Blockchain-Based Medical Certificate Generation and Verification for IoT-Based Healthcare Systems

Background Digital health technologies, including telemedicine, mobile health (mHealth), and remote monitoring, are playing a greater role in medical practice. Safe and accurate management of medical information leads to the advancement of digital health, which in turn results in a number of beneficial effects. Furthermore, mHealth can help lower costs by facilitating the delivery of care and connecting people to their health care providers. Mobile apps help empower patients and health care providers to proactively address medical conditions through near real-time monitoring and treatment, regardless of the location of the patient or the health care provider. Additionally, mHealth data are stored in servers, and consequently, data management that prevents all forms of manipulation is crucial for both medical practice and clinical trials. Objective The aim of this study was to develop and evaluate a tamper-resistant mHealth system using blockchain technology, which enables trusted and auditable computing using a decentralized network. Methods We developed an mHealth system for cognitive behavioral therapy for insomnia using a smartphone app. The volunteer data collected with the app were stored in JavaScript Object Notation format and sent to the blockchain network. Thereafter, we evaluated the tamper resistance of the data against the inconsistencies caused by artificial faults. Results Electronic medical records collected using smartphones were successfully sent to a private Hyperledger Fabric blockchain network. We verified the data update process under conditions where all the validating peers were running normally. The mHealth data were successfully updated under network faults. We further ensured that any electronic health record registered to the blockchain network was resistant to tampering and revision. The mHealth data update was compatible with tamper resistance in the blockchain network. Conclusions Blockchain serves as a tamperproof system for mHealth. Combining mHealth with blockchain technology may provide a novel solution that enables both accessibility and data transparency without a third party such as a contract research organization.

Blockchain is evolving to be a secure and reliable platform for secure data sharing in application areas such as the financial sector, supply chain management, food industry, energy sector, internet of things and healthcare. In this paper, we review existing literature and applications available for the healthcare system using blockchain technology. Besides, this work also proposes multiple workflows involved in the healthcare ecosystem using blockchain technology for better data management. Different medical workflows have been designed and implemented using the ethereum blockchain platform which involves complex medical procedures like surgery and clinical trials. This also includes accessing and managing a large amount of medical data. Within the implementation of the workflows of the medical smart contract system for healthcare management, the associated cost has been estimated for this system in terms of a feasibility study which has been comprehensively presented in this paper. This work would facilitate multiple stakeholders who are involved within the medical system to deliver better healthcare services and optimize cost.