Blockchain in Healthcare: A Patient-Centered Model

In the paper

“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.”

In the paper

“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”

In the paper

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

In the paper

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

In the paper

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

In the paper

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

In the paper

“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.”

In the paper

“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).”

What the sources say

• Not checked yetcites Ponemon Institute, 2018

In the paper

“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].”

What the sources say

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

In the paper

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

In the paper

“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].”

What the sources say

• Not checked yetcites [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. 29876661

In the paper

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

What the sources say

• Not checked yetcites [4] Ichikawa D, Kashiyama M and Ueno T (2017) Tamper-Resistant Mobile Health Using Blockchain Technology. JMIR Mhealth Uhealth 5(7): e111. 28747296 PMC5550736

In the paper

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

What the sources say

• Not checked yetcites [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. 29728780

In the paper

“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.”

What the sources say

• Not checked yetcites [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. 29728780

In the paper

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

What the sources say

• Not checked yetcites [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. 27565509

In the paper

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

What the sources say

• Not checked yetcites [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. 29876661

In the paper

“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.”

What the sources say

• Not checked yetcites [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. 27565509

In the paper

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

What the sources say

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

In the paper

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

What the sources say

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

In the paper

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

What the sources say

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

In the paper

“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].”

What the sources say

• Not checked yetcites [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. 29956061

In the paper

“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.”

What the sources say

• Not checked yetcites [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. 29956061

In the paper

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

What the sources say

• Not checked yetcites [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. 29956061

In the paper

“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].”

What the sources say

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

In the paper

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

In the paper

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

What the sources say

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

In the paper

“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.”

What the sources say

• Not checked yetcites [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. 28545835

In the paper

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

What the sources say

• Not checked yetcites [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. 29961160

In the paper

“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].”

What the sources say

• Not checked yetcites [16] Nugent T, Upton D and Cimpoesu M (2016) Improving data transparency in clinical trials using blockchain smart contracts. F1000Res 5: 2541. 28357041 PMC5357027

In the paper

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

What the sources say

• Not checked yetcites [18] Zhou L, Wang L and Sun Y (2018) MIStore: a Blockchain-Based Medical Insurance Storage System. J Med Syst 42: 149 29968202 PMC6028902

In the paper

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

In the paper

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

In the paper

“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].”

What the sources say

• Not checked yetcites [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 29464026

In the paper

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

What the sources say

• Not checked yetcites [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 PMC5977675

In the paper

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

In the paper

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

In the paper

“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).”

What the sources say

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

In the paper

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

What the sources say

• Not checked yetcites [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 29464026

In the paper

“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.”

In the paper

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

In the paper

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

What the sources say

• Not checked yetcites [16] Nugent T, Upton D and Cimpoesu M (2016) Improving data transparency in clinical trials using blockchain smart contracts. F1000Res 5: 2541. 28357041 PMC5357027

In the paper

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

What the sources say

• Not checked yetcites [17] Benchoufi M, Porcher R and Ravaud P (2017) Blockchain protocols Cinclinical trials: Transparency and traceability of consent. F1000Res 6: 66. 29167732 PMC5676196

In the paper

“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).”

In the paper

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

In the paper

“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.”

In the paper

“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).”

What the sources say

• Not checked yetcites EthereumPrice.org, 2019

In the paper

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

In the paper

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

In the paper

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

In the paper

“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.”

What the sources say

• Not checked yetcites Yli-Huumo et al., 2016

In the paper

“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.”

What the sources say

• Not checked yetcites The National Academies

In the paper

“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.”