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      Secure Collaborative Platform for Health Care Research in an Open Environment: Perspective on Accountability in Access Control

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          Abstract

          Background

          With the recent use of IT in health care, a variety of eHealth data are increasingly being collected and stored by national health agencies. As these eHealth data can advance the modern health care system and make it smarter, many researchers want to use these data in their studies. However, using eHealth data brings about privacy and security concerns. The analytical environment that supports health care research must also consider many requirements. For these reasons, countries generally provide research platforms for health care, but some data providers (eg, patients) are still concerned about the security and privacy of their eHealth data. Thus, a more secure platform for health care research that guarantees the utility of eHealth data while focusing on its security and privacy is needed.

          Objective

          This study aims to implement a research platform for health care called the health care big data platform (HBDP), which is more secure than previous health care research platforms. The HBDP uses attribute-based encryption to achieve fine-grained access control and encryption of stored eHealth data in an open environment. Moreover, in the HBDP, platform administrators can perform the appropriate follow-up (eg, block illegal users) and monitoring through a private blockchain. In other words, the HBDP supports accountability in access control.

          Methods

          We first identified potential security threats in the health care domain. We then defined the security requirements to minimize the identified threats. In particular, the requirements were defined based on the security solutions used in existing health care research platforms. We then proposed the HBDP, which meets defined security requirements (ie, access control, encryption of stored eHealth data, and accountability). Finally, we implemented the HBDP to prove its feasibility.

          Results

          This study carried out case studies for illegal user detection via the implemented HBDP based on specific scenarios related to the threats. As a result, the platform detected illegal users appropriately via the security agent. Furthermore, in the empirical evaluation of massive data encryption (eg, 100,000 rows with 3 sensitive columns within 46 columns) for column-level encryption, full encryption after column-level encryption, and full decryption including column-level decryption, our approach achieved approximately 3 minutes, 1 minute, and 9 minutes, respectively. In the blockchain, average latencies and throughputs in 1Org with 2Peers reached approximately 18 seconds and 49 transactions per second (TPS) in read mode and approximately 4 seconds and 120 TPS in write mode in 300 TPS.

          Conclusions

          The HBDP enables fine-grained access control and secure storage of eHealth data via attribute-based encryption cryptography. It also provides nonrepudiation and accountability through the blockchain. Therefore, we consider that our proposal provides a sufficiently secure environment for the use of eHealth data in health care research.

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          Most cited references59

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          FHIRChain: Applying Blockchain to Securely and Scalably Share Clinical Data

          Secure and scalable data sharing is essential for collaborative clinical decision making. Conventional clinical data efforts are often siloed, however, which creates barriers to efficient information exchange and impedes effective treatment decision made for patients. This paper provides four contributions to the study of applying blockchain technology to clinical data sharing in the context of technical requirements defined in the “Shared Nationwide Interoperability Roadmap” from the Office of the National Coordinator for Health Information Technology (ONC). First, we analyze the ONC requirements and their implications for blockchain-based systems. Second, we present FHIRChain, which is a blockchain-based architecture designed to meet ONC requirements by encapsulating the HL7 Fast Healthcare Interoperability Resources (FHIR) standard for shared clinical data. Third, we demonstrate a FHIRChain-based decentralized app using digital health identities to authenticate participants in a case study of collaborative decision making for remote cancer care. Fourth, we highlight key lessons learned from our case study.
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            Blockchain-based electronic healthcare record system for healthcare 4.0 applications

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              Attribute-based encryption for fine-grained access control of encrypted data

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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                October 2022
                14 October 2022
                : 24
                : 10
                : e37978
                Affiliations
                [1 ] Department of Computer and Information Security, and Convergence Engineering for Intelligent Drone Sejong University Seoul Republic of Korea
                Author notes
                Corresponding Author: Young-Gab Kim alwaysgabi@ 123456sejong.ac.kr
                Author information
                https://orcid.org/0000-0001-6484-5449
                https://orcid.org/0000-0001-9585-8808
                Article
                v24i10e37978
                10.2196/37978
                9617185
                36240003
                775b7e7c-886a-4b81-873f-821ad773af99
                ©Giluk Kang, Young-Gab Kim. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 14.10.2022.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 14 March 2022
                : 13 July 2022
                : 2 August 2022
                : 30 August 2022
                Categories
                Original Paper
                Original Paper

                Medicine
                blockchain,attribute-based encryption,ehealth data,security,privacy,cloud computing,research platform for health care,accountability,internet of things,interoperability,mobile phone

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