelessness in America: Policy Proposal

More than 500,000 people experience homelessness in America each day. Local and federal solutions to the problem have had limited success because of the fragmentation of services and lack of valid and timely information. Billions of dollars spent to provide reliable, timely, and actionable information in health care have exposed the difficulty of establishing such a system using the prevalent information technology solutions. However, relying on successful examples of the use of blockchain to help refugee populations and poor farmers internationally, we have partnered to propose an innovative solution to this problem using the case of people experiencing homelessness in Austin, Texas. This paper aims to describe one of the first applications of blockchain technology for addressing homelessness in the United States by creating a digital identity for people experiencing homelessness and engaging emergency medical services and clinical providers. The authors argue that a lack of documentation to prove personal identity and the inability to access own records are major hurdles for empowering persons experiencing homelessness to be resilient and overcome the life challenges they face. Furthermore, it is argued that this lack of information causes misdiagnosis, duplication, and fragmentation in service delivery, which can be potentially addressed by blockchain technology. Further planning for creating a program on the ground with additional funding will demonstrate the results of using blockchain technology to establish digital identity for persons experiencing homelessness.