Medchain: a design of blockchain-based system for medical records access and permissions management
Open accessAbstract
Although the blockchain technology was first introduced through Bitcoin, extending its usage to non-financial applications, such as managing electronic medical records, is an attractive mission for recent research to balance the needs for increasing data privacy and the regular interaction among patients and health providers. Various systems that adopts the blockchain in managing medical records have been proposed. However, there is a need for more work to better characterize, understand and evaluate the employment of blockchain technology in the healthcare industry. In this paper, a design of blockchain based system, namely MedChain, for managing medical records is proposed. MedChain is designed to improve the current systems as it provides interoperable, secure, and effective access for medical records by patients, health care providers, and other third parties, while keeping the patients' privacy. MedChain employs timed-based smart contracts for governing transactions and controlling accesses to electronic medical records. It adopts advanced encryption techniques for providing further security. This work proposes a new incentive mechanism that leverages the degree of health providers regarding their efforts on maintaining medical records and creating new blocks. Extensive experiments are conducted to evaluate the MedChain performance, and results indicate the efficiency of our proposal in handling a large dataset at low latency.
AI snapshot
Written from the paper’s full text.
TL;DR
MedChain is a blockchain-based design for managing electronic medical records (EMRs) with timed smart contracts, encryption, proxy re-encryption, and a Proof of Authority consensus integrated with a degree-based incentive mechanism. Experiments using an OpenMRS sample dataset show no significant performance difference from traditional relational EMR systems while handling large datasets at low latency.
Key findings
- MedChain stores EMRs in existing provider databases and uses the blockchain for access control, permissions, logs, and integrity via SHA-256 hashes.
- The incentive mechanism selects the provider node with the least degree to create the next block; nodes with degrees greater than the network average act as voters. The block creator receives an incentive added to its degree to reduce its chance of re-creating the next block.
- Using an OpenMRS dataset of 5,000 patients and 500,000 observations, throughput remained constant as submitted queries increased from 1,000–10,000 and stored records increased from 10,000–100,000.
- Results show no significant difference between MedChain and traditional relational EMR systems in average response time, average number of messages, throughput, and round-trip execution time of transactions.
Methods
- Design and prototype of MedChain on Ethereum using Solidity smart contracts, Truffle, GoEthereum, web3.js, and Apache JMeter for performance testing.
- Evaluation used an anonymized OpenMRS dataset with 5,000 patients and 500,000 observations, with MySQL for database creation and deployment.
- Experiments varied submitted queries from 1,000–10,000 and stored medical records from 10,000–100,000, with 25%, 50%, and 75% distribution variations, measuring average response time, throughput, communication overhead, and transaction round-trip execution time.
Limitations
- The paper does not include a dedicated limitations section.
- Evident from the text: evaluation is based on a prototype and a sample anonymized OpenMRS dataset, with no real-world clinical deployment or long-term operational data reported.
- Evident from the text: security and privacy claims are architectural and rely on encryption, hashing, and access-control contracts, but no formal security proof or adversarial attack evaluation is reported; the incentive mechanism’s quality scoring is described but not separately validated in the performance experiments.
Model-written summary. Check it against the paper before relying on it.
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Cites
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Claims the paper makes
0 of 17 cited sources checked · 0 supported · 0 flagged
- Findingown data
MedChain results indicate efficiency in handling a large dataset at low latency.
“Extensive experiments are conducted to evaluate the MedChain performance, and results indicate the efficiency of our proposal in handling a large dataset at low latency.”
- Also stated in: § I. INTRODUCTION · plain
“Results show the efficiency of our proposal in handling a large dataset at low latency.”
Quote in the paperSubstantial claim - Also stated in: § I. INTRODUCTION · plain
- Findingown data
There is no significant difference between the MedChain system and traditional EMRs management systems (relational database systems) in average response time, average number of messages, throughput, and round-trip execution time of transactions.
“Results show that there is no significant difference between our proposal MedChain system and the traditional EMRs management systems (i.e.relational database systems) in terms of the average response time (Fig. 5, Fig. 6), the average number of messages (Fig7.Fig. 8), the throughput (Fig9, Fig. 10) and the round-trip execution time of transactions (Fig. 11).”
- Also stated in: § 2) RESULTS AND DISCUSSION · hedged
“In this work, results indicate that there is no significant difference between the proposed Med-Chain and the traditional relational system.”
Quote in the paperSubstantial claim - Also stated in: § 2) RESULTS AND DISCUSSION · hedged
- Findingown data
The throughput of the system remains constant even with increments of submitted queries or increments of stored records.
“However, the throughput of the system remains constant even with the increments of the submitted queries or the increments of the stored records (Fig. 9 and Fig. 10).”
Quote in the paperSubstantial claim - Findingreasoning
The time spent on performing invoke transactions is more than the time spent on performing query transactions.
“Also, results show that time spent on performing invoke transactions is more than the time spent on performing the query transactions.”
Quote in the paperNot a substantial claim - Findingnone given
The round-trip execution time increases as the number of transactions increases.
“It was obvious to see that the round-trip execution time increases as the number of transactions increases.”
Quote in the paperNot a substantial claim
- Interpretationnone given
MedChain proposes a new incentive mechanism that leverages the degree of health providers regarding their efforts on maintaining medical records and creating new blocks.
“This work proposes a new incentive mechanism that leverages the degree of health providers regarding their efforts on maintaining medical records and creating new blocks.”
Quote in the paperSubstantial claim - Study design and conductnone given
MedChain employs SHA-256 hashing to ensure data integrity.
“Our proposed framework employs the hashing methods, i.e.SHA-256, to ensure data integrity.”
Quote in the paperSubstantial claim - Interpretationreasoning
Providers' nodes with less degrees are more likely to be selected for creating the new block.
“Providers' nodes with less degrees are more likely to be selected for creating the new block.”
- Also stated in: § C. EMRS ACCESS WITH/WITHOUT BLOCKCHAIN · hedged
“Providers' nodes with less degrees are more likely to be selected for creating the new block.”
Quote in the paperSubstantial claim - Also stated in: § C. EMRS ACCESS WITH/WITHOUT BLOCKCHAIN · hedged
- Interpretationreasoning
Medical records are fragmented and isolated, rather than cohesive, due to a lack of coordinated data management and exchange.
“These situations cause a lack of coordinated data management and exchange.In other words, medical records are fragmented and isolated, rather than cohesive.”
Quote in the paperSubstantial claim - Interpretationreasoning
The proposed incentive mechanism rewards the block's creator with an incentive added to its degree to decrease its probability of re-creating the next block.
“our proposal rewards the ''block's creator'' an incentive that will added to its degree to decrease its probability of re-creating the next block instead of just creating a digital currency.”
Quote in the paperSubstantial claim - Interpretationcitation
The NCC functions using the PoA consensus algorithm integrated with the proposed incentive mechanism for mining.
“For mining, which is defined as the process of adding transactions to the blockchain network, the NCC functions using the PoA Consensus algorithm [33] integrated with our proposed incentive mechanism.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [33] source
Not checked in the free run.
- Interpretationnone given
The design works on a permissioned blockchain network.
“Our design works on a permissioned blockchain network; therefore, nodes with permissions will use the client to access the private blockchain.”
Quote in the paperSubstantial claim - Interpretationnone given
Reading a record stored in a provider node from another provider node utilizes the proxy re-encryption mechanism to increase both the accessibility and the security of EMRs systems.
“The process of reading a record that is stored in a provider node from another provider node utilizes the proxy re-encryption mechanism to increase both the accessibility and the security of EMRs systems.”
Quote in the paperSubstantial claim - Interpretationreasoning
Providers with increased degrees will have less probability to perform the computational task of creating the new block.
“Accordingly, they will have less probability to perform the computational task of creating the new block.”
Quote in the paperSubstantial claim - Premisecitation
The PReC implements the proxy re-encryption schema proposed by [29].
“This contract functions the proxy re-encryption schema proposed by [29].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [29] source
Not checked in the free run.
- Interpretationnone given
MedChain maintains security and access control by adopting advanced encryption and authentication techniques throughout the blockchain.
“Security and access control are maintained by the adoption of advanced encryption and authentication techniques throughout the blockchain.”
Quote in the paperSubstantial claim - Interpretationnone given
MedChain maintains privacy by employing timed-based smart contracts for governing transactions.
“Privacy is maintained in the MedChain by employing timed-based smart contracts for governing transactions.”
Quote in the paperNot a substantial claim - Interpretationcitation
The proxy re-encryption schema allows transferring a record from one health provider to another without sharing the credentials information used to decrypt the record.
“Similar to [12] and [28], our proposed system adopts the proxy re-encryption schema to transfer a record from one health provider who stored the record to another without sharing the credentials information used to decrypt the record.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [12]
Not checked in the free run.
- cites [28]
Not checked in the free run.
- Interpretationreasoning
Medical records are isolated and fragmented across public hospitals, private clinics, private practices, labs and private companies collecting data from wearable devices rather than cohesive.
“Hence, medical records are isolated and fragmented across public hospitals, private clinics, private practices, labs and private companies collecting data from wearable devices rather than cohesive.”
Quote in the paperSubstantial claim- Rests on an assumption: A patient's record is stored in the private database of the provider who issued it, and only that provider is eligible to edit, manage and maintain it.
- Interpretationreasoning
MedChain meets the HIPAA security requirements and rules.
“MedChain meets the HIPAA security requirements and rules.”
Quote in the paperNot a substantial claim - Interpretationreasoning
The hash value stored in the blockchain ensures that no alterations have been made outside the blockchain during transfer because the hash value is unique to the original document.
“Therefore, its hash value stored in the blockchain ensures that no alterations have been made outside the blockchain during the transfer as the value of the hash is unique to the original document.”
Quote in the paperSubstantial claim - Interpretationown data
The stability of the system's throughput when increasing stored medical records and submitted queries proves the system's ability to handle and process a large dataset with high frequency at low latency as in EMRs systems.
“The stability of the system's throughput even when increasing the number of stored medical records and the number of submitted queries prove the ability of the system to handle and process a large dataset with high frequency at low latency as in EMRs systems.”
Quote in the paperSubstantial claim - Interpretationreasoning
For creating, validating, and appending a new block, the proposed system employs a new incentive mechanism integrated with the Proof of Authority (PoA) consensus algorithm.
“For crating, validation, and appending new block, the proposed system employs a new incentive mechanism integrated with the Proof of Authority (PoA) consensus algorithm.”
Quote in the paperSubstantial claim- Rests on an assumption: The majority of current healthcare systems are welfare oriented and do not intend to involve monetary value.
- Rests on an assumption: Medical records are patients' assets and not a cryptocurrency or digital currency to be exchanged.
- Interpretationnone given
The proposed framework uses a new incentive mechanism integrated with the PoA consensus algorithm for creating and validating new blocks.
“Unlike previous work, we propose a new incentive mechanism integrated with the PoA consensus algorithm for creating and validation new blocks.”
Quote in the paperNot a substantial claim- Rests on an assumption: The majority of current healthcare systems are welfare oriented and do not intend to involve monetary value.
- Rests on an assumption: Medical records are patients' assets and not a cryptocurrency or digital currency to be exchanged.
- Interpretationown data
Results indicate the efficiency of the proposal in handling a large dataset at low latency.
“Results indicate the efficiency of our proposal in handling a large dataset at low latency.”
Quote in the paperSubstantial claim - Interpretationreasoning
Because health providers solely maintain the records they issued, there is difficulty confirming data integrity when a malicious entity modifies a single copy of the record or removes a record from a provider database.
“Moreover, as health providers are solely maintaining the records in which they had issued, there is a difficulty to confirm data integrity when a malicious entity modifies that single copy of the record or even when a record is removed from a provider database.”
Quote in the paperSubstantial claim- Rests on an assumption: A patient's record is stored in the private database of the provider who issued it, and only that provider is eligible to edit, manage and maintain it.
- Interpretationreasoning
MedChain increases the level of data obfuscation by separating sensitive information using SRHC, PRC and ACC.
“MedChain system increases the level of data obfuscation by separating sensitive information by using SRHC, PRC and ACC.”
Quote in the paperSubstantial claim - Interpretationnone given
Sensitive information placed on the blockchain is encrypted to decrease the possibility of being accessed by unauthorized entities.
“Sensitive information that are placed on the blockchain are encrypted to decrease the possibility of being accessed by unauthorized entity.”
Quote in the paperSubstantial claim - Interpretationnone given
The proposed framework employs hashing methods, specifically SHA-256, to ensure data integrity.
“Our proposed framework employs the hashing methods, i.e.SHA-256, to ensure data integrity.”
Quote in the paperSubstantial claim
- May combine two claims. 44
- Classified as probably not a substantial claim. 53
May combine two claims.
FindingreasoningThe average response time and the average number of messages sent per node increased as the total number of submitted queries increased.
“Results show that the average response time and the average number of messages sent per node increased as the total submitted queries was increased as shown in Fig. 5 and Fig. 6.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingreasoningThe average response time and the average number of messages sent per node increased as the total number of stored records increased.
“Similarly, the average response time and the average number of messages sent per node increased as the total number of stored records was increased as shown in Fig. 7 and Fig. 8.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationnone givenMedChain employs timed-based smart contracts for governing transactions and controlling accesses to electronic medical records.
“MedChain employs timed-based smart contracts for governing transactions and controlling accesses to electronic medical records.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
InterpretationreasoningThe proposed incentive mechanism achieves fairness among providers and ensures the sustainability of the system.
“Thus, achieving a fairness among providers and ensuring the sustainability of the system.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationnone givenMedChain handles the issues of privacy, security, data fragmentation, data isolation, effective access to medical records, and system interoperability.
“In summary, this research presents the design of a blockchain based system for EMRs that handles the issues of privacy, security, data fragmentation, data isolation, effective access to medical records, and system interoperability.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenMedChain stores the query link, the key and the EMRs in different locations for further security.
“For further security, MedChain will store the query link, the key and the EMRs in different locations.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Interpretationnone givenMedChain adopts advanced encryption techniques for providing further security.
“It adopts advanced encryption techniques for providing further security.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningThe need for multiple access to EMRs has raised interoperability challenges between patients and health providers, posing additional barriers to effective data sharing.
“The need for multiple access to the EMRs had raised the interoperability challenges between patients and health providers which pose additional barriers to effective data sharing.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationnone givenMedChain provides interoperable, secure, and effective access to medical records by patients, health care providers, and third parties while keeping patients' privacy.
“MedChain is designed to improve the current systems as it provides interoperable, secure, and effective access for medical records by patients, health care providers, and other third parties, while keeping the patients' privacy.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable), S4 (based).
Premisenone givenThere is still a need for more research to better understand, characterize and evaluate the utility of blockchain in healthcare systems, such as EMRs management.
“Although a number of studies is proposed to employ the blockchain for managing EMRs, there is still a need for more research to better understand, characterize and evaluate its utility in healthcare systems, such as EMRs management.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationA medical record is complete if it has all the items mentioned in [34], [36], and [37].
“-Completeness (CM): A medical record is considered complete if it has all the above-mentioned items 34], [36], and [37].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [34]
Not checked in the free run.
- cites [36]
Not checked in the free run.
- cites [37]
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
InterpretationreasoningVoters' nodes validate whether the ID is suitable with the requested role and guarantee that the node is a legitimate health provider or third party, decreasing the possibility that illegitimate nodes can join the system.
“They validate whether the ID is suitable with the requested role and guarantee that the node is a legitimate health provider or third party.Accordingly, decreasing the possibility that illegitimate nodes can join the system.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningMedical records are encrypted using the symmetric key encryption schema, and the symmetric key is re-encrypted with the public keys of the provider node, patient node, and the set of proxy nodes.
“Medical records are encrypted using the symmetric key encryption schema.The Cipher/Decipher Manager first generates a symmetric key to encrypt the medical record, and then re-encrypt that key with the public keys of the: provider node, patient node, and the set of proxy nodes.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable).
PremisecitationThe correctness of a medical record refers to the accuracy of its collected data, meaning the data provided by health providers should be reflected by the medical record.
“-Correctness (CR): The medical record's correctness refers to the accuracy of its collected data.It means that the data provided by health providers should be reflected by the medical record [38], and [39].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [38]
Not checked in the free run.
- cites [39]
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Interpretationnone givenThe NCC determines voters' nodes in the system along with the provider block's creator node who will generate the next block.
“This contract determines voters' nodes in the system along with the provider ''block's creator'' node who will generate the next block.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationMedChain adopts the distributed ElGamal re-encryption schema with distributed blinding where a master public key is used to encrypt a message and the associated private key is distributed in pieces to the set of proxies.
“In this work, MedChain adopts the distributed ElGamal re-encryption schema with distributed blinding [29] where a master public key is used to encrypt a message and the associated private key is distributed in pieces to the set of proxies.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [29] source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationAny entry in a medical record must be legible, dated, timed, and authenticated by the health provider.
“-Legibility (L): Any entry in a medical record have to be legible, dated, timed and authenticated by the health provider [35].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [35]
Not checked in the free run.
Probably not a substantial claim: may not pass S4 (based). May combine two claims.
InterpretationreasoningThe proposal improves the data quality of EMRs because providers that fill more legal, correct, consistent, complete and non-redundant items, create new such records, and generate a new block will have their degrees increased.
“Our proposal plays a key role in improving the data quality of EMRs as providers that 1) fill more legal, correct, consist, complete and no redundant items to an existing record, 2) create new legal, complete, consistent, correct with no redundancy records, and 3) generate a new block will have their degrees increased.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Study design and conductreasoningThe DB manager creates a hash value for the created query link and the patient's medical record to be stored in the Participants' Record Contract (PRC) in the blockchain, and creates a hash value for the log to be stored in the Logs Contract (LC).
“To ensure data integrity, the DB manager creates a hash value for the created query link as well as the patient's medical record to be stored in the Participants' Record Contract (PRC) in the blockchain.It also creates a hash value for the log to be stored in the Logs Contract (LC).”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
Interpretationnone givenThe value of c depends on the size of the blockchain network and the distribution of health provider degrees, and c is defined as a fraction of the average degrees in the network.
“The value of c depends on the size of the blockchain network and the distribution of health provides degrees.Thus, c will be defined as a fraction of the average degrees in the network.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: The Ethereum addresses of all provider nodes that agree to join the blockchain network have been received, and the software components have been installed.
- Rests on an assumption: All health providers who accept to join the blockchain network share their EMRs.
- Rests on an assumption: All health providers who would like to join the blockchain system agree on the rules of the proposed smart contracts, the proposed incentive mechanism, the frequency of updating the blockchain network, and the process of generating, verifying, and appending a new block to the blockchain network.
Probably not a substantial claim: may not pass S4 (based).
Interpretationnone givenA node with a degree greater than the average degree of the blockchain is considered a voter node.
“Note, a node who has a degree that is greater than the average degree of the blockchain will be considered as a voter node”
Quote in the paperNot a substantial claim- The authors state this as an assumption: The Ethereum addresses of all provider nodes that agree to join the blockchain network have been received, and the software components have been installed.
- Rests on an assumption: All health providers who accept to join the blockchain network share their EMRs.
- Rests on an assumption: All health providers who would like to join the blockchain system agree on the rules of the proposed smart contracts, the proposed incentive mechanism, the frequency of updating the blockchain network, and the process of generating, verifying, and appending a new block to the blockchain network.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationFor designing the evaluation experiment, previous published research [19] was considered to select the experiment parameters, and the parameter values were selected to estimate the approximate number of EMRs based on statistics published by the ministry of health in Palestine [42].
“For designing the evaluation experiment, our previous published research was considered [19] to select the experiment parameters, and the values of that parameters were selected to estimate the approximate number of EMRs based on statistics published by the ministry of health in Palestine where the corresponding author lives [42].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [19]
Not checked in the free run.
- cites [42]
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductreasoningThe PRC stores a hash value h(QL) for the query link of each record and a hash value h(EMR) of the stored record to maintain data integrity.
“Moreover, to maintain data integrity, each record has a hash value h(QL) for the query link of the file, and a hash value h(EMR) of the stored record.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
Interpretationnone givenEncrypting the record via the symmetric key encryption schema improves efficiency and reduces the need for later re-encryption.
“Encrypting the record via the symmetric key encryption schema improves the efficiency and reduce the need for later re-encryption.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Interpretationnone givenVoters' nodes in the NCC validate other nodes who demand a role with higher levels upon being added to the system.
“For the registration process, voters' nodes in the NCC are responsible for validating other nodes who demand a role with ''higher levels'' upon added to the system.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataMore submitted queries lead to longer query completion times and more communications among participants' nodes.
“These situations are expected as the more queries to be submitted, the longer it takes for a query to be completed and the more communications among participants' nodes to be occurred.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Interpretationnone givenThe NCC assigns the block creation task to the provider node who has the least degree among all providers' nodes in the system.
“For selecting the ''block's creator'', the NCC assigns this task to the provider node who has the least degree among all providers' nodes in the system.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
PremisereasoningAccording to PoA, verifying blocks and transactions by authorities achieves benefits including maintaining privacy, improving security, minimizing computations, and increasing system performance with lower transaction acceptance latency and steady time intervals for issuing blocks.
“According to the PoA, verifying the blocks and transactions by authorities who act as moderators of the system achieves several benefits: maintaining the privacy of the system while acquiring the benefits of the blockchain technology; improving the security of the system; minimizing the intensive of computations, increasing the system performance as it provides lower transaction acceptance latency”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Interpretationnone givenMedChain employs a new incentive mechanism integrated with the Proof of Authority (PoA) consensus algorithm for creating, validation, and appending new blocks.
“For crating, validation, and appending new block, the proposed system employs a new incentive mechanism integrated with the Proof of Authority (PoA) consensus algorithm.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
PremisecitationA medical record is consistent when its included data are reliable and its data integrity has not been corrupted regardless of how often or in what way the data have been retrieved, viewed, stored, or processed.
“-Consistency (CN): A medical record is considered consistent when the included data are reliable, and the data integrity has not been corrupted regardless of how often or in what way the data have been retrieved, viewed, stored, or processed [39].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [39]
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Interpretationnone givenThe NCC stores the degree of each provider node to calculate the average degree of the network and select voters' nodes.
“For determining the voters' nodes, the NCC stores the degree of each provider node within the system that in turn will be used for calculating the average degree of the network and selecting voters' nodes.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningThe node with the least degree among the nodes in the network is assigned the task of generating the next new block, and the NCC assigns this task to the health provider with the lowest degree among other providers in the system.
“while the node that has the least degree among the nodes in the network will be assigned the task of generating the next new block.”
- Also stated in: § J. GENERATING/VERIFYING/ AND APPENDING A NEW BLOCK · plain
“The NCC assigns this task to the health provider with the lowest degree among other providers in the system.”
Quote in the paperSubstantial claim- The authors state this as an assumption: The Ethereum addresses of all provider nodes that agree to join the blockchain network have been received, and the software components have been installed.
- Rests on an assumption: All health providers who accept to join the blockchain network share their EMRs.
- Rests on an assumption: All health providers who would like to join the blockchain system agree on the rules of the proposed smart contracts, the proposed incentive mechanism, the frequency of updating the blockchain network, and the process of generating, verifying, and appending a new block to the blockchain network.
- Also stated in: § J. GENERATING/VERIFYING/ AND APPENDING A NEW BLOCK · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningPatients can be notified upon modifying the stewardship status field as a new stewardship is recommended or an update is available.
“Thus, patients can be notified upon modifying the stewardship status field as a new stewardship is recommended or an update is available.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Interpretationnone givenVoters' nodes guarantee that no threat will be created to the system.
“Voters' nodes guarantee that no threat will be created to the system.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Interpretationnone givenThe node with the least degree is classified as the block's creator, while nodes with degrees greater than the average degrees of the network are considered voters.
“The node with the least degree will be classified as ''a block's creator'' node, while the nodes with degrees greater than the average degrees of the network will be considered as ''voters''.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
InterpretationreasoningPatients can access their nodes via online wallets, so records access can be performed by any device with Internet connection, improving the interoperability of EMRs.
“Since patients can access their nodes via online wallets, records access can be performed by any device with Internet connection.Thus, improving the interoperability of EMRs.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAccording to Zhou schema, a master public key along with a shared private key is given to the set of proxy nodes.
“According to Zhou schema, a master public key along with a shared private key will be given to the set of proxy nodes.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [29] source
Not checked in the free run.
Classified as probably not a substantial claim.
Interpretationnone givenThe SRHC maintains the steward relationship history of each participant node in the system where the patient's medical record is stored and managed by the provider node.
“This contract maintains the steward relationship history of each participants' nodes in the system where the patient's medical record is stored and managed by the provider node.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
Interpretationnone givenMedChain provides interoperability, auditability, and accessibility by using comprehensive logs.
“Interoperability, auditability, and accessibility are provided by the use of comprehensive logs.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
Interpretationnone givenEvery node within the blockchain system will have a SRHC that will be created during the registration process.
“Every node within the blockchain system will have a SRHC that will be created during the registration process.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Interpretationnone givenThe degree of a provider node is calculated based on the quantity and the quality of the EMRs stored in its database.
“The degree of a node is calculated based on the quantity and the quality of the EMRs stored in its database.”
Quote in the paperSubstantial claim- Rests on an assumption: The quality of a medical record should be judged by whether or not that record serves the purpose for which it was intended.
May combine two claims.
InterpretationreasoningProviders with more degrees maintain more medical records or records with higher values, and thus they are less likely to be selected for generating a new block.
“According to the selection method in the proposed incentive mechanism, providers with more degrees maintain more medical records or records with higher values.Thus, they are less likely to be selected.”
Quote in the paperSubstantial claim- The authors state this as an assumption: The Ethereum addresses of all provider nodes that agree to join the blockchain network have been received, and the software components have been installed.
- Rests on an assumption: All health providers who accept to join the blockchain network share their EMRs.
- Rests on an assumption: All health providers who would like to join the blockchain system agree on the rules of the proposed smart contracts, the proposed incentive mechanism, the frequency of updating the blockchain network, and the process of generating, verifying, and appending a new block to the blockchain network.
Classified as probably not a substantial claim.
Interpretationown dataREM evaluates the degree of providers' nodes during the initialization stage based on the quantity and quality of medical records stored in each provider database.
“REM is a python-based tool that evaluates the degree of providers' nodes in the blockchain during the initialization stage.It will be installed and configured only on the providers' nodes.The evaluation process is based on the quantity and the quality of medical records stored in each provider database.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductnone givenOnly one parameter was changed each time so that any changes in performance would be based solely on this parameter.
“Only one parameter was changed each time so that any changes in the performance would be based solely on this parameter.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Interpretationnone givenThe health provider chosen to generate a new block gets an incentive c as a reward upon successful verification of the block by other health providers.
“According to the proposed incentive mechanism, the health provider who will be chosen to generate a new block will get an incentive c as a reward upon successfully verifying the block by other health providers.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: The Ethereum addresses of all provider nodes that agree to join the blockchain network have been received, and the software components have been installed.
- Rests on an assumption: All health providers who accept to join the blockchain network share their EMRs.
- Rests on an assumption: All health providers who would like to join the blockchain system agree on the rules of the proposed smart contracts, the proposed incentive mechanism, the frequency of updating the blockchain network, and the process of generating, verifying, and appending a new block to the blockchain network.
Classified as probably not a substantial claim. May combine two claims.
InterpretationreasoningThe proposal aims to achieve fairness and equality among providers' nodes by rewarding the block's creator an incentive added to its degree to decrease its probability of re-creating the next block, instead of creating a digital currency.
“Our proposal aims at achieving the fairness and the equality status among providers' nodes for ensuring the sustainability of the system by rewarding the ''block's creator'' an incentive that will be added to its degree for decreasing its probability of re-creating the next block, instead of just creating a digital currency.”
Quote in the paperSubstantial claim- Rests on an assumption: The majority of current healthcare systems are welfare oriented and do not intend to involve monetary value.
- Rests on an assumption: Medical records are patients' assets and not a cryptocurrency or digital currency to be exchanged.
May combine two claims.
Interpretationnone givenThe system utilizes timed smart contracts for controlling accesses to EMRs and monitoring computations performed on EMRs through enforcement of acceptable usage policies.
“Our system utilizes the timed smart contracts for controlling accesses to EMRs and monitoring the computations performed on the EMRs through the enforcement of the acceptable usage policies.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
Interpretationnone givenInteroperability, auditability, and accessibility are provided by the use of comprehensive logs.
“Interoperability, auditability, and accessibility are provided by the use of comprehensive logs.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
Interpretationnone givenThe proposal is independent of any specific system, and its variations can potentially accommodate other similar systems with multiple access for electronic records.
“Our proposal is independent of any specific system, and its variations can potentially accommodate other similar systems with multiple access for electronic records.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationPrevious research concluded that blockchain performance limits its applicability in various industries and recommended combining blockchain with relational databases to implement industrial functions.
“Although previous research concluded that the performance of blockchain limits its applicability in various industries, they recommended that a practical solution may be combining blockchain with relational databases to implement industrial functions [43].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [43]
Not checked in the free run.
May combine two claims.
InterpretationreasoningThe design maintains privacy while acquiring blockchain benefits, improves security, minimizes computations, and increases performance by providing lower transaction acceptance latency.
“Additionally, it maintains the privacy of the system while acquiring the benefits of the blockchain technology, improves the security of the system, minimizes the intensive of computations and increases the system performance as it provides lower transaction acceptance latency.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Interpretationnone givenThe adoption of timed-based smart contracts ensures a reasonable period for transactions and computations performed on the data.
“The adoption of timed-based smart contracts ensures a reasonable period for the transactions and the computations performed on the data.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationnone givenIn MedChain, blockchain maintenance including creation, verification and appending of new blocks is the responsibility of health providers, while patients can securely control access to their EMRs.
“In MedChain, the blockchain maintenance including creation, verification and appending of new blocks is the responsibility of health providers, while allowing patients to securely control accesses their EMRs.”
Quote in the paperSubstantial claim- Rests on an assumption: Health providers currently maintain and manage EMRs, while patients can only read data.
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
InterpretationreasoningMore stored records lead to more participants using the system and thus more queries submitted on the system.
“Also, the more records to be stored, the more participants to use the system; and thus, the more queries to be submitted on the system.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationnone givenMedChain confirms data integrity by adopting hashing techniques and employs proxy re-encryption to allow a third party to read an EMR stored in one provider node.
“MedChain confirms the integrity of data by adopting the hashing techniques and employs the proxy re-encryption to allow a third party to read the EMR stored in one provider node.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningThe incentive mechanism achieves fairness among providers and ensures the sustainability of the system.
“Thus, achieving a fairness among providers and ensuring the sustainability of the system.”
Quote in the paperNot a substantial claim- Rests on an assumption: The majority of current healthcare systems are welfare oriented and do not intend to involve monetary value.
- Rests on an assumption: Medical records are patients' assets and not a cryptocurrency or digital currency to be exchanged.
Probably not a substantial claim: may not pass S4 (based). May combine two claims.
InterpretationreasoningMedChain is designed to be compatible with existing EMRs' databases and to improve current EMRs management systems by providing interoperable, secure, and efficient access to EMRs by health providers, patients and third parties while maintaining patients' privacy.
“MedChain is designed to be compatible with the existing EMRs' databases and to improve the current EMRs management systems as it provides interoperable, secure, and efficient access to EMRs by health providers, patients and third parties, while maintaining the patients' privacy.”
Quote in the paperNot a substantial claim- Rests on an assumption: Relational databases have high performance and blockchain has high security and privacy.
Probably not a substantial claim: may not pass S4 (based). May combine two claims.
Interpretationnone givenThe need for multiple access to EMRs raised interoperability challenges between patients and health providers, posing additional barriers to effective data sharing.
“The need for multiple access to the EMRs had raised the interoperability challenges between patients and health providers which pose additional barriers to effective data sharing.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Interpretationnone givenBy the proposed smart contracts, MedChain verifies legitimate participants before registration and employs identity checking to ensure sensitive information is only given to authorized users.
“By the proposed smart contracts, MedChain verifies legitimate participants before performing the registration process, employs the identity checking for ensuring that sensitive information is only given to authorized users.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S4 (based).
Interpretationnone givenSecurity and access control are maintained by the adoption of advanced encryption and authentication techniques throughout the blockchain.
“Security and access control are maintained by the adoption of advanced encryption and authentication techniques throughout the blockchain.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
InterpretationreasoningProviders' nodes with more degrees are less likely to be assigned to the computation task of creating the new block.
“Providers' nodes with more degrees are less likely to be assigned to the computation task of creating the new block.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningThe MedChain system significantly increases the difficulty of attack and improves the privacy and security of EMRs.
“Therefore, it significantly increases the difficulty of attack and improves the privacy and security of EMRs.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisereasoningMedical records are considered major targets for information theft because they include private and sensitive information such as patients' names, identity numbers, contacts and addresses.
“Unfortunately, medical records are considered as major targets for information theft since they include private and sensitive information, e.g. the patients' names, identity numbers, contacts info and addresses.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningThe PoA consensus algorithm improves system performance and decreases computational time and cost compared with PoW and PoS because it can handle more transactions per second.
“Our system adopts the PoA consensus algorithm which plays a significant role in improving the system performance and decreasing the computational time and cost as it can handle more transactions per second compared with the PoW and the PoS.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
Interpretationnone givenPrivacy is maintained in MedChain by employing timed-based smart contracts for governing transactions.
“Privacy is maintained in the MedChain by employing timed-based smart contracts for governing transactions.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
InterpretationreasoningAll accesses to EMRs are performed through the blockchain, and the history of those accesses is stored in the blockchain to provide a full view of all events that occurred to EMRs.
“All accesses to the EMRs will be performed through the blockchain, and accordingly the history of those accesses will be stored in the blockchain to provide a full view of all events occurred to EMRs.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn 2015, a hack on Anthem insurance corporation resulted in stealing the records of 78.8 million U.S. patients.
“In 2015, a hack happened on Anthem which is an insurance corporation results in stealing the records of 78.8 million U.S patients [44].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [44]
Not checked in the free run.
Classified as probably not a substantial claim.
InterpretationreasoningProxy re-encryption is employed to solve the problem of transferring encrypted messages among nodes without sharing a symmetric key.
“The use of proxy re-encryption technique is employed to solve the problem of transferring encrypted messages among nodes with no need to share symmetric key.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningBecause most current healthcare systems are welfare oriented and do not involve monetary value, the proposal rewards the block's creator an incentive added to its degree to decrease its probability of re-creating the next block instead of just creating a digital currency.
“As most of the current healthcare systems are welfare oriented that have no intend to involve any monetary value, our proposal rewards the ''block's creator'' an incentive that will added to its degree to decrease its probability of re-creating the next block instead of just creating a digital currency.”
Quote in the paperSubstantial claim- Rests on an assumption: The majority of current healthcare systems are welfare oriented and do not intend to involve monetary value.
- Rests on an assumption: Medical records are patients' assets and not a cryptocurrency or digital currency to be exchanged.
May combine two claims.
Interpretationnone givenInvoke transactions require endorsement while query transactions do not require endorsement.
“The reason behinds this is invoke transactions require endorsement while endorsement is not required for query transactions.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningStoring access history in the blockchain ensures the integrity of data and prevents misuse of a patient's EMR.
“Thus, ensuring the integrity of data and preventing misuse of a patient EMR.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Medical records are major targets for information theft because they include private and sensitive information.
“Unfortunately, medical records are considered as major targets for information theft since they include private and sensitive information, e.g. the patients' names, identity numbers, contacts info and addresses.”
The paper relies on this without support.
A medical record is a patient's asset and not a cryptocurrency or digital currency to be exchanged.
“A medical record is a patient asset and not a digital currency or a cryptocurrency to be exchanged.”
The paper relies on this without support.
Most current healthcare systems are welfare oriented and have no intent to involve any monetary value.
“As most of the current healthcare systems are welfare oriented that have no intend to involve any monetary value, our proposal rewards the ''block's creator'' node an incentive that will be added to its degree for potential reducing its probability of re-creating the next block instead of just creating a digital currency; thus, achieving a fairness among providers and ensuring the sustainability”
The paper relies on this without support.
In current systems, the EMR is stored in the provider's database who issued the record, and only that eligible provider is responsible for editing, maintenance, and management of the record.
“The EMR will be stored in the provider's database who issued the record and will only be the eligible provider for editing it.This provider also will be responsible for the record's maintenance and management.”
The paper relies on this without support.
Health providers currently maintain and manage EMRs, while patients can only read data.
“As health providers currently maintains and manages the EMRs, while patients can only read data, providers' nodes in our design will be responsible for the maintenance of the blockchain.”
“As health providers currently maintains and manages the EMRs, while patients can only read data, providers' nodes in our design will be responsible for the maintenance of the blockchain.”
The authors state this as an assumption.
The Ethereum addresses of all provider nodes that agree to join the blockchain network have been received, and the software components have been installed.
“Also, it should be assumed that the Ethereum address (i.e. the Ethereum address is equivalent to a public key) of all providers' nodes that agree to join the blockchain network have been received, and the software components have been installed.”
The paper relies on this without support.
All health providers who accept to join the blockchain network share their EMRs.
“In this stage, all health providers who accept to join the blockchain network have to share their EMRs.”
The paper relies on this without support.
All health providers who would like to join the blockchain system agree on the rules of the proposed smart contracts, the proposed incentive mechanism, the frequency of updating the blockchain network, and the process of generating, verifying, and appending a new block to the blockchain network.
“All health providers who would like to join the blockchain system should agree on: the rules of the proposed smart contracts, the proposed incentive mechanism, the frequency of updating the blockchain network and the process of generating, verifying, and appending a new block to the blockchain network.”
The paper relies on this without support.
The quality of a medical record should be judged by whether or not that record serves the purpose for which it was intended.
“Generally, the quality of a medical record should be judged by whether or not that record serves the purpose for which it was intended.”
The paper relies on this without support.
The majority of current healthcare systems are welfare oriented and do not intend to involve monetary value.
“Since the majority of the current healthcare systems are welfare oriented with no intend to involve any monetary value, there is a need to propose a more suitable incentive mechanism for the EMRs systems.”
“Since most of the current health providers are welfare oriented that have no intend to involve any monetary value, our mechanism rewards the ''block's creator'' an incentive to be added to its degree and accordingly decreasing its probability of re-creating the next block instead of just creating a digital currency.”
The paper relies on this without support.
Medical records are patients' assets and not a cryptocurrency or digital currency to be exchanged.
“As medical records are patients' assets and not a cryptocurrency or digital currency to be exchanged, this work propose a new incentive mechanism integrated with the PoA for mining.”
The paper relies on this without support.
A patient's record is stored in the private database of the provider who issued it, and only that provider is eligible to edit, manage and maintain it.
“In fact, the record will be stored in the provider's private database who had issued the record and will only be the eligible provider for editing, managing and maintaining that record.”
The paper relies on this without support.
Relational databases have high performance and blockchain has high security and privacy.
“Thus, the advantages of the relational databases regarding its high performance and the advantages of the blockchain regarding the high security and privacy, in addition to the inter-operable and effective access to EMRs will be both utilized.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Daraghmi et al.'s timed smart contract-based medical record access and permission management architecture did not address security and privacy and did not access continuous health data onto the blockchain.
“However, the security and privacy was not addressed and accessing continuous health data onto the blockchain was not done.”
From A survey on the adoption of blockchain in IoT: challenges and solutions (2021) · cites this paper as [95]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rejected stewardship is marked as approved
MinorThe registration procedure says a canceled request is assigned the same "acknowledged patient approval" status as an accepted request, so the status does not distinguish rejection from approval.
“Otherwise, the process will be canceled, the status field will be updated with ''acknowledged patient approval'', and a notification will be sent to the provider node.”
“When the patient accepts the request, the status field of both the provider and the patient SRHC will be updated with ''acknowledged patient approval'' along with the last_update field.”
Messages result cites a response-time figure
MinorThe results discussion cites Figure 7 for the average number of messages, but Figure 7 is captioned as average response time.
“the average number of messages (Fig7.Fig. 8)”
“Figure: 7 FIGURE 7 . FIGURE 7. Average response time (sec) vs. medical records.”
Response-time result cites a messages figure
MinorThe results discussion cites Figure 6 for average response time, but Figure 6 is captioned as the average number of messages.
“the average response time (Fig. 5, Fig. 6)”
“Figure: 6 FIGURE 6 . FIGURE 6.Average number of messages vs. submitted queries.”
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- Authors
- Daraghmi, E.-Y., Daraghmi, Y.-A., & Yuan, S.-M.
- Affiliations
- Palestine Technical University - Kadoorie (PS)
- Venue
- IEEE Access
- Published
- 2019
- Volume
- 7
- Pages
- 164595-164613
- ISSN
- 2169-3536 (ISSN-L)
- OpenAlex
- W2988094919
- Cited by
- 196
- References
- 31
- Citations by year
- 2026: 11 · 2025: 24 · 2024: 37 · 2023: 36 · 2022: 45 · 2021: 34 · 2020: 9
- FWCI
- 27.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- IEEE Access (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Palestine Technical University Kadoorie
- Topics
- Physical Sciences › Computer Science › Information Systems › Blockchain Technology Applications and Security
- Physical Sciences › Computer Science › Information Systems › Blockchain Technology in Education and Learning
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- blockchain, electronic health records, data privacy, incentive mechanisms, encryption, interoperability, healthcare data security
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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