Blockchain in IoT-based smart healthcare (Part 23)
Welcome to the 23rd part of the 100 part series on Blockchain.
Previous parts: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 and 22.
Healthcare is an essential part of life, and technology is disrupting this space day in and day out. The current technology in healthcare and the general practice of medicine can be enhanced by using the Internet of Things or IoT systems. Let’s understand how these IoT systems and smart devices can enhance the healthcare services and create a positive impact on our health:
Benefits of IoT devices for healthcare
The benefits of IoT devices for healthcare are numerous.
Improve lifestyle: Smart wearables like Fitbits, Apple watches, health bands, etc. have many monitoring features to help you create goals and improve your fitness. Various sensors embedded in smart wearables track your activity levels, sleep cycle, and nutrient intake while checking your progress and making goals. There are certain other smart wearable pain relief patches like Thimble Bioelectronics which can send electric currents to chronic pain spots. This means treating pain the same way we treat a cut by putting a bandage on it and letting it heal. Other IoT devices like glucose monitoring devices provide continuous, automatic monitoring of glucose levels in patients. These devices eliminate the need to keep records manually, and they can alert patients when glucose levels are problematic.
Simultaneous monitoring and reporting: IoT health devices have the potential to collect real-time information about the patient and report this to the physician remotely. The IoT devices can collect information like blood pressure, heart rate, blood glucose level, etc., of a patient and store it on the cloud, and then this information can be shared with the authorized physician. This technology can save unnecessary clinical visits, allow healthcare providers to provide better care to their patients, and even facilitate remote consultation irrespective of place or time.
Essentially, these devices can improve access to healthcare resources while reducing strain on healthcare systems and giving people better control over their own health at all times.
Improved disease management: Another important advantage of IoT devices is that emergency situations like heart attacks and asthma can be analyzed by healthcare professionals remotely. For instance, a heart monitoring device continuously monitors heart rate, and in situations like fluctuations in heart rates and heart attacks, the healthcare professionals are notified by the device itself.
Because of IoT devices, the healthcare providers can even get access to the patients’ profiles way before their arrival because of which they can deliver essential care to the patients on time. In this way, associated losses are reduced, and emergency health care is improved.
IoT-aided robotic surgery: By deploying small Internet-connected robots inside the human body, surgeons can perform complex procedures and surgeries with more precision and control than is possible with human hands. At the same time, IoT-aided robotic surgeries can reduce the size of incisions required to perform surgery, leading to a less invasive process and faster healing for patients.
The IoT-aided robotic devices can also interact with doctors and interpret complex conditions inside bodies to make the right decisions about proceeding during a surgery.
Challenges faced by IoT devices
But there are certain challenges that IoT devices face:
(i) IoT smart devices capture data in real-time and store this data on the centralized cloud servers. The huge amount of data captured can be used to perform complex analysis of patients’ physical, cognitive, and physiological conditions, thus facilitating predictive and preventative healthcare. Moreover, the health data collected from groups of patients can also be used in medical research, e.g., clinical trials, randomized control trials, etc. The centralized cloud servers can introduce a single point of failure, which means the failure of a single component of a system/server can interrupt the running of the entire network. Thus, compromising the availability of the whole data.
(ii) Another biggest challenge of storing such huge sensitive data of patients on a centralized and cloud system is its security and privacy. A patient’s data in such a scenario is susceptible to medical data alteration, unauthorized sharing, data theft, data loss, etc. The patient’s data can be used to create fake IDs to buy drugs and can even be used to file fraudulent insurance claims. Moreover, cybercriminals can achieve complete remote control of wearable devices and pose a threat to a patient’s life. For instance, a hacker can take control of the smart insulin pump (commercialized by Johnson & Johnson) to overdose diabetic patients with insulin, causing them harm.
Blockchain- The Solution
The decentralized and peer-to-peer Blockchain technology can provide the required solution to solve security issues IoT health devices face as the data stored on the Blockchain will be resistant to hacking and tampering. Additionally, Blockchain technology will also prevent failure in any single node in a network (either because of a power outage or the node goes offline) from bringing the entire network to crash and compromise data.
Type of Blockchain used: Private permissioned Blockchain can be used instead of a permissionless public Blockchain to avoid costs associated with transactions on the public Blockchain and ensure patient’s privacy. The IoT health devices gather sensitive health information of the patient, which is then shared with the healthcare provider. This type of information should not be available to the public. Therefore, a consortium Blockchain, a private Blockchain, would be suitable for the IoT. Additionally, unlike permissionless public Blockchain, where anyone can become a node, in the permissioned Blockchain, all nodes are pre-selected. In the Blockchain, healthcare providers, medical experts, and researchers who should be able to access patient records act as nodes.
IPFS: Storing data on Blockchain is very expensive and energy-consuming. Therefore, it is recommended to store massive health data generated from the smart wearables in secured off-Blockchain peer-to-peer distributed file system IPFS. All the data captured by IoT devices will be stored on IPFS, and the hash from IPFS will be stored on the main Blockchain.
Smart contracts: Smart contracts on Blockchain eliminate the need for a mediator by automatically defining and enforcing rules and duties set out by the participants in the network.
Proposed Blockchain architecture
The Blockchain platform should be patient-centric in which the patient has complete control over their data. He should have the ability to grant and revoke access to the records as and when they wish to do so. Granting and revoking access to records is possible with the smart contracts on Blockchain.
(i) The patients and healthcare providers will be required to register themselves to become part of the Blockchain network.
(ii) Once the patient Login to the platform, Blockchain can enable the patients to share the LIVE data captured by IoT devices with the doctor.
(iii) The doctor will be required to get permission to access the patient’s data. Then the doctor will get complete access to the medical report along with the real-time data captured by the IoT devices like LIVE ECG of the patient to find the malfunction of the heart.
(iv) Blockchain technology also promotes collaboration among healthcare providers and research organizations to do qualitative research. The medical experts and researchers must take permission from the patients to access their medical records. The doctors and researchers are only allowed to go through those records to which the patient has permitted them.
Hence, through Blockchain technology, a patient can control and share their information without violating the privacy policy.
Better integration of data of IoT devices with Electronic Healthcare Records: IoT smart health wearables like Fitbit, health bands, watches, blood glucose monitors record the daily data and activities of a user like calories, step counts, miles, heart rate, quality of sleep, blood pressure, blood glucose level, etc. With Blockchain technology, all this daily data from a user’s smart health devices can be clubbed with the patient’s Electronic Health Records. These devices collect the real-time data of a patient, and because of this, doctors can see a patient’s condition in real-time. As data is acquired continuously, there is no need to conduct all the tests when the patient visits the hospital. This will reduce the costs of conducting basic tests and save valuable time for both the doctor and the patient. This could really be a boon for emergency cases where providing timely treatment is the biggest challenge.
Challenges of implementing Blockchain in smart healthcare
(i) Interoperability: Healthcare interoperability means exchanging medical information with each other in the Blockchain network. In the Healthcare sector, ensuring proper interoperability can be a challenge due to the presence of different players like hospitals, insurance companies, physicians, private doctors, etc.
(ii) Hesitation among hospitals in sharing information: Some hospitals can be reluctant to share their patient-related and other medical records, such as in for-profit situations, as they will want to charge fees from different customers. Thus, it can be competitively advantageous for them to keep the fees-related data with themselves. Therefore, it is essential to build trust between the parties and convince them to share their data for a better healthcare ecosystem.
(iii) Hesitation among patients to share their medical records: Trust building among the most crucial stakeholders, the patients, is very important for the success of a Blockchain-driven medical and healthcare system. Many patients can be hesitant to share and disclose their medical records in the public domain with third-party entities. So, it is essential to build trust and confidence among the patients regarding the security and privacy aspects of the Blockchain and IoT-driven healthcare system.
(iv) Scalability: It is not practically possible to maintain electronic health data and IoT data of every individual on Blockchain because of restricted transactional throughput (transactions/second), efficiency, and high computational cost. Thus, reducing the overall performance of the Blockchain. These issues can be overcome by implementing Blockchain scalability layer 1 and layer 2 solutions to increase the transactional throughput. And the entire patient’s data can be stored on IPFS, while the hash address of the IPFS data will be stored on smart contracts. Thus, scaling solutions and IPFS can handle the Blockchain’s scalability and storage issues.
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