Blockchain Papers

Francesco Verde, Arnaldo Stanzione, Valeria Romeo, Renato Cuocolo · 6 authors

No abstract is available for this record.

Talha Burki

No abstract is available for this record.

V. Lakshman Narayana, Arepalli Peda Gopi, Kosaraju Chaitanya

Blockchain is using in every aspect now because of its distributed ledger which is immutable. It provides the information to the users directly without any third party involvement. It mediates the transactions directly between the interacting parties securely. It also eliminates the friction and also the cost of current intermediaries. It is now using in healthcare system to provide the interoperability, security, decentralization and other. EMR is presently using in healthcare which has some issues. The issues in healthcare are patient cannot access the data of his/her own health information. So by this healthcare has issues like interoperability and delay in communication and some other. These issues can be solved by using the Blockchain in healthcare. By this Blockchain provide security by giving the patients to access their own data rather than provider.

Vijayakumar, V., K.M. Sabarivelan, J. Tamizhselvan, B Ranjith · 5 authors

Blockchain is a decentralized network technology. Blockchain consists of a number of blocks. The blocks are connected with other through a chain. Hence the name Blockchain. A block consists of a number of transactions. The links between the blocks are made up of hash values. The hash values are calculated using the transactions in a block and the hash value of the previous block. Healthcare is one of the biggest industry. It also remains as a industry which lacks transparency. At crucial situations the patients medical reports are not readily available. Interoperability between medical organizations is not available due to trust issues. Blockchain is a technology which can provide trust and transparency to its participants. Combining blockchain with healthcare can bring a huge change in the healthcare domain. By including frameworks like Hyperledger, we can provide an industrial standard to healthcare industry along with transparency and trust. All the medical data can be stored in a distributed ledger, which can be used at critical periods for examining report details. Blockchain also provides high security to the data. The data in the blockchain will remain tamper proof.

Qiuzi Huang, Shuyu Chen, Hui Zhao, Junhao Wen

With the rapid development of medical information services, the construction of intelligent hospitals is opening up a new mode of medical treatment in the health care industry. Medical data is gradually becoming more and more important, while it also faces some challenges, among which the most urgent problem to be solved is data security and privacy protection. In the construction of intelligent hospitals, the safety issues among the basic information of patients, the protection of medical information and inter-institutional information sharing have become the focus at this stage. Blockchain technology, with highly security, reliable architecture and algorithm design have operated stably in the financial industry for more than seven years. The related innovative technologies such as distributed ledgers, smart contracts, symmetric encryptions and consensus mechanisms are used widely in many fields. This paper will take the demonstration construction of Chongqing Intelligent Hospital as an example, which tries to combine the blockchain, homomorphic encryption and zero-knowledge proof technology to carry out the research on the security construction and data privacy protection of intelligent hospitals.

Devendra Dhagarra, Mohit Goswami, P. R. S. Sarma, A.K. Choudhury

Abstract Purpose Significant advances have been made in the field of healthcare service delivery across the world; however, health coverage particular for the poor and disadvantaged still remains a distant dream in developing world. In large developing countries like India, disparities in access to healthcare are pervasive. Despite recent progress in ensuring improved access to health care in past decade or so, disparities across gender, geography and socioeconomic status continue to persist. Fragmented and scattered health records and lack of integration are some of the primary causes leading to uneven healthcare service delivery. The devised framework is intended to address these challenges. The paper aims to discuss these issues. Design/methodology/approach In view of such challenges, in this research a Big Data and blockchain anchored integrative healthcare framework is proposed focusing upon providing timely and appropriate healthcare services to every citizen of the country. The framework uses unique identification number (UID) system as formalized and implemented by the Government of India for identification of the patients, their specific case histories and so forth. Findings The key characteristic of our proposed framework is that it provides easy access to secure, immutable and comprehensive medical records of patients across all treatment centers within the country. The model also ensures security and privacy of the medical records based upon the incorporation of biometric authentication by the patients for access of their records to healthcare providers. Originality/value A key component of our evolved framework is the Big Data analytics-based framework that seeks to provide structured health data to concerned stakeholders in healthcare services. The model entails all pertinent stakeholders starting from patients to healthcare service providers.

Eko Yunianto, Yudi Prayudi, Bambang Sugiantoro

Digital evidence handling and preservation are one stage of digital forensic process. This part is very crucial because digital evidence is the basis of digital forensic process. The credibility of digital evidence must be maintaned for law and court process. Process of preservation of digital evidence known as chain of custody (CoC). CoC is a document that used to ensure that digital evidence remains and does not change. Both during the investigation process until the completion of the forensic process. Electronic evidence documentation is different from digital evidence documentatation. The different are character and the metadata. Some adjustments need to be accomodated on system for digital evidence. Digital evidence is easy to change as well as its CoC document. It needs to be protected. A new technology is needed that can ensure integrity of digital evidence and CoC Document like the blockchain. In this study, digital evidence management will be built on the CoC concept with blockchain technology. More precisely, this design combines the framework of the Digital Evidence Bag (DEC) with blockchain technology. This prototype is known as the Blockchain Digital Evidence Bag (B-DEC). B-DEC utilizes the data storage integrity to accommodate digital evidence management that refers to DEC. In this case, the prototype will build on a smart contract based on Ethereum. The development of the DEC framework also will be adjusted to accommodate DEC applications in the blockchain.

Sonali Vyas, Mahima Gupta, Rakesh Kumar Yadav

The power of machine learning in understanding the patterns in data, analyzing and making decisions, has shown its importance in various sectors. Machine Learning requires reasonable amount of data to make accurate decisions. Data sharing and reliability of data is very crucial in machine learning in order to improve its accuracy. The decentralized database in Blockchain Technology emphasizes on data sharing. The consensus in Blockchain technology makes sure that data is legitimate and secured. The convergence of these two technologies can give highly accurate results in terms of machine learning with the security and reliability of Blockchain Technology. This paper gives an overview of how combining these two technologies can help in healthcare sectors.

Alan Litchfield, Arshad Khan

Healthcare is a data-driven domain where a large volumes of data are created, accessed, stored, and disseminated daily. In this paper, issues such as security, privacy, data transparency, interoperability, data accessibility, user interface issues in healthcare information management systems are presented. In addition, blockchain technology related studies in healthcare information systems are discussed with the aim to find what issues in healthcare system present research opportunities using blockchains.

StanislawPeter Stawicki, SagarC Galwankar, Sebastian Clarke, Iain Craig · 11 authors

Technological progress is reshaping multiple domains of human activity, from financial transactions to medical care.[1] This paradigm shift represents a global movement that will transform our lives for generations to come.[2] The democratization of decision-making capacity, including consensus-based mechanisms for transaction verification, will enable global implementation of projects that were previously not feasible because of the requirement for centralized control.[34] Blockchain represents a decentralized ledger technology that operates by consensus and serves to democratize decision-making processes and to disintermediate traditionally understood intermediaries.[1] According to Deutsche Bank forecasts, by mid-2020's, approximately 10% of the worldwide gross domestic product could be regulated by blockchain-based solutions.[5] It is estimated that more than $400 billion will be invested in this technology in 2019 to advance its capabilities.[6] Within this broader context, it is important to understand that cryptocurrencies and financial transactions constitute only one small aspect of the blockchain concept, which also incorporates areas like verification, transparency, encryption, and maintenance of data integrity.[378] Blockchain technology appears to be following a fairly typical pattern of adoption, with multiple early entrants into the increasingly crowded and competitive cryptocurrency space and the fast-growing sphere of blockchain-based applications.[91011] It is the latter that will help truly define, and be responsible for the societal impact of, “the era of distributed ledgers” that is under way.[1112] The primary goal of the strategic global partnership between Litecoin Cash Foundation (LCCF, https://litecoinca.sh/) and OPUS 12 Foundation, Inc. (O12FI, http://www.opus12.org/), is to leverage our collective resources to establish early leadership in the development and implementation of practical, real-life, blockchain-based solutions in academic and clinical medicine.[11314] The practicality of the dual blockchain utilization, featuring both currency and application layers, becomes apparent with the realization that the need for ongoing data processing relies on constant verification and encryption activity throughout the entire network of blockchain nodes.[113] Thus, the approach selected by the LCCF-O12FI consortium creates significantly more synergy than a single-track approach based on subcomponent strategy. Within this context, the technology provides not only a “digital wallet” functionality for currency exchange, but also different blockchain-based use cases incorporating academic and medical information. In one example, cell phones are ubiquitous in low- and middle-income countries (LMIC) whereas electronic health records are not. Older, less costly cell phone technology would suffice as only SMS capability is needed to utilize blockchain or cryptocurrency, enabling broad access to the populations of LMICs. Blockchain can support information exchange across disparate data types, while providing digital payments on a global scale and across borders. The functional dimension of introducing the primary currency feature of Litecoin Cash (LCC) cryptocurrency has the potential to bring tremendous benefits to the areas of the world where banking services (and infrastructure) are severely underdeveloped, yet basic components for the successful adoption of cryptocurrencies clearly exist (e.g., limited internet access and mobile devices capable of supporting blockchain transactions). Much like entire regions of the world that essentially “bypassed” landline-based telephony following the introduction of cellular networks, many localities stand to “bypass and leapfrog” traditional banking, and progress directly to distributed ledger technologies.[151617181920] There is growing recognition of the role of microeconomies and the critical need for efficient, dependable, accessible, safe, and scalable financial transactions and infrastructures, especially in low-resource regions, a topic that was recently recognized with a Nobel Prize in Economics.[2122] Of note, this does not necessarily preclude traditional banking firms from participation; however, they will need to adapt to new competitive pressures across economic realities for which high-resource environment models are not optimized. Ability to appropriately scale current blockchain capabilities will be critical to such implementations.[32324] Blockchain-based mechanisms also allow for crossover of monetary value from various loyalty cards and rewards programs, similar to currency exchange between different nations. Such reward points (mileage, car rental, and hotel stay) can then become an alternative subsidy for healthcare services. This can, for example, help establish a modernized barter system where a patient could use their “frequent flyer miles” to pay for medical costs, exchanging their reward points for “health care coins” through an intermediary exchange market. Institutions, such as nongovernmental organizations, could turn “flyer miles” used to shuttle staff between locations into vaccine and medical equipment purchases. Further, direct and real-time transparent payment for services in healthcare could lead to a reduction of both “intermediary” insurance companies and inefficiencies in the system. This streamlining would result in substantial healthcare savings, translating to lower costs, more access for patients, and decreased overhead with increased revenue for clinics, hospitals, and providers. Security of the blockchain (including various “side chains” and “layers”) is of paramount importance to ensuring trust and wider mainstream adoption of this technology.[252627] The inherent risk in the concept of distributed ledger “democratization” is the possibility of emerging inequality due to maldistribution of infrastructure responsible for the maintenance and ongoing operations of the blockchain.[2829] Within this broader topic area, our group previously described the risk of ill-intended, third-party actors to project massive bursts of “hashing power” and effectively take over the blockchain for a limited duration of time.[1] This, in turn, allows such destructive actors to “double spend” cryptocurrency output to the detriment of the broader populace.[114] To effectively prevent the risk of the blockchain being “hijacked,” the LCCF Developer Team devised an innovative paradigm of agent-based mining (e.g., the creation of new cryptocurrency) that helps ensure democratization of the LCC generation/transaction process while providing sustainable, long-term security of the distributed ledger.[14] Another significant advantage of this prototype mining technique is that it is not based on technologies that are becoming increasingly energy and resource inefficient, thus not requiring ever greater amounts of energy to generate diminishing amounts of block rewards (e.g., “coins”). The synergy between secure mining processes and the need for the highest possible levels of distributed ledger security creates a unique environment for the development of blockchain-based educational and medical applications. Our joint implementation framework of blockchain-based application layer includes clearly stated and reasonably achievable milestones, each defined within the broader contexts of adoption readiness and resource availability. Parallel to these developments will be the phased introduction of LCC as a voluntary medium of exchange for various international medical programs (IMPs) collaborating within our global network of institutions, providers, and clinical sites.[30] The initial step in the strategic LCCF-O12FI collaboration will be the development of a cryptography-based “Secure ID” (SID) that will serve as the foundation for the future developments. This SID will contain each user's unique identifying information, accessible only to the end-user (incorporating various best practices in cyber security such as 2-factor or multisource verification), and shareable for viewing and information verification only with end-user's designees. The SID will also serve as a “Secure Key” to access other, downstream blockchain-based applications including “Academic Activity Logger” (AAL) and “Credentialing Document Repository” (CDR). We will now discuss the development and implementation of AAL and CDR. The AAL will be the first step toward the integration of blockchain technology into real-life academic international medicine (AIM) applications. Powered by the global LCC network, the AAL will help record and track activities by faculty members, facilitating the categorization and quantification of academic efforts into the following subtypes: (a) teaching, (b) clinical medicine, (c) community/government interactions, (d) research, and (e) other/miscellaneous. Each entry will include the activity date/time/duration as well as basic description, with a number of generic entries available through a drop-down menu. Activities entered by academic faculty will then be analyzed periodically and will serve as a basis for resource mobilization and allocation. Access to the AAL will only be possible using the SID, thus making the AAL a logical extension and a springboard for subsequent LCC blockchain-based implementations. On this foundation, the CDR and ultimately a “basic electronic medical record” (BEMR, see below) will be constructed. Although the task of constructing a high-fidelity, immutable, and accurate ledger of academic activities will not be easy, certain steps can be taken to minimize the likelihood of “false claims.” Much like the blockchain-based cryptocurrency paradigm, a secure mechanism for consensus building and data verification can be constructed. Such a “network of trust” (NOT) is technically workable and analogous to how “pretty good privacy” keys were distributed at signing parties attended by people known to each other, and also similar to the way “secure socket layer” certificate authorities work.[3132] For example, if Party A's certificate is signed by some Party B who is trusted by Party C, Party C can trust Party A's certificate, etc. The next developmental step in our strategic plan will be the implementation of the CDR, where provider credentials will be securely uploaded and stored in decentralized fashion. These documents will follow predefined credentialing requirements by most institutions globally such as record of college education/graduation, professional school record/diploma, professional licensing/verification/certification, and any additional elements deemed important to the safe conduct of AIM efforts globally. Uploading of credentialing information will be voluntary, and access to this information will only be possible with the permission of the record owner, utilizing his or her unique SID. Optimally, this important credentialing instrument will help providers verify their identity, education, and qualifications, and ensure that appropriate standards are followed by all stakeholders. The end-result will be the provision of safe and efficient care to the patients worldwide. Similar to the academic activity verification process, there will be important challenges to consider before successfully implementing the global CDR. In principle, there will need to exist some form of “data onboarding” authority. This should be performed by a “verification agent” (e.g., independent organization/group) with equivalent authority to that which it takes to set up a legitimate record of specific type (e.g., a medical school diploma and medical board specialty certification). In terms of identity verification, for example, the level of diligence required is similar to that already present in “know your customer” legislation. The case for verifying professional credentials would be similar, including the process of independent data validation and certification. Again, this is technically possible with a NOT arrangement as mentioned above; however, there will be obvious limitations inherent to the workability of credential verification similar to traditional efforts already in place. If a practitioner is claiming to possess credentials from some credentialing provider, only that particular provider really has (and only should have) the authority to confirm that. At the same time, there must also be a mechanism to revoke trust and to hardwire time-defined recertification processes based on the expiry of records currently on file. The final step in the strategic LCCF-O12FI collaboration will be the development of a super secure, BEMR that could be deployed in low-resource environments, utilizing rudimentary portable device technology, and containing fundamental health information for each end-user. Much like the SID, information stored on the BEMR would be owned by the end-user and could be shared with healthcare providers only with the end-user's consent, requiring SID as the “Secure Key” to unlock information. We recognize the substantial challenges in the global implementation of this concept, especially with regards to the enormity of healthcare-related data (often from multiple systems and sources), the need for privacy, timely and accurate access, and verification of data. Other potential shortcomings, at this time, include the need for further development of the technology, limited availability of expert knowledge, significant gaps in public awareness, along with growth-related issues of scalability, security, and user adoption.[6] Nonetheless, it is our hope that the lessons learned from other blockchain application layers will serve as the foundation for successful development, evolution, and adoption of BEMR.[1] There are many other considerations related to blockchain technology implementations in healthcare. Although full discussion of such a broad topic is beyond the scope of this manuscript, certain key ramifications must be discussed in the context of the proposed O12FI-LCCF initiatives. Blockchain technology may be an important tool for increasing transparency of how charities collect and allocate funds, propelling a much leaner system that will benefit intended recipients to a much greater degree.[1] This application of the blockchain technology will help verify the integrity of an organization's operations such as the transparency regarding the proportion of contributions distributed to medical and educational causes versus the overhead. In turn, the public, philanthropic donors, and potential collaborators will be able to make more informed choices regarding where their contributions can be allocated most efficiently. Pharmaceutical companies may utilize blockchain to keep track of medications manufacturing and shipment, supply, expiration, and possible points of contamination.[33] By extension, similar technological approaches could be useful for tracking opiates in this age of epidemic prescription drug abuse.[34] In such cases, blockchain would make it easier to investigate and determine the source of access as the supply chain would become much more transparent. Various built-in data verification and safety features could also be used to prevent duplication of medications from different providers and other hazards that occur with polypharmacy. Furthermore, the same tracking approaches could be used to secure food supply chains and safeguard against disease outbreaks.[35] Contaminated food products could be quickly and more efficiently traced to specific farms, processing or packaging plants for immediate identification, and removal from circulation. When combined with potential applications for AIM and global health equity, blockchain-based applications could help catalyze further innovation. First, they can enable universal access to financial resources by removing third-party intermediaries and offering transparent, secure, and accountable means for AIM financing.[36] Next, they could help facilitate multilateral financing mechanisms dedicated to health system development and strengthening.[136] In addition, they could reduce fraud and corruption through the use of immutable, tamper-proof transaction ledgers.[136] Finally, entire new capital markets for healthcare data could be created, providing better access (and opportunities) to patients, institutions, governments, researchers, and other key stakeholders.[136] Additional benefit offered by any token with fixed or “capped” supply as a medium of international exchange – subject to harmonization with region-specific laws and regulations – is the noninflationary character of such cryptocurrency. This, in turn, may help provide end-users with a protective mechanism against inflation and loss of monetary value – a phenomenon experienced across many LMICs.[3738] In conclusion, the global partnership between OPUS 12 Foundation (including its allied partners and subsidiaries) and LCCF provides a unique platform for the parallel development of both global currency support framework and medical/educational application layer for the academic international medical community.

E. V. Melnik, Anna Klimenko, Donat Ivanov

No abstract is available for this record.

Rong Wang, Wei‐Tek Tsai, Juan He, Can Liu · 6 authors

In recent years, artificial intelligence (AI) has played an increasingly important role in the medical field. AI based on big data analysis and deep learning algorithms has become the core driving force for the future development of the medical industry, but the biggest obstacle to its development is incompleteness and inaccuracy of medical data. The main reason is that medical big data is difficult to achieve sharing. This paper studies and analyzes the problems of medical big data sharing, proposes a medical data sharing platform based on permissioned blockchains (BCs), which uses dual-BCs architecture (Account BC and transaction BC), Concurrent Byzantine Fault Tolerance (CBFT) consensus mechanism, encryption technology and smart contract technology. Account BC (ABC) is used to store user data hash after encryption and transaction BC (TBC) is used to process computing tasks. The use of encryption technology ensures that users have full autonomy in their own medical data. Smart contract technology is used to enable users to set up different access permissions of medical data. A TBC can be used by multiple ABCs and TBC does not save users' medical data, but only obtains users' medical data from ABCs when needs computation. When the computing task is completed, the TBC deletes all users' medical data and packages the operation record to save into ABCs, thereby it realizes data sharing while protecting users' privacy. In addition, this paper compares the functions with other medical data systems, analyzes and compares their advantages and disadvantages. Finally, the conclusions and future works of the medical data sharing platform based on BC technology are prospected.

Tsung-Ting Kuo, Rodney A. Gabriel, Lucila Ohno‐Machado

OBJECTIVE: Decentralized privacy-preserving predictive modeling enables multiple institutions to learn a more generalizable model on healthcare or genomic data by sharing the partially trained models instead of patient-level data, while avoiding risks such as single point of control. State-of-the-art blockchain-based methods remove the "server" role but can be less accurate than models that rely on a server. Therefore, we aim at developing a general model sharing framework to preserve predictive correctness, mitigate the risks of a centralized architecture, and compute the models in a fair way. MATERIALS AND METHODS: We propose a framework that includes both server and "client" roles to preserve correctness. We adopt a blockchain network to obtain the benefits of decentralization, by alternating the roles for each site to ensure computational fairness. Also, we developed GloreChain (Grid Binary LOgistic REgression on Permissioned BlockChain) as a concrete example, and compared it to a centralized algorithm on 3 healthcare or genomic datasets to evaluate predictive correctness, number of learning iterations and execution time. RESULTS: GloreChain performs exactly the same as the centralized method in terms of correctness and number of iterations. It inherits the advantages of blockchain, at the cost of increased time to reach a consensus model. DISCUSSION: Our framework is general or flexible and can also address intrinsic challenges of blockchain networks. Further investigations will focus on higher-dimensional datasets, additional use cases, privacy-preserving quality concerns, and ethical, legal, and social implications. CONCLUSIONS: Our framework provides a promising potential for institutions to learn a predictive model based on healthcare or genomic data in a privacy-preserving and decentralized way.

Peter Williams

New technologies and the knowledge economy are destabilising graduate professions, with artificial intelligence and the analysis of ‘big data’ making significant impacts on formerly secure jobs. Blockchain technology, offering automated secure credentialling of undergraduate students’ activities and achievements, may significantly erode existing systems of assessment. The challenge for universities will be not only to maintain the relevance of their curricula but also to manage erosion of their current near-monopoly in awarding degrees. This paper envisions a landscape in which universities must outsource parts of their course delivery and assessment in order to remain competitive. It examines a potentially sustainable mission strategy: to move away from narrow academic disciplines towards an authentic learning curriculum focusing on the development of students as whole persons with rounded educations. This paper examines implications for the academy of the convergence of artificial intelligence, data analytics and blockchain technology.

Tsigab Angosom Gebremedhin

Fear of stigmatization and discrimination from colleagues, friends and family drives patients with various type of mental health problems away from a traditional face-to-face therapy and enforces them to look for an alternative treatment methods. Internet-based mental health therapy helps patients to get their needed therapies and support from healthcare professional and peers, or as a part of automated online form of therapy. Conducting Internet based therapy anonymously is vital for the patient privacy. However, lack of trust, access permission, ownership control and traceability undermines patient safety and security. Blockchain technology is an innovative technology initially designed for a cryptocurrency. However, with the introduction of programming blockchain and smart contracts, the technology has extended its importance to other areas for developing decentralized application (DApp), such as mental health related information management, which is the primary focus of this thesis. Privacy and security are very crucial for patient safety and to preserve patient’s medical history from adversaries. Sharing of private medical information online between the patient and their respective provider contains sensitive information that can easily be compromised if a proper security measure is not put in place. Blockchain is consensus-based peer-to-peer distributed ledger technology that stores and maintains an updated copy of all transactions within the network. It makes trust more transparent and traceable by keeping auditable-logs of all transactions in the form of blocks. In this thesis, Blockchain and its underlying technology are studied, and a prototype has been developed to explore the potential of the blockchain technology. Furthermore, we explore alternative distributed ledger technologies and their respective security models such as consensus protocols, cryptographic techniques, privacy and scalability. The prototype was proposed based on Ethereum blockchain.

Manish Chand, Navin Ramachandran, Danail Stoyanov, Laurence Lovat

No abstract is available for this record.

Edward Meinert, Abrar Alturkistani, Kimberley Foley, Tasnime Osama · 9 authors

BACKGROUND: A blockchain is a digitized, decentralized, distributed public ledger that acts as a shared and synchronized database that records cryptocurrency transactions. Despite the shift toward digital platforms enabled by electronic medical records, demonstrating a will to reform the health care sector, health systems face issues including security, interoperability, data fragmentation, timely access to patient data, and silos. The application of health care blockchains could enable data interoperability, enhancement of precision medicine, and reduction in prescription frauds through implementing novel methods in access and patient consent. OBJECTIVE: To summarize the evidence on the strategies and frameworks utilized to implement blockchains for patient data in health care to ensure privacy and improve interoperability and scalability. It is anticipated this review will assist in the development of recommendations that will assist key stakeholders in health care blockchain implementation, and we predict that the evidence generated will challenge the health care status quo, moving away from more traditional approaches and facilitating decision making of patients, health care providers, and researchers. METHODS: A systematic search of MEDLINE/PubMed, Embase, Scopus, ProQuest Technology Collection and Engineering Index will be conducted. Two experienced independent reviewers will conduct titles and abstract screening followed by full-text reading to determine study eligibility. Data will then be extracted onto data extraction forms before using the Cochrane Collaboration Risk of Bias Tool to appraise the quality of included randomized studies and the Risk of Bias in nonrandomized studies of Interventions to assess the quality of nonrandomized studies. Data will then be analyzed and synthesized. RESULTS: Database searches will be initiated in September 2018. We expect to complete the review in January 2019. CONCLUSIONS: This review will summarize the strategies and frameworks used to implement blockchains in health care to increase data privacy, interoperability, and scalability. This review will also help clarify if the strategies and frameworks required for the operationalization of blockchains in health care ensure the privacy of patient data while enabling efficiency, interoperability, and scalability. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/10994.

David M. Maslove, Jacob Klein, M. Kathryn Brohman, Patrick Martin

<sec> <title>BACKGROUND</title> Blockchain technology is emerging as an innovative tool in data and software security. </sec> <sec> <title>OBJECTIVE</title> This study aims to explore the role of blockchain in supporting clinical trials data management and develop a proof-of-concept implementation of a patient-facing and researcher-facing system. </sec> <sec> <title>METHODS</title> Blockchain-based Smart Contracts were built using the Ethereum platform. </sec> <sec> <title>RESULTS</title> We described BlockTrial, a system that uses a Web-based interface to allow users to run trials-related Smart Contracts on an Ethereum network. Functions allow patients to grant researchers access to their data and allow researchers to submit queries for data that are stored off chain. As a type of distributed ledger, the system generates a durable and transparent log of these and other transactions. BlockTrial could be used to increase the trustworthiness of data collected during clinical research with benefits to researchers, regulators, and drug companies alike. In addition, the system could empower patients to become more active and fully informed partners in research. </sec> <sec> <title>CONCLUSIONS</title> Blockchain technology presents an opportunity to address some of the common threats to the integrity of data collected in clinical trials and ensure that the analysis of these data comply with prespecified plans. Further technical work is needed to add additional functions. Policies must be developed to determine the optimal models for participation in the system by its various stakeholders. </sec>

Claude Pirtle, Jesse M. Ehrenfeld

No abstract is available for this record.

Huanrong Tang, Ning Tong, Jianquan Ouyang

At present, medical images account for nearly 70% of medical diagnostic data, which is an important basis for disease diagnosis. However, medical data leakage incidents have occurred in more than 90% medical institutions, the protection of patients' medical data is of great urgency. At present, all types of medical institutions involved in the medical imaging business use the PACS to archive, manage, and use the collected medical images, but only sharing the managed video resources within the organization. This method applies only the traditional data protection strategy and cannot guarantee a stronger protection for patients' private information. And patients have no control over medical information at the time of treatment. For this reason, this paper proposes a method of secure sharing of medical images based on smart contracts of block chain and credit scores. Through a blockchain based on distributed, reliable database of recording image sharing process, we realize a cross-organizational, cross-regional, trustworthy, and supervisory medical image sharing system. And the establishment of smart contracts based on credit scores of patients and medical institutions guarantee intelligent sharing by rules and conditions. Compared with traditional PACS, the method proposed in this paper extends its scope of application on the basis of PACS, increases its robustness, and provides new ideas for more extensive, multi-level, safe and reliable medical images sharing.

Igor Radanović, Robert Likić

No abstract is available for this record.

E.E. Funk, Jeff Riddell, Felix Ankel, Daniel Cabrera

Health professions educators face multiple challenges, among them the need to adapt educational methods to new technologies. In the last decades, multiple new digital platforms have appeared in the learning arena, including massive open online courses and social-media-based education. The major critique of these novel methods is the lack of the ability to ascertain the origin, validity, and accountability of the knowledge that is created, shared, and acquired. Recently, a novel technology based on secured data storage and transmission, called blockchain, has emerged as a way to generate networks where validity, trust, and accountability can be created. Conceptually, blockchain is an open, public, distributed, and secure digital registry where information transactions are secured and have a clear origin, explicit pathways, and concrete value. Health professions education based on blockchain will potentially allow improved tracking of content and the individuals who create it, quantify educational impact on multiple generations of learners, and build a relative value of educational interventions. Furthermore, institutions adopting blockchain technology would be able to provide certification and credentialing of health care professionals with no intermediaries. There is potential for blockchain to significantly change the future of health professions education and radically transform how patients, professionals, educators, and learners interact around safe, valid, and accountable information.

Juan M. Román-Belmonte, Hortensia De la Corte‐Rodríguez, E. Carlos Rodríguez‐Merchán

Although the best-known use of blockchain technology (BCT) is in the field of economics and cryptocurrencies in general, its usefulness is extending to other fields, including the biomedical field. The purpose of this article is to clarify the role that BCT can play in the field of medicine. We have performed a narrative review of the literature on BCT in general and on medicine in particular. The great advantage of BCT in the health arena is that it allows development of a stable and secure data set with which users can interact through transactions of various types. This environment allows the entry and operation of clinical data without compromising other sensitive data. Another important advantage of BCT is that the entire network is decentralized and is maintained by the users themselves; thus, there is no need to rely on organizations for storage. The Blockchain code is open source and can be used, modified and revised by its users. BCT literature is scarce so far. This article describes the basics of this technology and summarizes the various aspects in which BCT could change the paradigm of current medicine. The great potential of BCT, as well as its many applications in the field of health sciences, encompasses the fields of legal medicine, research, electronic medical records, medical data analysis (big data), teaching and the regulation of payment for medical services. If technological advances continue along these lines, it could bring about a revolution in medicine as we know it.

Mark Gaynor, Betsy Tuttle, Allison Roe

In this paper, we present the applications of blockchain technology in healthcare. Furthermore, we evaluate the choice and deployment of Blockchain technology in such applications, review the advantages and disadvantages of such an approach. We review the Estonian system, which is the first blockchain-based health system at the national level, in detail and discuss its ramifications to Turkey. This paper is one of the first papers in this domain and, to the best of authors' knowledge, the first in Turkish.