Blockchain in Healthcare: A Patient-Centered Model

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Research about blockchain and healthcare is currently limited.

“Research about blockchain and healthcare is currently limited, but blockchain is on the brink of transforming the healthcare system”

• Also stated in: § Conclusion · plain

  “Research about blockchain’s applications to healthcare is currently limited, but more research becomes available every day.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The MIStore study is the only one of its kind so far.

“This study is the only one of its kind so far, but blockchain has many potential applications for insurance and more research will certainly become available soon”

Probably not a substantial claim: may not pass S3 (load-bearing).

Various mobile apps and Electronic Medical Record (EMR) systems based on blockchain have been proposed.

“various mobile apps and Electronic Medical Record (EMR) systems based on blockchain have also been proposed.”

May combine two claims.

Blockchain can be applied to mobile applications and remote monitoring machines and improve security and quality of machinery.

“Blockchain can be applied to these technologies and improve security and quality of machinery.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Through decentralized principles, blockchain can improve accessibility and security of patient information.

“through its decentralized principles, blockchain can improve accessibility and security of patient information”

May combine two claims.

Sensitive medical records currently lack a secure structure, leading to data breaches with severe consequences.

“Sensitive medical records currently lack a secure structure, leading to data breaches with severe consequences.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Blockchain can improve mobile health applications, monitoring devices, sharing and storing of electronic medical records, clinical trial data, and insurance information storage.

“Blockchain has many applications in healthcare, and can improve mobile health applications, monitoring devices, sharing and storing of electronic medical records, clinical trial data, and insurance information storage.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The average total cost of data breach in the United States was $7.91 million, with the health sector having the highest per capita cost.

“the average total cost of data breach in the United States was $7.91 million, with the health sector having the highest per capita cost (Ponemon Institute, 2018).”

• cites Ponemon Institute, 2018Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

In 2018, the Department of Health and Human Services' Office for Civil Rights (OCR) received notifications of many data breaches that resulted in the exposure of 13 million total healthcare records.

“In 2018, the Department of Health and Human Services’ Office for Civil Rights (OCR) received notifications of many data breaches that resulted in the exposure of 13 million total healthcare records [1].”

• cites [1] Journal H (2018) Largest Healthcare Data Breaches of 2018. HIPAA Journal.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Improving blockchain based smart contracts may help monitoring devices operate securely.

“Additionally, improving blockchain based smart contracts may help monitoring devices operate securely.”

May combine two claims.

A private blockchain based on the Ethereum model has been developed to improve remote monitoring; in this private blockchain, sensors interact with smart devices that utilize smart contracts to record events in the blockchain.

“A private blockchain which is based on the Ethereum model has been developed to improve remote monitoring; in this private blockchain, sensors interact with smart devices that utilize smart contracts to record events in the blockchain [6].”

• cites [6] Griggs KN, Ossipova O, Kohlios CP, Alessandro N Baccarini, Howson Emily A, (2018) Healthcare Blockchain System Using Smart Contracts for Secure Automated Remote Patient Monitoring. J Med Syst 42: 130. 29876661Not checked yet

  Not checked in the free run.

May combine two claims.

In the mHealth application, the data was accessible to and controlled by the patient.

“and the data was accessible to and controlled by the patient.”

• cites [4] Ichikawa D, Kashiyama M and Ueno T (2017) Tamper-Resistant Mobile Health Using Blockchain Technology. JMIR Mhealth Uhealth 5(7): e111. 28747296 PMC5550736Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

One study investigated root exploit, the most vicious type of mobile malware, and its interactions with blockchain.

“One study investigated root exploit, the most vicious type of mobile malware, and its interactions with blockchain [7].”

• cites [7] Firdaus A, Anuar NB, Razak MFA, Hashem Ibrahim Abaker Targio, Bachok Syafiq, (2018) Root Exploit Detection and Features Optimization: Mobile Device and Blockchain Based Medical Data Management. J Med Syst 42: 112. 29728780Not checked yet

  Not checked in the free run.

May combine two claims.

The biological method of Practical Swarm Optimization (PSO) was used in this study to select for root exploits, along with boosters, which can strengthen machine learning activity to uncover new root exploits and glean new information about malware.

“The biological method of Practical Swarm Optimization (PSO) was used in this study to select for root exploits, along with boosters, which can strengthen machine learning activity to uncover new root exploits and glean new information about malware.”

• cites [7] Firdaus A, Anuar NB, Razak MFA, Hashem Ibrahim Abaker Targio, Bachok Syafiq, (2018) Root Exploit Detection and Features Optimization: Mobile Device and Blockchain Based Medical Data Management. J Med Syst 42: 112. 29728780Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Another mobile application, called Healthcare Data Gateway (HGD), has been presented for organization of patient data.

“another mobile application, called Healthcare Data Gateway (HGD), has been presented for organization of patient data [5].”

• cites [5] Yue X, Wang H, Jin D, Mingqiang Li, Jiang Wei (2016) Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control. J Med Syst 40: 218. 27565509Not checked yet

  Not checked in the free run.

May combine two claims.

The smart contracts enable real-time patient monitoring, as important notifications are sent to patients and healthcare providers securely.

“The smart contracts enable real-time patient monitoring, as important notifications are sent to patients and healthcare providers securely.”

• cites [6] Griggs KN, Ossipova O, Kohlios CP, Alessandro N Baccarini, Howson Emily A, (2018) Healthcare Blockchain System Using Smart Contracts for Secure Automated Remote Patient Monitoring. J Med Syst 42: 130. 29876661Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

HGD uses a simple unified Indicator-Centric Schema (ICS) to organize data and a secure Multi-Party Computing (MPC) system, which enables third party interaction with protected healthcare data without privacy breaches and without authoritative power over the information.

“The application uses a simple unified Indicator-Centric Schema (ICS) to organize this data, and a secure Multi-Party Computing (MPC) system, which enables third party interaction with protected healthcare data without privacy breaches and with-out authoritative power over the information.”

• cites [5] Yue X, Wang H, Jin D, Mingqiang Li, Jiang Wei (2016) Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control. J Med Syst 40: 218. 27565509Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

A prototype of DPS has been created which is modeled after the Ethereum blockchain.

“A prototype of DPS has been created which is modeled after the Ethereum blockchain.”

• cites [9] Li H, Zhu L, Shen M, Feng Gao, Xiaoling Tao, (2018) BlockchainBased Data Preservation System for Medical Data. J Med Syst 42: 141. 29956058Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

This new cryptographic framework based on multiple levels of encryption maximizes security.

“This new cryptographic framework based on multiple levels of encryption maximizes security.”

• cites [11] Wang H and Song Y (2018) Secure Cloud-Based EHR System Using Attribute-Based Cryptosystem and Blockchain. J Med Syst 42(8): 152. 29974270Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

A blockchain based Data Preservation System (DPS) for medical data has been engineered.

“a blockchain based Data Preservation System (DPS) for medical data has been engineered [9].”

• cites [9] Li H, Zhu L, Shen M, Feng Gao, Xiaoling Tao, (2018) BlockchainBased Data Preservation System for Medical Data. J Med Syst 42: 141. 29956058Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Zhang and Lin curated a patient information sharing plan, called a BSPP scheme, that may improve diagnosis of patients in virtual health systems.

“Zhang and Lin curated a patient information sharing plan, called a BSPP (blockchain-based secure and privacy-preserving patient health information sharing) scheme, that may improve diagnosis of patients in virtual health systems [12].”

• cites [12] Zhang A and Lin X (2018) Towards Secure and Privacy-Preserving Data Sharing in e-Health Systems via Consortium Blockchain. J Med Syst 42(8): 140. 29956061Not checked yet

  Not checked in the free run.

May combine two claims.

In the BSPP scheme, private patient health information is stored in the private blockchain while the records of patient health information activity, rather than the actual information, are stored in the consortium blockchain, and all the data is encrypted.

“The private patient health information is stored in the private blockchain while the records of patient health information activity, rather than the actual information, are stored in the consortium blockchain, and all the data is encrypted.”

• cites [12] Zhang A and Lin X (2018) Towards Secure and Privacy-Preserving Data Sharing in e-Health Systems via Consortium Blockchain. J Med Syst 42(8): 140. 29956061Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

The BSPP scheme includes the use of private and consortium blockchains and consensus mechanisms for the utmost security.

“Their scheme includes the use of private and consortium blockchains and consensus mechanisms for the utmost security.”

• cites [12] Zhang A and Lin X (2018) Towards Secure and Privacy-Preserving Data Sharing in e-Health Systems via Consortium Blockchain. J Med Syst 42(8): 140. 29956061Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Another electronic health record (EHR) system has been established in addition to omniPHR, and this system combines attribute-based encryption (ABE), identity-based encryption (IBE), and identity-based signatures (IBS) to create a new type of cryptographic framework called combined attribute-based/identity-based encryption and signature (C-AB-/IB-ES).

“Another electronic health record (EHR) system has been established in addition to omniPHR, and this system combines attribute-based encryption (ABE), identity-based encryption (IBE), and identity-based signatures (IBS) to create a new type of cryptographic framework called combined attribute-based/identity-based encryption and signature (C-AB-/IB-ES) [11].”

• cites [11] Wang H and Song Y (2018) Secure Cloud-Based EHR System Using Attribute-Based Cryptosystem and Blockchain. J Med Syst 42(8): 152. 29974270Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Access to all of a patient's medical data in one forum will improve efficiency of care.

“Patients should be able to access all of their medical data in one forum, and this access will improve efficiency of care.”

• AssumptionRests on an assumption: Medical records are generally spread out across many different healthcare facilities, making them difficult to access.

Probably not a substantial claim: may not pass S3 (load-bearing).

DPS uses similar data storage mechanisms and cryptographic algorithms to ensure security.

“DPS uses similar data storage mechanisms and cryptographic algorithms to ensure security.”

• cites [9] Li H, Zhu L, Shen M, Feng Gao, Xiaoling Tao, (2018) BlockchainBased Data Preservation System for Medical Data. J Med Syst 42: 141. 29956058Not checked yet

  Not checked in the free run.

May combine two claims.

In omniPHR, each block is encrypted and the chain of blocks carrying the different pieces of one patient's health information is fully accessible to that patient.

“Each block is then encrypted and the chain of blocks carrying the different pieces of one patient’s health information is fully accessible to that patient.”

• cites [10] Roehrs A, da Costa CA and da Rosa Righi R (2017) OmniPHR: A distributed architecture model to integrate personal health records. J Biomed Inform 71: 70– 81. 28545835Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

A Blockchain-Based Multi-Level Privacy Preserving Location Sharing scheme (BMPLS) has been proposed for telecare medical information systems.

“A Blockchain-Based Multi-Level Privacy Preserving Location Sharing scheme (BMPLS) has been proposed for telecare medical information systems [15].”

• cites [15] Ji Y, Zhang J, Jianfeng Ma, Chao Yang, Xin Yao, (2018) BMPLS: Blockchain-Based Multi-level Privacy-Preserving Location Sharing Scheme for Telecare Medical Information Systems. J Med Syst 42: 147. 29961160Not checked yet

  Not checked in the free run.

May combine two claims.

Blockchains can easily detect fake information because of their transparency, and smart contracts in the blockchain can serve as security promoters for clinical trial data.

“Blockchains can easily detect fake information because of their transparency, and smart contracts in the blockchain can serve as security promoters for clinical trial data [16].”

• cites [16] Nugent T, Upton D and Cimpoesu M (2016) Improving data transparency in clinical trials using blockchain smart contracts. F1000Res 5: 2541. 28357041 PMC5357027Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

A recent study outlines MIStore, a blockchain-based medical insurance storage system.

“A recent study outlines MIStore, a blockchain-based medical insurance storage system [18].”

• cites [18] Zhou L, Wang L and Sun Y (2018) MIStore: a Blockchain-Based Medical Insurance Storage System. J Med Syst 42: 149 29968202 PMC6028902Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Blockchain technology has also been applied to clinical trials and, very recently, to medical insurance storage.

“Blockchain technology has also been applied to clinical trials and, very recently, to medical insurance storage.”

May combine two claims.

This model not only provides the security and immutability provided by blockchain, but also offers a multisig solution to data ownership and accessibility.

“This model not only provides the security and immutability provided by blockchain, but also offers a multisig solution to data ownership and accessibility.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Another data sharing system was developed that uses LifePound, a digital currency similar to bitcoin, which can buy and sell biomedical data.

“Another data sharing system was developed that uses LifePound, a digital currency that is similar to bitcoin, which can buy and sell biomedical data [14].”

• cites [14] Mamoshina P, Ojomoko L, Yanovich Y, (2018) Converging blockchain and next-generation artificial intelligence technologies to decentralize and accelerate biomedical research and healthcare. Oncotarget 2018; 9: 5665– 5690. PMC5814166 29464026Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Their method emphasizes security, availability, privacy, and control of data access, and lowers access time for records.

“Their method emphasizes security, availability, privacy, and control of data access, and lowers access time for records.”

• cites [13] Dubovitskaya A, Xu Z, Ryu S, (2017) Secure and Trustable Electronic Medical Records Sharing using Blockchain. AMIA Annu Symp Proc 2017: 650– 659. 29854130 PMC5977675Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Systems such as MIStore can encourage a more productive relationship between patients, caregivers, and insurance companies.

“Systems such as MIStore can encourage a more productive relationship between patients, caregivers, and insurance companies.”

May combine two claims.

In the proposed model, the patient cannot alter the record without permission of the hospital, but he still has control over who can access his record.

“This way, the patient cannot alter the record without permission of the hospital, but he still has control over who can access his record.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Blockchains are by nature susceptible to a type of attack known as the 51% attack (also called a double-spend attack or majority attack).

“Although blockchains are extremely secure, they are by nature susceptible to a type of attack known as the 51% attack (also called a double-spend attack or majority attack) (Yli-Huumo, Ko, Choi, Park, & Smolander, 2016).”

• cites Yli-Huumo, Ko, Choi, Park, & Smolander, 2016Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

LifePound rewards a patient for entering data and encourages participation in data sharing.

“LifePound rewards a patient for entering data and encourages participation in data sharing.”

• cites [14] Mamoshina P, Ojomoko L, Yanovich Y, (2018) Converging blockchain and next-generation artificial intelligence technologies to decentralize and accelerate biomedical research and healthcare. Oncotarget 2018; 9: 5665– 5690. PMC5814166 29464026Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

The change in the data will automatically change the swarm hash, which can then be secured once again until it receives the required permissions for access.

“The change in the data will automatically change the swarm hash, which can then be secured once again until it receives the required permissions for access.”

May combine two claims.

The root chunks are securely stored in smart contracts through the blockchain and are released only under specific conditions.

“Thus, the root chunks are securely stored in smart contracts through the blockchain and are released only under specific conditions.”

May combine two claims.

These smart contracts can keep a truthful record of trials and produce truthful data that can fuel new and effective treatments and pharmaceuticals.

“These smart contracts can keep a truthful record of trials and produce truthful data that can fuel new and effective treatments and pharmaceuticals.”

• cites [16] Nugent T, Upton D and Cimpoesu M (2016) Improving data transparency in clinical trials using blockchain smart contracts. F1000Res 5: 2541. 28357041 PMC5357027Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Another study also outlines the benefits of blockchain in clinical trials and presents a successful procedure for implementation.

“Another study also outlines the benefits of blockchain in clinical trials and presents a successful procedure for implementation [17].”

• cites [17] Benchoufi M, Porcher R and Ravaud P (2017) Blockchain protocols Cinclinical trials: Transparency and traceability of consent. F1000Res 6: 66. 29167732 PMC5676196Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

We propose a medical data management system using blockchain technology that is secure and allows patients to retain ownership over their own records while allowing hospitals to have easy access.

“We propose a medical data management system using blockchain technology that is secure and allows patients to retain ownership over their own records while allowing hospitals to have easy access (see the following Figure 2).”

• AssumptionRests on an assumption: Patients are currently unable to have full ownership of their own medical data.
• AssumptionRests on an assumption: Blockchains do not innately offer sufficient storage.

Classified as probably not a substantial claim.

When a transaction is requested, the user must pay for the computation.

“When a transaction is requested, the user must pay for the computation.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

Because blockchain maximizes security and accessibility, the technology can be used in many different areas of the healthcare system, such as for storing and sharing medical records and insurance information both in healthcare venues and in mobile applications and remote monitoring systems, and for clinical trials.

“Because blockchain maximizes security and accessibility, the technology can be used in many different areas of the healthcare system, such as for storing and sharing medical records and insurance information both in healthcare venues and in mobile applications and remote monitoring systems, and for clinical trials.”

• AssumptionRests on an assumption: The probability of a successful 51% attack is extremely low.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the Ethereum network, the payment is calculated in "gas" and the gas is paid in "ETH," valued around $120 USD as of January 2019.

“In the Ethereum network, the payment is calculated in “gas” and the gas is paid in “ETH,” valued around $120 USD as of January 2019 (EthereumPrice.org, 2019).”

• cites EthereumPrice.org, 2019Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

This transfer of authority may lead to an overall shift toward patient-centered care.

“This transfer of authority may lead to an overall shift toward patient-centered care; the blockchain movement for patients is just beginning.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Blockchain can change the hierarchy of healthcare by returning authority over medical records and health data to the patient.

“it can change the hierarchy of healthcare by returning authority over medical records and health data to the patient.”

• AssumptionRests on an assumption: Patients are currently unable to have full ownership of their own medical data.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The vast amount of transactions needed to be processed in hospital settings would amount to a sizable cost.

“The vast amount of transactions needed to be processed in hospital settings would amount to a sizable cost.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A 51% attack occurs when a miner, or group of miners, controls over 50% of the total mining hash rate (computing power) in the network and becomes able to prevent new transactions or reverse completed transactions.

“This occurs when a miner, or group of miners, controls over 50% of the total mining hash rate (computing power) in the network and becomes able to prevent new transactions or reverse completed transactions.”

• cites Yli-Huumo et al., 2016Not checked yet

  Not checked in the free run.

May combine two claims.

The use of a blockchain system would replace current storage systems (EHRs, personal medical records, disease registries, and other databases) and eliminate costly data breaches and other errors, ultimately rendering the system cost-efficient.

“However, the use of a blockchain system would replace current storage systems (electronic health records (EHRs), personal medical records, disease registries, and other databases (The National Academies)) and eliminate costly data breaches and other errors, ultimately rendering the system cost-efficient.”

• cites The National AcademiesNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

By controlling over 50% of the computing power, the malicious user is able to form blocks at a faster rate than the rest of the network, and by the longest chain rule, the network is forced to switch to the attacker's desired chain.

“By controlling over 50% of the computing power, the malicious user is able to form blocks at a faster rate than the rest of the network, and by the longest chain rule (which states that the longest blockchain is the valid chain), the network is forced to switch to the attacker’s desired chain.”