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Background As digital healthcare services handle increasingly more sensitive health data, robust access control methods are required. Especially in emergency conditions, where the patient’s health situation is in peril, different healthcare providers associated with critical cases may need to be granted permission to acquire access to Electronic Health Records (EHRs) of patients. The research objective of this work is to develop a proactive access control method that can grant emergency clinicians access to sensitive health data, guaranteeing the integrity and security of the data, and generating trust without the need for a trusted third party. Methods A contextual and blockchain-based mechanism is proposed that allows access to sensitive EHRs by applying prognostic procedures where information based on context, is utilized to identify critical situations and grant access to medical data. Specifically, to enable proactivity, Long Short Term Memory (LSTM) Neural Networks (NNs) are applied that utilize patient’s recent health history to prognose the next two-hour health metrics values. Fuzzy logic is used to evaluate the severity of the patient’s health state. These techniques are incorporated in a private and permissioned Hyperledger-Fabric blockchain network, capable of securing patient’s sensitive information in the blockchain network. Results The developed access control method provides secure access for emergency clinicians to sensitive information and simultaneously safeguards the patient’s well-being. Integrating this predictive mechanism within the blockchain network proved to be a robust tool to enhance the performance of the access control mechanism. Furthermore, the blockchain network of this work can record the history of who and when had access to a specific patient’s sensitive EHRs, guaranteeing the integrity and security of the data, as well as recording the latency of this mechanism, where three different access control cases are evaluated. This access control mechanism is to be enforced in a real-life scenario in hospitals. Conclusions The proposed mechanism informs proactively the emergency team of professional clinicians about patients’ critical situations by combining fuzzy and predictive machine learning techniques incorporated in the private and permissioned blockchain network, and it exploits the distributed data of the blockchain architecture, guaranteeing the integrity and security of the data, and thus, enhancing the users’ trust to the access control mechanism.

Over the past several years, many healthcare applications have been developed to enhance the healthcare industry. Recent advancements in information technology and blockchain technology have revolutionized electronic healthcare research and industry. The innovation of miniaturized healthcare sensors for monitoring patient vital signs has improved and secured the human healthcare system. The increase in portable health devices has enhanced the quality of health-monitoring status both at an activity/fitness level for self-health tracking and at a medical level, providing more data to clinicians with potential for earlier diagnosis and guidance of treatment. When sharing personal medical information, data security and comfort are essential requirements for interaction with and collection of electronic medical records. However, it is hard for current systems to meet these requirements because they have inconsistent security policies and access control structures. The new solutions should be directed towards improving data access, and should be managed by the government in terms of privacy and security requirements to ensure the reliability of data for medical purposes. Blockchain paves the way for a revolution in the traditional pharmaceutical industry and benefits from unique features such as privacy and transparency of data. In this paper, we propose a novel platform for monitoring patient vital signs using smart contracts based on blockchain. The proposed system is designed and developed using hyperledger fabric, which is an enterprise-distributed ledger framework for developing blockchain-based applications. This approach provides several benefits to the patients, such as an extensive, immutable history log, and global access to medical information from anywhere at any time. The Libelium e-Health toolkit is used to acquire physiological data. The performance of the designed and developed system is evaluated in terms of transaction per second, transaction latency, and resource utilization using a standard benchmark tool known as Hyperledger Caliper. It is found that the proposed system outperforms the traditional health care system for monitoring patient data.

The proliferation of smart devices in the Internet of Things (IoT) networks creates significant security challenges for the communications between such devices. Blockchain is a decentralized and distributed technology that can potentially tackle the security problems within the 5G-enabled IoT networks. This paper proposes a Multi layer Blockchain Security model to protect IoT networks while simplifying the implementation. The concept of clustering is utilized in order to facilitate the multi-layer architecture. The K-unknown clusters are defined within the IoT network by applying techniques that utillize a hybrid Evolutionary Computation Algorithm while using Simulated Annealing and Genetic Algorithms. The chosen cluster heads are responsible for local authentication and authorization. Local private blockchain implementation facilitates communications between the cluster heads and relevant base stations. Such a blockchain enhances credibility assurance and security while also providing a network authentication mechanism. The open-source Hyperledger Fabric Blockchain platform is deployed for the proposed model development. Base stations adopt a global blockchain approach to communicate with each other securely. The simulation results demonstrate that the proposed clustering algorithm performs well when compared to the earlier reported approaches. The proposed lightweight blockchain model is also shown to be better suited to balance network latency and throughput as compared to a traditional global blockchain.

The development of information technology has brought great convenience to our lives, but at the same time, the unfairness and privacy issues brought about by traditional centralized systems cannot be ignored. Blockchain is a peer-to-peer and decentralized ledger technology that has the characteristics of transparency, consistency, traceability and fairness, but it reveals private information in some scenarios. Secure multi-party computation (MPC) guarantees enhanced privacy and correctness, so many researchers have been trying to combine secure MPC with blockchain to deal with privacy and trust issues. In this paper, we used homomorphic encryption, secret sharing and zero-knowledge proofs to construct a publicly verifiable secure MPC protocol consisting of two parts—an on-chain computation phase and an off-chain preprocessing phase—and we integrated the protocol as part of the chaincode in Hyperledger Fabric to protect the privacy of transaction data. Experiments showed that our solution performed well on a permissioned blockchain. Most of the time taken to complete the protocol was spent on communication, so the performance has a great deal of room to grow.

With increased specialization of health care services and high levels of patient mobility, accessing health care services across multiple hospitals or clinics has become very common for diagnosis and treatment, particularly for patients with chronic diseases such as cancer. With informed knowledge of a patient's history, physicians can make prompt clinical decisions for smarter, safer, and more efficient care. However, due to the privacy and high sensitivity of electronic health records (EHR), most EHR data sharing still happens through fax or mail due to the lack of systematic infrastructure support for secure, trustable health data sharing, which can also cause major delays in patient care. Our goal was to develop a system that will facilitate secure, trustable management, sharing, and aggregation of EHR data. Our patient-centric system allows patients to manage their own health records across multiple hospitals. The system will ensure patient privacy protection and guarantee security with respect to the requirements for health care data management, including the access control policy specified by the patient. We propose a permissioned blockchain-based system for EHR data sharing and integration. Each hospital will provide a blockchain node integrated with its own EHR system to form the blockchain network. A web-based interface will be used for patients and doctors to initiate EHR sharing transactions. We take a hybrid data management approach, where only management metadata will be stored on the chain. Actual EHR data, on the other hand, will be encrypted and stored off-chain in Health Insurance Portability and Accountability Act-compliant cloud-based storage. The system uses public key infrastructure-based asymmetric encryption and digital signatures to secure shared EHR data. In collaboration with Stony Brook University Hospital, we developed ACTION-EHR, a system for patient-centric, blockchain-based EHR data sharing and management for patient care, in particular radiation treatment for cancer. The prototype was built on Hyperledger Fabric, an open-source, permissioned blockchain framework. Data sharing transactions were implemented using chaincode and exposed as representational state transfer application programming interfaces used for the web portal for patients and users. The HL7 Fast Healthcare Interoperability Resources standard was adopted to represent shared EHR data, making it easy to interface with hospital EHR systems and integrate a patient's EHR data. We tested the system in a distributed environment at Stony Brook University using deidentified patient data. We studied and developed the critical technology components to enable patient-centric, blockchain-based EHR sharing to support cancer care. The prototype demonstrated the feasibility of our approach as well as some of the major challenges. The next step will be a pilot study with health care providers in both the United States and Switzerland. Our work provides an exemplar testbed to build next-generation EHR sharing infrastructures.

Electronic health record (EHR) management systems require the adoption of effective technologies when health information is being exchanged. Current management approaches often face risks that may expose medical record storage solutions to common security attack vectors. However, healthcare-oriented blockchain solutions can provide a decentralized, anonymous and secure EHR handling approach. This paper presents PREHEALTH, a privacy-preserving EHR management solution that uses distributed ledger technology and an Identity Mixer (Idemix). The paper describes a proof-of-concept implementation that uses the Hyperledger Fabric’s permissioned blockchain framework. The proposed solution is able to store patient records effectively whilst providing anonymity and unlinkability. Experimental performance evaluation results demonstrate the scheme’s efficiency and feasibility for real-world scale deployment.

Blockchain technology is the most trusted all-in-one cryptosystem that provides a framework for securing transactions over networks due to its irreversibility and immutability characteristics. Blockchain network, as a decentralized infrastructure, has drawn the attention of various startups, administrators, and developers. This system preserves transactions from tampering and provides a tracking tool for tracing past network operations. A personal health record (PHR) system permits patients to control and share data concerning their health conditions by particular peoples. In the case of an emergency, the patient is unable to approve the emergency staff access to the PHR. Furthermore, a history record management system of the patient’s PHR is required, which exhibits hugely private personal data (e.g., modification date, name of user, last health condition, etc.). In this paper, we suggest a healthcare management framework that employs blockchain technology to provide a tamper protection application by considering safe policies. These policies involve identifying extensible access control, auditing, and tamper resistance in an emergency scenario. Our experiments demonstrated that the proposed framework affords superior performance compared to the state-of-the-art healthcare systems concerning accessibility, privacy, emergency access control, and data auditing.

From the last decade, pharmaceutical companies are facing difficulties in tracking their products during the supply chain process, allowing the counterfeiters to add their fake medicines into the market. Counterfeit drugs are analyzed as a very big challenge for the pharmaceutical industry worldwide. As indicated by the statistics, yearly business loss of around $200 billion is reported by US pharmaceutical companies due to these counterfeit drugs. These drugs may not help the patients to recover the disease but have many other dangerous side effects. According to the World Health Organization (WHO) survey report, in under-developed countries every 10th drug use by the consumers is counterfeit and has low quality. Hence, a system that can trace and track drug delivery at every phase is needed to solve the counterfeiting problem. The blockchain has the full potential to handle and track the supply chain process very efficiently. In this paper, we have proposed and implemented a novel blockchain and machine learning-based drug supply chain management and recommendation system (DSCMR). Our proposed system consists of two main modules: blockchain-based drug supply chain management and machine learning-based drug recommendation system for consumers. In the first module, the drug supply chain management system is deployed using Hyperledger fabrics which is capable of continuously monitor and track the drug delivery process in the smart pharmaceutical industry. On the other hand, the N-gram, LightGBM models are used in the machine learning module to recommend the top-rated or best medicines to the customers of the pharmaceutical industry. These models have trained on well known publicly available drug reviews dataset provided by the UCI: an open-source machine learning repository. Moreover, the machine learning module is integrated with this blockchain system with the help of the REST API. Finally, we also perform several tests to check the efficiency and usability of our proposed system.

Maritime Domain Awareness (MDA) is a strategic field of study that seeks to provide a coastal country with an effective monitoring of its maritime resources and its Exclusive Economic Zone (EEZ). In this scope, a Maritime Monitoring System (MMS) aims to leverage active surveillance of military and non-military activities at sea using sensing devices such as radars, optronics, automatic Identification Systems (AISs), and IoT, among others. However, deploying a nation-scale MMS imposes great challenges regarding the scalability and cybersecurity of this heterogeneous system. Aiming to address these challenges, this work explores the use of blockchain to leverage MMS cybersecurity and to ensure the integrity, authenticity, and availability of relevant navigation data. We propose a prototype built on a permissioned blockchain solution using HyperLedger Fabric—a robust, modular, and efficient open-source blockchain platform. We evaluate this solution’s performance through a practical experiment where the prototype receives sensing data from a Software-Defined-Radio (SDR)-based low-cost AIS receiver built with a Raspberry Pi. In order to reduce scalability attrition, we developed a dockerized blockchain client easily deployed on a large scale. Furthermore, we determined, through extensive experimentation, the client optimal hardware configuration, also aiming to reduce implementation and maintenance costs. The performance results provide a quantitative analysis of the blockchain technology overhead and its impact in terms of Quality of Service (QoS), demonstrating the feasibility and effectiveness of our solution in the scope of an MMS using AIS data.

Providing security and privacy to the Internet of Things (IoT) networks while achieving it with minimum performance requirements is an open research challenge. Blockchain technology, as a distributed and decentralized ledger, is a potential solution to tackle the limitations of the current peer-to-peer IoT networks. This paper presents the development of an integrated IoT system implementing the permissioned blockchain Hyperledger Fabric (HLF) to secure the edge computing devices by employing a local authentication process. In addition, the proposed model provides traceability for the data generated by the IoT devices. The presented solution also addresses the IoT systems’ scalability challenges, the processing power and storage issues of the IoT edge devices in the blockchain network. A set of built-in queries is leveraged by smart-contracts technology to define the rules and conditions. The paper validates the performance of the proposed model with practical implementation by measuring performance metrics such as transaction throughput and latency, resource consumption, and network use. The results show that the proposed platform with the HLF implementation is promising for the security of resource-constrained IoT devices and is scalable for deployment in various IoT scenarios.