Electronic Health Records (EHRs) have improved many aspects of healthcare and allowed for easier patient management for medical providers. Blockchains have been proposed as a promising solution for supporting Electronic Health Records (EHRs), but have also been linked to scalability concerns about supporting real-world healthcare systems. This paper quantifies the scalability issues and bottlenecks related to current blockchains and puts into perspective the limitations blockchains have with supporting healthcare systems. Particularly we show that well known blockchains such as Bitcoin, Ethereum, and IOTA cannot support transactions of a large scale hospital system such as the University of Kentucky HealthCare system and leave over 7.5M unsealed transactions per day. We then discuss how bottlenecks of blockchains can be relieved with sidechains, enabling well-known blockchains to support even larger hospital systems of over 30M transactions per day. We then introduce the Patient-Healthchain architecture to provide future direction on how scaling blockchains for EHR systems with sidechains can be achieved.
A new type of watermarks for handwritten black-white documents is suggested. Insertion of the watermark in a document minimizes distortion of the latter. The method is intended for validation of handwritten records placed in blockchain database.
Medical Record Management System is an important information management system in healthcare centers and hospitals. Information kept in such systems need to be clean, correct and tamper-proof. In this paper, we take advantage of blockchains' tamper-proof and decentralization properties to develop a robust and secure electronic medical record management system. In particular we choose HyperLedger Fabric as our underlying technical architecture. HyperLedger Fabric yields higher throughput and lower latency compared with other blockchains, which is a perfect candidate for enterprise software deve…
Technology has evolved over the years, making our lives easier. It has impacted the healthcare sector, increasing the average life expectancy of human beings. Still, there are gaps that remain unaddressed. There is a lack of transparency in the healthcare system, which results in inherent trust problems between patients and hospitals. In the present day, a patient does not know whether he or she will get the proper treatment from the hospital for the fee charged. A patient can claim reimbursement of the medical bill from any insurance company. However, today there is minimal scope for the Insu…
The proportion of Energy consumption in the building industry is great, as well as the amount of cooling and heating system. Scholars have been working on energy conservation of Heating, ventilation, and air-conditioning and other systems in buildings. The application of occupant behavior data for building energy optimization has started gaining attention from scholars. However, occupant behavior data concerns many aspects of occupants' privacy. Different types of occupant behavior data contain occupants' private information to different levels. It is crucial to conduct privacy protection of o…
Electronic medical record (EMR) is a crucial form of healthcare data, currently drawing a lot of attention. Sharing health data is considered to be a critical approach to improve the quality of healthcare service and reduce medical costs. However, EMRs are fragmented across decentralized hospitals, which hinders data sharing and puts patients' privacy at risks. To address these issues, we propose a blockchain based privacy-preserving data sharing for EMRs, called BPDS. In BPDS, the original EMRs are stored securely in the cloud and the indexes are reserved in a tamper-proof consortium blockcha…
In recent years, the advancement in modern technologies has experienced an explosion of huge data sets being captured and recorded in different fields, but also given rise to concerns the security and protection of data storage, transmission, processing, and access to data. The blockchain is a distributed ledger that records transactions in a secure, flexible, verifiable and permanent way. Transactions in a blockchain can be an exchange of an asset, the execution of the terms of a smart contract, or an update to a record. In this paper, we have developed a blockchain access control ecosystem t…
The Covid-19 pandemic has made individuals and organizations to rethink the way of handling identity verification and credentials sharing particularly in quarantined situations. In this study, we investigate the inefficiencies of traditional identity systems, and discuss how a proper implementation of Blockchain technology would result in safer, more secure, privacy respecting and remote friendly identity systems. As a result, we propose a Blockchain based framework for digital identity verification, record attestation and record sharing, and we explain the framework in details with certain us…
Electronic Health Records(EHR) are gaining a lot of popularity all over the world. The current EHR systems however have their fair share of problems related to privacy and security. We have proposed a mechanism which provides a solution to most of these problems. Using a permissioned Ethereum blockchain allows the hospitals and patients across the world to be connected to each other. Our mechanism uses a combination of symmetric and asymmetric key cryptography to ensure the secure storage and selective access of records. It gives patients full control over their health records and also allows …
Vaccination passports are being issued by governments around the world in order to open up their travel and hospitality sectors. Civil liberty campaigners on the other hand argue that such mandatory instruments encroach upon our fundamental right to anonymity, freedom of movement, and are a backdoor to issuing "identity documents" to citizens by their governments. In this paper we present a privacy-preserving framework that uses two-factor authentication to create a unique identifier that can be used to locate a person's vaccination record on a blockchain, but does not store any personal infor…
Medical data sharing needs to be done with the utmost respect for privacy and security. It contains intimate data of the patient and any access to it must be highly regulated. With the emergence of vertical solutions in healthcare institutions, interoperability across organisations has been hindered. The authors of this paper propose a blockchain based medical-data sharing solution, utilising Hyperledger Fabric to regulate access to medical data, and using the InterPlanatory File System for its storage. We believe that the combination of these two distributed solutions can enable patients to a…
The system proposed in this study uses zero-knowledge proof (ZKP) to verify the traceability of wood recorded in a public blockchain. Wood is a byproduct of several states, ranging from standing trees to logs, lumber, and wood products (hereinafter ``wood objects''). The advantage of using the blockchain for record keeping is that participants can freely record the information at their discretion, without any restrictions. However, the openness of the blockchain may allow a malicious third party to introduce disinformation. In this study, we employ ZKP and near-field communication (NFC) chips …
Blockchain is a distributed database that keeps a chronologically-growing list (chain) of records (blocks) secure from tampering and revision. While computerisation has changed the nature of a ledger from clay tables in the old days to digital records in modern days, blockchain technology is the first true innovation in record keeping that could potentially revolutionise the basic principles of information keeping. In this note, we provide a brief self-contained introduction to how the blockchain works.
Self-Sovereign Identity (SSI), a Blockchain-based technology for digital identity management, is a promising concept for handling health data. It could represent a step forward in empowering users, granting them control over their data. This work conducts a systematic literature review to investigate state-of-the-art measures based on SSI and Blockchain technologies for dealing with electronic health records (EHRs), identifying gaps, and determining the key questions for future research. As a result, this review shows a growing interest in Blockchain methods to handle EHRs, but few works consi…
The global Electronic Health Record (EHR) market is growing dramatically and expected to reach $39.7 billions by 2022. To safe-guard security and privacy of EHR, access control is an essential mechanism for managing EHR data. This paper proposes a hybrid architecture to facilitate access control of EHR data by using both blockchain and edge node. Within the architecture, a blockchain-based controller manages identity and access control policies and serves as a tamper-proof log of access events. In addition, off-chain edge nodes store the EHR data and apply policies specified in Abbreviated Lan…
Electronic medical records (EMRs) are critical, highly sensitive private information in healthcare, and need to be frequently shared among peers. Blockchain provides a shared, immutable and transparent history of all the transactions to build applications with trust, accountability and transparency. This provides a unique opportunity to develop a secure and trustable EMR data management and sharing system using blockchain. In this paper, we present our perspectives on blockchain based healthcare data management, in particular, for EMR data sharing between healthcare providers and for research …
With a growing number of institutions involved in the global education market, it has become increasingly challenging to verify the authenticity of academic achievements such as CVs and diplomas. Blockchain is an enabling technology that can play a key role in solving this problem. This study introduces a blockchain-based achievement record system that produces a verifiable record of achievements. The proposed system aims to facilitate the process of authentication and validation of certificates reliably, easily, and quickly, leveraging the unique capabilities offered through Blockchain techno…
While vaccinations continue to be rolled out to curb the ongoing COVID-19 pandemic, their verification is becoming a requirement for the re-incorporation of individuals into many social activities or travel. Blockchain technology has been widely proposed to manage vaccination records and their verification in many politically-bound regions. However, the high contagiousness of COVID-19 calls for a global vaccination campaign. Therefore, a blockchain for vaccination management must scale up to support such a campaign and be adaptable to the requirements of different countries. While there have b…
With the advent of blockchain technology, multiple research avenues and platforms for dialogue have opened up. However technology transfer to the pubic has not been implemented, such that regular public can access and make use of secure and decentralized software. Most blockchain solutions till date deal with financial applications or monetary transactions, which may not be helpful or be accessible to the general public, especially the lower levels of the financial society. Medi-Chain is a people-first medical blockchain with a usable desktop application and interface which makes use of cuttin…
From Transactions to Records: Reconceptualizing Blockchain Systems through a Lifecycle Lens
Netherlands Institute for Applied Scientific Research (TNO)（荷兰应用科学研究组织）；University of Amsterdam（阿姆斯特丹大学）；University of Applied Sciences for Police and Public Administration（警察与公共管理应用科学大学）
The continuing expansion of the blockchain ecosystems has attracted much attention from the research community. However, although a large number of research studies have been proposed to understand the diverse characteristics of individual blockchain systems (e.g., Bitcoin or Ethereum), little is known at a comprehensive level on the evolution of blockchain ecosystems at scale, longitudinally, and across multiple blockchains. We argue that understanding the dynamics of blockchain ecosystems could provide unique insights that cannot be achieved through studying a single static snapshot or a sin…
Blockchain has been widely deployed in various sectors, such as finance, education, and public services. Since blockchain runs as an immutable distributed ledger, it has decentralized mechanisms with persistency, anonymity, and auditability, where transactions are jointly performed through cryptocurrency-based consensus algorithms by worldwide distributed nodes. There have been many survey papers reviewing the blockchain technologies from different perspectives, e.g., digital currencies, consensus algorithms, and smart contracts. However, none of them have focused on the blockchain data manage…
Verification of data generated by wearable sensors is increasingly becoming of concern to health service providers and insurance companies. There is a need for a verification framework that various authorities can request a verification service for the local network data of a target IoT device. In this paper, we leverage blockchain as a distributed platform to realize an on-demand verification scheme. This allows authorities to automatically transact with connected devices for witnessing services. A public request is made for witness statements on the data of a target IoT that is transmitted o…
Innovative solutions addressing product anti-counterfeiting and record provenance have been deployed across today's internationally spanning supply chain networks. These product anti-counterfeiting solutions are developed and implemented with centralized system architecture relying on centralized authorities or any form of intermediaries. Vulnerabilities of centralized product anti-counterfeiting solutions could possibly lead to system failure or susceptibility of malicious modifications performed on product records or various potential attacks to the system components by dishonest participant…
A blockchain is a decentralized ledger where all transactions are recorded. For having a reliable blockchain and double-spending prevention, we need a decentralized consensus and agreement on a blockchain. Bitcoin uses proof-of-work (PoW). It is a cryptographic puzzle that is difficult to solve but easy to verify. However, because of significant latency of proof-of-work for transactions confirmation, this consensus mechanism is vulnerable against double-spending. On the other hand, PoW consumes a significant amount of energy that by growing the network, it becomes a major problematic of this c…
One of the biggest challenges associated with connected and autonomous vehicles (CAVs) is to maintain and make use of vehicles health records (VHR). VHR can facilitate different entities to offer various services in a proactive, transparent, secure, reliable and in an efficient manner. The state-of-the-art solutions for maintaining the VHR are centralized in nature, mainly owned by manufacturer and authorized in-vehicle device developers. Owners, drivers, and other key service providers have limited accessibility and control to the VHR. We need to change the strategy from single or limited par…
The outbreak of the COVID-19 pandemic has deeply influenced the lifestyle of the general public and the healthcare system of the society. As a promising approach to address the emerging challenges caused by the epidemic of infectious diseases like COVID-19, Internet of Medical Things (IoMT) deployed in hospitals, clinics, and healthcare centers can save the diagnosis time and improve the efficiency of medical resources though privacy and security concerns of IoMT stall the wide adoption. In order to tackle the privacy, security, and interoperability issues of IoMT, we propose a framework of bl…
Traditional data collection, storage and processing of Electronic Health Records (EHR) utilize centralized techniques that pose several risks of single point of failure and lean the systems to a number of internal and external data breaches that compromise their reliability and availability. Blockchain is an emerging distributed technology that can solve these issues due to its immutability and architectural nature that prevent records manipulation or alterations. In this paper, we discuss the progress and opportunities of remote patient monitoring using futuristic blockchain technologies and …
With blockchain technology, information is recorded in a permanent distributed ledger that is maintained by multiple computers in a peer-to-peer network. There is no central authority that can alter records or change network consensus rules. Such technology could be utilized for voting, title transfers, issuance of company shares, document notarization, but currently, the most popular use-case are virtual currencies. An interesting feature that some virtual currencies have is a multisignature (multisig) protocol that requires the electronic signatures from more than one private key to initiate…
The application of blockchain technology can be beneficial in the field of healthcare as well as in the fight against the COVID-19 epidemic. In this work, the importance of blockchain is analyzed and it is observed that blockchain technology and the processes associated with it will be utilised in the healthcare systems of the future for data acquisition from sensors, automatic patient monitoring, and secure data storage. This technology substantially simplifies the process of carrying out operations because it can store a substantial quantity of data in a dispersed and secure manner, as well …
We present a secure approach for maintaining and reporting credit history records on the Blockchain. Our approach removes third-parties such as credit reporting agencies from the lending process and replaces them with smart contracts. This allows customers to interact directly with the lenders or banks while ensuring the integrity, unmalleability and privacy of their credit data. Most importantly, each customer is given full control over complete or selective disclosure of her credit records, eliminating the risk of privacy violations or data breaches such as the one that happened to Equifax i…
Blockchains are tamper evident and tamper resistant digital ledgers implemented in a distributed fashion (i.e., without a central repository) and usually without a central authority (i.e., a bank, company, or government). At their basic level, they enable a community of users to record transactions in a shared ledger within that community, such that under normal operation of the blockchain network no transaction can be changed once published. This document provides a high-level technical overview of blockchain technology. The purpose is to help readers understand how blockchain technology work…
A blockchain is an append-only linked-list of blocks, which is maintained at each participating node. Each block records a set of transactions and their associated metadata. Blockchain transactions act on the identical ledger data stored at each node. Blockchain was first perceived by Satoshi Nakamoto as a peer-to-peer digital-commodity (also known as crypto-currency) exchange system. Blockchains received traction due to their inherent property of immutability-once a block is accepted, it cannot be reverted.
Blockchain offers a decentralized, immutable, transparent system of records. It offers a peer-to-peer network of nodes with no centralised governing entity making it unhackable and therefore, more secure than the traditional paper-based or centralised system of records like banks etc. While there are certain advantages to the paper-based recording approach, it does not work well with digital relationships where the data is in constant flux. Unlike traditional channels, governed by centralized entities, blockchain offers its users a certain level of anonymity by providing capabilities to intera…
Trustworthy Blockchain-based Federated Learning for Electronic Health Records: Securing Participant Identity with Decentralized Identifiers and Verifiable Credentials
Federal Institute of Education, Science, and Technology of Rio Grande do Norte (IFRN)（里约格兰德北教育科学和技术联邦学院）
We investigate Bitcoin network monitoring the dynamics of blocks and transactions. We unveil that 43\% of the transactions are still not included in the Blockchain after 1h from the first time they were seen in the network and 20\% of the transactions are still not included in the Blockchain after 30 days, revealing therefore great inefficiency in the Bitcoin system. However, we observe that most of these `forgotten' transactions have low values and in terms of transferred value the system is less inefficient with 93\% of the transactions value being included into the Blockchain within 3h. The…
