Application of Blockchain in Healthcare

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Application of Blockchain in Healthcare
Akruti Sinha
Department of Computer and
Communication
Manipal University Jaipur
Jaipur, India
Email: akruti.sinha25@gmail.com
Akshet Patel
Department of Mechatronics
Manipal University Jaipur
Jaipur, India
ORCID: https://orcid.org/0000-0002-
2884-3080
Mukta Jagdish
Department of Information Technology
Vardhaman College of
Engineering(Autonomous)
Hyderabad, India
Email: mukta.jagdish13@gmail.com
Abstract—
Blockchain appears to be the way of the future in today's
technological age. Blockchain technology has recently proven
itself worthy of praise by facilitating cryptocurrency financial
transactions. Despite being widely researched, there have
recently been growing worries about the privacy and security
of patient data because of the use of a centralized system to
handle patient data. The General Data Protection Regulation
(GDPR) grants the subject the right to know where and how
his or her personal data is stored, as well as who is privy to it
and to what extent. Blockchain has been shown in numerous
studies to be capable of supporting the safe and secure
recording of patient data in the health-care system. This paper
summarizes recent research into how blockchain technology
can be successfully implemented in the healthcare field. In our
assessment of such publications, we discovered that the
majority of blockchain applications are limited when only
briefly examined. The products are only used by a small
number of people. Perhaps this is due to the fact that
healthcare blockchain applications have more demanding
authentication, interoperability, and record sharing
requirements. However, the quality of the products is
constantly improving.
Keywords—blockchain, healthcare, security, privacy, IoT.
I. INTRODUCTION
Smart healthcare and biomedical breakthroughs have
been extensively investigated in light of current
technological improvements, with the purpose of enhancing
treatment and healthy living. The advances, however, have
put the healthcare system at the peril of a variety of security
threats. There is a dearth of awareness and education of
security issues in the healthcare arena, as [1] indicates.
Blockchain sprang to prominence recently because of its
ability to eliminate the requirement for a centralized
authority or management, which was previously required for
financial transactions. [2]
That is precisely how blockchain should be applied to
address the security issues in smart healthcare. The
architecture, process, and performance of health-care
services can all be improved by blockchain. As a result,
patients will have more trust in the system, and the sector
will be less vulnerable to privacy issues.
The Internet of Things (IoT)'s superiority in the
healthcare applications areas has been mentioned by both
[2] and [3] and although developments are continuing to
increase in the field of IoT, the privacy and security of the
data is always a concern. This occurs due to the utilization
by the stakeholders who often pursue their respective
activities. [2] Since patient data is typically maintained on a
server, or in a centralized application, potential threats have
considerably increased.
Blockchain technology has the ability to secure data
from misuse while also establishing a clear level of trust
between patients and various stakeholders.
With the convergence of IoT and blockchain, it might
thus simplify the diagnostic procedures and conveniently
monitor the activities of patients. Regrettably, however,
while the applications of how Blockchain can help increase
data privacy, it has received relatively little attention to date.
What is unique about blockchain is that it operates
through a time-stamped sequence of data entries that are not
administered by any single entity or corporation but rather
by a group of computers.
Cryptographic concepts, known as chains, are used to
link the blocks together. First, a record of each transaction is
created, which comprises the information about the people
who initiated the transaction and is further authenticated
using each person's digital signature. The verification
process is conducted by computers linked to the network
that operate independently.
Each block also contains a hash value, which is actually
a code. This hash value serves as a function that identifies it
and displays its position on the blockchain. The hash also
verifies that the data in the block has not been changed since
it was recorded. The block is attached to the end of the
blockchain once it is finished.
By eliminating the need for intermediaries, blockchain
technology will enable healthcare businesses to minimize
operating expenses, avoid costly middleman management
processes. In the sphere of healthcare, it appears that
blockchain combined with IoT applications can have a
significant influence.
II. LITERATURE REVIEW
The authors in [2] offer a framework that incorporates
Internet of Things (IoT), Blockchain, and Machine
Learning. This framework is used to discover anomalies in
the behavior of a patient's health data. Patients must wear
devices that record data like heart rate, calorie burn, breath
strengthening, and sleep stage monitoring. According to [2],
the IoT module intercepts, fetches, and monitors this data.
The blockchain module utilized by the authors in [2] is
particularly intriguing. The Blockchain Network is in charge
of managing and processing the massive amounts of data
supplied by patients.
Personal Health Care (PHC) as well as the External
Record Management (ERM) Blockchain, were the two vital
blockchain networks that are employed by the authors in
[2]. The PHC collects data from the patients' wearable
devices and is thus maintained by the patients themselves.
This information can be used to determine how the patient is
affected by the disease and to prescribe medications
accordingly. However, because all this information is being
2022 First International Conference on Artificial Intelligence Trends and Pattern Recognition (ICAITPR) | 978-1-6654-2521-6/22/$31.00 ©2022 IEEE | DOI: 10.1109/ICAITPR51569.2022.9844186
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housed in a third-party cloud database, there are certain
privacy concerns. According to the authors, this database is
governed by the blockchain network.
The External Record Management Blockchain stores the
data generated when patients visit their doctors.
Finally, the Machine Learning Module was used by the
authors of [2]. The module examines the data gathered by
the patient wearable devices and detects any irregularities.
When an aberration is detected, the module sends an alert to
the concerned doctor, who can then take any appropriate
action based on the information and the irregularity.
The authors in [3] propose a modification to the
traditional Blockchain architecture in order to protect
patients' privacy. The authors of [3] commenced by
reducing data redundancy by clustering the miners. As a
result, all miners are not involved in the consensus
procedure. Another advantage of this is that it reduces the
size of transactions.
In contrast to [2], the authors of [3] store the hash of a
patient's healthcare data rather than the original data. This
appears to be a promising solution for ensuring data
security. The authors of [3] have put in a lot of effort to
address and resolve the privacy concerns. They collect and
manage data in the location closest to the patient.
To protect the patients' privacy, they are given a
pseudonym, as well. [3]'s system model is made up of
several components. In contrast to [2], patients need not
wear any device to capture their data like blood pressure,
and heart rate; but nevertheless, sensors are attached to the
patient's body.
There is a central server that uses the Internet of Things
Module to manage and store the patient’s data [11]. The IoT
module is in charge of a variety of tasks, such as receiving
and storing data from sensors and smartphones.
The IoT module also performs major operations such as
hashing and other cryptographic operational activities. This
hash of the data is then sent to the central blockchain
network.
The authors of [3] propose storing hash and user data in
separate entities. Because there are different transaction
structures, policy management is simplified. In comparison
to [2], the operation of this architecture [3] is rather
complex. The first step is to collect data from sensors
obtained through smartphone usage. The data is classified
by the PDA and sent to the Internet of Things Module
known as the IoT Healthcare Manager.
The IoT module then decrypts the encrypted data and
stores it in the database. After computing the hash of the
data, the module encrypts it using asymmetric cryptographic
data. This encrypted data is then sent as a transaction to the
blockchain network's cluster miner.
The commendable feature of [3]'s developed framework
is that if the patient's responsible doctor desires to access the
data, they can request a transaction that includes the
patient's ID.
The miners usually check the patient's data policies. If
the policies are validated, the data and its location are
encrypted using the public key of the responsible doctor and
sent to the doctor [9]. After receiving the response, the
doctor can obtain the hash of the patient's data and decrypt it
with a private key.
Finally, a message containing the hash of the patient's
data is sent to the IoT module [10]. It is decrypted and the
hash value is computed by this module. When a valid hash
value is obtained, the patient's data is returned.
While this process appears to be time-consuming and
necessitates extensive knowledge of cryptography, it
ensures that patients' privacy is not jeopardized. The data is
completely secure.
The authors of [1] are focused on using blockchain to
achieve smart healthcare in smart cities. While no
framework is proposed, the authors do an excellent work of
distinguishing and summarizing how blockchain can be
useful in the healthcare sector.
According to [1] a startling number of people are
unaware of the privacy risks associated with their data.
According to [5] 60 percent of mobile health users are
unaware of the security risks associated with storing
medical data on their smartphones. This raises concerns
about the use of smartphones in [3].
The authors of [5] conduct an interesting survey on the
use of mobile healthcare applications to provide services to
patients. While the overwhelming majority, 90 percent of
those polled, have embraced technology, there have been a
select few, 10%, who have yet to trust technology and
transition to using mobile healthcare applications.
People who use these medical monitoring applications
believe that Blockchain technology allows them to secure
their money during medical transactions [12].
The robust encryption of data that blockchain
technology is capable of providing increases user trust in it.
The technology can keep sensitive information secure by
making it visible only to authorized users in the system. [1]
The authors of [3] have yet to implement the
architectural design and conduct analysis in order to
evaluate the proposed architecture's performance.
Despite the complex architecture, the proposed system in
[2] is such that it can be considered as a possible
implementation in society, with the potential to significantly
influence existing privacy and security concerns while also
providing effective and precise healthcare.
III. APPLICATION OF BLOCKCHAIN IN HEALTHCARE
Healthcare systems can be greatly improved with the
introduction of Blockchain technology [13]. Without the
explicit requirement for a centralized system, blockchain
can thus be used to eliminate or at least minimize risks to
security and medical data privacy. Because blockchain is a
new concept, research on how to import any information
from outside a blockchain distributed ledger has yet to be
completed [4].
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Fig.1: Architecture of Blockchain in Healthcare
Fig.1 depicts the architecture of Blockchain in Healthcare
where in the hash of the previous block is stored in the
current block so that it becomes nearly impossible to tamper
with the data since one change will alter the hash of all the
proceeding blocks. Following the laudable solution of
financial transaction security, blockchain is now being
considered as the solution to all privacy issues in the field of
healthcare [14]. The healthcare industry has seen an increase
in the hazard to data integrity, which means that not only is
data accessed by third parties, but it is also altered.
Integration of Blockchain and Internet of Things.
The authors of [7] suggest an intriguing framework that
combines the Internet of Things model with Blockchain
Technology. The proposed framework consists of five
separate sections: a blockchain-to-device interface, a chain
code execution interface, a membership service provider
(MSP), a peers node, and an ordering node.
The data from the IoT model is received via the API
gateway [16]. When the data is received, the gateway
triggers the chain code configured in each blockchain peer
by broadcasting a transaction proposal to the peers.[7]
A. Integration of Blockchain and Machine Learning
Recently, there has been an increase in the use of machine
learning models and blockchain technology to address
privacy concerns in the healthcare sector. Some of these
proposed architectures disseminate the gathered data to
several divergent nodes, and then machine learning models
are applied. Finally, they are assembled after the local
application.[1]
Unfortunately, these models are not completely secure
because the use of a centralized server increases security
risks. This shortcoming, however, is addressed by using a
decentralized server, as stated in [1].Blockchain guarantees
that the system is protected and authentic, which only
satisfies the requirements of Machine Learning models to
provide efficient findings. As the authors of [6] suggest,
combining these two technologies complements each other
and has the potential to produce accurate and reliable results
in terms of security.
The authors of [6] do an excellent job of providing an
overview of machine learning and blockchain network
integration. According to [6], the certificates issued by the
Certificate Authority in the blockchain network provide
users with a unique identity, adding an additional layer of
security. This certificate will contain the user's digital
signature and will be submitted to the blockchain.
The authors of [6] explain the advantages of digital
signatures. Here are a few examples:
i. The signature ensures that users have legal access
to the ledger, which contains transaction details.
ii. Most importantly, it verifies the identity of the
user who is seeking the transaction.
Many people have criticized the idea of combining
blockchain and machine learning [15]. Nonetheless,
proponents of the concept claim that this integration will
effectively address privacy concerns.
The following are the most distinctive features that ensure
the safety and privacy of data records: The following are the
most distinctive features that ensure the safety and privacy
of data records:
a. When machine learning models are trained with
actual data, it opens the door to increased efficiency and
accuracy. As a result, the additional cost is reduced.
b. Because the results are stored in blockchain and
governed by machine learning models, this integrated model
can predict outbreaks. This speeds up the process of the
doctor issuing the correct prescription.
c. Each user who has been authenticated will
receive a copy of the ledger [17]. This increases the user's
trust and ensures that the data is only acquired by the parties
to whom he grants access.
Several other models, such as Natural Language Processing,
can also be used to provide accurate and precise
prescriptions. Machine Learning models can recommend
methods and medications based on the symptoms displayed
by the patient.
Among these observations are numerous others that
demonstrate how well blockchain technology can integrate
with machine learning models to produce more reliable
results [18].
The authors of [6] have taken care not to overlook the
challenges. They state that the main challenge is that once a
transaction takes place, it cannot be changed, and because
there is always risk of human error, this issue must be
addressed.
IV. CHALLENGES BY THE INTEGRATION OF BLOCKCHAIN
Healthcare is one of the most prominent application
areas for blockchain technology because of its decentralized
and distributed technology. The application of blockchain in
the field of healthcare, however, faces numerous challenges
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and obstacles, as with any other application. These issues
must be investigated and resolved prior to the sector's actual
adoption of technology.
A. High Costs of Development
As [8] suggests, the application of blockchain in the
healthcare industry may take some time due to the high
costs involved. The total implementation cost, as well as the
operating costs, are extremely high, posing a significant
challenge to the global adoption of this technology. As a
result, it is critical that unnecessary costs be eliminated, and
total costs be minimized when constructing such systems.
B. Issue with Smart Contracts
Both [1] and [8] authors demonstrated how a Smart
Contract is an essential component of blockchain-based
applications. Smart Contracts are computer-based digital
programs that serve as a type of agreement between various
parties. The authors of [8] propose that during the
implementation of blockchain in the healthcare sector, the
patient and other network stakeholders agree to a deal to
accept the terms in order to develop the requirements in the
smart contract. As a result, the process is more reliable. The
authors of [1] have made it perfectly clear that the public
may require some time to fully trust the process of smart
contracts because users are being asked to trust a completely
virtual process. In the event of a coding error, the system is
bound to throw an error that cannot be resolved unless a
technician with the necessary knowledge is present on-site.
[8]
CONCLUSION
There have been numerous technological advancements, and
with them, we must also improve the healthcare sector,
which is currently dealing with a major issue of security and
privacy concerns. The current centralized approach used in
the healthcare sector exacerbates these flaws. Blockchain
technology appears to be a promising solution for
addressing the shortcomings, as well as many others.
While the works we've looked at have created commendable
blockchain solutions that introduce blockchain technology
into the healthcare business, there are still a lot of
roadblocks to overcome. They make use of smart contracts,
which allow for personalized care without violating clinical
guidelines. The blockchain will ensure that data cannot be
tampered with. It will successfully disseminate a large
amount of data while maintaining privacy. Blockchain
technology, when combined with IoT and Machine
Learning models, has the potential to significantly improve
efficiency. Using a decentralized approach through use of
Blockchain Technology aids in guaranteeing data integrity
and security.
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