A Framework for Securing Health Information Using Blockchain in Cloud Hosted Cyber Physical Systems

Electronic Health Records (EHRs) have undergone numerous technical improvements in recent years, including the incorporation of mobile devices with the cloud computing technologies to facilitate medical data exchanges between patients and the healthcare professionals. This cutting-edge architecture enables cyber physical systems housed in the cloud to provide healthcare services with minimal operational costs, high flexibility, security, and EHR accessibility. If patient health information is stored in the hospital database, there will always be a risk of intrusion, i.e., unauthorized file access and information modification by attackers. To address this concern, we propose a decentralized EHR system based on Blockchain technology. To facilitate secure EHR exchange across various patients and medical providers, we develop a reliable access control method based on smart contracts. We incorporate Cryptocurrency, specifically Ethereum, in the suggested system to protect sensitive health information from potential attackers. In our suggested approach, both physicians and patients are required to be authenticated. Patients can register, and a block with a unique hash value will be generated. Once the patient discusses the disease with the physician, the physician can check the patient's condition and offer drugs. For experimental findings, we employ the public Block chain Ganache and solidity remix-based smart contracts to protect privacy. Ethers are used as the crypto currencies

A novel architecture for tamper proof electronic health record management system using blockchain wrapper

In this paper, we present a novel architecture of blockchain-based tamper-proof electronic health record (EHR) management system. Recording electronic health data in cloud-based storage systems always pose a threat to information security. Intruders can delete or tamper EHR of patients, giving benefits to insurance companies or hiding medical malpractices (e.g. misdiagnosis and delayed diagnosis). A tamper-proof EHR management system is required that would essentially solve such issues. The blockchain is an emerging technology that can be adapted to develop a tamper-proof data management system. However, establishing a new blockchain based system replacing the existing system is expensive. In our proposed architecture, we introduce a wrapper layer integration mechanism, named as the blockchain handshaker, between the existing cloud-based EHR management system and public blockchain network to develop a tamper-proof health record management system. We implement a prototype to provide evidence on the feasibility of the proposed concept. - 2019 Association for Computing Machinery.Scopu

Enhancing healthcare services through cloud service: a systematic review

Although cloud-based healthcare services are booming, in-depth research has not yet been conducted in this field. This study aims to address the shortcomings of previous research by analyzing all journal articles from the last five years using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) systematic literature review methodology. The findings of this study highlight the benefits of cloud-based healthcare services for healthcare providers and patients, including enhanced healthcare services, data security, privacy issues, and innovative information technology (IT) service delivery models. However, this study also identifies challenges associated with using cloud services in healthcare, such as security and privacy concerns, and proposes solutions to address these issues. This study concludes by discussing future research directions and the need for a complete solution that addresses the conflicting requirements of the security, privacy, efficiency, and scalability of cloud technologies in healthcare

Advancing Healthcare Security: A Cutting-Edge Zero-Trust Blockchain Solution for Protecting Electronic Health Records

The effective management of electronic health records (EHRs) is vital in healthcare. However, traditional systems often need help handling data inconsistently, providing limited access, and coordinating poorly across facilities. This study aims to tackle these issues using blockchain technology to improve EHR systems' data security, privacy, and interoperability. By thoroughly analyzing blockchain's applications in healthcare, we propose an innovative solution that leverages blockchain's decentralized and immutable nature, combined with advanced encryption techniques such as the Advanced Encryption Standard and Zero Knowledge Proof Protocol, to fortify EHR systems. Our research demonstrates that blockchain can effectively overcome significant EHR challenges, including fragmented data and interoperability problems, by facilitating secure and transparent data exchange, leading to enhanced coordination, care quality, and cost-efficiency across healthcare facilities. This study offers practical guidelines for implementing blockchain technology in healthcare, emphasizing a balanced approach to interoperability, privacy, and security. It represents a significant advancement over traditional EHR systems, boosting security and affording patients greater control over their health records. Doi: 10.28991/HIJ-2023-04-03-012 Full Text: PD

Security for networked smart healthcare systems: A systematic review

Background and Objectives Smart healthcare systems use technologies such as wearable devices, Internet of Medical Things and mobile internet technologies to dynamically access health information, connect patients to health professionals and health institutions, and to actively manage and respond intelligently to the medical ecosystem's needs. However, smart healthcare systems are affected by many challenges in their implementation and maintenance. Key among these are ensuring the security and privacy of patient health information. To address this challenge, several mitigation measures have been proposed and some have been implemented. Techniques that have been used include data encryption and biometric access. In addition, blockchain is an emerging security technology that is expected to address the security issues due to its distributed and decentralized architecture which is similar to that of smart healthcare systems. This study reviewed articles that identified security requirements and risks, proposed potential solutions, and explained the effectiveness of these solutions in addressing security problems in smart healthcare systems. Methods This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines and was framed using the Problem, Intervention, Comparator, and Outcome (PICO) approach to investigate and analyse the concepts of interest. However, the comparator is not applicable because this review focuses on the security measures available and in this case no comparable solutions were considered since the concept of smart healthcare systems is an emerging one and there are therefore, no existing security solutions that have been used before. The search strategy involved the identification of studies from several databases including the Cumulative Index of Nursing and Allied Health Literature (CINAL), Scopus, PubMed, Web of Science, Medline, Excerpta Medical database (EMBASE), Ebscohost and the Cochrane Library for articles that focused on the security for smart healthcare systems. The selection process involved removing duplicate studies, and excluding studies after reading the titles, abstracts, and full texts. Studies whose records could not be retrieved using a predefined selection criterion for inclusion and exclusion were excluded. The remaining articles were then screened for eligibility. A data extraction form was used to capture details of the screened studies after reading the full text. Of the searched databases, only three yielded results when the search strategy was applied, i.e., Scopus, Web of science and Medline, giving a total of 1742 articles. 436 duplicate studies were removed. Of the remaining articles, 801 were excluded after reading the title, after which 342 after were excluded after reading the abstract, leaving 163, of which 4 studies could not be retrieved. 159 articles were therefore screened for eligibility after reading the full text. Of these, 14 studies were included for detailed review using the formulated research questions and the PICO framework. Each of the 14 included articles presented a description of a smart healthcare system and identified the security requirements, risks and solutions to mitigate the risks. Each article also summarized the effectiveness of the proposed security solution. Results The key security requirements reported were data confidentiality, integrity and availability of data within the system, with authorisation and authentication used to support these key security requirements. The identified security risks include loss of data confidentiality due to eavesdropping in wireless communication mediums, authentication vulnerabilities in user devices and storage servers, data fabrication and message modification attacks during transmission as well as while the data is at rest in databases and other storage devices. The proposed mitigation measures included the use of biometric accessing devices; data encryption for protecting the confidentiality and integrity of data; blockchain technology to address confidentiality, integrity, and availability of data; network slicing techniques to provide isolation of patient health data in 5G mobile systems; and multi-factor authentication when accessing IoT devices, servers, and other components of the smart healthcare systems. The effectiveness of the proposed solutions was demonstrated through their ability to provide a high level of data security in smart healthcare systems. For example, proposed encryption algorithms demonstrated better energy efficiency, and improved operational speed; reduced computational overhead, better scalability, efficiency in data processing, and better ease of deployment. Conclusion This systematic review has shown that the use of blockchain technology, biometrics (fingerprints), data encryption techniques, multifactor authentication and network slicing in the case of 5G smart healthcare systems has the potential to alleviate possible security risks in smart healthcare systems. The benefits of these solutions include a high level of security and privacy for Electronic Health Records (EHRs) systems; improved speed of data transaction without the need for a decentralized third party, enabled by the use of blockchain. However, the proposed solutions do not address data protection in cases where an intruder has already accessed the system. This may be potential avenues for further research and inquiry

Sdhcare: Secured Distributed Healthcare System

In the healthcare sector, the move towards Electronic Health Records (EHR) systems has been accelerating in parallel with the increased adoption of IoT and smart devices. This is driven by the anticipated advantages for patients and healthcare providers. The integration of EHR and IoT makes it highly heterogeneous in terms of devices, network standards, platforms, types of data, connectivity, etc. Additionally, it introduces security, patient and data privacy, and trust challenges. To address such challenges, this thesis proposes an architecture that combines biometric-based blockchain technology with the EHR system. More specifically, this thesis describes a mechanism that uses a patient’s fingerprint for recovery of patient’s access control on their EHRs securely without compromising their privacy and identity. A secure distributed healthcare system (SDHCARE) is proposed to uniquely identify patients, enable them to control access to, and ensure recoverable access to their EHRs that are exchanged and synchronized between distributed healthcare providers. The system takes into account the security and privacy requirements of Health Insurance Portability and Accountability Act (HIPAA) compliance, and it overcomes the challenges of using secret keys as a patient’s identity to control access to EHRs. The system used distributed architecture with two layers being local to each healthcare provider that is a member of SDHCARE, and two layers shared across all members of SDCHARE system. SDHCARE system was prototyped and implemented in order to validate its functional requirements, security requirements, and to evaluate its performance. The results indicated successful fulfillment of design requirements without significant overhead on the performance as required by healthcare environment