journal article·2019-04-01Open access

Proof-of-Familiarity: A Privacy-Preserved Blockchain Scheme for Collaborative Medical Decision-Making

Jinhong Yang, Md Mehedi Hassan Onik, Nam-Yong Lee, Mohiuddin Ahmed, Chul-Soo Kim

Applied Sciences· Volume 9· Issue 7

Abstract

The current healthcare sector is facing difficulty in satisfying the growing issues, expenses, and heavy regulation of quality treatment. Surely, electronic medical records (EMRs) and protected health information (PHI) are highly sensitive, personally identifiable information (PII). However, the sharing of EMRs, enhances overall treatment quality. A distributed ledger (blockchain) technology, embedded with privacy and security by architecture, provides a transparent application developing platform. Privacy, security, and lack of confidence among stakeholders are the main downsides of extensive medical collaboration. This study, therefore, utilizes the transparency, security, and efficiency of blockchain technology to establish a collaborative medical decision-making scheme. This study considers the experience, skill, and collaborative success rate of four key stakeholders (patient, cured patient, doctor, and insurance company) in the healthcare domain to propose a local reference-based consortium blockchain scheme, and an associated consensus gathering algorithm, proof-of-familiarity (PoF). Stakeholders create a transparent and tenable medical decision to increase the interoperability among collaborators through PoF. A prototype of PoF is tested with multichain 2.0, a blockchain implementing framework. Moreover, the privacy of identities, EMRs, and decisions are preserved by two-layer storage, encryption, and a timestamp storing mechanism. Finally, superiority over existing schemes is identified to improve personal data (PII) privacy and patient-centric outcomes research (PCOR).
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Blockchain Technology Applications and Security

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Healthcare and IT, Inje University, Gimhae 50834, Korea

Department of Computer Engineering, Inje University, Gimhae 50834, Korea

Department of Applied Mathematics, Inje University, Gimhae 50834, Korea

School of Science, Edith Cowan University, Perth 6027, Australia

Funding

Institute for Information and communications Technology Promotion

References (85)

Show source-provided references
1. Collaborative medical decision making10.1177/0272989X9301300410 ↗
2. Dowell, J., Williams, B., and Snadden, D. (2018). Patient-Centered Prescribing: Seeking Concordance in Practice, CRC Press.10.1201/9781315375694 ↗
3. (1982). Making Health Care Decisions, President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Report.
4. (2018, December 21). Accenture. Available online: https://www.accenture.com/t20170411T012518__w__/us-en/_acnmedia/PDF-43/Accenture-Health-Are-You-One-Breach-Away-From-Losing-a-Healthcare-Consumer.pdf.
5. Lord, N. (2018, December 21). Top 10 Biggest Healthcare Data Breaches. Available online: https://digitalguardian.com/blog/top-10-biggest-healthcare-data-breaches-all-time.
6. Infrequent pattern mining in smart healthcare environment using data summarization10.1007/s11227-018-2376-8 ↗
7. Chaudhry, J., Qidwai, U., Miraz, M.H., Ibrahim, A., and Valli, C. (2017). Data Security among ISO/IEEE 11073 Compliant Personal Healthcare Devices through Statistical Fingerprinting, Institute of Electrical and Electronics Engineers.
8. Jahan, S., Chowdhury, M., Islam, R., and Chaudhry, J. (2017, January 22–25). Securing Healthcare Data Using Biometric Authentication. Proceedings of the Security and Privacy in Communication Networks: SecureComm 2017 International Workshops, ATCS and SePrIoT, Niagara Falls, ON, Canada.
9. Saleem, K., Tan, Z., and Buchanan, W. (2017). Security for cyber-physical systems in healthcare. Health 4.0: How Virtualization and Big Data are Revolutionizing Healthcare, Springer.10.1007/978-3-319-47617-9_12 ↗
10. (2018, November 21). Identity Theft Resource Center (ITRC). Available online: https://www.idtheftcenter.org/images/breach/2017Breaches/2017AnnualDataBreachYearEndReview.pdf.
11. Ahmed, M., and Ullah, A.S.S.M.B. (2017). False Data Injection Attacks in Healthcare. Proceedings of the Australasian Conference on Data Mining, Springer.10.1007/978-981-13-0292-3_12 ↗
12. Snell, E. (2017). Healthcare data breach costs highest for 7 th straight year. Heal. IT Secur., 20, Available online: https//healthitsecurity. com/news/healthcare-data-breach-costshighest-for-7th-straight-year.
13. Review of electronic patient-reported outcomes systems used in cancer clinical care10.1200/JOP.2013.001067 ↗
14. Collaborative affordances of medical records10.1007/s10606-017-9298-5 ↗
15. Shared decision-making in the paediatric field: A literature review and concept analysis10.1111/scs.12496 ↗
16. Patient engagement in healthcare: Pathways for effective medical decision making
17. Thomas, P.A., Kern, D.E., Hughes, M.T., and Chen, B.Y. (2015). Curriculum Development for Medical Education: A Six-Step Approach, JHU Press.
18. Forecasting, uncertainty and risk; perspectives on clinical decision-making in preventive and curative medicine10.1016/j.ijforecast.2017.11.003 ↗
19. Hesse, F., Care, E., Buder, J., Sassenberg, K., and Griffin, P. (2015). A framework for teachable collaborative problem solving skills. Assessment and Teaching of 21st Century Skills, Springer.10.1007/978-94-017-9395-7_2 ↗
20. (2018, December 10). HIPAA (Office for Civil Rights). Available online: https://www.hipaajournal.com/healthcare-data-breach-statistics/.
21. Factors determining the success and failure of ehealth interventions: Systematic review of the literature10.2196/10235 ↗
22. Burke, W., Oseni, T., Jolfaei, A., and Gondal, I. (2019, January 29–31). Cybersecurity Indexes for eHealth. Proceedings of the Australasian Computer Science Week Multiconference, Sydney, Australia.10.1145/3290688.3290721 ↗
23. Ahmed, M., and Ullah, A.S.S.M.B. (2018). Health Care Security Analytics. Data Analytics, CRC Press.10.1201/9780429446177-16 ↗
24. Patient Privacy in the Era of Big Data10.4274/balkanmedj.2017.0966 ↗
25. Miraz, M.H., and Ali, M. (arXiv, 2018). Applications of Blockchain Technology beyond Cryptocurrency, arXiv.10.33166/AETiC.2018.01.001 ↗
26. European union data privacy law reform: General data protection regulation, privacy shield, and the right to delisting
27. (2018, December 21). GDPR-EU. Available online: https://gdpr-info.eu/art-4-gdpr/.
28. Fhirchain: Applying blockchain to securely and scalably share clinical data10.1016/j.csbj.2018.07.004 ↗
29. Zhang, P., White, J., Schmidt, D.C., and Lenz, G. (arXiv, 2017). Applying software patterns to address interoperability in blockchain-based healthcare apps, arXiv.
30. (2018, December 25). Chainforg Blockchain and GDPR. Available online: http://www.chainfrog.com/wp-content/uploads/2017/08/gdpr.pdf.
31. Patient activation and health literacy: What’s the difference? How do each contribute to health outcomes
32. (2018, May 15). Blockchain: Technology Fundamentals of the Trust Machine. Available online: https://www.legalanalytics.law.cuhk.edu.hk/single-post/2017/12/23/Blockchain-Technology-Fundamentals-of-the-Trust-Machine.
33. Kuo, T.-T., and Ohno-Machado, L. (arXiv, 2018). ModelChain: Decentralized Privacy-Preserving Healthcare Predictive Modeling Framework on Private Blockchain Networks, arXiv.
34. Realizing the potential of blockchain technologies in genomics10.1101/gr.207464.116 ↗
35. (2018, June 15). Bitcoin: A Peer-to-Peer Electronic Cash System. Available online: https://bitcoin.org/en/bitcoin-paper.
36. Chuen, D.L.E.E.K., and Deng, R.H. (2017). Handbook of Blockchain, Digital Finance, and Inclusion: Cryptocurrency, FinTech, InsurTech, Regulation, ChinaTech, Mobile Security, and Distributed Ledger, Academic Press.
37. Practical Byzantine fault tolerance
38. Vasin, P. (2018, October 10). Blackcoin’s Proof-of-Stake Protocol v2. Available online: https//blackcoin.co/blackcoin-pos-protocolv2-whitepaper.pdf.
39. The Ripple protocol consensus algorithm
40. Kwon, J. (2018, December 10). Tendermint: Consensus without Mining. Available online: https//tendermint.com/static/docs/tendermint.pdf.
41. Castor, A. (2018, December 10). A (Short) Guide to Blockchain Consensus Protocols. Available online: http//www. coindesk.com/short-guide-blockchain-consensus-protocols.
42. (2019, January 10). The Global Fintech Report. Available online: https://www.pwc.com/gx/en/industries/financial-services/assets/pwc-global-fintech-report-2017.pdf.
43. Cocco, L., Pinna, A., and Marchesi, M. (2017). Banking on blockchain: Costs savings thanks to the blockchain technology. Futur. Internet, 9.10.3390/fi9030025 ↗
44. Panarello, A., Tapas, N., Merlino, G., Longo, F., and Puliafito, A. (2018). Blockchain and IoT integration: A systematic survey. Sensors, 18.10.3390/s18082575 ↗
45. Zyskind, G., and Nathan, O. (2015, January 21–22). Decentralizing privacy: Using blockchain to protect personal data. Proceedings of the Security and Privacy Workshops (SPW), San Jose, CA, USA.10.1109/SPW.2015.27 ↗
46. Onik, M.M.H., Miraz, M.H., and Kim, C.-S. (2018, January 22–23). A Recruitment and Human Resource Management Technique using Blockchain Technology for Industry 4.0. Proceedings of the Smart Cities Symposium (SCS-2018), Manama, Bahrain.10.1049/cp.2018.1371 ↗
48. Miraz, M.H., and Donald, D.C. (arXiv, 2018). Application of Blockchain in Booking and Registration Systems of Securities Exchanges, arXiv.10.1109/iCCECOME.2018.8658726 ↗
49. Al-Zaben, N., Onik, M.M.H., Yang, J., Lee, N.-Y., and Kim, C.-S. (2018, January 16–17). General Data Protection Regulation Complied Blockchain Architecture for Personally Identifiable Information Management. Proceedings of the International Conference on Computing, Electronics & Communications Engineering 2018 (iCCECE ’18), Southend, UK.10.1109/iCCECOME.2018.8658586 ↗
50. Islam, A., Kader, M., and Shin, S.Y. (arXiv, 2018). BSSSQS: A Blockchain Based Smart and Secured Scheme for Question Sharing in the Smart Education System, arXiv.
51. Swan, M. (2015). Blockchain: Blueprint for a New Economy, O’Reilly Media, Inc.
52. Onik, M.M.H., and Ahmed, M. (2018). Blockchain in the Era of Industry 4.0. Data Analytics, CRC Press.
53. Pinheiro, P., Macedo, M., Barbosa, R., Santos, R., and Novais, P. (2018, January 20–22). Multi-agent Systems Approach to Industry 4.0: Enabling Collaboration Considering a Blockchain for Knowledge Representation. Proceedings of the International Conference on Practical Applications of Agents and Multi-Agent Systems, Toledo, Spain.10.1007/978-3-319-94779-2_14 ↗
54. Feng, L., Zhang, H., Chen, Y., and Lou, L. (2018). Scalable Dynamic Multi-Agent Practical Byzantine Fault-Tolerant Consensus in Permissioned Blockchain. Appl. Sci., 8.10.3390/app8101919 ↗
55. Hölbl, M., Kompara, M., Kamišalić, A., and Nemec Zlatolas, L. (2018). A Systematic Review of the Use of Blockchain in Healthcare. Symmetry (Basel), 10.10.20944/preprints201809.0136.v1 ↗
56. Schwartz, A., and Bergus, G. (2008). Medical Decision Making: A Physician’s Guide, Cambridge University Press.10.1017/CBO9780511722080 ↗
57. Jayanti, A., Neuvonen, M., Wearden, A., Morris, J., Foden, P., Brenchley, P., and Mitra, S. (2015). Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates. BMC Nephrol., 16.10.1186/s12882-015-0180-8 ↗
58. Gatteschi, V., Lamberti, F., Demartini, C., Pranteda, C., and Santamaría, V. (2018). Blockchain and Smart Contracts for Insurance: Is the Technology Mature Enough?. Futur. Internet, 10.10.3390/fi10020020 ↗
59. Shae, Z., and Tsai, J.J.P. (2017, January 5–8). On the design of a blockchain platform for clinical trial and precision medicine. Proceedings of the 2017 IEEE 37th International Conference on Distributed Computing Systems (ICDCS), Atlanta, GA, USA.10.1109/ICDCS.2017.61 ↗
60. Privacy-friendly platform for healthcare data in cloud based on blockchain environment10.1016/j.future.2018.12.044 ↗
61. MedBlock: Efficient and Secure Medical Data Sharing Via Blockchain10.1007/s10916-018-0993-7 ↗
62. Secure attribute-based signature scheme with multiple authorities for blockchain in electronic health records systems10.1109/ACCESS.2018.2801266 ↗
63. Lee, S.-J., Cho, G.-Y., Ikeno, F., and Lee, T.-R. (2018). BAQALC: Blockchain Applied Lossless Efficient Transmission of DNA Sequencing Data for Next Generation Medical Informatics. Appl. Sci., 8.10.3390/app8091471 ↗
64. Azaria, A., Ekblaw, A., Vieira, T., and Lippman, A. (2016, January 22–24). Medrec: Using blockchain for medical data access and permission management. Proceedings of the International Conference on Open and Big Data (OBD), Vienna, Austria.10.1109/OBD.2016.11 ↗
65. Secure and trustable electronic medical records sharing using blockchain
66. Analyzing the Performance of a Blockchain-based Personal Health Record Implementation10.1016/j.jbi.2019.103140 ↗
67. (2018, December 15). Josh Youbase. Available online: https://www.youbase.io/.
68. Blockchain challenges and opportunities: A survey10.1504/IJWGS.2018.095647 ↗
69. Chen, J., Ma, X., Du, M., and Wang, Z. (April, January 30). A Blockchain Application for Medical Information Sharing. Proceedings of the 2018 IEEE International Symposium on Innovation and Entrepreneurship (TEMS-ISIE), Beijing, China.10.1109/TEMS-ISIE.2018.8478645 ↗
70. Tseng, J.-H., Liao, Y.-C., Chong, B., and Liao, S. (2018). Governance on the Drug Supply Chain via Gcoin Blockchain. Int. J. Environ. Res. Public Health, 15.10.3390/ijerph15061055 ↗
71. Greenspan, G. (2018, May 10). MultiChain Private Blockchain—White Paper. Available online: http//www. multichain.com/download/MultiChain-White-Paper.pdf.
72. Greenspan, G. (2019, January 01). Off-Chain (Alpha 3) Multichain 2.0. Available online: https://www.multichain.com/blog/2018/06/scaling-blockchains-off-chain-data/.
73. Shrestha, A.K., and Vassileva, J. (2018). Blockchain-Based Research Data Sharing Framework for Incentivizing the Data Owners. Proceedings of the International Conference on Blockchain, Springer.10.1007/978-3-319-94478-4_19 ↗
74. Shrestha, A.K., and Vassileva, J. (2017, January 29–30). User-controlled privacy-preserving user profile data sharing based on blockchain. Proceedings of the Future Technologies Conference (FTC), Vancouver, QC, Canada.
75. Ramya, U.M., Sindhuja, P., Atsaya, R.A., Dharani, B.B., and Golla, S.S.M.V. (2018). Reducing Forgery in Land Registry System Using Blockchain Technology. Proceedings of the International Conference on Advanced Informatics for Computing Research, Springer.10.1007/978-981-13-3140-4_65 ↗
76. Onik, M.M.H., Al-Zaben, N., Phan Hoo, H., and Kim, C.-S. (2017). MUXER—A New Equipment for Energy Saving in Ethernet. Technologies, 5.10.3390/technologies5040074 ↗
77. Translucent network design from a CapEx/OpEx perspective10.1007/s11107-011-0310-6 ↗
78. Maxwell, W., and Salmon, J. (Hogan Lovells, 2017). A guide to blockchain and data protection, Hogan Lovells.
79. (2019, March 14). About Throughput Performance—MultiChain Developer Q & A. Available online: https://www.multichain.com/qa/5556/about-throughput-performance.
80. (2019, March 14). Inje University Haeundae Paik Hospital. Available online: http://haeundae.paik.ac.kr/eng/main/main.asp.
81. (2019, March 11). Ashish Tool to Measure Blockchain Performance: Hyperledger Caliper. Available online: https://medium.com/coinmonks/tool-to-measure-blockchain-performance-hyperledger-caliper-f192adfba52.
82. Zheng, Z., Xie, S., Dai, H., Chen, X., and Wang, H. (2017, January 25–30). An overview of blockchain technology: Architecture, consensus, and future trends. Proceedings of the 2017 IEEE International Congress on Big Data (BigData Congress), Honolulu, HI, USA.10.1109/BigDataCongress.2017.85 ↗
83. Mingxiao, D., Xiaofeng, M., Zhe, Z., Xiangwei, W., and Qijun, C. (2017, January 5–8). A review on consensus algorithm of blockchain. Proceedings of the 2017 IEEE International Conference on Systems, Man, and Cybernetics (SMC), Banff, AB, Canada.10.1109/SMC.2017.8123011 ↗
84. Bach, L.M., Mihaljevic, B., and Zagar, M. (2018, January 21–25). Comparative analysis of blockchain consensus algorithms. Proceedings of the 2018 41st International Convention on Information and Communication Technology, Electronics and Microelectronics (MIPRO), Opatija, Croatia.10.23919/MIPRO.2018.8400278 ↗
85. (2019, March 10). Proof of Stake and Scalability—Pool Of Stake—Medium. Available online: https://medium.com/@poolofstake/proof-of-stake-and-scalability-2ecaa8fd5d7c.