A Systematic Review of Blockchain in Healthcare: Frameworks, Prototypes, and Implementations

Abstract

Blockchain, a form of distributed ledger technology has attracted the interests of stakeholders across several sectors including healthcare. Its' potential in the multi-stakeholder operated sector like health has been responsible for several investments, studies, and implementations. Electronic Health Records (EHR) systems traditionally used for the exchange of health information amongst healthcare stakeholders have been criticised for centralising power, failures and attack-points with exchange data custodians. EHRs have struggled in the face of multi-stakeholder and system requirements while adhering to security, privacy, ethical and other regulatory constraints. Blockchain is promising amongst others to address the many EHR challenges, primarily trustless and secure exchange of health information amongst stakeholders. Many blockchain-in-healthcare frameworks have been proposed; some prototyped and/or implemented. This study leveraged the PRISMA framework to systematically search and evaluate the different models proposed; prototyped and/or implemented. The bibliometric and functional distribution of all 143 articles from this study were presented. This study evaluated 61 articles that discussed either prototypes or pilot or implementations. The technical and architectural analysis of these 61 articles for privacy, security, cost, and performance were detailed. Blockchain was found to solve the trust, security and privacy constraints of traditional EHRs often at significant performance, storage and cost trade-offs. INDEX TERMS Bioinformatics, blockchain, DLT, distributed ledger technology, distributed computing, distributed databases, health information management, health information exchange, hospitals, pharmaceutical technology, telemedicine, digital health, eHealth, mHealth.

Anonymity Preserving IoT-Based COVID-19 and Other Infectious Disease Contact Tracing Model

“…Blockchain technology promises trust-oriented intermediation in healthcare [3]. This intermediation capability can help address citizen privacy concerns [3].…”

“…Blockchain technology promises trust-oriented intermediation in healthcare [3]. This intermediation capability can help address citizen privacy concerns [3]. Therefore, we are proposing extending the current digital contact tracing solutions by updating anonymized contact proximity information to a blockchain as against traditional centralized government servers.…”

“…The rules for how messages (or transactions) representing state changes are appended to the ledger is cryptographically defined for any given blockchain. This rule is referred to as consensus algorithm, and it can proof-based or vote-based [3]. The consensus mechanism is implemented as part of the core layer of any blockchain implementation.…”

“…Traditional approaches to sharing information amongst healthcare stakeholders have been with the help of central intermediaries who facilitate care coordination [2]. Blockchain promises the trusted and secure decentralization of these intermediaries [3].…”

Smart Parking System With Privacy Preservation and Reputation Management Using Blockchain

“…Motivated by the research gaps in the literature in terms of security and privacy as explained above, in this paper, we propose a blockchain-based smart parking system with privacy preservation and reputation management. In recent years, a promising blockchain technology with advantages of decentralization, security and transparency has been used in different applications, such as intelligent transportation systems [22], [23], eHealth systems [24], smart grids [25], human resource record management [26], wireless sensor networks [27], etc. Creating a blockchain network from the parking lots to manage the parking service could tackle the previously mentioned security issues as follows.…”