Blockchain Papers

K. Selva Sheela, C. Priya

No abstract is available for this record.

May Alnafrani, Subrata Acharya

No abstract is available for this record.

Dragoş Daniel Ţarălungă, Bogdan Florea

Presently modern technology makes a significant contribution to the transition from traditional healthcare to smart healthcare systems. Mobile health (mHealth) uses advances in wearable sensors, telecommunications and the Internet of Things (IoT) to propose a new healthcare concept centered on the patient. Patients' real-time remote continuous health monitoring, remote diagnosis, treatment, and therapy is possible in an mHealth system. However, major limitations include the transparency, security, and privacy of health data. One possible solution to this is the use of blockchain technologies, which have found numerous applications in the healthcare domain mainly due to theirs features such as decentralization (no central authority is needed), immutability, traceability, and transparency. We propose an mHealth system that uses a private blockchain based on the Ethereum platform, where wearable sensors can communicate with a smart device (a smartphone or smart tablet) that uses a peer-to-peer hypermedia protocol, the InterPlanetary File System (IPFS), for the distributed storage of health-related data. Smart contracts are used to create data queries, to access patient data by healthcare providers, to record diagnostic, treatment, and therapy, and to send alerts to patients and medical professionals.

Nihar Ranjan Pradhan, Siddhartha Suman Rout, Akhilendra Pratap Singh

Chronic disease exists over a period of time and it is very crucial because it can affect the health of disability people more. Normally people think that they are not suffering or affected by the disease because they do not have symptoms. But it does not necessarily mean a person with no symptom has no chronic disease. This paper presents design and prototype implementation of a blockchain system which remotely monitors patient health records. The patient monitoring system is a big challenge and other security threats arises as the health care data transferred from one to another and authorization to create and read transactions, is a major concern related to data loss. The data loss of the patient protected health information which are generated from the devices should be handled carefully. So in this paper we proposed a solidity based smart contract run over a Ethereum virtual machine to facilitate the secure analysis and storing of transactions from and to the sensors. Using the Ethereum protocol, based on a private blockchain and writing the smart contracts to keep track of the patient health information. We have created an automatic system through which the sensors collects the data, then communicates with the decentralized application via the smart contract. The method inside the smart contract collects data when they are called, also reads and writes transactions of all events on the Ethereum virtual network. This solidity based smart contract system along with injected web3, metamask, and truffle environment would support alert transaction to the patient and medical professionals.

Edgar Roberto Dulce Villarreal, Julio Ariel Hurtado Alegría

No abstract is available for this record.

Nurnadiah Zamri, Zarina Mohamad, Wan Nor Shuhadah Wan Nik, Aznida Hayati Zakaria Mohamad

No abstract is available for this record.

Wendy Charles

Blockchain is an innovative data management technology using distributed ledgers that has potential to achieve efficiency in data processing and greater control over healthcare record access. Interest is growing beyond uses for cryptocurrency, but blockchain technologies remain poorly understood in the general public and healthcare community. While there are many promising uses for healthcare and supply chain, most potential uses of blockchain for mental health are still in the pilot or development stage. This chapter presents blockchain to the mental health community with a detailed introduction to the unique facets blockchain with a few examples of current uses of blockchain in healthcare with promising proposed uses for mental health.

Laavanya Rachakonda, Anand K. Bapatla, Saraju P. Mohanty, Elias Kougianos

Considering today's lifestyle, people just sleep forgetting the benefits sleep provides to the human body. Smart-Yoga Pillow (SaYoPillow) is proposed to help in understanding the relationship between stress and sleep and to fully materialize the idea of “Smart-Sleeping” by proposing an edge device. An edge processor with a model analyzing the physiological changes that occur during sleep along with the sleeping habits is proposed. Based on these changes during sleep, stress prediction for the following day is proposed. The secure transfer of the analyzed stress data along with the average physiological changes to the IoT cloud for storage is implemented. A secure transfer of any data from the cloud to any third party applications is also proposed. A user interface is provided allowing the user to control the data accessibility and visibility. SaYoPillow is novel, with security features as well as consideration of sleeping habits for stress reduction, with an accuracy of up to 96%.

Anupam Tiwari, Usha Batra

In 10 years the electronic medical record will be the minor player, in terms of where a person's health history lives. Most of that information will be kept on the phone or in a secure cloud, and the patient will be highly engaged with collecting, curating and sharing that data. Most doctor visits will be like calling up a YouTube meets virtual human docs and there will also be an aspect of virtual reality.

Pascal Meier, Jan Heinrich Beinke, Christian Fitte, Jan Schulte to Brinke · 5 authors

Abstract In the course of digitization in healthcare, personal health records (PHRs) are handled as a key solution. Despite the indisputable benefits, the adoption of PHRs is hampered by data security and data privacy concerns. Blockchain technology offers promising potential to address these issues by enabling secure transactions of sensitive data. With regards to PHRs, the blockchain can be used to manage the access to health-related data. Besides existing generic PHR architectures, we systematically identified issues for the healthcare sector that need to be considered for the development of a PHR. We subsequently derived eight meta-requirements that were consolidated into three design principles. Within a 1-year design science research project, we developed the blockchain-secured PHR prototype, OSHealthRec, and evaluated the system in four evaluation cycles. The findings of our research are twofold. On the one hand, we contribute to the design knowledge base by presenting three design principles. On the other hand, we present the development of a real, operational blockchain-secured PHR and the findings from its continuous evaluation, which may serve as useful advice for further solutions.

Jesús Peral, Eduardo Gallego, David Gil, Mohan Tanniru · 5 authors

With patients demanding services to control their own health conditions, hospitals are looking to build agility in delivering care by extending their reach into patient and partner ecosystems and sharing relevant patient data to support care continuity. However, sharing patient data with several external stakeholders outside a hospital network calls for the development of a digital platform that is trusted by both hospitals and stakeholders, given that there is often no single entity supporting such coordination. In this paper, we propose a methodology that uses a blockchain architecture to address the technical challenge of linking disparate systems used by multiple stakeholders and the social challenge of engendering trust by using visualization to bring about transparency in the way in which data are shared. We illustrate this methodology using a pilot implementation. The paper concludes with a discussion and directions for future research and makes some concluding comments.

Chandan Garg, Agam Bansal, Rana Prathap Padappayil

No abstract is available for this record.

Rania El-Gazzar, Karen Stendal

There has been an increasing interest in blockchain technology from the health care sector in the last couple of years. The value proposition for using blockchain technology in the health care sector is to share sensitive patient data among health care entities securely and to empower patients. Blockchain technology allows patients to have an active role in developing and updating their own patient data. However, is blockchain technology really the silver bullet it seems to be? With this paper, we aim to understand the benefits and challenges of blockchain technology in the health care sector. We discuss innovation and security implications concerning blockchain technology in health care. Furthermore, we show that there is a need for more use cases to ensure the secure sharing of data within the health care sector. In our opinion, blockchain technology will not solve the issues encountered by the health care sector; in fact, it may raise more issues than it will solve.

Ammar Ibrahim El Sayed, Mahmoud Abdelaziz, Mohamed Helmy Megahed, Mohamed Hassan Abdel Azeem

According to Medical Statistics conducted in the USA, the number of patients who die every year from Medical errors are estimated to be around 200 to 400 thousand. The most common types of medical mistakes are (Billing errors, incorrect medication/incorrect dosage). Moving towards Electronic Health Records (EHR) instead of the paper-based system can prevent Medical errors. The (EHR) faces challenges regarding the issues of security and privacy. Utilizing blockchain can provide the proper solution to the above-stated challenges. This paper aims to introduce a new supervising strategy regarding accessing, sharing, and storing the (EHR). The proposed strategy enhances the security in a distributed network environment, through applying blockchain technology and hash table. Furthermore, it is applying a newly developed collision-resistant hash function in generating a unique ID for each patient in the EHR System. The Proposed scenario will improve the overall performance of the EHR system making it more efficient and reliable than the traditional system.

Yan Zhuang, Lincoln Sheets, Yin-Wu Chen, Zon‐Yin Shae · 6 authors

Health Information Exchange (HIE) exhibits remarkable benefits for patient care such as improving healthcare quality and expediting coordinated care. The Office of the National Coordinator (ONC) for Health Information Technology is seeking patient-centric HIE designs that shift data ownership from providers to patients. There are multiple barriers to patient-centric HIE in the current system, such as security and privacy concerns, data inconsistency, timely access to the right records across multiple healthcare facilities. After investigating the current workflow of HIE, this paper provides a feasible solution to these challenges by utilizing the unique features of blockchain, a distributed ledger technology which is considered "unhackable". Utilizing the smart contract feature, which is a programmable self-executing protocol running on a blockchain, we developed a blockchain model to protect data security and patients' privacy, ensure data provenance, and provide patients full control of their health records. By personalizing data segmentation and an "allowed list" for clinicians to access their data, this design achieves patient-centric HIE. We conducted a large-scale simulation of this patient-centric HIE process and quantitatively evaluated the model's feasibility, stability, security, and robustness.

Hanaa Fatoum, Sam Hanna, John Halamka, Douglas Sicker · 6 authors

BACKGROUND In the era of big data, artificial intelligence (AI), and the Internet of Things (IoT), digital data have become essential for our everyday functioning and in health care services. The sensitive nature of health care data presents several crucial issues such as privacy, security, interoperability, and reliability that must be addressed in any health care data management system. However, most of the current health care systems are still facing major obstacles and are lacking in some of these areas. This is where decentralized, secure, and scalable databases, most notably blockchains, play critical roles in addressing these requirements without compromising security, thereby attracting considerable interest within the health care community. A blockchain can be maintained and widely distributed using a large network of nodes, mostly computers, each of which stores a full replica of the data. A blockchain protocol is a set of predefined rules or procedures that govern how the nodes interact with the network, view, verify, and add data to the ledger. OBJECTIVE In this article, we aim to explore blockchain technology, its framework, current applications, and integration with other innovations, as well as opportunities in diverse areas of health care and clinical research, in addition to clarifying its future impact on the health care ecosystem. We also elucidate 2 case studies to instantiate the potential role of blockchains in health care. METHODS To identify related existing work, terms based on Medical Subject Headings were used. We included studies focusing mainly on health care and clinical research and developed a functional framework for implementation and testing with data. The literature sources for this systematic review were PubMed, Medline, and the Cochrane library, in addition to a preliminary search of IEEE Xplore. RESULTS The included studies demonstrated multiple framework designs and various implementations in health care including chronic disease diagnosis, management, monitoring, and evaluation. We found that blockchains exhibit many promising applications in clinical trial management such as smart-contract application, participant-controlled data access, trustless protocols, and data validity. Electronic health records (EHRs), patient-centered interoperability, remote patient monitoring, and clinical trial data management were found to be major areas for blockchain usage, which can become a key catalyst for health care innovations. CONCLUSIONS The potential benefits of blockchains are limitless; however, concrete data on long-term clinical outcomes based on blockchains powered and supplemented by AI and IoT are yet to be obtained. Nonetheless, implementing blockchains as a novel way to integrate EHRs nationwide and manage common clinical problems in an algorithmic fashion has the potential for improving patient outcomes, health care experiences, as well as the overall health and well-being of individuals.

Alaa Awad Abdellatif, Abeer Z. Al-Marridi, Amr Mohamed, Aiman Erbad · 6 authors

The future of healthcare systems is being shaped by incorporating emerged technological innovations to drive new models for patient care. By acquiring, integrating, analyzing, and exchanging medical data at different system levels, new practices can be introduced, offering a radical improvement to healthcare services. This article presents a novel smart and secure Healthcare system (ssHealth), which, leveraging advances in edge computing and blockchain technologies, permits epidemics discovering, remote monitoring, and fast emergency response. The proposed system also allows for secure medical data exchange among local healthcare entities, thus realizing the integration of multiple national and international entities and enabling the correlation of critical medical events for, for example, emerging epidemics management and control. In particular, we develop a blockchain-based architecture and enable a flexible configuration thereof, which optimize medical data sharing between different health entities and fulfil the diverse levels of Quality of Service (QoS) that ssHealth may require. Finally, we highlight the benefits of the proposed ssHealth system and possible directions for future research.

Dinh C. Nguyen, Ming Ding, Pubudu N. Pathirana, Aruna Seneviratne

The beginning of 2020 has seen the emergence of coronavirus outbreak caused by a novel virus called SARS-CoV-2. The sudden explosion and uncontrolled worldwide spread of COVID-19 show the limitations of existing healthcare systems to timely handle public health emergencies. In such contexts, innovative technologies such as blockchain and Artificial Intelligence (AI) have emerged as promising solutions for fighting coronavirus epidemic. On the one hand, blockchain can combat pandemics by enabling early detection of outbreaks, protecting user privacy, and ensuring reliable medical supply chain during the outbreak tracking. On the other hand, AI provides intelligent solutions for identifying symptoms caused by coronavirus for treatments and supporting drug manufacturing. Motivated by these, in this paper we present an extensive survey on the use of blockchain and AI for combating coronavirus (COVID-19) epidemics based on the rapidly emerging literature. First, we introduce a new conceptual architecture which integrates blockchain and AI specific for COVID-19 fighting. Particularly, we highlight the key solutions that blockchain and AI can provide to combat the COVID-19 outbreak. Then, we survey the latest research efforts on the use of blockchain and AI for COVID-19 fighting in a wide range of applications. The newly emerging projects and use cases enabled by these technologies to deal with coronavirus pandemic are also presented. Finally, we point out challenges and future directions that motivate more research efforts to deal with future coronavirus-like epidemics.

Alexander Pilozzi, Xudong Huang

Alzheimer's disease (AD) imposes a considerable burden on those diagnosed. Faced with a neurodegenerative decline for which there is no effective cure or prevention method, sufferers of the disease are subject to judgement, both self-imposed and otherwise, that can have a great deal of effect on their lives. The burden of this stigma is more than just psychological, as reluctance to face an AD diagnosis can lead people to avoid early diagnosis, treatment, and research opportunities that may be beneficial to them, and that may help progress towards fighting AD and its progression. In this review, we discuss how recent advents in information technology may be employed to help fight this stigma. Using artificial intelligence (AI) technologies, specifically natural language processing (NLP), to classify the sentiment and tone of texts, such as those of online posts on various social media sites, has proven to be an effective tool for assessing the opinions of the general public on certain topics. These tools can be used to analyze the public stigma surrounding AD. Additionally, there is much concern among individuals that an AD diagnosis, or evidence of pre-clinical AD such as a biomarker or imaging test results, may wind up unintentionally disclosed to an entity that may discriminate against them. The lackluster security record of many medical institutions justifies this fear to an extent. Adopting more secure and decentralized methods of data transfer and storage, and giving patients enhanced ability to control their own data, such as a blockchain-based method, may help to alleviate some of these fears.

Anjum Khurshid, Vivian Rajeswaren, Steven Andrews

BACKGROUND: In the homeless population, barriers to housing and supportive services include a lack of control or access to data. Disparate data formats and storage across multiple organizations hinder up-to-date intersystem access to records and a unified view of an individual's health and documentation history. The utility of blockchain to solve interoperability in health care is supported in recent literature, but the technology has yet to be tested in real-life conditions encompassing the complex regulatory standards in the health sector. OBJECTIVE: This study aimed to test the feasibility and performance of a blockchain system in a homeless community to securely store and share data across a system of providers in the health care ecosystem. METHODS: We performed a series of platform demonstrations and open-ended qualitative feedback interviews to determine the key needs and barriers to user and stakeholder adoption. Account creation and data transactions promoting organizational efficiency and improved health outcomes in this population were tested with homeless users and service providers. RESULTS: Persons experiencing homelessness and care organizations could successfully create accounts, grant and revoke data sharing permissions, and transmit documents across a distributed network of providers. However, there were issues regarding the security of shared data, user experience and adoption, and organizational preparedness for service providers as end users. We tested a set of assumptions related to these problems within the project time frame and contractual obligations with an existing blockchain-based platform. CONCLUSIONS: Blockchain technology provides decentralized data sharing, validation, immutability, traceability, and integration. These core features enable a secure system for the management and distribution of sensitive information. This study presents a concrete evaluation of the effectiveness of blockchain through an existing platform while revealing limitations from the perspectives of user adoption, cost-effectiveness, scalability, and regulatory frameworks.

Alyssa Donawa, Inema Orukari, Corey E. Baker

Electronic Health Records (EHRs) have improved many aspects of healthcare and allowed for easier patient management for medical providers. Blockchains have been proposed as a promising solution for supporting Electronic Health Records (EHRs), but have also been linked to scalability concerns about supporting real-world healthcare systems. This paper quantifies the scalability issues and bottlenecks related to current blockchains and puts into perspective the limitations blockchains have with supporting healthcare systems. Particularly we show that well known blockchains such as Bitcoin, Ethereum, and IOTA cannot support transactions of a large scale hospital system such as the University of Kentucky HealthCare system and leave over 7.5M unsealed transactions per day. We then discuss how bottlenecks of blockchains can be relieved with sidechains, enabling well-known blockchains to support even larger hospital systems of over 30M transactions per day. We then introduce the Patient-Healthchain architecture to provide future direction on how scaling blockchains for EHR systems with sidechains can be achieved.

Themba Makubalo, Brenda Scholtz, Temitope Oluwaseyi Tokosi

No abstract is available for this record.

Yan Zhuang, Lincoln Sheets, Xiyuan Gao, Yuanyuan Shen · 7 authors

Clinical trials are essential for discovering new treatments, but there are multiple challenges to patient recruitment, patient engagement, and cost containment. Virtual clinical trials (VCT) are an innovative approach that provides potential solutions by conducting home-based, rather than site-based, clinical trials. Virtual clinical trials are still the exception rather than general practice due to technical barriers. "Blockchain," a distributed ledger technology, is a perfect match for virtual clinical trials. Its peer-to-peer design, security settings, and data transparency meet the needs of many healthcare applications. The programmable "Smart Contract" feature makes blockchain more suitable and feasible for VCT by solving computational issues. Our previous work has shown the power of applying blockchain to clinical trial recruitment. This work develops a comprehensive blockchain framework, with simulations and case studies, including patient recruitment, patient engagement, and persistent monitoring modules.

Ravi Sharma, Charcy Zhang, Stephen C. Wingreen, Nir Kshetri · 5 authors

Purpose The purpose of this paper is to describe the application of soft systems methodology (SSM) to address the problematic situation of low opt-in rates for Precision Health-Care (PHC). Design/methodology/approach The design logic is that when trust is enhanced and compliance is better assured, participants such as patients and their doctors would be more likely to share their medical data and diagnosis for the purpose of precision modeling. Findings The authors present the findings of an empirical study that confronts the design challenge of increasing participant opt-in to a PHC repository of Electronic Medical Records and genetic sequencing. Guided by SSM, the authors formulate design rules for the establishment of a trust-less platform for PHC which incorporates key principles of transparency, traceability and immutability. Research limitations/implications The SSM approach has been criticized for its lack of “rigour” and “replicability”. This is a fallacy in understanding its purpose – theory exploration rather than theory confirmation. Moreover, it is unlikely that quantitative modeling yields any clearer an understanding of complex, socio-technical systems. Practical implications The application of Blockchain, a platform for distributed ledgers, and associated technologies present a feasible approach for resolving the problematic situation of low opt-in rates. Social implications A consequence of low participation is the weak recall and precision of descriptive, predictive and prescriptive analytic models. Factors such as cyber-crime, data violation and the potential for misuse of genetic and medical records have led to a lack of trust from key stakeholders – accessors, participants, miners and regulators – to varying degrees. Originality/value The application of Blockchain as a trust-enabling platform in the domain of an emerging eco-system such as precision health is novel and pioneering.