Blockchain Applications in Healthcare E-Book
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- Herausgeber: John Wiley & Sons
- Kategorie: Wissenschaft und neue Technologien
- Sprache: Englisch
Blockchain is new-age technology used to track every transaction using cryptocurrency across servers linked in a peer-to-peer network, enabling transactions to be secure, transparent and reliable. Retaining an efficient, secure and patient-centric healthcare industry has never been so important, especially due to the damaging effects of the Covid-19 pandemic. The applicability of Blockchain in the healthcare domain can be seen as a remarkable opportunity for researchers and scientists to solve real-world problems. This book focuses on the fundamentals of Blockchain technology along with the methods of its integration with the healthcare industry. It also provides an enhanced understanding of Blockchain technology, AI and IoT across the various application areas of the healthcare industry. Furthermore, throughout the book, areas of relevant applications, such as patient data privacy protection, pharmaceutical supply chains and genomics are discussed.
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Seitenzahl: 368
Veröffentlichungsjahr: 2023
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Contents
Cover
Dedication Page
Title Page
Copyright Page
Foreword
Preface
Acknowledgments
Chapter 1. Framework for Blockchain in Healthcare
1.1. Concept of Blockchain
1.2. Blockchain as distributed database
1.3. Architecture of Blockchain in healthcare
1.4. Development of Blockchain: A state of art
1.5. Information distribution in Blockchain
1.6. The growing anticipation of Blockchain
1.7. The benefits of Blockchain in healthcare
1.8. Open issues related to Blockchain
1.9. Future trends of Blockchain
1.10. References
Chapter 2. Role of Smart Contracts in Blockchain
2.1. Introduction to Blockchain
2.2. Smart contracts
2.3. Quantitative analysis
2.4. Role of smart contracts in healthcare
2.5. Example of smart contracts
2.6. Challenges related to smart contracts
2.7. Conclusion
2.8. References
Chapter 3. Blockchain-based Platforms for the Healthcare Industry
3.1. Introduction
3.2. Literature review
3.3. Blockchain technology
3.4. Blockchain applications that can be useful for treating the medical sector problems
3.5. Examples of healthcare platforms using Blockchain
3.6. Blockchain during the Covid-19 pandemic
3.7. Conclusion
3.8. References
Chapter 4. Analyzing and Modeling the Challenges Faced by the Healthcare Sector in the Adoption Process of Blockchain Technologies
4.1. Introduction
4.2. Literature review
4.3. Challenges of Blockchain in healthcare
4.4. Research methodology
4.5. Data analysis
4.6. Discussion
4.7. Conclusion
4.8. References
Chapter 5. Blockchain as an Effective Technology in Maintaining Electronic Health Record Systems
5.1. Introduction
5.2. Background concepts on Blockchain technology
5.3. Blockchain in healthcare
5.4. Electronic health records using Blockchain
5.5. Quantitative analysis
5.6. Proposed framework for the EHRs using Blockchain
5.7. Issues in Blockchain-based EHRs
5.8. Case studies
5.9. Conclusion
5.10. References
Chapter 6. An Optimistic Approach to Share Private Health Records Using Blockchain Technology
6.1. Introduction
6.2. Related work
6.3. Blockchain-based EHR system
6.4. Blockchain in healthcare
6.5. Conclusion and future scope
6.6. References
Chapter 7. Patient Data Privacy Using Blockchain
7.1. Introduction
7.2. Threat modeling – digitalization in the healthcare industry
7.3. Privacy versus security
7.4. Regulatory compliance requirements
7.5. Differential privacy
7.6. Privacy by Design
7.7. Conclusion
7.8. References
Chapter 8. Decentralized Smart Healthcare Systems Using Blockchain and AI
8.1. Introduction to the healthcare system
8.2. Use of AI in healthcare systems
8.3. Use of Blockchain in healthcare systems
8.4. History of medical care
8.5. Literature review
8.6. Bringing intelligence to medical devices and machines
8.7. Using artificial intelligence to transform clinical decision-making in hospitals
8.8. Results of existing models
8.9. Conclusion
8.10. References
Chapter 9. Component-based Healthcare Software Application Using Blockchain
9.1. Introduction
9.2. Literature review
9.3. Software development models
9.4. Proposed model
9.5. Comparison among different software development life-cycle models
9.6. Conclusion and future works
9.7. References
Chapter 10. The Role of Smart Contracts and Blockchain Technology in Healthcare and Other Use Cases
10.1. Introduction
10.2. Ethereum: Generation Two of Blockchain technology
10.3. Smart contracts
10.4. Use of smart contracts in healthcare, patient monitoring, and other use cases
10.5. Building smart contracts on the Ethereum Blockchain
10.6. Real-time use cases of smart contracts
10.7. Six companies using smart contracts in real-world applications
10.8. Challenges
10.9. Historical attacks and issues with smart contracts
10.10. Conclusion
10.11. References
Chapter 11. Healthcare Research Using Blockchain Technology: A Future Perspective
11.1. Introduction
11.2. Benefits of using Blockchain in the healthcare industry
11.3. Application of Blockchain in the healthcare industry
11.4. Merging of Blockchain with artificial intelligence in healthcare
11.5. Drawbacks of using Blockchain in the healthcare industry
11.6. Conclusion and future scope
11.7. References
List of Authors
Index
Other titles from ISTE in Computer Engineering
Wiley End User License Agreement
List of Figures
Chapter 1
Figure 1.1. The attributes of distributed ledger technology
Figure 1.2. Blockchain architecture
Figure 1.3. Schematic of data blocks
Figure 1.4. The Blockchain implementation in healthcare
Chapter 2
Figure 2.1. Working of Blockchain.
Figure 2.2. Operating mechanisms of a smart contract.
Figure 2.3. Number of publications
Figure 2.4. Top 5 countries in terms of publications
Figure 2.5. Top 5 sources in terms of number of publications
Chapter 3
Figure 3.1. Publication classification for Blockchain.
Figure 3.2. Publication classification for Blockchain in the healthcare industry.
Figure 3.3. Healthcare industry
Chapter 4
Figure 4.1. Confirmatory factor analysis for the latent variables.
Figure 4.2. The final model.
Chapter 5
Figure 5.1. Detailed flow of transaction in the Blockchain.
Figure 5.2. Features of Blockchain.
Figure 5.3. Number of publications
Figure 5.4. Top 5 countries in terms of publications
Figure 5.5. Top 5 sources in terms of number of publications
Figure 5.6. Proposed model.
Figure 5.7. Working of MedRec (Xia et al. 2017).
Chapter 6
Figure 6.1. Architecture diagram
Figure 6.2. Blockchain P-to-P architecture
Figure 6.3. Healthcare Blockchain
Figure 6.4. HIE model
Figure 6.5. Process of the model
Chapter 7
Figure 7.1. A generic healthcare application – high-level DFD
Figure 7.2. Digitalization in healthcare industry – connected health and service model
Figure 7.3. Threat surfaces mapping in a generic health application – high-level DFD
Figure 7.4. Blockchain structure
Figure 7.5. Working of digital signature
Figure 7.6. Blockchain – a P2P DLT
Figure 7.7. Process flow – Example 1 (high-level architecture)
Figure 7.8. Process flow – Example 1 (low-level architecture)
Figure 7.9. Process flow – Example 2
Figure 7.10. HIPAA requirements
Figure 7.11. Differential privacy algorithm example
Figure 7.12. Local system and global system
Figure 7.13. Privacy by Design principles
Chapter 8
Figure 8.1. Healthcare system relationships
Figure 8.2. Centralized system and decentralized Blockchain system
Chapter 9
Figure 9.1. Component-based software development (Cai et al. 2000)
Figure 9.2. Structure of Blockchain
Figure 9.3. Basic model for software development
Figure 9.4. Waterfall model for software development
Figure 9.5. Iterative model for software development
Figure 9.6. Prototyping model for software development
Figure 9.7. Spiral model for software development (Kumar et al. 2014)
Figure 9.8. Agile model for software development
Figure 9.9. V model for software development (Chaudron et al. 2005)
Figure 9.10. Y model for software development (Capretz et al. 2005)
Figure 9.11. W model for software development (Lau et al. 2011)
Figure 9.12. X model for software development (Tomar et al. 2010)
Figure 9.13. An improved model for software development (Khan et al. 2012)
Figure 9.14. Proposed method
List of Tables
Chapter 4
Table 4.1. Respondents’ demographics.
Table 4.2. KMO and Bartlett’s test.
Table 4.3. Rotated factor matrix.
Table 4.4. Model fit measures for the confirmatory factor analysis.
Table 4.5. Construct correlation and AVE.
Table 4.6. Path analysis result for confirmatory factor analysis.
Table 4.7. Model parameter for the structural model.
Table 4.8. Structural model results.
Chapter 7
Table 7.1. Threat analysis for DFD shown in Figures 7.1 and 7.2
Chapter 9
Table 9.1. Advantages and disadvantages of various SDLC models
Table 9.2. Comparative analysis of various software models with our proposed model
Guide
Cover
Table of Contents
Title Page
Copyright
Begin Reading
Index
End User License Agreement
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Dr. Tanupriya Choudhury would like to dedicate this book to The Indian Army for their dedication, sacrifice and excellency towards our motherland India and he would also love to dedicate this book to his parents Sri Mrigendra Choudhury and Smt. Minakshi Choudhury, his beloved wife Rituparna Choudhury and beloved son Rajrup Choudhury for their immense support throughout this work. He would also like to dedicate this book to his research guides Prof. (Dr.) Vivek Kumar, Prof. (Dr.) V Cyril Raj, Prof. Sumathy Eswaran and Dr. Darshika Nigam, who have always mentored him during his master’s and doctoral research.
Mr. Abhirup Khanna would like to dedicate this book to his parents Mr. Ravi Khanna and Mrs. Abha Khanna for all their blessings, love and support. Mr. Abhirup Khanna would also like to dedicate this book to Dr. Sapna Jain, Dr. Anushree Sah and Dr. Divya Srivastava for their warmth, compassion and esteemed council.
Mr. Abhishek Bhattacharya would like to dedicate this book to his family.
Prof. (Dr.) Jung-Sup Um would like to dedicate this book to his family and workplace.
Dr. Prasenjit Chatterjee would like to dedicate this book to his grandparents, his father late Dipak Kumar Chatterjee, his mother Mrs. Kalyani Chatterjee, his beloved wife Amrita and his little angel Aheli.
International Perspectives in Decision Analytics and Operations Research Set
coordinated byPrasenjit Chatterjee
Volume 1
Blockchain Applications in Healthcare
Innovations and Practices
Tanupriya ChoudhuryAbhirup KhannaPrasenjit ChatterjeeJung-Sup UmAbhishek Bhattacharya
First published 2023 in Great Britain and the United States by ISTE Ltd and John Wiley & Sons, Inc.
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms and licenses issued by the CLA. Enquiries concerning reproduction outside these terms should be sent to the publishers at the undermentioned address:
ISTE Ltd27-37 St George’s RoadLondon SW19 4EUUKwww.iste.co.uk
John Wiley & Sons, Inc.111 River StreetHoboken, NJ 07030USAwww.wiley.com
© ISTE Ltd 2023The rights of Tanupriya Choudhury, Abhirup Khanna, Prasenjit Chatterjee, Jung-Sup Um and Abhishek Bhattacharya to be identified as the authors of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act 1988.
Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s), contributor(s) or editor(s) and do not necessarily reflect the views of ISTE Group.
Library of Congress Control Number: 2022948726
British Library Cataloguing-in-Publication DataA CIP record for this book is available from the British LibraryISBN 978-1-78630-894-8
Foreword
Due to the vast amount of health-related data, Blockchain technology offers a significant answer in applications related to healthcare. With the help of a peer-to-peer network, Blockchain technology records each cryptocurrency transaction. The fundamental goal of Blockchain is to provide high-end security in order to address the problems that arise in handling healthcare data more effectively. Many scholars have focused their efforts on this subject with the goal of providing extensive research on the introduction to Blockchain, its platforms and different consensus algorithms. The movement of its uses towards healthcare and medical-related data has also attracted the attention of researchers. Aside from mentioning Blockchain technology, the writers have also mentioned the use of the IoT (Internet of Things) and AI (Artificial Intelligence), which together define the next technological era. The editors have done an excellent job of combining a number of chapters from autonomic computing with the viewpoint of applications connected to healthcare. The editors have also done a good job of providing a thorough review of the application of Blockchain technology in healthcare. The book helps readers become more knowledgeable about how Blockchain technology is being used in healthcare-related applications, such as maintaining patient monitoring systems. In order to combine the benefits of both technologies, it also elaborates on how Blockchain and the IoT may work together. We strongly believe that the book explores Blockchain and healthcare researchers.
Dr. Praveen KUMARAssociate ProfessorAmity University, Tashkent, Uzbekistan
Dr. Roohi SILLEAssistant Professor University of Petroleum and Energy Studies (UPES) Dehradun, Uttarakhand, India
Preface
The healthcare sector has always been an important part of society. With the recent outbreak of a pandemic, the importance of a robust, efficient, secure and patient-centric healthcare industry has never been more apparent. Blockchain is a new technology that keeps a record of every transaction performed using a cryptocurrency across server computers that are linked in a peer-to-peer network. Blockchain enables transactions to be secure, transparent and reliable. The question of revolutionizing the healthcare sector is being seen across various countries across the world and Blockchain could be integral in achieving this goal. The applicability of Blockchain in the healthcare domain can be seen as a remarkable opportunity by researchers and scientists across the globe for solving pertinent real-world problems dealing with patient records, medical supply chains, wearable diagnostic tools and telemedicine sessions. This book focuses on the fundamentals of Blockchain technology along with the means and methods of its integration with the healthcare industry. It provides an exploration of the current challenges in the healthcare sector and how Blockchain technology can provide solutions to these issues. It dives deep into specific areas where Blockchain technology can be adopted in the healthcare industry, such as patient data privacy protection, pharmaceutical supply chain, clinical trials and genomics. This book serves as a resource for readers to understand the fundamentals of Blockchain and the IoT (Internet of Things) across various application areas of healthcare and identify futuristic problem areas resulting from technological convergence. It also talks through futuristic research areas for the healthcare industry wherein Blockchain and its allied technologies can prove beneficial. However, it is important to note that these are only potential benefits and no guarantees can be made about their effectiveness. This book has a total of 11 chapters.
Chapter 1 proposes a framework for managing and operating a healthcare system using Blockchain technology. The framework aims to present a detailed overview of all the actors in a healthcare ecosystem, their working principles and ways of communication. Moreover, the authors present a comprehensive integration of other technologies such as the IoT and machine learning with the proposed framework.
Chapter 2 deals with the concept of smart contracts. It discusses the role of smart contracts in ensuring seamless transactions among various intermediaries. This chapter illustrates the creation and working of smart contracts along with their set of benefits. Furthermore, we discuss specific use cases involving the implementation of smart contacts for streamlining complex processes.
Chapter 3 discusses various platforms for the implementation of Blockchain technology. This chapter aims to present a detailed analysis of prominent Blockchain platforms such as Ethereum, Hyperledger Fabric, Multichain, etc.
Chapter 4 looks at the variety of challenges faced while implementing techniques from Blockchain technology in healthcare. This may include data protection and data sharing challenges, cross-border information sharing challenges, data security challenges, challenges in stakeholder management using an appropriate permissioned network, and study challenges.
Chapter 5 discusses growing concerns about medical data security in an online ecosystem. This chapter explores present-day data ownership laws and compliance regulations dealing with the administration of medical records. It illustrates the means and methods of creating an interoperable decentralized Blockchain-enabled health record system. Moreover, the authors illustrate the problem faced by many in terms of the number of devices used in a healthcare system and the manageability of the vast variety of data generated.
Chapter 6 presents the proposed system that connects with methods such as on-chain and off-chain communication patterns to allow patients and healthcare professionals to share personal health records. This chapter proposes a scheme that emphasizes the importance of maintaining a true fair-exchange policy when transferring medical records without the involvement of a trusted third party.
Chapter 7 explores ways in which Blockchain can assist in preventing access and misuse of patient data by third part intermediates. The authors illustrate the means of strict and efficient implementation of data privacy laws by the use of smart contracts and consensus algorithms. Identification of data controllers and perspectives on anonymity and pseudonymity are discussed in later parts of the chapter.
Chapter 8 describes a Blockchain-enabled fragmented personal fitness facts ecosystem that enables unique drug discovery, biomarker development and preventative healthcare procedures, as well as secure personal records using Blockchain and deep learning technologies to connect users and providers of personal records with medical records.
Chapter 9 discusses the life-cycles of software development through the component-based software engineering approach. Furthermore, we discuss how to create a Blockchain-based repository that stores software components and also discuss how Blockchain technology helps to secure our data in healthcare applications. The proposed software development life-cycle model ensures the security of user data and also improves the quality of healthcare applications.
Chapter 10 discusses the role of smart contracts and Blockchain technology in healthcare and other use cases. Smart contracts are computer protocols that facilitate, verify or enforce the negotiation or performance of a contract. Smart contracts were first proposed by Nick Szabo in 1996. He defined a smart contract as “a set of promises, specified in digital form, including protocols within which the parties perform on these promises”. Since then, much research has been conducted on smart contracts and their potential applications. Some challenges that have been identified include scalability issues and the need for more user-friendly interfaces. Despite these challenges, many companies are already using smart contracts in various ways. For example, some companies use them to create digital wallets or to streamline supply chain management processes.
Chapter 11 describes the future aspects of Blockchain and the healthcare industry. Blockchain technology has the potential to revolutionize healthcare research by providing a secure, decentralized platform for storing and sharing data. This could potentially allow for more efficient and accurate clinical trials, as well as better tracking of patient outcomes. While there are still some challenges to be overcome, such as ensuring data quality and privacy, the future potential of Blockchain in healthcare is very exciting. These points will be discussed throughout this chapter.
We hope that our efforts are appreciated and the reader benefits from this book.
Tanupriya CHOUDHURYAbhirup KHANNA Prasenjit CHATTERJEEJung-Sup UM Abhishek BHATTACHARYANovember 2022
Acknowledgments
Dr. Tanupriya Choudhury and Mr. Abhirup Khanna would like to thank their work place, the University of Petroleum and Energy Studies, Dehradun, India for creating a positive research environment to start this proposal. They would like to thank all the contributors from different countries and especially the reviewers throughout the globe who helped review the chapters to improve the quality of the book. They are also thankful to the senior leadership of UPES and the administration for giving them the opportunity to work on BAHIP 2022 and providing them with all possible support. They are thankful to Sh. Sharad Mehra, CEO, GUS-Asia for his “all-time-go-ahead” blessings and freedom of work. The Honorable Vice-Chancellor Dr. Sunil Rai has continuously supported us as a torchbearer, big thanks to you sir for your mentorship. They would like to thank everyone for their involvement and willingness to take on the completion of tasks beyond their comfort zone. See you all in the next edition of the book. We also acknowledge the support of Dr. Roohi Sille during the editing of the chapters at the final stage of publication.
Mr. Abhishek Bhattacharya would like to thank his family for all their support.
Dr. Jung-Sup Um is grateful to his workplace, Kyungpook National University, South Korea, for supporting and providing him with such a working environment that he could devote time to such projects.
Dr. Prasenjit Chatterjee wishes to thank his family for all their support.
1Framework for Blockchain in Healthcare
Blockchain technology could be seen as one of the uptakes from the field of digitization that has attracted the attention of researchers and academicians over recent years. A Blockchain is a distributed database with an immutable committed block that provides transparency and robustness, which are the inherent characteristics of the architecture of Blockchain. Blockchain can also be understood as the set of connections which are interconnected to provide the connection in the entire architecture. Blockchain has been recognized as a development for addressing the distribution issues of information with the significant characterization towards data privacy and information security. Thus, the focus here has been to highlight the state of art in terms of Blockchain development, personalization, applications and limitations within the healthcare sector.
Blockchain is one of the most innovative and crucial advancements in the technology world. It belongs to the professional world, bringing together the distributed ledger technology with its architecture and applications in the medical field. This framework will include the evolution and ownership aspects of Blockchain along with the working principles and the different methods in the healthcare ecosystem. Since Blockchain is one of the technologies which is being used in the improvement of the prevailing standards of data sharing, handling and security, the growing anticipation of Blockchain, with its data management ranging from the traditional to its extensions, will be discussed. Emphasizing the benefits of Blockchain in healthcare, this chapter will also go over the challenges and limitations of Blockchain. The present editorial will also make efforts to approach the challenges of Blockchain in healthcare. A comprehensive interpretability in Blockchain with its open issues and future trends will be described. This enhancement in the medical field has also set the path of a new revolution in transforming the individual sectors in the healthcare industry. Thus, the focus has been on showing the direction of persistent revolution towards the potential of Blockchain technology in making efforts to establish innovation in the healthcare industry.
1.1. Concept of Blockchain
A Blockchain is a system for storing data in a manner so that it becomes impossible or extremely difficult to hack or change the system. Blockchain is generally a book of digital transactions, which are first copied and circulated across the complete network of systems present in the Blockchain architecture. All the blocks present in the chain are made up of a number of complete transactions, including each time any new transaction occurs for the system of Blockchain, a newly entered transaction is entered into each participant’s book. And whenever there are multiple participants, the multiple participant architecture is managed by the decentralized database, which is popularly called distributed ledger technology (DLT). Blockchain may be marked as a common and permanent book that organizes the activity of record keeping in a network of blocks through input transactions, new insertions and asset tracking. According to Ahram et al. (2017), Blockchain presents a safer way for exchanging service and information transactions.
An asset might be physical (e.g. a car) or intangible (e.g. land), physical (patient treatment) or intellectual (creative property, patents, copyrights, branding) data or medical records (personal information, laboratory results, medical findings, history of diseases, doctor’s prescription). Things of value can be followed virtually and can also be alternated on a network of Blockchain, via cost cutting, along with the reduced risk for all those users involved in it. Blockchain is a DLT in which all the transactions are documented through an enduring cryptographic signature known as a hash.
Blockchain has provided a platform that can improve the transparency as well as authenticity of healthcare data, maintaining permissions and also streamlining the claim process (Angraal et al. 2017).
Blockchain is a form of dashed information. The quicker it is received, the more accuracy it preserves. Blockchain provides each shared piece of data and all of the entirely transparent data that is stored on an accounting book immediately, but only the network’s members that have permission have access to it. Hence, according to the researchers, Blockchain is considered to be an ideal way for delivering information, although Blockchain has always faced the limiting issues of latency and throughput, solutions to which have been given by many researchers such as ECBC produced by Xu et al. (2017). A Blockchain can track prescriptions, records, clinical data, payments, medication, a patient’s accounts much more, where people can believe that every single piece data is true, and the user can see all the details of the transactions to give greater confidence, end-to-end communication, new efficiencies and greater opportunities. But, due to the newly developed technology, it still has a very limited number of users (Aru 2017), along with certain challenges and limitations towards the development of Blockchain applications, including security, scalability, speed, privacy, interoperability and patient management (Agbo et al. 2018).
How does Blockchain initiate?
Blockchain rests on three major concepts: the Blocks, the Miners and the Nodes.
The Blocks
Every Blockchain consists of various numbers of blocks, along with the three primary elements in each block, which are:
–
data
: acting as an input for the block;
–
nonce
: a 32-bit entity based number referred to as a
nonce.
When any block is created, the nonce is generated randomly which further achieves a “hash” as a block header;
–
hash:
a 256-bit number and linked to the nonce, which appears with a large number of 0s.
A nonce develops the cryptographic hash, whenever the initial (first) block of a Blockchain emerges. Then, the acknowledgement is done for unless it is dug, the data in the block is signed and connected to the nonce and hash.
The Miners’ association
The newly developed blocks in the chain are generated through a development procedure known as mining. Every block in the Blockchain mining of a block is not evident, especially for the larger chains, because each block has its unique nonce and hash, as well as the hash of the previous block in the chain. Miners are special pieces of software that solve the strangely complex math nonce finding problem that generates an accepted hash. Because the hash is 256 bits and the nonce is only 32 bits, there are approximately four billion nonce–hash possible combinations that need to be mined after finding the right one. This block is then added to the chain, which when it appears is referred to by the miners as the “golden nonce”.
All of the blocks that come after changing the previously existing block in the chain necessitate re-mining; hence, it is always reported as a tough job to manipulate Blockchain technology. Thus, as a “safety in math”, finding golden nonces needs a long time and much computer power. This modification must be approved by all existing devices in the system, and if a block is successfully mined, the miner is compensated financially.
Nodes
Nodes are any type of electronic device that helps in keeping the network functioning and in maintaining the copies of the Blockchain. Any newly introduced mined block for the Blockchain needs to be verified, trusted and also updated for each node with its own copy of the Blockchain, and the network must also be algorithmically approved. Each action performed in the ledger is easily checked and viewed due to the transparent nature of the Blockchains, where each member is identified with a different alphanumeric identification number, showing their transactions.
The Blockchain also maintains its integrity and develops trust among its users, thus combining public information with a reliable scalability of trust and a system of checks-and-balances through efficient use of technology.
Components of basic Blockchain
Distributed ledger technology (DLT) is used by all network participants which are involved in the Blockchain and have an access to the distributed book and its maintenance of the record of transactions. The shared ledger allows the transactions to be recorded only once, and any duplicate efforts to be discarded, as has always been found in typical classical networks. The different attributes of the distributed ledger technology are presented in Figure 1.1.
Figure 1.1.The attributes of distributed ledger technology
Immutable records
In Blockchain technology, none of the members are allowed to change the input after a transaction has been recorded in the common ledger, nor can they modify or tamper with it. However, it does give the following opportunity: if a transaction record contains an error, then a new transaction will need to be combined in order to reverse the error; then both the transactions will be cleared.
Contracts that are smart
Smart contracts are a collection of rules for completing transactions quickly, which is gathered on the Blockchain for its automatic execution. A smart contract describes conditions and regulations for incorporating, combining terms for the data, guaranteed services and much more.
Benefits of Blockchain
Operations generally squander time and money on duplicate records and third-party verification. The recorded systems may also be liable to cyber attacks and fraud; therefore, the defined data verification can be slowed by transparency. Transaction volumes have exploded as a result of the Internet of Things (IoT). As a result, every process takes longer towards the end result drains – or necessitates a better move, namely, entry into the Blockchain.
As a member of a members-only system, we can be sure that we are getting correct and timely data, because the classified Blockchain documents will only be shared with network members to whom access is given. According to Dey et al. (2017), all network members must agree to data efficiency, and then all verified transactions are fixed as they are always stored. A transaction cannot be deleted by anyone, not even a system authority. The time-consuming record agreements are often rejected with a vanished ledger that is shared across network participants. A set of rules to speed up the transactions, known as a smart contract, are executed automatically and can be stored on the Blockchain. For example, one of the most well known (and maybe most controversial) applications of Blockchain are cryptocurrencies, like Bitcoin, Ethereum or Litecoin, which can be used to buy goods and services. Cryptocurrencies are digital currencies (or tokens). Crypto can be used to buy everything from your lunch to your next home just like a digital form of cash. Online transactions are always recorded and secured so, despite the currency, cryptography employs Blockchain to serve as a public ledger as well as a data encryption system. Researchers have also given examples of using Blockchains for energy transactions, as in Park et al. (2018).
As far as healthcare is concerned, the devices related to the IoT use the real-time data of the patient, which is processed and further analyzed. Thus, Blockchain in accommodation with the IoT is one of the reasonable choices for e-healthcare systems (Ray et al. 2020).
Blockchain networks
A Blockchain network might be public, private, federated or developed by consortia, among other options.
Blockchain networks open to the public
A public Blockchain, like Bitcoin, is one that anybody may register and contribute to. The disadvantages of a public Blockchain include no or little transaction privacy, inadequate security and a high processing power requirement.
Network of private Blockchains
A private Blockchain resembles a distributed mentoring or public Blockchain network in appearance. However, if one entity manages the network, implements a shared ledger, maintains the public database and controls who is allowed to participate based on the utilization case, trust and confidence amongst participants will skyrocket. A Blockchain frequently runs under a company’s security and might be handled on-site.
Blockchain networks with permissions
Businesses that discover a specific chain will often discover a highly secure Blockchain network. It is vital to note that public Blockchain networks can also be described as being of a restrictive nature where one is allowed to join the network and specific transactions. Participants must get either an involved participation or hitch permission.
Blockchain in a consortium
Multiple entities can share the burden of maintaining Blockchain architecture. This is before the entities decide who has access to the information and who is allowed to make transactions. When all players must have permission and share responsibility for the Blockchain, a consortium Blockchain is the way to go. In this category, significant processing power is necessary, but only a small amount of it is available.
1.2. Blockchain as distributed database
Even though the terms bitcoin and Blockchain technology (DLT) are often used interchangeably, they are not interchangeable. To allow Blockchain technology, bitcoin employs a variety of technologies, including distributed ledger technology. Digital signatures, distributed (peer-to-peer) networking and encoding techniques are the additional technologies and computational/mathematical techniques used in Blockchain technology to link the recordings (block) of a database. Blockchain technology might be classified as a distributed ledger.
A Blockchain is a decentralized and permanent ledger that may be used to take possession, transact data, evaluate the effectiveness and assure visibility, safety, confidence and currency transfers in a range of electronic asset transactions.
Distributed ledger technology is based on Blockchain technology across a distributed database that serves as a ledger and an encoded database that stores transaction records. DLT is a cutting-edge database solution with such a knowledge base in which encryption is used in each transactional update and confirmation is feasible across the particular public Blockchain, based on the platform’s aim and shareholders. Blockchain technology has progressed from a buzzword to a reality.
Despite being hyped at the present, Blockchain is just one of a list of solutions that are incredibly relevant within the context of, among other things, the transition to digital (but for many applications being from the early phases of hype cycles). It is not the panacea for all problems (far from it), because as the hype goes, it is also quite useful in selected situations whereby the use is appropriate. (Multiple) Blockchain technologies are being used and tested in a range of digital trust and exchanging use situations in industry, in and across cryptocurrency, and also as a contract basis to provide faith in the digital world. Over the next few years, DLT is expected to be among the fastest developing digitalization developments, with a vital role in numerous relevant application cases inside the digitalization of multiple methods and industry.
The hype around cryptocurrency also creates a huge gap between what a technology could conceivably achieve and what it actually can do. Furthermore, there is no denying that distributed ledger technology is gaining traction in the commercial world, particularly in the financial sector. There will be various reasons that DLT adoption is predicted to accelerate throughout all use cases and industry, though in many cases it will fall short of expectations or be unnecessary.
Business projects advancing Blockchain technology
Many corporations, both world leaders and leadership in their particular nations or regions throughout numerous sectors, launched key bitcoin and DLT efforts in 2017 or 2018. Simply looking at the clients of a few key efforts, we can note projects, such as IBM’s cross-border transaction bitcoin action plan, that also primarily will have industries from the Asian region on board. This was how it started and it was then confirmed in October 2017 to still be on the verge of reaching 100 industries. At the same time, most of these projects will fall short of their goals, whereas others will grow in importance. Therefore, while various use cases and initiatives as produced by the researchers have been investigated more profoundly, DLT has been introduced to businesses. For a variety of reasons, Blockchain technology is very new, especially outside the scope of bitcoin and cryptocurrencies, which would be the domain beyond which most commercial projects desire of using DLT.
According to Zhou et al. (2020), the Blockchain also has a wide application for the health record management system, where the system uses Blockchain as a storage tool. One of the most prominent issues facing the modern-day clinical system is data handling, which in turn has drastically hampered the efficiency of the medical systems and their process of further development. Moreover, the data breaches that occur to this day are just one of the regular tasks that are committed for the theft of medical data in a similar way to the theft of banking data. Certain projects have been started, including the medical chain. The goal of this project was to develop a single version of the patient’s data and thus give them the ability to share their data with anybody in their network. The medical chain unites pharmacy research, therapeutic, operational, prescribed and insurance data through the Blockchain-based application, myclinic.com. Medibloc is another Blockchain-based healthcare project that works on the structuring of big data. Medibloc delivers its service from an application called Medipass. Another, most promising Blockchainbased project in 2020, Dentacoin, has combined the dental industry with the Blockchain industry. The application has accommodated about 2,000 dentists along with 100 locations in a single board. After its launch in 2017, Dentacoin provided many platforms, leading to further improvements. DentaVox is also one of the applications that has served for collecting information and conducting research surveys. Dentacare is another application that provides education aids related to dental care. Another is Robomed Network; this project has been created to help the healthcare ecosystem thrive and thus gives a universal care solution. The Robomed Network has produced a different range of EMR/CRM solutions.
1.3. Architecture of Blockchain in healthcare
Blockchain as a ledger technology has a continuous list of transactions and data records. It simplifies and expedites healthcare and its related processes. The interoperability nature along with the property of supply chain validation allows us to dramatically reduce the back office load, data management and maintenance cost. There are five key areas in healthcare that are promptly driven by Blockchain technology.
1) Online access – the Blockchain allows patients to have online access to their longitudinal medical records, providing them with the security key and thus allowing the interoperability of data.
2) Maintenance of health records – the Blockchain allows the longitudinal way of maintaining healthcare records. It also maintains a secure medical record between multiple healthcare organizations and the patient. This gives the futuristic approach to the Blockchain.
3) Automation of adjudication of health claims – the smart architecture of Blockchain allows the execution of the transactions of the contract, which helps the support of compliance audits as well as the completion of a claim through the business rules. Thus, it also follows the concept of disintermediation.
4) Management of supply chain – using a supply chain, we may improve the efficiency of your business. The Blockchain enables contract healthcare through real-time health tracking and execution. This architectural feature of Blockchain management also benefits the contract administration and thus reduces its costs. This approach also innervates the satisfied and completed contracts that provide the consumers with information about quality and sources of the facilities (including drugs) being provided.
5) Interoperable nature – this feature of the Blockchain enhances the efficiency of the Blockchain by facilitating and encapsulating the large amount of patient data, thus providing further health initiatives. It promotes the additional high transaction in volume of patient data, along with the negotiation of chain data with the consortium of the views of healthcare experts. The Blockchain architecture, shown in
Figure 1.2
, consists of two main blocks, the transaction block and the maintenance block. The transaction block, which consists of several blocks through different network sources, tends to transmit the data towards the Blockchain in different time slots. Each time a new transaction occurs, it is transmitted to the network of computers which are connected worldwide. The network then checks and confirms the validity of the transaction that has occurred and thus allows it to become clustered within the block. All of these blocks are then chained with each other, and the entire transaction is said to be completed.
Figure 1.2.Blockchain architecture
Figure 1.3 shows the schematic of data blocks.
The Blockchain architecture is a decentralized type of P to P architecture, where the different digital transactions are recorded in the distributed network within the shared ledger. These digital transactions are the copy of encrypted signal data which are structured in the block format with the index pointing towards the earlier block. Where the members stored the copy of the shared ledger and these changes made in the shared ledger are reflected to all. All the original data of original size as a stream towards the data make the implementation of Blockchain in healthcare, as given in Figure 1.4.
Figure 1.3.Schematic of data blocks
Figure 1.4.The Blockchain implementation in healthcare
The Blockchain is the shared and distributed infrastructure that addresses the interoperability and thus provides a comprehensive view of the health data along with the healthcare entities. In this way, the Blockchain offers an efficient approach towards the interoperability and establishes the architecture for health IT, where the patient is encompassed within a chain having completed several activities like prescription, monitoring, radiology, laboratory and biosensors, whichever is applicable to them and the data encrypted is in the form of blocks leading its path towards the Blockchain and the data lake. Each time the data is entered, a new block is accomplished in the ledger and it also acts as an entry in the data lake.
Due to its large architecture and its wide usage of technologies, the patient data remains inaccessible; thus, many studies have confronted this shortcoming of the Blockchain along with its security constraint. Thus, studies have addressed the security concern (Dagher et al. 2018), along with the designing of information management systems, like Medlock (Fan et al. 2018), for handling the patient data. A separate domain related to Blockchain in healthcare has also come into effect through the application of Blockchain in the pharmaceutical industry, as produced by Haq and Esuka (2018), where a permissioned Blockchain is applied to track the movement of drugs from manufacturing up to its delivery and thus recording its after-effects.
