Nowadays, there are a lot of new mobile devices that have the potential to assist healthcare professionals when working and help to increase the well-being of the people. These devices comprise the Internet of Medical Things, but it is generally difficult for healthcare institutions to meet compliance of their systems with new medical solutions efficiently. A technology that promises the sharing of data in a trust-less scenario is the Distributed Ledger Technology through its properties of decentralization, immutability, and transparency. The Blockchain and the Internet of Medical Things can be considered as at an early stage, and the implementations successfully applying the technology are not so many. Some aspects covered by these implementations are data sharing, interoperability of systems, security of devices, the opportunity of data monetization and data ownership that will be the focus of this review. This work aims at giving an overview of the current state-of-the-art of the Blockchain-based systems for the Internet of Medical Things, specifically addressing the challenges of reaching user-centricity for these combined systems, and thus highlighting the potential future directions to follow for full ownership of data by users.
The privacy issue limits the Internet of Medical Things. Medical information would enhance new medical studies, formulate new treatments, and deliver new digital health technologies. Solving the sharing issue will have a triple impact: handling sensitive information easily, contributing to international medical advancements, and enabling personalised care. A possible solution could be to decentralise the notion of privacy, distributing it directly to users. Solutions enabling this vision are closely linked to Distributed Ledger Technologies. This technology would allow privacy-compliant solutions in contexts where privacy is the first need through its characteristics of immutability and transparency. This work lays the foundations for a system that can provide adequate security in terms of privacy, allowing the sharing of information between participants. We introduce an Internet of Medical Things application use case called "Balance", networks of trusted peers to manage sensitive data access called "Halo", and eventually leverage Smart Contracts to safeguard third party rights over data. This architecture should enable the theoretical vision of privacy-based healthcare solutions running in a decentralised manner.
With the dramatic increase of the Internet of Medical Things devices, self and remote health data monitoring is consistently receiving more attention. However, medical devices are usually challenging to deploy due to privacy regulations, and they generally leverage a centralized third party. Enabling data sharing would enhance new medical studies, formulate new treatments, and deliver new digital health technologies. Solving the issue will have a triple impact: we will handle sensitive information easily, contribute to international medical advancements, and enable personalized care. A possible solution is to exploit decentralization distributing privacy concerns directly to users. Solutions enabling this vision are closely linked to Distributed Ledger Technologies. Through its characteristics of immutability and transparency, this technology would allow privacy-compliant solutions in contexts where privacy is the first need. This paper envisions the InterPlanetary Health Layer and related real-world implementations in the Internet of Medical Things domain. The main idea of the proposed solution is to handle sensitive data by preserving privacy and guaranteeing data availability. Specifically, users can build their private network, collaboratively authorize operations among their data and manage their privacy conditions without relying on a third party. The results of several stress tests conducted on a real case study confirmed the feasibility of the proposed solution, which shows good scalability and a modest impact on the application performance measured during the decentralized data access.
The management, protection and sharing of sensitive data such as those associated with the health domain are crucial in enabling personal care and contributing to worldwide medical advancements. Distributed Ledger Technologies (DLTs) allow for data protection compliant solutions in untrusted contexts that guarantee data immutability, protection and transparency when needed. This paper proposes an architecture based on DLTs, Smart Contracts and Distributed File Storage (DFS), enabling user data sovereignty, confidentiality and secure access control. A use case on health data is presented, where we apply a combination of DLT, DFS and an access control mechanism to allow users to distribute their data. Finally, we show an experimental evaluation of the overall architecture to demonstrate the feasibility of implementing practical DLT-based healthcare solutions. The results are collected through independent tests, available opensource, that verify the system's response time in each of its functions and as the load increases. The results are promising and show that the system is feasible and can scale as the load increases.
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