Blockchain-Based Internet of Medical Things

Blockchain-Based Internet of Medical Things: History

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Subjects: Computer Science, Information Systems

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The Internet of Things (IoT) or other decentralized platforms may be employed in this context for achieving dispersed coverage. In light of this, healthcare systems are a crucial IoT application. Internet of Medical Things (IoMT) is the kind of IoT that is used in the healthcare industry. IoMTs are the wave of the future in healthcare since they will enable the connectivity and remote monitoring of all medical equipment. Due to these developments, healthcare may now be provided more rapidly and at a lower cost. Medical workers (nurses, physicians, etc.), medical data servers, and medical sensor equipment make up the bulk of an IoMT system that provides remote healthcare.

Internet of Medical Things
IoMT
blockchain

1. Introduction

Securely recovering and correctly managing the amount of individual health data created by delivering service operations and normal business is a major challenge for the healthcare industry. Most of the health data is not easy to access or standardized across systems, and is difficult to interchange, utilize, and understand. They are compiled from several locations and stored in centralized information technology systems, making them challenging to share and administer. Time and energy are required to synthesize, receive, send, and request medical information [1]. Safe data retrieval and management enable healthcare systems to improve health outcomes, communication, treatment quality, and patient views in their entirety [2].

Legacy systems are notorious for being incompatible with newer technologies and for only being able to communicate with other healthcare and medical systems on a limited scale. Data shows various advantages of integrating these networks for better and linked healthcare; however, researchers in health informatics should consider interconnection across different companies [3]. One of the biggest challenges in this area is multi-organizational data sharing, which requires healthcare providers to make their patients’ medical records freely accessible to other organizations, including research or physician institutions [4].

2. Blockchain-Based Internet of Medical Things

IoMT has significant benefits for human health, including improved quality of life and reduced healthcare costs [13]. The healthcare industry stands to save as much as USD 300 billion annually if it adopts IoMT devices, notably for telemedicine and chronic diseases. Investing in the IoMT is lucrative since it brought in USD 28 billion in 2017 and is projected to bring in USD 135 billion by 2025 [21]. Key elements, as shown in Figure 4, are wireless sensors that may be used to perform remote monitoring of patient’s health states and communication technologies to relay that data to healthcare providers.

Figure 4. Conceptual design for the IoMT.

Because of its sensitivity, volume, and importance, medical data requires rigorous guarding [22]. Furthermore, blockchain technology is paving the way for innovative approaches to healthcare data management, access control, sharing, retrieval, storage, and more [23]. Now that blockchain technology is introduced, researchers are more focused on employing blockchain strategies to ensure the security of applications in healthcare [24]. IoMT problems emerged as soon as IoT systems started incorporating medical devices. The lack of consistency is a major barrier. The extensive application of blockchain technology in healthcare is expected to bring along a rise to new “smart” healthcare provider applications that sidestep the latest medical research and create individualized pathways to address the situations [25]. The same level of access to information will be provided for both the patient and the healthcare professionals allowing them to engage in a productive dialogue based on hard facts about the best course of therapy for the patient’s illness [26,27].

Several recent studies have focused on the potential of blockchain technology in the healthcare sector [28,29,30,31,32]. Blockchain technology has made a significant impact on the healthcare sector in terms of transforming digitally in recent years. Blockchain applications for healthcare data management facilitate the regulation of patient record access, the handling of payments and claims, the protection of IoMT [33], and the verification and exchange of research results for financial audits [34] and transparency. To handle, analyze, and make sense of patient health data, the main features of blockchain, including encrypted and distributed ledgers that are updated in real time, are employed [35]. Conceptually, there are layers to access technologies that are new in the blockchain-based healthcare area including healthcare applications, stakeholders, data sources, and blockchain technology [36]. Daisuke et al. [37] employed Hyperledger fabric blockchain technology to transport medical data to the Hyperledger blockchain network, with a particular emphasis on medical records. Telephones were used to collect medical records. The goal of their work was to use the blockchain to record medical records.

There are a number of different approaches in which blockchain technology might improve healthcare for patients, doctors, and scientists [38]. The benefits of customized and research treatment will be maximized by establishing granular data access rights, monitoring individualized data in real-time, and building a central repository for all health data [39]. To better manage healthcare data, Anuraag et al. [40] looked at blockchain technology. They considered a wide range of articles for their research; much of it speculated about the advantages and disadvantages of using blockchain technology in the healthcare industry without providing proof or a system evaluation. The group has finished debating whether or not blockchain technology is more suitable than existing solutions for managing patients’ health information in the cloud without compromising patient confidentiality. When it comes to healthcare management, Khezr et al. [41] found several problems that may be solved with the use of blockchain technology. They highlighted the current research on the application of distributed ledger technology in healthcare and numerous prospective medical applications where blockchain technology may play a critical role in improving efficiency. They also proposed a way for delivering IoMT over existing network infrastructure.

Researchers in the healthcare field are reliant on large sets of data to construct tailored therapies that are based on lifetime, the environment, and genetics, promptly monitoring the development of novel pharmaceuticals, accelerating biomedical discovery, and expanding understanding of the condition [42]. The shared data system in the blockchain would provide a diversified collection of data [43,44] if it included patients from a wide range of ethnic, socioeconomic, and geographical backgrounds. As blockchain records medical information over a person’s whole life, it is well suited for longitudinal studies [45]. Through the use of a healthcare blockchain, those who are underserved by the medical community or who are not generally engaged in research may be included in studies [46]. Because of blockchain’s shared data environment, it is much easier to include formerly difficult-to-reach communities and boost public confidence in the reliability of results [47]. Smart healthcare systems, as can be guessed, need copious amounts of data sharing between medical professionals and their respective tools [48].

A “blockchain” was developed to link all the databases on the network to address this issue. As time goes on, blocks of data are added to a distributed ledger and secured using cryptographic hashing in what is known as a blockchain. Each record includes a cryptographic hash of the previous record to prevent constant unnecessary modifications [49]. A blockchain is recognized by its immutable “ledger,” which implies that once a record is recorded, it cannot be changed in any manner and is available to individuals and under their control. This is the basic aspect of the smart contract system with which the blockchain conforms to the maintenance of one’s identity. Therefore, only licensed medical professionals are allowed to access patient electronic medical records (EMRs) [50]. The “MedBlock” is a blockchain-based information management system that provides immediate EMR access and retrieval [51] thanks to its secure access control and encryption. Vangipuram et al. [52] developed a blockchain implementation and edge architecture called the “Healthcare Data Gateway” (HDG) to ensure the privacy of medical records for COVID-19 patients being transferred to hospitals. To combat the spread of the COVID-19 virus, Alsamhi et al. [53] developed a blockchain setup for a distributed network of robots.

The benefits of employing blockchain technology are outlined below. These include open architecture, trustless consensus, transparency, tamper-proofing, smart contracts, and a distributed ledger [59].

The term “open architecture” refers to a kind of technological infrastructure whose developers provide detailed plans for the system. It encompasses both government-sanctioned norms and custom-built structures.
Trustless consensus: since distributed consensus is at the heart of blockchain-based IoMT applications, relying on third-party trusted intermediaries such as banks and governments is unnecessary.
Transparency: all peers in the network may see all data that is recorded in a block, and the data cannot be modified once it is recorded. To combat problems like counterfeit pharmaceuticals, for instance, it is possible to verify and secure critical drug information by tracking every transaction between drug makers, pharmacists, and patients. The capacity to track where drugs came from will result.
Recordings cannot be tampered with, so any attempts to steal or modify patients’ health records are easily uncovered. The dishonest practice of manipulating or altering data from clinical studies, for instance, might be eliminated.
In situations where rule-based approaches to patient data access are developed, smart contracts are likely to be utilized to ensure that only authorized parties have access to that data. In this section, authorization for certain medical institutions might be made. Smart contracts may be employed to define the behavior of IoMT applications, automate routine tasks, and provide secure two-way communication and financial transactions between IoMT devices and third parties including patients, and physicians.
Because of its decentralized design, the blockchain cannot be hacked or brought down by any one central authority.

Some of the privacy and security benefits that may be realized when a blockchain is integrated with IoMT systems are provided in the following:

To ensure that only those who need access to a patient’s medical records do so by the rules put out by the lawful administrator, smart contracts may give access to control property.
Each participant in an IoMT system values their privacy and does not want it invaded in any way by the exchange of information. The digital identity of the transactions is used by blockchain to make transactional data unreadable to other parties.
CIA (confidentiality, integrity, availability): because the blocks containing data are signed, blockchain provides high levels of integrity protection. In addition, the linking through hashes and the unanimity requirement make it very difficult, if not impossible, to alter the contents inside a block. In addition, a complete version of the data is copied and stored in all nodes, which means a high degree of availability is supplied by construction.

Blockchain is an immutable and append-only database that allows for auditable and transparent data management [61]. A hash of the prior block is stored in each block, and the whole structure is implemented as a linked list [62]. The scalability problem is a major issue with blockchain and has been examined at length in [63,64]. The difficulty of scaling blockchain-based Internet of Things applications is addressed in detail in several recent publications [65,66]. Blockchains have scalability issues due to inefficient architecture and consensus procedures [67].

With bitcoin, for instance, the transaction confirmation time is around 10 min, and 7 transactions per second may happen. Companies such as Visa, which handle large volumes of transactions, have a throughput of roughly 24,000 per second. When discussing blockchain scalability, the following metrics are of primary interest [68]:

Transaction latency is the time it takes for a payment to be approved. There are other measures, such as bootstrap time and cost per confirmed transaction (CPCT) for the approval process.
If you want to know how many transactions per second a blockchain can confirm, you need to know the maximum block size and the average block duration.

3. Conclusions

A growing number of people are paying attention to the blockchain-based Internet of Medical Things (IoMT) since not only it is likely to reduce healthcare costs but also it can enhance the quality of treatment by relying on continuous and real-time continuous monitoring. IoMT sensor nodes, Internet of Things (IoT) wearable medical devices, patients, healthcare facilities, and insurance companies are just some of the numerous entities that are increasingly being included in IoMT systems. As scalability is one of the key features of blockchain technology, it is challenging to develop a blockchain framework for such systems.

This entry is adapted from the peer-reviewed paper 10.3390/app13031287

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