A secure and interoperable blockchain-based information sharing system for healthcare providers in developing countries

A Dissertation Submitted in Partial Fulfilment of the Requirements for the Degree of Doctor of Philosophy in Information and Communication Sciences and Engineering of the Nelson Mandela African Institution of Science and TechnologySystems in the health sector are very crucial for human life and they should be efficient, reliable and secure. Unfortunately, electronic health record (EHR) systems do not work effectively when managing multi-institutional medical records. The EHR, which is a digital system in which patient health information is systematically stored. The information stored includes medical history, laboratory test results, demographics, and billing information, poses problems to patients related to interoperability, privacy, and data integrity. Most solutions to these threats focus on a centralized architecture that faces a single point of failure and internal threats, such as unreliable system administrators. The promising solution that many researchers are interested in is the use of blockchains. However, in developing countries, and particularly in sub-Saharan Africa, very little attention has been given to the issues of interoperability, privacy and data integrity for EHRs using blockchain technology. As such, this research has designed and developed self-sovereign identity management and secure information sharing system for health systems in developing countries, based on blockchain technology, which helps to solve the mentioned problems. The study used a Design Science Research (DSR) methodology to develop solutions to the research problem through three sub studies. The first and the second sub studies conducted under problem awareness and suggestion phases of DSR, and third sub study conducted under development and evaluation phases of DSR. The first sub study deal with the assessment of three most common blockchain based healthcare systems (MedicalChain, Patientory, and MediLedger). The second sub study studies the problem of existing EHR systems in Tanzania regarding privacy issues in identity management and secure sharing of medical data from one healthcare facility to the other. The third sub study deal with the development of two systems, one for identity management using blockchain (self-sovereign identity), and one for secure sharing of medical data from one healthcare facility to another through blockchain technology. The systems provide additional privacy protection tools to the existing infrastructures. They reduce development cost, transparency, data integrity, protection against single-point-offailure vulnerabilities, and prevention of internal threats such as untrusted system administrators. The systems will make the existing and future health information systems trustable to healthcare service providers and the end-users of the healthcare systems. Also, will help the stakeholders in the healthcare sector to properly manage the healthcare systems

Design of Land Administration and Title Registration Model Based on Blockchain Technology

Land administration and title registration system is the system for storing land title information and managing transactions involving land titles. Due to the sensitivity of land issues, land administration and title registration system should be strong to avoid any document forgery, available all the time, and take a short time to complete tasks. Thus, this study aims at designing a model for such system based on blockchain technology. The proposed model is designed using UML diagrams and then tested for verification using statistical usage models (Markov chains). The proposed model integrates the Integrated Land Management Information System (ILMIS) with factom and bitcoin blockchains which enables encryption of information from ILMIS to get the fingerprint information of each land title and store it to the blockchains. The model further encrypts the land information from ILMIS when needed and then compare it with fingerprints from blockchains for verification. Such implementation of the proposed model will help ILMIS to have the capability of providing tamper proof for stored data, providing the self-notarization mechanism, and availability of evidence for the land title from distributed databases. Furthermore, the society is expected to benefit from this study as the time and cost for registering land title will decrease and the possibilities of a piece of land having more than one owner will not be there. Keywords: Blockchain, Bitcoin Blockchain, Factom Blockchain, Land Management System, Model Design.

A review on healthcare information systems and consensus protocols in blockchain technology

This research article published by the International Journal of Advanced Technology and Engineering Exploration, Vol 5(49), 2018Blockchain is a distributed ledger technology whereby transactions are bundled into blocks that are chained together cryptographically by hash pointers. Blockchain solutions add trust and privacy to the existing internet due to its tampering resistance and advanced cryptography characteristics. In healthcare systems, the technology has been implemented to ensure transparency, auditability, interoperability, and proper governance and management of patient information. This study evaluates blockchain based healthcare systems. Three most common systems were chosen from public, private/consortium blockchains. The evaluation was done using framework for performance monitoring for blockchain systems. To describe resource usage, we used five performance evaluation metrics i.e. memory consumption, disk write and read performance, network data utilization, transaction execution per unit time, and central processing unit (CPU) usage. The study revealed that the system developed using consortium-based platform outperformed private and public blockchain for more transactions per unit time, and proper utilization of resources of connected nodes such as CPU, Memory, and Disk storage

Blockchain-based Data Storage Security Architecture for e-Health Care Systems: A Case of Government of Tanzania Hospital Management Information System

A research article was published by IJCSNS International Journal of Computer Science and Network Security, VOL.22 No.3, March 2022Health information systems (HIS) are facing security challenges on data privacy and confidentiality. These challenges are based on centralized system architecture creating a target for malicious attacks. Blockchain technology has emerged as a trending technology with the potential to improve data security. Despite the effectiveness of this technology, still HIS are suffering from a lack of data privacy and confidentiality. This paper presents a blockchain-based data storage security architecture integrated with an e-Health care system to improve its security. The study employed a qualitative research method where data were collected using interviews and document analysis. Execute-order-validate Fabric’s storage security architecture was implemented through private data collection, which is the combination of the actual private data stored in a private state, and a hash of that private data to guarantee data privacy. The key findings of this research show that data privacy and confidentiality are attained through a private data policy. Network peers are decentralized with blockchain only for hash storage to avoid storage challenges. Cost-effectiveness is achieved through data storage within a database of a Hyperledger Fabric. The overall performance of Fabric is higher than Ethereum. Ethereum’s low performance is due to its execute-validate architecture which has high computation power with transaction inconsistencies. E-Health care system administrators should be trained and engaged with blockchain architectural designs for health data storage security. Health policymakers should be aware of blockchain technology and make use of the findings. The scientific contribution of this study is based on; cost-effectiveness of secured data storage, the use of hashes of network data stored in each node, and low energy consumption of Fabric leading to high performanc

Blockchain Technology in Sub-Saharan Africa: Where does it fit in Healthcare Systems: A case of Tanzania

This research article published by the Journal of Health Informatics in Developing Countries, 2019Background: Blockchain technology is a distributed electronic ledger containing digital records, transactions or events that are protected with advanced encryptions, extremely hard to tamper, and updateable through a consensus algorithm agreeable to all connected network nodes. In Sub-Sahara Africa, the technology has started to be adopted in real estate, supply chain, agriculture, and financial sector. Unfortunately, there is a lack of effort in introducing this technology in the healthcare sector. Therefore, this study aims to explore the issues facing electronic healthcare systems in Sub-Sahara Africa taking Tanzania as a case study and introduce blockchain-based solutions for the discovered issues. Methods: The study used qualitative methods for data collection and analysis. Data were collected through interviews, observation and documentary analysis. Interviews were done with the sample size of 50 participants who were selected from groups of healthcare facility leaders, ICT experts, government representatives, doctors, nurses, laboratory technicians, pharmacists, accountants, and receptionists. Direct observation and participatory observation were used to assess different electronic healthcare records systems’ functions. Moreover, researchers used document analysis to collect data from public records (like policy manuals), personal documents (like incident reports), and physical evidence (like training materials and handbooks). NVivo 11 software was applied in managing and organizing data analysis. Results: Out of 710 healthcare facilities involved in this study, 34.5% fully implemented electronic healthcare records systems and 78% installed Mfumo wa Taarifa za Uendeshaji Huduma za Afya (MTUHA) also known as (District Health Information Software (DHIS) II). The findings showed that the issues facing electronic healthcare records are; difficulties in taking care of the patients’ private information, problems in safely sharing medical information between healthcare facilities, bandwidth issues, and improper handling of data integrity