–Organizational, social, or technical threats of blockchain
TITLE-ABSTR-KEY (distributed ledger technology OR DLT OR blockchain) AND TITLE-ABSTR-KEY (health* OR medical) AND TITLE-ABSTR-KEY (application OR scenario OR use case)
4.1.1 use case description..
Use case: patient-centric health data management | ||
---|---|---|
PHI: patient health information | ||
Access management | Enabling patients to authorize and revoke access to specific health information | : Interoperability [ ]; Use of smart contracts [ ]; Token support [ ] : Transaction content visibility [ ]; User unidentifiability [ ]; Node controller verification [ ]; : Compliance [ ] : Scalability [ ]; Resource consumption [ ]; Transaction validation latency [ ] : Ease of node setup [ ]; Ease of use [ ] : Authenticity [ ]; Availability [ ]; Confidentiality [ ]; Consistency [ ]; Fault tolerance [ ]; Integrity [ ]; Isolation [ ]; Strength of cryptography [ ] |
Secure record-keeping | Maintaining log files of activities within DLT-based applications for patient-centric health data management to prevent tampering | : Interoperability [ ]; Use of smart contracts [ ]; Token support [ ] : Transaction content visibility [ ]; User unidentifiability [ ]; Node controller verification [ ] : Compliance [ ] : Scalability [ ]; Resource consumption [ ] : Ease of use [ ] : Confidentiality [ ]; Integrity [ ]; Isolation [ ]; Strength of cryptography [ ]; |
Data sharing incentivization | Establishing a trustworthy and transparent environment to encourage patients to share their health data | : Interoperability [ ]; Use of smart contracts [ ] : Transaction content visibility [ ]; Node controller verification [ ] : Degree of decentralization [ ]; Incentive mechanism [ ] : Availability [ ]; Confidentiality [ ]; Integrity [ ] |
4.1.3 secure record-keeping., 4.1.4 data sharing incentivization., 4.2 management of electronic healthcare records (ehrs), 4.2.1 use case description..
Use case: management of EHRs | ||
---|---|---|
Access management | Controlling access permissions for EHRs | : Interoperability [ ]; Use of smart contracts [ ]; Token support [ ] : User unidentifiability [ ]; Node controller verification [ ] : Compliance [ ] : Resource consumption [ ]; Transaction validation latency [ ] : Ease of use [ ] : Authenticity [ ]; Availability [ ]; Confidentiality [ ]; Consistency [ ]; Integrity [ ]; Non-repudiation [ ] |
Secure record-keeping | Recording log files of operations on EHRs in a secure and transparent manner | : Interoperability [ ]; Use of smart contracts [ ] : User unidentifiability [ ]; Node controller verification [ ] : Scalability [ ]; Resource consumption [ ] : Ease of use [ ] : Authenticity [ ]; Availability [ ]; Confidentiality [ ]; Integrity [ ]; Non-repudiation [ ]; Strength of cryptography [ ] |
4.2.3 secure record-keeping., 4.3.1 use case description..
Use case: RPM | ||
---|---|---|
Access management | Controlling fine-grained access permissions over health data gathered by various remote devices | : Interoperability [ ]; Use of smart contracts [ ] : Transaction content visibility [ ]; User unidentifiability [ ]; Node controller verification [ ] : Compliance [ ]; Degree of decentralization [ ] : Scalability [ ]; Resource consumption [ ]; Throughput [ ]; Transaction validation latency [ ] : Transaction fee [ ] : Availability [ ]; Censorship resistance [ ]; Confidentiality [ ]; Fault tolerance [ ]; Integrity [ ]; Non-repudiation [ ]; Reliability [ ] |
Secure record-keeping | Timestamping and logging data transmissions with RPM accurately and securely | : Node controller verification [ ] : Compliance [ ]; Degree of decentralization [ ] : Scalability [ ]; Resource consumption [ ]; Throughput [ ]; Transaction validation latency [ ] : Transaction fee [ ] : Authenticity [ ]; Availability [ ]; Confidentiality [ ]; Integrity [ ]; Non-repudiation [ ] |
Process automation | Notifying of abnormal situations automatically for the timely detection of possible medical conditions | : Use of smart contracts [ ] : User unidentifiability [ ]; Node controller verification [ ] : Compliance [ ] : Scalability [ ]; Transaction validation latency [ ]; Authenticity [ ]; Strength of cryptography [ ] |
4.3.3 secure record-keeping., 4.3.4 process automation., 4.4 biomedical research, 4.4.1 use case description..
Use case: biomedical research | ||
---|---|---|
Access management | Defining and operating rules for access to research data and preventing study results from arbitrary manipulation | : Interoperability [ ]; smart contracts [ ] : Traceability [ ]; Transaction validation latency [ ]; User unidentifiability [ ]; Node controller verification [ ] : Integrity [ ] |
Secure record-keeping | Recording data gathered through research studies according to documentation requirements for biomedical research | : Traceability [ ]; Transaction validation latency [ ]; Node controller verification [ ] : Confidentiality [ ]; Integrity [ ] |
Data sharing incentivization | Incentivizing individuals to participate in research studies | : User unidentifiability [ ]; Node controller verification [ ] : Confidentiality [ ]; Integrity [ ] |
Process automation | Monitoring specific values (e.g., effects of a drug on participants) generated in biomedical research without manual checks | : Interoperability [ ]; Use of smart contracts [ ] : Node controller verification [ ] : Block creation interval [ ]; Throughput [ ] |
4.4.3 secure record-keeping., 4.4.4 data sharing incentivization., 4.4.5 process automation., 4.5 supply chain management (scm) for pharmaceutical drugs or medical devices, 4.5.1 use case description..
Use case: SCM for pharmaceutical drugs or medical devices | ||
---|---|---|
Secure record-keeping | Recording data generated during procurement, production, and delivery of pharmaceutical drugs or medical devices according to related regulations in an accurate manner | : Use of smart contracts [ ] : Transaction content visibility [ ]; Node controller verification [ ] : Compliance [ ] : Block size limit [ ]; Scalability [ ]; Throughput [ ]; Transaction validation latency [ ] : Ease of node setup [ ]; Ease of use [ ] : Authenticity [ ]; Availability [ ]; Integrity [ ] |
Process automation | (Partly) Automating negotiation and payment processes within the supply of pharmaceutical drugs or medical devices | : Use of smart contracts [ ] : Transaction content visibility [ ] : Availability [ ]; Confidentiality [ ]; Consistency [ ]; Integrity [ ]; Non-repudiation [ ] |
4.5.3 process automation., 4.6 contact tracing and warning for pandemics, 4.6.1 use case description..
Use case: contact tracing and warning for pandemics | ||
---|---|---|
Secure record- keeping | Storing individuals’ spatial movements, their infection status, and other related information for tracing their encounters with others | : Use of smart contracts [ ]; : Traceability [ ]; User unidentifiability [ ]; Node controller verification [ ] : Compliance [ ]; Degree of decentralization [ ] : Scalability [ ]; Transaction validation latency [ ]; Authenticity [ ]; Availability [ ]; Consistency [ ]; Integrity [ ] |
Process automation | Evaluating individuals’ movements and notifying them of potential infection risks based on their encounters | : Use of smart contracts [ ]; : Node controller verification [ ]; : Scalability [ ]; Transaction validation latency [ ] |
4.6.3 process automation., 5 discussion, 5.1 principal findings, 5.2 implications.
RQ | Key findings | Implications for research |
---|---|---|
RQ1 | —Six pertinent and two nascent DLT use cases in the health domain —Four general purposes of utilizing DLT in healthcare —While the basic idea of a purpose is consistent across use cases, there are use case-specific peculiarities | Our results reinforce the need for more contextualized research on and designs of DLT-based applications in healthcare. Especially researchers should consider and transparently report the domain-specific use case and the purpose for which they use DLT, when proposing, discussing, or evaluating DLT-based applications for healthcare. |
RQ2 | —30 DLT characteristics were proposed for DLT-based applications in the six pertinent use cases —Both use cases and purposes of utilizing DLT as well as their interplay can influence the requirements of DLT-based applications —The identified rationales provide a useful basis for explaining the suitability of specific DLT characteristics for a DLT-based application —Some DLT characteristics (e.g., auditability) are currently understudied | The identified rationales help to disentangle the concrete contributions of DLT to various use case-specific challenges in healthcare. Besides, the saturation of existing studies on DLT in healthcare in terms of some DLT characteristics is insufficient. Research on DLT in healthcare has a long way to go for a holistic picture of DLT-based applications. |
6 conclusion, a.1. dlt characteristics.
DLT Property | DLT Characteristics |
---|---|
—Interoperability | |
—Maintainability | |
—Use of Smart Contracts | |
—Token Support | |
—Transaction Payload | |
—Traceability | |
—Transaction Content Visibility | |
—User Unidentifiability | |
—Node Controller Verification | |
—Auditability | |
—Compliance | |
—Degree of Decentralization | |
—Incentive Mechanism | |
—Liability | |
—Block Creation Interval | |
—Block Size Limit | |
—Confirmation Latency | |
—Resource Consumption | |
—Propagation Delay | |
—Scalability | |
—Stale Block Rate | |
—Throughput | |
—Transaction Validation Latency | |
—Transaction Fee | |
—Ease of Node Setup | |
—Ease of Use | |
—Support for Constrained Devices | |
—Atomicity | |
—Authenticity | |
—Availability | |
—Censorship Resistance | |
—Confidentiality | |
—Consistency | |
—Durability | |
—Fault Tolerance | |
—Integrity | |
—Isolation | |
—Non-Repudiation | |
—Reliability | |
—Strength of Cryptography |
Applied computing
Life and medical sciences
Health care information systems
Software and its engineering
Software creation and management
Designing software
Trade-offs between distributed ledger technology characteristics.
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Blockchain has been increasingly used as a component to enable decentralisation in software architecture for a variety of applications. Blockchain governance has received considerable attention to ensure the safe and appropriate use ...
Blockchain in healthcare applications requires robust security and privacy mechanism for high-level authentication, interoperability and medical records sharing to comply with the strict legal requirements of the Health Insurance Portability and ...
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University of Pennsylvania, USA
William and Mary, USA
Association for Computing Machinery
New York, NY, United States
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