Blockchain Article Citations

Blockchain Article Citations

This document is a compilation of blockchain documents (I find interesting) pertaining mostly to health care but also to:

• Electronic Health Records (and Interoperability), Health Systems, or Health Advocacy

• Clinical Trials

• Security, Encryption, Software Engineering

• Identity Management

• Legal or Regulatory considerations

• Business and Community management

The citations are nearly exclusively comprised of the following reference types:

• Journal articles (traditional and electronic)

• Books and Book Sections (traditional, electronic, edited)

• Conference Papers

• Conference Proceedings

• Government Documents, such as Bills, Hearings, Reports, Regulations, and Statutes

• Theses

Some Magazine Articles, (Company) Reports, or Unpublished Work were also included in this listing if they contributed unique perspective—even if not peer reviewed.

Reference Format

Bibliographic references follow the standards summarized in the National Library of Medicine’s (NLM) International Committee of Medical Journal Editors (ICMJE) Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals. Sample references can be found at https://www.nlm.nih.gov/bsd/uniform_requirements.html, and detailed guidance found in the NLM’s Citing Medicine, 2nd edition (www.ncbi.nlm.nih.gov/books/NBK7256/.

Disclaimers

• Citation information was downloaded from the publisher whenever possible, but it was necessary to use discretion to determine the correct “Reference Type” and to manually augment several details or correct inaccuracies. It is not feasible to identify all of the publisher’s inaccuracies.

• Journal Abbreviations were manually obtained from PubMed or http://www.journalabbr.com/ and other internet sources.

• For Conference Papers and Conference Proceedings, it was also necessary to manually look up the conference location, dates, and publisher—requiring up to 30-45 minutes of searching per Conference article. Different websites provides slightly different information and I used discretion to add as much information as I could find; however, it is not feasible to obtain all information.

• The Abstract was copied and pasted from the Abstract section of the article whenever available; otherwise, the first few paragraphs were provided. I corrected obvious publisher spelling errors whenever identified, but I did not modify unconventional capitalizations, punctuations, or spellings.

• Website locations are considered part of the formal citation for electronic articles and books. For other types of articles, I created a separate listing as a courtesy so the reader can find the article.

  • Nature of website location: I provided the web location of the publisher’s page so the reader can easily find the citation information and the link to download. When access to the article was limited by subscription, I searched to see if Open Access versions were also available on the internet. When more than one access method was available, I provided both methods of access.

  • Website locations found in the citation: Because ICMJE convention allows optional additional permission access notes such as “Subscription required to view” to be added to the citation, I provided this information in the citation. When no “Subscription” notes are provided, the reader should assume that the link is “Open Access.”

Contact Information

For questions or corrections, please contact me: Wendy Charles: wendy.charles [@] msn.com.

Citations

Abdulghani HA, Nijdam NA, Collen A, Konstantas D. A study on security and privacy guidelines, countermeasures, threats: IoT data at rest perspective. Symmetry. 2019;11(6). Epub 2019 Jun 10.

Reference Type: Journal Article

Available from: https://www.mdpi.com/2073-8994/11/6/774

Abstract: The Internet of Things (IoT) makes our lives much easier, more valuable, and less stressful due to the development of many applications around us including smart cities, smart cars, and smart grids, offering endless services and solutions. Protecting IoT data of such applications at rest either on the objects or in the cloud is an indispensable requirement for achieving a symmetry in the handling and protection of the IoT, as we do with data created by persons and applications. This is because unauthorised access to such data may lead to harmful consequences such as linkage attacks, loss of privacy, and data manipulation. Such undesired implications may jeopardise the existence of IoT applications if protection measures are not taken, and they stem from two main factors. One is that IoT objects have limited capabilities in terms of memory capacity, battery life, and computational power that hamper the direct implementation of conventional Internet security solutions without some modifications (e.g., traditional symmetric algorithms). Another factor is the absence of widely accepted IoT security and privacy guidelines for IoT data at rest and their appropriate countermeasures, which would help IoT stakeholders (e.g., developers, manufacturers) to develop secure IoT systems and therefore enhance IoT security and privacy by design. Toward this end, we first briefly describe the main IoT security goals and identify IoT stakeholders. Moreover, we briefly discuss the most well-known data protection frameworks (e.g., General Data Protection Regulation (GDPR), Health Insurance Portability (HIPAA)). Second, we highlight potential attacks and threats against data at rest and show their violated security goals (e.g., confidentiality and integrity). Third, we review a list of protection measures by which our proposed guidelines can be accomplished. Fourth, we propose a framework of security and privacy guidelines for IoT data at rest that can be utilised to enhance IoT security and privacy by design and establish a symmetry with the protection of user-created data. Our framework also presents the link between the suggested guidelines, mitigation techniques, and attacks. Moreover, we state those IoT stakeholders (e.g., manufacturers, developers) who will benefit most from these guidelines. Finally, we suggest several open issues requiring further investigation in the future, and we also discuss the limitations of our suggested framework.

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Abelseth B. Blockchain tracking and cannabis regulation: developing a permissioned blockchain network to track Canada's cannabis supply chain. Dalhousie J Interdiscip Manag [Internet]. 2018; 14. Available from: https://ojs.library.dal.ca/djim/article/view/7869

Reference Type: Electronic Article

Abstract: Achieving government’s goals for cannabis regulation requires legal cannabis to be a cheaper, more attractive consumer alternative compared to the illegal market. This goal may be undermined by the costs and disadvantages of traditional regulatory management.

A Canada wide, real-time blockchain tracking system appears to be a viable technical solution architecture.

A permissioned blockchain network could be tested alongside traditional tracking. This investment, if proven effective, could reduce regulatory costs for government and red tape for business, helping to achieve Governments’ objectives to:
1) Enhance public safety by ensuring quality and monitoring product sales
2) Undermine illegal markets to reduce crime and prevent product diversion

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Agbo CC, Mahmoud HQ, Eklund MJ. Blockchain technology in healthcare: a systematic review. Healthcare. 2019;7(2):56. Epub 2019 Apr 4.

Reference Type: Journal Article

Available from: https://www.mdpi.com/2227-9032/7/2/56

Abstract: Since blockchain was introduced through Bitcoin, research has been ongoing to extend its applications to non-financial use cases. Healthcare is one industry in which blockchain is expected to have significant impacts. Research in this area is relatively new but growing rapidly; so, health informatics researchers and practitioners are always struggling to keep pace with research progress in this area. This paper reports on a systematic review of the ongoing research in the application of blockchain technology in healthcare. The research methodology is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and a systematic mapping study process, in which a well-designed search protocol is used to search four scientific databases, to identify, extract and analyze all relevant publications. The review shows that a number of studies have proposed different use cases for the application of blockchain in healthcare; however, there is a lack of adequate prototype implementations and studies to characterize the effectiveness of these proposed use cases. The review further highlights the state-of-the-art in the development of blockchain applications for healthcare, their limitations and the areas for future research. To this end, therefore, there is still the need for more research to better understand, characterize and evaluate the utility of blockchain in healthcare.

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Ahmad SS, Khan S, Kamal MA. What is blockchain technology and its significance in the current healthcare system? A brief Insight. Curr Pharm Des. 2019. Epub 2019 Jun 20.

Reference Type: Journal Article

Available from: http://www.eurekaselect.com/172892/article Subscription required to view

Abstract: BACKGROUND: The promising eventual fate of blockchain in healthcare has a lot more extensive horizon. The blockchain is a novel structure that gives another design to storage and trade of data among different members of a particular network. In case of a hospital, blockchain takes into consideration for the creation of better treatment structure by the expert doctor in order to arrange the meeting based on a symptom of patients throughout the world by the electronic system. The blockchain technology is crucial for biomedical and human services applications as social insurance has turned out to be a standout amongst the most essential rising application areas of the blockchain distributed ledger technology. RESULT: By and large, blockchain is treated as a conveyed record to store social insurance related information for allocation, trading, dissecting, footage, and affirming purposes among accomplices. The advantage of blockchain databases versus traditional dispersed databases is that they are decentralized, permanent and perfected with advanced digital payment frameworks and hash chain occasion structure. The blockchain code is unlocked resource and can be utilized, altered and customized by its clients. CONCLUSION: Now a day, blockchain is expected to be almost universally adopted across medical organizations around the world. The purpose of this review article is to comprehend the current explore subjects, difficulties and future headings in regards to blockchain innovation from the specialized perspective in the health care system.

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Ahmed S, Broek NT. Food supply: blockchain could boost food security. Nature. 2017;550(7674):43. Epub 2017 Oct 4.

Reference Type: Journal Article

Available from: https://www.nature.com/articles/550043e

Abstract: Blockchain technology is helping to meet sustainability challenges for example in renewable energy and conservation. Food security could also benefit from the technology's transparency, relatively low transaction costs and instantaneous application. Blockchain assignment of unique digital identifiers to food products would make them traceable through supply chains, along with their growth conditions, batch numbers and expiry dates. This would help to prevent food waste, allow consumers to work out the ecological footprint of their food, and guide the distribution of surplus food to those who need it.

This shared and immutable register of foods and transactions would prevent fraud and enable source identification of food-borne illness. And as digital technologies are increasingly used to manage farms, blockchain will promote sharing of on-farm data.

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Ahram T, Sargolzaei A, Sargolzaei S, Daniels J, Amaba B. Blockchain technology innovations. In: IEEE Technology and Engineering Management Society, editor. 2017 IEEE Technology & Engineering Management Conference (TEMSCON); 2017 June 8-10; Santa Clara, CA. Piscataway, NJ: IEEE Technology and Engineering Management Society; 2017. p. 137-41.

Reference Type: Conference Paper

Available from: https://ieeexplore.ieee.org/abstract/document/7998367 Subscription required to view.

Abstract: Digital world has produced efficiencies, new innovative products, and close customer relationships globally by the effective use of mobile, IoT (Internet of Things), social media, analytics and cloud technology to generate models for better decisions. Blockchain is recently introduced and revolutionizing the digital world bringing a new perspective to security, resiliency and efficiency of systems. While initially popularized by Bitcoin, Blockchain is much more than a foundation for crypto currency. It offers a secure way to exchange any kind of good, service, or transaction. Industrial growth increasingly depends on trusted partnerships; but increasing regulation, cybercrime and fraud are inhibiting expansion. To address these challenges, Blockchain will enable more agile value chains, faster product innovations, closer customer relationships, and quicker integration with the IoT and cloud technology. Further Blockchain provides a lower cost of trade with a trusted contract monitored without intervention from third parties who may not add direct value. It facilitates smart contracts, engagements, and agreements with inherent, robust cyber security features. This paper is an effort to break the ground for presenting and demonstrating the use of Blockchain technology in multiple industrial applications. A healthcare industry application, Healthchain, is formalized and developed on the foundation of Blockchain using IBM Blockchain initiative. The concepts are transferable to a wide range of industries as finance, government and manufacturing where security, scalability and efficiency must meet.

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Al Omar A, Rahman MS, Basu A, Kiyomoto S. MediBchain: a blockchain based privacy preserving platform for healthcare data. In: Wang G, Atiquzzaman M, Yan Z, Choo K-KR, editors. Security, Privacy, and Anonymity in Computation, Communication, and Storage; 2017 Dec 12-15; Guangzhou, China. Cham, Switzerland: Springer International Publishing; 2017. p. 534-43.

Reference Type: Conference Paper

Available from: https://www.researchgate.net/publication/321674033_MediBchain_A_Blockchain_Based_Privacy_Preserving_Platform_for_Healthcare_Data Open access; https://link.springer.com/chapter/10.1007%2F978-3-319-72395-2_49 Subscription required to view.

Abstract: Healthcare data are grabbing the interest of cyber attackers in recent years. Annihilating consequences of healthcare data could be alleviated through decentralization. A peer to peer (P2P) network enables the property of decentralization, where different parties can store and run computation while keeping the sensitive health data private. Blockchain technology leverages decentralized or distributed process, which ensures the accountability and integrity of its use. This paper presents a patient centric healthcare data management system by using Blockchain as storage to attain privacy. Pseudonymity is ensured by using the cryptographic functions to protect patient’s data.

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Alcarria R, Bordel B, Robles T, Martin D, Manso-Callejo MA. A blockchain-based authorization system for trustworthy resource monitoring and trading in smart communities. Sensors (Basel). 2018;18(10). Epub 2018 Oct 20.

Reference Type: Journal Article

Available from: https://www.mdpi.com/1424-8220/18/10/3561

Abstract: Resource consumption in residential areas requires novel contributions in the field of consumer information management and collaborative mechanisms for the exchange of resources, in order to optimize the overall consumption of the community. We propose an authorization system to facilitate access to consumer information and resource trading, based on blockchain technology. Our proposal is oriented to the Smart communities, an evolution of Community Energy Management Systems, in which communities are involved in the monitoring and coordination of resource consumption. The proposed environment allows a more reliable management of monitoring and authorization functions, with secure data access and storage and delegation of controller functions among householders. We provide the definition of virtual assets for energy and water resource sharing as an auction, which encourages the optimization of global consumption and saves resources. The proposed solution is implemented and validated in application scenarios that demonstrate the suitability of the defined consensus mechanism, trustworthiness in the level of provided security for resource monitoring and delegation and reduction on resource consumption by the resource trading contribution.

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Alexander A, McGill M, Tarasova A, Ferreira C, Zurkiya D. Scanning the future of medical imaging. J Am Coll Radiol. 2019;16(4 Pt A):501-7. Epub 2018 Dec 3.

Reference Type: Journal Article

Available from: https://www.jacr.org/article/S1546-1440(18)31282-1/fulltext

Abstract: The medical device industry is undergoing rapid change as innovation accelerates, new business models emerge, and artificial intelligence and the Internet of Things create disruptive possibilities in health care. On the innovation front, global annual patent applications related to medical devices have tripled in 10 years, and technology cycle times have halved in just 5 years. Connectivity has exploded-by 2021, the world will have more than three times as many smart connected devices as people-and more and more medical devices and processes contain integrated sensors. In this article, we report on recent McKinsey (McKinsey & Company, New York, New York) work to map start-ups and trends shaping the future of medical imaging. We identify technology clusters with prospects of future growth, look at some of their cutting-edge practices, and consider what the implications may be for our specialty.

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Alhadhrami A, Alghfeli S, Alghfeli M, Abedlla JA, Shuaib K. Introducing blockchains for healthcare. In: Al-Qudah Z, editor. 2017 International Conference on Electrical and Computing Technologies and Applications (ICECTA); 2017 Nov 21-23; Ras Al Khaimah, United Arab Emirates. Piscataway, NJ: IEEE; 2017.

Reference Type: Conference Paper

Available from: https://ieeexplore.ieee.org/abstract/document/8252043 Subscription required to view.

Abstract: Blockchains as a technology emerged to facilitate money exchange transactions and eliminate the need for a trusted third party to notarize and verify such transactions as well as protect data security and privacy. New structures of Blockchains have been designed to accommodate the need for this technology in other fields such as e-health, tourism and energy. This paper is concerned with the use of Blockchains in managing and sharing electronic health and medical records to allow patients, hospitals, clinics, and other medical stakeholder to share data amongst themselves, and increase interoperability. The selection of the Blockchains used architecture depends on the entities participating in the constructed chain network. Although the use of Blockchains may reduce redundancy and provide caregivers with consistent records about their patients, it still comes with few challenges which could infringe patients' privacy, or potentially compromise the whole network of stakeholders. In this paper, we investigate different Blockchains structures, look at existing challenges and provide possible solutions. We focus on challenges that may expose patients' privacy and the resiliency of Blockchains to possible attacks.

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Al-Nemrat A, Houari Boumediene University of Sciences and Technology, IEEE, editors. Identity theft on e-government/e-governance digital forensics [abstract]. 2018 International Symposium on Programming and Systems (ISPS); 2018 Apr 24-26; Algiers, Algeria. IEEE.

Reference Type: Conference Proceedings

Available from: https://ieeexplore.ieee.org/abstract/document/8378961 Subscription required to view.

Abstract: In the context of the rapid technological progress, the cyber-threats become a serious challenge that requires immediate and continuous action. As cybercrime poses a permanent and increasing threat, governments, corporate and individual users of the cyber-space are constantly struggling to ensure an acceptable level of security over their assets. Maliciousness on the cyber-space spans identity theft, fraud, and system intrusions. This is due to the benefits of cyberspace-low entry barriers, user anonymity, and spatial and temporal separation between users, make it a fertile field for deception and fraud. Numerous, supervised and unsupervised, techniques have been proposed and used to identify fraudulent transactions and activities that deviate from regular patterns of behaviour. For instance, neural networks and genetic algorithms were used to detect credit card fraud in a dataset covering 13 months and 50 million credit card transactions. Unsupervised methods, such as clustering analysis, have been used to identify financial fraud or to filter fake online product reviews and ratings on e-commerce websites. Blockchain technology has demonstrated its feasibility and relevance in e-commerce. Its use is now being extended to new areas, related to electronic government. The technology appears to be the most appropriate in areas that require storage and processing of large amounts of protected data. The question is what can blockchain technology do and not do to fight malicious online activity?

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Alonso SG, Arambarri J, López-Coronado M, de la Torre Díez I. Proposing new blockchain challenges in eHealth. J Med Syst. 2019;43(3):64. Epub 2019 Feb 7.

Reference Type: Journal Article

Available from: https://link.springer.com/article/10.1007/s10916-019-1195-7 Subscription required to view.

Abstract: The blockchain technology has reached a great boom in the health sector, due to its importance to overcome interoperability and security challenges of the EHR and EMR systems in eHealth. The main objective of this work is to show a review of the existing research works in the literature, referring to the new blockchain technology applied in ehealth and exposing the possible research lines and trends in which this technology can be focused. The search for blockchain studies in eHealth field was carried out in the following databases: IEEE Xplore, Google Scholar, Science Direct, PubMed, Web of Science and ResearchGate from 2010 to the present. Different search criteria were established such as: “Blockchain” AND (“eHealth” OR “EHR” OR “electronic health records” OR “medicine”) selecting the papers considered of most interest. A total of 84 publications on blockchain in eHealth were found, of which 18 have been identified as relevant works, 5.56% correspond to the year 2016, 22.22% to 2017 and 72.22% to 2018. Many of the publications found show how this technology is being developed and applied in the health sector and the benefits it provides. The new blockchain technology applied in eHealth identifies new ways to share the distributed view of health data and promotes the advancement of precision medicine, improving health and preventing diseases.

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Angeletti F, Chatzigiannakis I, Vitaletti A. Privacy preserving data management in recruiting participants for digital clinical trials. Proceedings of the First International Workshop on Human-centered Sensing, Networking, and Systems; 2017; Delft, Netherlands. New York, NY: ACM.

Reference Type: Conference Proceedings

Available from: https://dl.acm.org/citation.cfm?id=3144733 Subscription required to view.

Abstract: Our data is now more valuable than ever. The uncontrolled growth of internet-centered services has led us to accept many compromises about how we share it. In the era of Internet of Things, smart devices are collecting personal data continuously. Now, more than ever, we are in need of privacy-preserving applications where users are always in control of their sensitive data. Previous work focus on the preservation of privacy on datasets possibly collected during clinical trials. In contrast, here we focus on the preservation of privacy during the preliminary recruiting phase of a clinical trial. Our solution, is the first where a) user's data are not stored in any public database and remain in the user's private space during the whole recruiting phase and b) at the same time the Clinical Research Institute is assured that it is acquiring useful and authentic data. We provide a proof-of-concept implementation and study its performance based on a real-world evaluation.

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Angeletti F, Chatzigiannakis I, Vitaletti A. The role of blockchain and IoT in recruiting participants for digital clinical trials. In: Begušić D, International Conference on Software Telecommunications and Computer Networks, IEEE Communications Society, editors. 2017 25th International Conference on Software, Telecommunications and Computer Networks (SoftCOM); 2017 Sept 21-23; Split, Croatia. Piscataway, NJ: IEEE Communications Society; 2017.

Reference Type: Conference Paper

Available from: https://ieeexplore.ieee.org/abstract/document/8115590 Subscription required to view.

Abstract: Our personal data is now more valuable than ever. The uncontrolled growth of internet-centered services has led us to accept many compromises about how we share it. In the era of Internet of Things, personal data is collected continuously. Now, more than ever, we are in need of privacy-preserving applications where users always retain control of their personal data. In this paper, we present a secure way to control the flow of personal data in the specific case of the recruitment of participants for clinical trials. We take special care to protect the interests of both parties: the individual can keep its data private until an agreement is reached, and the Clinical Research Institute can be assured that it is acquiring useful and authentic data. We provide a proof-of-concept implementation and study its performance based on a real-world evaluation.

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Angeletti F, Chatzigiannakis I, Vitaletti A. Towards an architecture to guarantee both data privacy and utility in the first phases of digital clinical trials. Sensors (Basel). 2018;18(12):4175. Epub 2018 Nov 28.

Reference Type: Journal Article

Available from: https://www.ncbi.nlm.nih.gov/pmc/PMC6308650/

Abstract: In the era of the Internet of Things (IoT), drug developers can potentially access a wealth of real-world, participant-generated data that enable better insights and streamlined clinical trial processes. Protection of confidential data is of primary interest when it comes to health data, as medical condition influences daily, professional, and social life. Current approaches in digital trials entail that private user data are provisioned to the trial investigator that is considered a trusted party. The aim of this paper is to present the technical requirements and the research challenges to secure the flow and control of personal data and to protect the interests of all the involved parties during the first phases of a clinical trial, namely the characterization of the potential patients and their possible recruitment. The proposed architecture will let the individuals keep their data private during these phases while providing a useful sketch of their data to the investigator. Proof-of-concept implementations are evaluated in terms of performances achieved in real-world environments.

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Angelis J, Ribeiro da Silva E. Blockchain adoption: A value driver perspective. Bus Horiz. 2019;62(3):307-14. Epub 2018 Dec 26.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S0007681318302088

Abstract: The ongoing discussion regarding blockchain technologies is focused primarily on cryptocurrencies, but blockchain features and functionalities have developed beyond financial instruments. As the technologies provide new functionalities, the associated value proposition changes as well. This study explores the relationship between blockchain technologies and their underlying value drivers. Four identified distinct blockchain stages of increased maturity are analyzed and discussed. This covers the evolutionary technology types focused on transactions, smart contracts, decentralized applications, and the introduction of artificial intelligence supporting decentralized decision making. In addition, we address management issues around appropriate blockchain adoption using a blockchain value driver-focused framework that gives decision makers actionable questions and recommendations. We provide practitioners with a method for assessing suitable blockchain adoption that addresses the specific value creation associated with a given organizational strategy. For academics, we critically identify and assess the characteristics of the blockchain stages and their strategy implications and provide a structured approach conceptualizing blockchain technology evolution.

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Angraal S, Krumholz HM, Schulz WL. Blockchain technology: applications in health care. Circ Cardiovasc Qual Outcomes. 2017;10(9):1-3. Epub 2017 Sep 16.

Reference Type: Journal Article

Available from: https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.117.003800

Abstract: Blockchain technology has gained substantial attention in recent years with increased interest in several diverse fields, including the healthcare industry. Blockchain offers a secure, distributed database that can operate without a central authority or administrator. Blockchain uses a distributed, peer-to-peer network to make a continuous, growing list of ordered records called blocks to form a digital ledger. Each transaction, represented in a cryptographically signed block, is then automatically validated by the network itself. Blockchain has also garnered interest as a platform to improve the authenticity and transparency of healthcare data through many use cases, from maintaining permissions in electronic health records (EHR) to streamlining claims processing. In this article, we describe the basics of blockchain and illustrate current and future applications of this technology within the healthcare industry.

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Anjum A, Sporny M, Sill A. Blockchain standards for compliance and trust. IEEE Cloud Comput. 2017;4(4):84-90.

Reference Type: Journal Article

Available from: https://ieeexplore.ieee.org/document/8066010

Abstract: Cryptocurrency applications of distributed ledger methods such as blockchains are now well established, but their implications for more general topics are just beginning to be appreciated. Beyond applications in finance and banking, new applications are emerging in supply chain management, manufacturing, agricultural product tracking, advertising verification, Internet of Things, healthcare, and the pharmaceutical industry, among others.

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Antonucci F, Figorilli S, Costa C, Pallottino F, Raso L, Menesatti P. A review on blockchain applications in the agri-food sector. J Sci Food Agric. 2019. Epub 2019 Jul 5.

Reference Type: Journal Article

Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/jsfa.9912 Subscription required to view.

Abstract: Food security can benefit from the technology's transparency, relatively low transaction costs and instantaneous applications. A blockchain is a distributed database of records in the form of encrypted blocks, or a public ledger of all transactions or digital events that have been executed and shared among participating parties and can be verified at any time in the future. Generally, the robust and decentralized functionality of the blockchain is used for global financial systems, but it can easily be expanded to contracts and operations such as tracking of the global supply chain. In the precision agriculture context, Information and Communications Technology can be further implemented with a blockchain infrastructure to enable new farm systems and e-agriculture schemes. The purpose of this review is to show a panorama of the scientific studies (enriched by a terms mapping analysis) on the use of blockchain in the agri-food sector, from both an entirely computational and an applicative point of view. As evidenced by the network analysis, the reviewed studies mainly focused on software aspects (e.g., the architecture and smart contracts). However, some aspects regarding the different blockchain knots (computers always connected to the blockchain network) having the role to store and distribute an updated copy of each block in a food supply-chain, result of crucial importance. These technologies appear very promising and rich of great potential showing a good flexibility for applications in several sectors but still immature and hard to apply due to their complexity. This article is protected by copyright. All rights reserved.

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Arenas R, Fernandez P. CredenceLedger: a permissioned blockchain for verifiable academic credentials. 2018 IEEE International Conference on Engineering, Technology and Innovation (ICE/ITMC); 2018 Jun 17-20; Stuttgart, Germany. Piscataway, NJ: IEEE Technology Engineering and Management Society.

Reference Type: Conference Proceedings

Available from: https://ieeexplore.ieee.org/abstract/document/8436324 Subscription required to view.

Abstract: Blockchain, the underlying technology that powers cryptocurrencies such as Bitcoin and Ethereum, is gaining so much attention from different industry stakeholders, governments and research communities. Its application is extending beyond cryptocurrencies and has been exploited in different domains such as finance, E-commerce, Internet of Things (IoT), healthcare, and governance. Some key attributes of the technology are decentralization, immutability, security and transparency. This paper aims to describe how permissioned Blockchain can be applied to a specific educational use case - decentralized verification of academic credentials. The proposed Blockchain-based solution, named `CredenceLedger', is a system that stores compact data proofs of digital academic credentials in Blockchain ledger that are easily verifiable for education stakeholders and interested third party organizations.

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Arias-Oliva M, Pelegrin-Borondo J, Matias-Clavero G. Variables influencing cryptocurrency use: a technology acceptance model in Spain. Front Psychol. 2019;10:475. Epub 2019 Mar 18.

Reference Type: Journal Article

Available from: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00475/full

Abstract: The first commercial transaction with the first cryptocurrency in 2010 marked the start of a revolution in transactions. Blockchain and cryptocurrencies will dramatically transform how we do transactions, just as the Internet revolutionized how we communicate. Currently, more than 2,000 cryptocurrencies are quoted on the market, and many more are being launched in initial coin offerings for use as an exchange method in a specific business ecosystem or as rights to assets or liabilities. As an emerging fintech, cryptocurrencies open up many opportunities, but they also pose significant challenges and limitations. This paper analyzes the key factors for the successful development of a cryptocurrency from a consumer-behavior perspective. Using a technology acceptance theoretical framework, we test a model able to explain almost 85% of the intention to use cryptocurrencies. Surprisingly, risk was not a significant factor. This could be because most of the respondents considered operating with cryptocurrencies to be risky; the lack of variability in their responses to the questions about perceived risk would explain this lack of explanatory power. However, willingness to manage cryptocurrency risk could be a precondition for adoption. The performance expectancy for a given cryptocurrency was the most important factor for its success. The research was conducted in Spain with college-educated adults with basic knowledge of the Internet.

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Aspnes J, Jackson C, Krishnamurthy A. Exposing computationally-challenged byzantine imposters. 2005 Jul 26. Report No.: TR-1332.

Reference Type: Report

Available from: http://www.collinjackson.com/research/papers/iptps.pdf

Abstract: Internet protocols permit a single machine to masquerade as many, allowing an adversary to appear to control more nodes than it actually does. The possibility of such Sybil attacks has been taken to mean that distributed algorithms that tolerate only a fixed fraction of faulty nodes are not useful in peer-to-peer systems unless identities can be verified externally. The present work argues against this assumption by presenting practical algorithms for the distributed computing problem of Byzantine agreement that defend against Sybil attacks by using moderately hard puzzles as a pricing scheme for identities. Though our algorithms do not prevent Sybil attacks entirely, they solve Byzantine agreement (and some useful variants) when the limited fraction of nodes that can fail is replaced by a limited fraction of the total computational power. These results suggest that Byzantine agreement and similar tools from the distributed computing literature are likely to help solve the problem of adversarial behavior by components of peer-to-peer systems.

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Augot D, Chabanne H, Clémot O, George W. Transforming face-to-face identity proofing into anonymous digital identity using the bitcoin blockchain. In. 2017 15th Annual Conference on Privacy, Security and Trust (PST); 2017 Aug 28-30; Calgary, AB, Canada. IEEE; 2017. p. 25-34.

Reference Type: Conference Paper

Available from: https://arxiv.org/abs/1710.02951 Open access; https://ieeexplore.ieee.org/abstract/document/8476875 Subscription required to view.

Abstract: The most fundamental purpose of blockchain technology is to enable persistent, consistent, distributed storage of information. Increasingly common are authentication systems that leverage this property to allow users to carry their personal data on a device while a hash of this data is signed by a trusted authority and then put on a blockchain to be compared against. For instance, in 2015, MIT introduced a schema for the publication of their academic certificates based on this principle. In this work, we propose a way for users to obtain assured identities based on face-to-face proofing that can then be validated against a record on a blockchain. Moreover, in order to provide anonymity, instead of storing a hash, we make use of a scheme of Brands to store a commitment against which one can perform zero-knowledge proofs of identity. We also enforce the confidentiality of the underlying data by letting users control a secret of their own. We show how our schema can be implemented on Bitcoin's blockchain and how to save bandwidth by grouping commitments using Merkle trees to minimize the number of Bitcoin transactions that need to be sent. Finally, we describe a system in which users can gain access to services thanks to the identity records of our proposal.

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Axfoundation, SKL Kommentus, Swedish county councils and regions, Martin & Servera, Kairos Future. Blockchain use cases for food traceability and control: a study to identify the potential benefits from using blockchain technology for food traceability and control. Sweden: 2017 Nov 30.

Reference Type: Report

Available from: http://axfoundation.se/wp-content/uploads/2017/12/Blockchain-use-cases-for-food-tracking-and-control-dig-l%C3%A4tt.pdf

Abstract: Food and food production is one of the largest industries in the world. It is also the most fragmented industry with production scattered all over the world. The food supply chain also becomes more global over time. Keeping control of the supply chain of food is therefore a costly and difficult task. The dependence on trust in third party operations, ethics in production, transportation, to name a few areas, is evident. Stamps and documentation, IT-systems, certificates, food origin, mixing of food, the use of chemicals etc. are areas where fraud or ignorance can create problems on a large scale. At worst, it can cause health problems, even deaths.

While existing IT-solutions have mitigated some of these challenges there is still a lot of uncertainty. Integration costs remain high, there is still a lot of undetected fraud, and transparency levels are insufficient to comply with the current and future demands of consumers and other stakeholders. A new area of technology, the blockchain, can potentially solve many of the remaining problems for food transparency and control.

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Azaria A, Ekblaw A, Vieira T, Lippman A. MedRec: using blockchain for medical data access and permission management. In: Awan I, Younas M, IEEE Computer Society Technical Committee on the Internet, editors. 2016 2nd International Conference on Open and Big Data (OBD); 2016 Aug 22-24; Vienna, Austria. Piscataway, NJ: IEEE Computer Society; 2016. p. 25-30.

Reference Type: Conference Paper

Available from: http://dpnm.postech.ac.kr/cs490u/MedRec.pdf Open access; https://ieeexplore.ieee.org/abstract/document/7573685 Subscription required to view.

Abstract: Years of heavy regulation and bureaucratic inefficiency have slowed innovation for electronic medical records (EMRs). We now face a critical need for such innovation, as personalization and data science prompt patients to engage in the details of their healthcare and restore agency over their medical data. In this paper, we propose MedRec: a novel, decentralized record management system to handle EMRs, using blockchain technology. Our system gives patients a comprehensive, immutable log and easy access to their medical information across providers and treatment sites. Leveraging unique blockchain properties, MedRec manages authentication, confidentiality, accountability and data sharing- crucial considerations when handling sensitive information. A modular design integrates with providers' existing, local data storage solutions, facilitating interoperability and making our system convenient and adaptable. We incentivize medical stakeholders (researchers, public health authorities, etc.) to participate in the network as blockchain miners;. This provides them with access to aggregate, anonymized data as mining rewards, in return for sustaining and securing the network via Proof of Work. MedRec thus enables the emergence of data economics, supplying big data to empower researchers while engaging patients and providers in the choice to release metadata. The purpose of this short paper is to expose, prior to field tests, a working prototype through which we analyze and discuss our approach.

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Baars DS. Towards self-sovereign identity using blockchain technology [Master's Thesis]: University of Twente; 2016.

Reference Type: Thesis

Available from: https://essay.utwente.nl/71274/

Abstract: With more than three billion internet users, each with multiple digital identities, the management of these identities is very important. Surveys show that people often use the identity management systems they don't want to use. They don't have full control over their infor- mation, have no way to know what is shared with other parties and are dependent on trusted parties when logging in to websites. Blockchain technology is used as basis for a secure and transparent distributed ledger for the Bitcoin cryptocurrency. Its decentralized, pub- lic and immutable properties solve the double spending problem and allow every participant of the network to read the transaction history, help in the validation process and pay and receive Bitcoin. Cryptographically complex math ensures that everyone can do trans- actions with everyone without the need for a trusted third party. Next to nancial transactions, this also holds for other claims. Entities can put claims on a decentralized ledger by digitally signing it, which allows any other entity to verify that these claims are made by that speci c entity. This allows authorities like governments to make claims about indi- viduals, which can be combined with other claims to create a very strong claim about someone. Because both the claimant and the claimee can be veri ed, this allows entities like mortgage lenders to outsource their Customer Due Diligence (CDD) processes. In this research we will explore the possibility of self-sovereign identity, where you are in control of your digital identity. We started with a desk research on currently available identity man- agement solutions. We concluded that in most systems, the end-user is not able to store their own data. Currently only one decentralized system is available, but has not gained wide adoption yet. A case study has been performed on a solution which allows the ex- change of KYC attributes, resulting from thorough Customer Due Dili- gence (CDD) as is often performed when opening a bank account. These attributes can be used by other entities, like insurance companies and mortgage lenders to make their on-boarding process easier for customers, since they don't need to supply copies of the same documentation all over again. Also, the companies themselves could outsource their Customer Due Diligence (CDD) this way to lower costs and make fewer errors. Al- though the idea is very interesting, the studied solution did not meet the expectations. At the time the company behind the solution was very small and the process to improve very complex. The solution was also propri- etary, creating dependence on the vendor, which heightens the adoption barrier. Because of the lessons learned from the case study, the results of the literature research and the desk research, we designed an architecture for a Decentralized Identity Management System (DIMS) using the concept of claim-based identity and blockchain technology. To lower adoption barriers and create a self-sustaining ecosystem, it will be developed on a public blockchain and source code will be made open-source. The solution will be privacy-friendly by using privacy-enhancing techniques and storing only claims about one's identity. We also provide a solution to allow retrieval of more sensitive data, and made it as modular as possible to make integration within existing IT architecture easier. The Decentralized Identity Management System (DIMS) can be use- ful in a wide range of use cases, like proving your age when buying liquor at the supermarket or applying for a health insurance where you get a student discount if you can show your are enrolled at a university. This shows that our work resulted in a solid foundation for self-sovereign identity using blockchain technology.

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Back A, Corallo M, Dashjr L, Friedenbach M, Maxwell G, Miller A, et al. Enabling blockchain innovations with pegged sidechains. Blockstream, 2014 Oct 22. Report No.: 5650e43.

Reference Type: Report

Available from: https://blockstream.com/sidechains.pdf

Abstract: Since the introduction of Bitcoin[Nak09] in 2009, and the multiple computer science and electronic cash innovations it brought, there has been great interest in the potential of decentralised cryptocurrencies. At the same time, implementation changes to the consensus critical parts of Bitcoin must necessarily be handled very conservatively. As a result, Bitcoin has greater difficulty than other Internet protocols in adapting to new demands and accommodating new innovation. We propose a new technology, pegged sidechains, which enables bitcoins and other ledger assets to be transferred between multiple blockchains. This gives users access to new and innovative cryptocurrency systems using the assets they already own. By reusing Bitcoin’s currency, these systems can more easily interoperate with each other and with Bitcoin, avoiding the liquidity shortages and market fluctuations associated with new currencies. Since sidechains are separate systems, technical and economic innovation is not hindered. Despite bidirectional transferability between Bitcoin and pegged sidechains, they are isolated: in the case of a cryptographic break (or malicious design) in a sidechain, the damage is entirely confined to the sidechain itself. This paper lays out pegged sidechains, their implementation requirements, and the work needed to fully benefit from the future of interconnected blockchains.

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Badr S, Gomaa I, Abd-Elrahman E. Multi-tier blockchain rramework for IoT-EHRs Systems. In: Shakshuki E, Yasar A, editors. The 9th International Conference on Emerging Ubiquitous Systems and Pervasive Networks; Leuven, Belgium. Oxford, UK: Elsevier B.V.; 2018. p. 159-66.

Reference Type: Conference Paper

Available from: http://www.sciencedirect.com/science/article/pii/S187705091831812X

Abstract: Recently, Blockchain is considered as one of the main powerful techniques in security and privacy domains. It is considered as the promised security concept for replacing the current third parities trusting solutions. This could be achieved by mixing some cryptography techniques, consensus algorithms alongside with some peer-to-peer communication protocols. In this paper, to meet the requirement of distributed structure in the eHealth Records (EHRs) system, we propose a novel protocol to achieve a perfect privacy preserving for the patient namely Pseudonym Based Encryption with Different Authorities (PBE-DA) by applying the concept of Blockchain on the healthcare communication entities in an e-health platform. Therefore, PBE-DA will be used to help the patient anonymously to access, check or update his sensitive data on EHRs system. Moreover, we analyzed not only the public blockchain tier between the different EHRs cloud provider but also another Blockchain tier between the patient sensors (IoT devices used to do some patient measurements) and the patient system as a gateway for the whole healthcare platform.

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Bahga A, Madisetti VK. Blockchain platform for industrial Internet of Things. J Softw Eng Appl. 2016;9(10):533-46. Epub 2016 Oct 28.

Reference Type: Journal Article

Available from: https://www.scirp.org/journal/PaperInformation.aspx?PaperID=71596

Abstract: Internet of Things (IoT) are being adopted for industrial and manufacturing applica-tions such as manufacturing automation, remote machine diagnostics, prognostic health management of industrial machines and supply chain management. Cloud-Based Manufacturing is a recent on-demand model of manufacturing that is leve-raging IoT technologies. While Cloud-Based Manufacturing enables on-demand access to manufacturing resources, a trusted intermediary is required for transactions between the users who wish to avail manufacturing services. We present a decentra-lized, peer-to-peer platform called BPIIoT for Industrial Internet of Things based on the Block chain technology. With the use of Blockchain technology, the BPIIoT plat-form enables peers in a decentralized, trustless, peer-to-peer network to interact with each other without the need for a trusted intermediary.

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Balakrishnan YV. Redefining regulatory information management with blockchain. Tata Consultancy Services, 2018 Mar 23. Report No.: M I 03 I 18.

Reference Type: Report

Available from: https://www.tcs.com/content/dam/tcs/pdf/Industries/life-sciences-and-healthcare/solution-brochure/Redefining-RIM.pdf

Abstract: With more consumers demanding a greater say in how their health is managed, life sciences and healthcare companies are increasingly adopting a patient-centric business model. In response to this paradigm shift, enterprises will need to reimagine how they receive regulatory approval for new products while meeting local and global regulatory requirements and gain access to information that can be shared rapidly with the patients and care givers. Regulatory affairs (RA) is one of the most critical areas within the life sciences domain and is the gateway for acquiring product approvals. Regulatory process are subject to changes and adoption due to the ever changing updates to regulation as well as the new and emerging regulations. This causes several challenges – traceability and global visibility of the process, are the submissions being done as per the current or the earlier regulations, are we current on the latest labelling requirements, and are the products being shipped to that country in conformance with the submission made there in?

Equally important is that the entire organization and external consumers (such as clinical research organization (CRO), institutional review board (IRB), patients, and contract manufacturing organization (CMO) in the ecosystem have the most relevant and current data or information sets are the regulatory data like CMC coming from the several stakeholders consistent? This becomes a complicated affair when a globally distributed network of affiliates are responsible for managing a significant volume of critical product information.

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Balis C, Tagopoulos I, Dimola K. Moving towards a blockchain-based healthcare information system. Stud Health Technol Inform. 2019;262:168-71. Epub 2019 Jul 4.

Reference Type: Journal Article

Available from: http://ebooks.iospress.nl/publication/51706 Subscription required to view.

Abstract: One of the major problems that a national health system face is the lack of a unified clinical data management. In Greece, the critical and sensitive medical data generated during a patient lifetime are fragmented in one or more hospitals and healthcare services are not characterized by a 'continuity' factor. There is not the appropriate technological and administrative infrastructure for a unified patient medical history, prescriptions, laboratory tests or therapeutic plan. Technological, administrative and economic factors have led to this situation. We propose the integration and implementation of a blockchain network as a complementary technology to the existing information systems, so reliable and effective information management could be provided by a healthcare organization or the national healthcare system. Blockchain technology could be implemented as a bridge that can provide information systems interoperability within a hospital or between different hospitals.

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Banga R, Juneja M. Clinical trials on blockchain. In. PhUSE EU Connect; 2018 Nov 4-7; Frankfurt, Germany. Kent, United Kingdom: PhUSE; 2018.

Reference Type: Conference Paper

Available from: https://www.lexjansen.com/phuse/2018/tt/TT11.pdf

Abstract: The objective of this paper is to demonstrate how blockchain technology can be used to optimize the clinical trial workflow. We will demonstrate how pharmaceutical companies and other clinical trial participants (such as CROs, regulatory agencies) can collect and store subjects' data and analysis results in a secure, distributed manner and introduce a sample use case and technical architecture used for implementation of a blockchain based Clinical Trial Management Solution. We will demonstrate this concept using Hyperledger Fabric, an open source enterprise blockchain hosted by the Linux Foundation.

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Bariviera AF, Zunino L, Rosso OA. An analysis of high-frequency cryptocurrencies prices dynamics using permutation-information-theory quantifiers. Chaos. 2018;28(7):075511. Epub 2018 Jul 19.

Reference Type: Journal Article

Available from: https://aip.scitation.org/doi/10.1063/1.5027153

Abstract: This paper discusses the dynamics of intraday prices of 12 cryptocurrencies during the past months' boom and bust. The importance of this study lies in the extended coverage of the cryptoworld, accounting for more than 90% of the total daily turnover. By using the complexity-entropy causality plane, we could discriminate three different dynamics in the data set. Whereas most of the cryptocurrencies follow a similar pattern, there are two currencies (ETC and ETH) that exhibit a more persistent stochastic dynamics, and two other currencies (DASH and XEM) whose behavior is closer to a random walk. Consequently, similar financial assets, using blockchain technology, are differentiated by market participants.

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Bass J. The truth about blockchain and its application to health care. Healthc Financ Manage. 2019 Feb 1.

Reference Type: Magazine Article

Available from: https://www.hfma.org/Content.aspx?id=63125 Subscription required to view.

Abstract: The potential for blockchain to transform health care is very much a future prospect in 2019. But there are ways the technology can be applied today that can begin to pave the way to such a future.

Over the past few years, the healthcare industry has seen a rise in understanding of the timestamped, distributed-register technology blockchain and how it might, over time, affect the complex relationship between commerce and care. Healthcare leaders are beginning to have a realistic grasp of blockchain’s potential and how it might transform the industry.

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Batubara FR, Ubacht J, Janssen M, Zuiderwijk A, Hinnant CC, editors. Challenges of blockchain technology adoption for e-government: a systematic literature review. 19th Annual International Conference on Digital Government Research: Governance in the Data Age; 2018 May 30 - Jun 1; Delft, Netherlands. New York, NY: Advancing Computing as a Science & Profession.

Reference Type: Conference Proceedings

Available from: https://www.researchgate.net/profile/Jolien_Ubacht/publication/325497149_Blockchain_applications_in_government/links/5ba4bffa92851ca9ed1a80db/Blockchain-applications-in-government.pdf Open access; https://dl.acm.org/citation.cfm?id=3209317 Subscription required to view

Abstract: In this paper, we present the applications of blockchain technology in healthcare. Furthermore, we evaluate the choice and deployment of Blockchain technology in such applications, review the advantages and disadvantages of such an approach. We review the Estonian system, which is the first blockchain-based health system at the national level, in detail and discuss its ramifications to Turkey. This paper is one of the first papers in this domain and, to the best of authors' knowledge, the first in Turkish.

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Baynham-Herd Z. Technology: enlist blockchain to boost conservation. Nature. 2017;548(7669):523. Epub 2017 Aug 30.

Reference Type: Journal Article

Available from: https://www.nature.com/articles/548523c

Abstract: Blockchain technology stands to improve governance of the environment and of renewable energy. It could also facilitate peer-to-peer fundraising donations to transform nature conservation, which is drastically underfunded.

Cryptocurrency transactions are instant and transparent. They do not require bank accounts and international exchange fees are small. Donations can be sent directly to individuals or projects worldwide, rather than being collected, pooled and distributed by organizations. This encourages donors because the blockchain tracks the impact of donations.

By removing funding barriers, anyone can do conservation work — from restoring urban ecology to preventing conflicts between humans and wildlife. With a greater number and variety of conservationists and natural spaces, such small participatory efforts will be amplified through social networks.

Peer-to-peer conservation will not solve issues such as the ivory trade, could enable fraudulent or counterproductive projects, and may result in a bias towards flagship species. Yet it can still make an important contribution.

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Beckstrom K. Utilizing blockchain to improve clinical trials. In: Metcalf D, Bass J, Hooper M, Cahana A, Dhillon V, editors. Blockchain in healthcare: innovations that empower patients, connect professionals and improve care. 1st ed. Orlando, FL: Merging Traffic; 2019. p. 109-21.

Reference Type: Book Section

Available from: https://www.crcpress.com/Blockchain-in-Healthcare-Innovations-that-Empower-Patients-Connect-Professionals/Dhillon-Bass-Hooper-Metcalf-Cahana/p/book/9780367031084 Purchase required.

Abstract: The pharmaceutical industry is in the midst of transformation as a result of confounding demands to accelerate time to market, increase patient centricity and reduce the development and validation costs for new drugs. This chapter explores how the mistrust that exists between clinical trial stakeholders can affect this transformation and identifies areas where distributed ledger technology, aka blockchain, could help. We present how pharmaceutical and other industry consortiums such as PhUSE and IEEE, as well as individual companies, are advancing the concept of blockchain from thought exercises and white papers to pilots, prototypes and beyond. In conclusion, we review our lessons learned from early stage blockchain projects, identify where blockchain can provide the most value and provide a roadmap for standard clinical trial use.

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Bell L, Buchanan WJ, Cameron J, Lo O. Applications of blockchain within healthcare. Blockchain Healthc Today [Internet]. 2018 May 29 [cited 2018 Oct 23]; 1(8):[7 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/8

Reference Type: Electronic Article

Abstract: There are several areas of healthcare and well-being that could be enhanced using blockchain technologies. These include device tracking, clinical trials, pharmaceutical tracing, and health insurance. Within device tracking, hospitals can trace their asset within a blockchain infrastructure, including through the complete lifecycle of a device. The information gathered can then be used to improve patient safety and provide after-market analysis to improve efficiency savings. This paper outlines recent work within the areas of pharmaceutical traceability, data sharing, clinical trials, and device tracking.

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Bellini V, Petroni A, Palumbo G, Bignami E. Data quality and blockchain technology. Anaesth Crit Care Pain Med. 2019;(in press). Epub 2019 Jan 8.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S2352556818305368 Subscription required to view.

Abstract: [FIRST FEW PARAGRAPHS] Dear Editor, We recently read with great interest a paper published in your journal entitled “Big data and targeted machine learning in action to assist medical decision in the ICU” by Pirracchio et al. It is an extremely precise analysis of the most recent developments in the fields of big data, technology, and statistics. These innovations can lead to increasingly tailored health treatment; real-time processing of data might also allow their application in time-dependent medical specialisations, such as in the case of perioperative medicine and intensive care.

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Benchoufi M, Porcher R, Ravaud P. Blockchain protocols in clinical trials: transparency and traceability of consent. F1000Res. 2018;6:66. Epub 2018 Feb 1.

Reference Type: Journal Article

Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676196/

Abstract: Clinical trial consent for protocols and their revisions should be transparent for patients and traceable for stakeholders. Our goal is to implement a process allowing for collection of patients' informed consent, which is bound to protocol revisions, storing and tracking the consent in a secure, unfalsifiable and publicly verifiable way, and enabling the sharing of this information in real time. For that, we build a consent workflow using a trending technology called Blockchain. This is a distributed technology that brings a built-in layer of transparency and traceability. From a more general and prospective point of view, we believe Blockchain technology brings a paradigmatical shift to the entire clinical research field. We designed a Proof-of-Concept protocol consisting of time-stamping each step of the patient's consent collection using Blockchain, thus archiving and historicising the consent through cryptographic validation in a securely unfalsifiable and transparent way. For each protocol revision, consent was sought again. We obtained a single document, in an open format, that accounted for the whole consent collection process: a time-stamped consent status regarding each version of the protocol. This document cannot be corrupted and can be checked on any dedicated public website. It should be considered a robust proof of data. However, in a live clinical trial, the authentication system should be strengthened to remove the need for third parties, here trial stakeholders, and give participative control to the peer users. In the future, the complex data flow of a clinical trial could be tracked by using Blockchain, which core functionality, named Smart Contract, could help prevent clinical trial events not occurring in the correct chronological order, for example including patients before they consented or analysing case report form data before freezing the database. Globally, Blockchain could help with reliability, security, transparency and could be a consistent step toward reproducibility.

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Benchoufi M, Ravaud P. Blockchain technology for improving clinical research quality. Trials. 2017;18:335. Epub 2017 Jul 19.

Reference Type: Journal Article

Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5517794/

Abstract: Reproducibility, data sharing, personal data privacy concerns and patient enrolment in clinical trials are huge medical challenges for contemporary clinical research. A new technology, Blockchain, may be a key to addressing these challenges and should draw the attention of the whole clinical research community. Blockchain brings the Internet to its definitive decentralisation goal. The core principle of Blockchain is that any service relying on trusted third parties can be built in a transparent, decentralised, secure “trustless” manner at the top of the Blockchain (in fact, there is trust, but it is hardcoded in the Blockchain protocol via a complex cryptographic algorithm). Therefore, users have a high degree of control over and autonomy and trust of the data and its integrity. Blockchain allows for reaching a substantial level of historicity and inviolability of data for the whole document flow in a clinical trial. Hence, it ensures traceability, prevents a posteriori reconstruction and allows for securely automating the clinical trial through what are called Smart Contracts. At the same time, the technology ensures fine-grained control of the data, its security and its shareable parameters, for a single patient or group of patients or clinical trial stakeholders. In this commentary article, we explore the core functionalities of Blockchain applied to clinical trials and we illustrate concretely its general principle in the context of consent to a trial protocol. Trying to figure out the potential impact of Blockchain implementations in the setting of clinical trials will shed new light on how modern clinical trial methods could evolve and benefit from Blockchain technologies in order to tackle the aforementioned challenges.

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Bennett B. Blockchain HIE overview: a framework for healthcare interoperability. Telehealth Med Today. 2017;2(3).

Reference Type: Journal Article

Available from: https://telehealthandmedicinetoday.com/index.php/journal/article/view/14

Abstract: Data stored in a blockchain is immutable and available for access by separate parties. The excellent potential residing in this technology includes security, verification, and expanded data management for healthcare records, making it ideal for a new interoperability standard. As it stands today, public blockchain technology (i.e. Bitcoin) is a secure P2P (peer-to-peer) ledger system that uses public key encryption to protect information. Once entries are created on the chain, they are immutable, making blockchain ideal for storing permanent records. Because of this, authorized members of a network are confident of their data's authenticity within the encrypted chains. The shared ledger structure provides an immutable audit trail for every transaction. In healthcare, organizations can create authenticated records and entries without needing a central authority. Each link in the chain verifies the next, traceable back to what’s called the Genesis block, a.k.a. the first block in the chain ever created.

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Bennett B. Using telehealth as a model for blockchain HIT adoption. Telehealth Med Today. 2017;2(4):1-4.

Reference Type: Journal Article

Available from: https://telehealthandmedicinetoday.com/index.php/journal/article/view/25

Abstract: Telemedicine and blockchain technology share a core philosophy of empowering the individual. Blockchain solutions that focus on empowering patients and enhancing the workflows for the providers who treat them continue to make big headlines, as does enterprise investment and adoption of telehealth. Both models focus on direct-to-consumer health services, with a personalized care experience designed from the ground up to save time and money for everyone involved. The typical binding factor between the telehealth and HIT (health information technology) blockchain adoption is a patient centric, value-based care model. Therefore, it is as no coincidence that value-based care is at the center of the fastest growing (and operational) part of HIT blockchain adoption. For this reason, telehealth can demonstrate adoption synergies than most other lines of business in healthcare cannot.

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Bennett K, Decker C. Certified blockchain business foundations: official exam study guide [Internet]: Blockchain Training Alliance, Inc. 2019; cited 2019 Jan 22]. 50 p. Available from: Not available online

Reference Type: Electronic Book

Abstract: None

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Benniche S. Using blockchain technology to recycle cancer drugs. Lancet Oncol. 2019;In press. Epub 2019 May 10.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S1470204519302918 Subscription required to view.

Abstract: [FIRST FEW PARAGRAPHS] Two startup organisations that are committed to recycling expensive cancer drugs for re-use have been chosen by the US Food and Drug Administration (FDA) to form part of a consortium for a drug supply chain pilot project.

Following the enaction of the Drug Quality and Security Act in 2013, the FDA announced plans to launch a pilot programme intending to develop technologies for identifying and tracing prescription drugs, to enhance the safety and security of the drug supply chain.

RemediChain and Good Shepherd Pharmacy (both in Memphis, TN, USA) take unused cancer drugs and give them to patients who otherwise cannot afford them. The unused drugs are donated by cancer clinics and individuals no longer in need of them and are given to suitable patients in need across the USA.

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Bernardi F, Lima V, Pellison F, de Azevedo Marques PM, Rijo R, Galliez RM, et al. Blockchain based network for tuberculosis: a data sharing initiative in Brazil. Stud Health Technol Inform. 2019;262:264-7. Epub 2019 Jul 4.

Reference Type: Journal Article

Available from: https://www.researchgate.net/publication/334273400_Blockchain_Based_Network_for_Tuberculosis_A_Data_Sharing_Initiative_in_Brazil Open access: http://ebooks.iospress.nl/publication/51731 Subscription required to view.

Abstract: Data sharing, information exchange, knowledge acquisition and health intelligence are the basis of an efficient and effective evidence-based decision-making tool. A decentralized blockchain architecture is a flexible solution that can be adapted to institutional and managerial culture of organizations and services. Blockchain can play a fundamental role in enabling data sharing within a network and, to achieve that, this work defines the high-level resources necessary to apply this technology to Tuberculosis related issues. Thus, relying in open-source tools and in a collaborative development approach, we present a proposal of a blockchain based network, the TB Network, to underpin an initiative of sharing of Tuberculosis scientific, operational and epidemiologic data between several stakeholders across Brazilian cities.

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Blackford WJ. Hashing it out: blockchain as a solution for Medicare improper payments. Belmont Law Rev. 2018;5(10):219-52. Epub 2019 Feb 22.

Reference Type: Journal Article

Available from: https://repository.belmont.edu/lawreview/vol5/iss1/10/

Abstract: Part I highlights the inadequacies and inefficiencies of our Medicare payment system, focusing on the initiatives currently in place and the susceptibilities that persist. Part II offers a broad overview of the development, importance, features, and collateral technologies surrounding blockchain. Part III posits that Congress and HHS, through its various subsidiary agencies, should work in tandem with private stakeholders to create and/or implement a blockchain-based infrastructure to facilitate federal healthcare payments and support future growth of quality-based initiatives. This Note concludes with a recommendation for future agency research focusing on the viability and cost efficiency of a blockchain solution.

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Blemus S. Law and blockchain: a legal perspective on current regulatory trends worldwide. RTDF [Internet]. 2017 Dec 11 [cited 2019 Feb 28]; (4-2017):[15 p.]. Available from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3080639

Reference Type: Electronic Article

Abstract: This paper expounds the latest main regulatory projects and industry-wide consultations in the United States (US), in the European Union (EU) and in the main economic countries where distributed ledgers (thereafter, “Blockchain”) regulations have been discussed, proposed and/or adopted.

In just a few years, the Blockchain has become a major topic for public decision-makers worldwide. As this disruptive and decentralized technology has emerged as a key business issue for start-ups and market participants, the central banks and financial regulators have changed, most notably in the US and in the EU, from an initial strong hostility to a more cautious and market-friendly position.

The paper extensively covers and compares the current regulatory trends in selected relevant countries on the various applications enabled or issues raised by the Blockchain technology (Bitcoin/virtual currencies/crypto-tokens, smart contracts, decentralized autonomous organization (“DAO”), initial coin offerings/“ICO”…).

Three main regulatory items should be distinguished and will be analyzed separately thereafter:
(I) the virtual currencies regulation,
(II) the ICO (and crypto tokens) regulation, and
(III) the legal validity of Blockchain technology and smart contracts.

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Boucher P, Nascimento S, Kritikos M. How blockchain technology could change our lives [Internet]. Brussels, Belgium: European Parliamentary Research Service. 2017 [updated 2017 Feb; cited 2018 Oct 23]. 24 p. Available from: http://www.europarl.europa.eu/RegData/etudes/IDAN/2017/581948/EPRS_IDA(2017)581948_EN.pdf

Reference Type: Electronic Book

Abstract: Blockchains are a remarkably transparent and decentralised way of recording lists of transactions. Their best-known use is for digital currencies such as Bitcoin, which announced blockchain technology to the world with a headline-grabbing 1000% increase in value in the course of a single month in 2013. This bubble quickly burst, but steady growth since 2015 means Bitcoins are currently valued higher than ever before.

There are many different ways of using blockchains to create new currencies. Hundreds of such currencies have been created with different features and aims. The way blockchain-based currency transactions create fast, cheap and secure public records means that they also can be used for many non-financial tasks, such as casting votes in elections or proving that a document existed at a specific time. Blockchains are particularly well suited to situations where it is necessary to know ownership histories. For example, they could help manage supply chains better, to offer certainty that diamonds are ethically sourced, that clothes are not made in sweatshops and that champagne comes from Champagne. They could help finally resolve the problem of music and video piracy, while enabling digital media to be legitimately bought, sold, inherited and given away second-hand like books, vinyl and video tapes. They also present opportunities in all kinds of public services such as health and welfare payments and, at the frontier of blockchain development, are self-executing contracts paving the way for companies that run themselves without human intervention.

Blockchains shift some control over daily interactions with technology away from central elites, redistributing it among users. In doing so, they make systems more transparent and, perhaps, more democratic. That said, this will not probably not result in a revolution. Indeed, the governments and industry giants investing heavily in blockchain research and development are not trying to make themselves obsolete, but to enhance their services. There are also some wider issues to consider. For example, blockchain's transparency is fine for matters of public record such as land registries, but what about bank balances and other sensitive data? It is possible (albeit only sometimes and with substantial effort), to identify the individuals associated with transactions. This could compromise their privacy and anonymity. While some blockchains do offer full anonymity, some sensitive information simply should not be distributed in this way. Nevertheless, although blockchains are not the solution for every problem and even if they will not revolutionise every aspect of our lives, they could have a substantial impact in many areas and it is necessary to be prepared for the challenges and opportunities they present.

This report provides an accessible entry point for those in the European Parliament and beyond who are interested in learning more about blockchain development and its potential impacts. In doing so, the aim is to stimulate reflection and discussion of this complicated, controversial and fast-moving technology. The report is non-sequential, so readers are invited to choose the sections that interest them and read them in any order. The section immediately below presents an introduction to how blockchain technology works. The subsequent eight sections each present two-page briefings about how it could be deployed in various application areas, its potential impacts, and its implications for European policy. Finally, a concluding section presents some overall remarks and potential responses to blockchain development.

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Brogan J, Baskaran I, Ramachandran N. Authenticating health activity data using distributed ledger technologies. Comput Struct Biotechnol J. 2018;16:257-66. Epub 2018 Jul 17.

Reference Type: Journal Article

Available from: https://www.sciencedirect.com/science/article/pii/S2001037018300345

Abstract: The on-demand digital healthcare ecosystem is on the near horizon. It has the potential to extract a wealth of information from “big data” collected at the population level, to enhance preventive and precision medicine at the patient level. This may improve efficiency and quality while decreasing cost of healthcare delivered by professionals. However, there are still security and privacy issues that need to be addressed before algorithms, data, and models can be mobilized safely at scale. In this paper we discuss how distributed ledger technologies can play a key role in advancing electronic health, by ensuring authenticity and integrity of data generated by wearable and embedded devices. We demonstrate how the Masked Authenticated Messaging extension module of the IOTA protocol can be used to securely share, store, and retrieve encrypted activity data using a tamper-proof distributed ledger.

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Burchert C, Decker C, Wattenhofer R. Scalable funding of Bitcoin micropayment channel networks. R Soc Open Sci. 2018;5(8):180089. Epub 2018 Aug 29.

Reference Type: Journal Article

Available from: https://royalsocietypublishing.org/doi/full/10.1098/rsos.180089

Abstract: The Bitcoin network has scalability problems. To increase its transaction rate and speed, micropayment channel networks have been proposed; however, these require to lock funds into specific channels. Moreover, the available space in the blockchain does not allow scaling to a worldwide payment system. We propose a new layer that sits in between the blockchain and the payment channels. The new layer addresses the scalability problem by enabling trustless off-blockchain channel funding. It consists of shared accounts of groups of nodes that flexibly create one-to-one channels for the payment network. The new system allows rapid changes of the allocation of funds to channels and reduces the cost of opening new channels. Instead of one blockchain transaction per channel, each user only needs one transaction to enter a group of nodes-within the group the user can create arbitrarily many channels. For a group of 20 users with 100 intra-group channels, the cost of the blockchain transactions is reduced by 90% compared to 100 regular micropayment channels opened on the blockchain. This can be increased further to 96% if Bitcoin introduces Schnorr signatures with signature aggregation.

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Cai W, Du X, Xu J. A personalized QoS prediction method for web services via blockchain-based matrix factorization. Sensors (Basel). 2019;19(12). Epub 2019 Jun 19.

Reference Type: Journal Article

Available from: https://www.mdpi.com/1424-8220/19/12/2749

Abstract: Personalized quality of service (QoS) prediction plays an important role in helping users build high-quality service-oriented systems. To obtain accurate prediction results, many approaches have been investigated in recent years. However, these approaches do not fully address untrustworthy QoS values submitted by unreliable users, leading to inaccurate predictions. To address this issue, inspired by blockchain with distributed ledger technology, distributed consensus mechanisms, encryption algorithms, etc., we propose a personalized QoS prediction method for web services that we call blockchain-based matrix factorization (BMF). We develop a user verification approach based on homomorphic hash, and use the Byzantine agreement to remove unreliable users. Then, matrix factorization is employed to improve the accuracy of predictions and we evaluate the proposed BMF on a real-world web services dataset. Experimental results show that the proposed method significantly outperforms existing approaches, making it much more effective than traditional techniques.

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Cai Y, Zhu D. Fraud detections for online businesses: a perspective from blockchain technology. Financ Innov. 2016;2(20):1-10. Epub 2016 Dec 6.

Reference Type: Journal Article

Available from: https://link.springer.com/article/10.1186/s40854-016-0039-4

Abstract: Background: The reputation system has been designed as an effective mechanism to reduce risks associated with online shopping for customers. However, it is vulnerable to rating fraud. Some raters may inject unfairly high or low ratings to the system so as to promote their own products or demote their competitors.
Method: This study explores the rating fraud by differentiating the subjective fraud from objective fraud. Then it discusses the effectiveness of blockchain technology in objective fraud and its limitation in subjective fraud, especially the rating fraud. Lastly, it systematically analyzes the robustness of blockchain-based reputation systems in each type of rating fraud.
Results: The detection of fraudulent raters is not easy since they can behave strategically to camouflage themselves. We explore the potential strengths and limitations of blockchain-based reputation systems under two attack goals: ballot-stuffing and bad-mouthing, and various attack models including constant attack, camouflage attack, whitewashing attack and sybil attack. Blockchain-based reputation systems are more robust against bad-mouthing than ballot-stuffing fraud.
Conclusions: Blockchain technology provides new opportunities for redesigning the reputation system. Blockchain systems are very effective in preventing objective information fraud, such as loan application fraud, where fraudulent information is fact-based. However, their effectiveness is limited in subjective information fraud, such as rating fraud, where the ground-truth is not easily validated.

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Cao S, Zhang G, Liu P, Zhang X, Neri F. Cloud-assisted secure eHealth systems for tamper-proofing EHR via blockchain. Inf Sci (Ny). 2019;485:427-40. Epub 2019 Feb 14.

Reference Type: Journal Article

Available from: https://www.sciencedirect.com/science/article/pii/S0020025519301471 Subscription required to view.

Abstract: The wide deployment of cloud-assisted electronic health (eHealth) systems has already shown great benefits in managing electronic health records (EHRs) for both medical institutions and patients. However, it also causes critical security concerns. Since once a medical institution generates and outsources the patients’ EHRs to cloud servers, patients would not physically own their EHRs but the medical institution can access the EHRs as needed for diagnosing, it makes the EHRs integrity protection a formidable task, especially in the case that a medical malpractice occurs, where the medical institution may collude with the cloud server to tamper with the outsourced EHRs to hide the medical malpractice. Traditional cryptographic primitives for the purpose of data integrity protection cannot be directly adopted because they cannot ensure the security in the case of collusion between the cloud server and medical institution. In this paper, a secure cloud-assisted eHealth system is proposed to protect outsourced EHRs from illegal modification by using the blockchain technology (blockchain-based currencies, e.g., Ethereum). The key idea is that the EHRs only can be outsourced by authenticated participants and each operation on outsourcing EHRs is integrated into the public blockchain as a transaction. Since the blockchain-based currencies provide a tamper-proofing way to conduct transactions without a central authority, the EHRs cannot be modified after the corresponding transaction is recorded into the blockchain. Therefore, given outsourced EHRs, any participant can check their integrity by checking the corresponding transaction. Security analysis and performance evaluation demonstrate that the proposed system can provide a strong security guarantee with a high efficiency.

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Carter G, White D, Nalla A, Shahriar H, Sneha S. Integrating blockchain for data sharing and collaboration in mobile healthcare applications. 2017 IEEE 28th Annual International Symposium on Personal, Indoor, and Mobile Radio Communications (PIMRC); 2017 Oct 8-13; Montreal, QC, Canada. Piscataway, NJ: IEEE eXpress Conference Publishing; 2017.

Reference Type: Conference Proceedings

Available from: https://ieeexplore.ieee.org/document/8292361 Subscription required to view.

Abstract: Enabled by mobile and wearable technology, personal health data delivers immense and increasing value for healthcare, benefiting both care providers and medical research. The secure and convenient sharing of personal health data is crucial to the improvement of the interaction and collaboration of the healthcare industry. Faced with the potential privacy issues and vulnerabilities existing in current personal health data storage and sharing systems, as well as the concept of self-sovereign data ownership, we propose an innovative user-centric health data sharing solution by utilizing a decentralized and permissioned blockchain to protect privacy using channel formation scheme and enhance the identity management using the membership service supported by the blockchain. A mobile application is deployed to collect health data from personal wearable devices, manual input, and medical devices, and synchronize data to the cloud for data sharing with healthcare providers and health insurance companies. To preserve the integrity of health data, within each record, a proof of integrity and validation is permanently retrievable from cloud database and is anchored to the blockchain network. Moreover, for scalable and performance considerations, we adopt a tree-based data processing and batching method to handle large data sets of personal health data collected and uploaded by the mobile platform.

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Carter G, White D, Nalla A, Shahriar H, Sneha S. Toward application of blockchain for improved health records management and patient care. Blockchain Healthc Today [Internet]. 2019 Jun 17 [cited 2019 Jul 8]; 2(37):[12 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/37

Reference Type: Electronic Article

Abstract: Technological advancements have proven to be indispensable for improving patient care, yet they continue to present a host of problems. One of the most pressing concerns is how to improve quality of care while controlling costs. Beyond clinical care, one plausible solution is to share patient information freely and efficiently. Hospitals and clinics may share data internally, but external information sharing remains an issue. Despite the digitization of medical records, there remains a lack of adequate computing infrastructure or unwillingness to share data among providers. Care quality often suffers as a result. Implementing a type of peer-to-peer distributed digital technology, known as a blockchain, to record and transmit transactional data could be a solution to these concerns. Originally, blockchain was developed to record cryptocurrency transactions. However, as blockchain technologies have matured and adopted across dissimilar industries, the feasibility of possible applications of blockchain technology in healthcare is getting more attention. This article explores possible opportunities of adoption of blockchain technology to improve patient data security, privacy, and care while outlining the challenges that practitioners may encounter.

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Casado-Vara R, Prieto J, De la Prieta F, Corchado JM. How blockchain improves the supply chain: case study alimentary supply chain. In: Shakshuki E, Yasar A, editors. 15th International Conference on Mobile Systems and Pervasive Computing (MobiSPC 2018) / The 13th International Conference on Future Networks and Communications (FNC-2018) / Affiliated Workshops; 2018 Aug 13-15; Gran Canaria, Spain. Oxford, UK: Elsevier; 2018. p. 393-8.

Reference Type: Conference Paper

Available from: http://www.sciencedirect.com/science/article/pii/S187705091831158X

Abstract: Current supply chain is a linear economy model that directly or indirectly fulfills supply needs. But this model has some disadvantages, such as the relationships between the members of the supply chain or the lack of information for the consumer about the origin of the products. In this paper we propose a new model of supply chain via blockchain. This new model enables the concept of circular economy and eliminates many of the disadvantages of the current supply chain. In order to coordinate all the transactions that take place in the supply chain a multi-agent system is created for this paper.

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Casino F, Dasaklis TK, Patsakis C. A systematic literature review of blockchain-based applications: current status, classification and open issues. Telemat Informatics. 2019;36:55-81.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S0736585318306324

Abstract: This work provides a systematic literature review of blockchain-based applications across multiple domains. The aim is to investigate the current state of blockchain technology and its applications and to highlight how specific characteristics of this disruptive technology can revolutionise “business-as-usual” practices. To this end, the theoretical underpinnings of numerous research papers published in high ranked scientific journals during the last decade, along with several reports from grey literature as a means of streamlining our assessment and capturing the continuously expanding blockchain domain, are included in this review. Based on a structured, systematic review and thematic content analysis of the discovered literature, we present a comprehensive classification of blockchain-enabled applications across diverse sectors such as supply chain, business, healthcare, IoT, privacy, and data management, and we establish key themes, trends and emerging areas for research. We also point to the shortcomings identified in the relevant literature, particularly limitations the blockchain technology presents and how these limitations spawn across different sectors and industries. Building on these findings, we identify various research gaps and future exploratory directions that are anticipated to be of significant value both for academics and practitioners.

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Chamber of Digital Commerce. "Smart contracts" legal primer. Washington, DC: 2018 Jan.

Reference Type: Report

Available from: https://digitalchamber.org/wp-content/uploads/2018/02/Smart-Contracts-Legal-Primer-02.01.2018.pdf

Abstract: The term “smart contract” has entered the public consciousness following the rise to mainstream awareness of virtual currencies and blockchain technology. However, this term is frequently misunderstood and used incorrectly, creating unnecessary and potentially harmful confusion surrounding the application of U.S. law to smart contracts, and prompting states to attempt to clarify their position through legislation. The purpose of this document is to provide a plain language explanation of smart contracts and how they fit within existing law, demonstrating that further state legislation is unnecessary to support the growth of this industry.

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Chamber of Digital Commerce, Smart Contracts Alliance, Earls J, Smith M, Smith R. Smart contracts: is the law ready? Washington, DC: 2018 Aug.

Reference Type: Report

Available from: https://lowellmilkeninstitute.law.ucla.edu/wp-content/uploads/2018/08/Smart-Contracts-Whitepaper.pdf

Abstract: [FIRST TWO PARAGRAPHS] Smart contracts have come a long way in a short time. They will help to realize the many possibilities of distributed ledger technology (DLT). Certainty of outcome, automation of performance, and efficiencies in the streamlining of processes are reasons enough for smart contracts to be fundamental to the uptake of DLT. Their potential is now being actively considered and developed in sectors as diverse as Financial Services, Life Sciences and Healthcare, Technology and Telecoms, Transport, Energy, Infrastructure, Mining and Commodities. In Financial Services, for example, no one will be surprised to see smart contracts being used in areas such as securities clearing and settlement, collateral management, derivatives contracts, securities asset servicing, international money transfers, and perhaps even syndicated lending.

For many sectors it is the ability of smart contracts to be transformative in relation to existing business processes that is compelling. For others it is the potential of smart contracts to reduce execution risk (by making transfer of the relevant asset or instrument in question near to inevitable by virtue of automatic performance). As Chapter 3 of this white paper discusses, that may only achieve factual (that is, de facto) transfer. It may still be necessary, therefore, to apply established legal concepts and principles in order to determine whether transfer has been achieved at law (de jure).

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Chang MC, Hau YS, Park JC, Lee JM. The application of blockchain technology in stroke rehabilitation. Am J Phys Med Rehabil. 2019;98(7):e74. Epub 2018 Dec 4.

Reference Type: Journal Article

Available from: https://journals.lww.com/ajpmr/Citation/2019/07000/The_Application_of_Blockchain_Technology_in_Stroke.17.aspx Subscription required to view.

Abstract: [FIRST PARAGRAPH] Blockchain has turned the conventional wisdom about data storage and management on its head. Instead of keeping transaction data in a centralized server, blockchain distributes the data to all users in the network and jointly manages them via a peer-to-peer network, thereby ensuring the safety, reliability, integrity, and transparency of data. Whereas all data are stored in a central server and only the central authority owns the data in a traditional centralized network, a decentralized network powered by blockchain distributes ledgers that contain all the data across all users' personal computers.1 Blockchain is hack-proof: hackers may attempt to alter or manipulate information contained in a blockchain network, but their attempts are futile when information is scattered across multiple individuals at once. Therefore, information is highly reliable and easy to track because it cannot be deleted or lost, and all transactions are transparent to everyone. Blockchain streamlines transaction processes and reduces time, saves costs for contract arbitration, and creates a new ecosystem of open-source service. The technology is expected to have huge social and economic ripple effects. Use of blockchain technology was originally confined to the financial sector but has now forayed into various nonfinancial industries such as logistics, distribution, energy, public service, and, in particular, health care, arousing much interest among healthcare professionals on its potential.2 Currently, medical data are stored in electronic medical record systems and are owned by hospitals, which hampers information-sharing between hospitals. Patients who visit other hospitals often have to retake the same medical tests and doctors often fail fully understand the patient's condition. In contrast, medical data that are distributed across a blockchain network are owned by patients rather than medical institutions. Blockchain technology, once implemented in medical data management, will give control over medical data back to patients themselves, allowing them to easily submit their digitalized medical records directly to the clinic of their choice. This not only eliminates the need for repeated examinations but also enables medical institutions to identify their patients quickly and easily using the information provided by the patients themselves. Medical practitioners can just focus on planning further examinations and the course of treatment.

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Chattu KV, Nanda A, Chattu KS, Kadri MS, Knight WA. The emerging role of blockchain technology applications in routine disease surveillance systems to strengthen global health security. Big Data Cogn Comput. 2019;3(2). Epub 2019 May 8.

Reference Type: Journal Article

Available from: https://www.mdpi.com/2504-2289/3/2/25

Abstract: Blockchain technology has an enormous scope to revamp the healthcare system in many ways as it improves the quality of healthcare by data sharing among all the participants, selective privacy and ensuring data safety. This paper explores the basics of blockchain, its applications, quality of experience and advantages in disease surveillance over the other widely used real-time and machine learning techniques. The other real-time surveillance systems lack scalability, security, interoperability, thus making blockchain as a choice for surveillance. Blockchain offers the capability of enhancing global health security and also can ensure the anonymity of patient data thereby aiding in healthcare research. The recent epidemics of re-emerging infections such as Ebola and Zika have raised many concerns regarding health security which resulted in strengthening the surveillance systems. We also discuss how blockchains can help in identifying the threats early and reporting them to health authorities for taking early preventive measures. Since the Global Health Security Agenda addresses global public health threats (both infectious and NCDs); strengthen the workforce and the systems; detect and respond rapidly and effectively to the disease threats; and elevate global health security as a priority. The blockchain has enormous potential to disrupt many current practices in traditional disease surveillance and health care research.

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Cheifet B. Where is genomics going next? Genome Biol. 2019;20(1):17. Epub 2019 Jan 22.

Reference Type: Journal Article

Available from: https://genomebiology.biomedcentral.com/articles/10.1186/s13059-019-1626-2

Abstract: We polled the Editorial Board of Genome Biology to ask where they see genomics going in the next few years. Here are some of their responses.

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Chen H, Huang X. Will blockchain technology transform healthcare and biomedical sciences? EC Pharmacol Toxicol. 2018;6(11):910-1. Epub 2018 Oct 29.

Reference Type: Journal Article

Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711478/

Abstract: With the rise of technology, modern healthcare and biomedical sciences have largely shifted their content to cyberspace. This raises the challenges of accessibility and security of such data, and the solution may lie in a recent technology called blockchain. Blockchain is a public transaction ledger that offers two unique capabilities, immutability and decentralization of data, that make it stand out as an unparalleled technology in the spheres of healthcare and biomedicine.

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Chen L, Lee WK, Chang CC, Choo KWR, Zhang N. Blockchain based searchable encryption for electronic health record sharing. Futur Gener Comput Syst. 2019;95:420-9. Epub 2019 Jan 19.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S0167739X18314134 Subscription required to view.

Abstract: Data leakage in electronic health records (EHRs) could result in the compromise of patient privacy (e.g. medical conditions). Generally most data in EHRs remain unchanged once they are uploaded to the system; thus, blockchain can be potentially used to facilitate the sharing of such data. Different participating medical organizations and individuals (e.g. medical practitioners, hospitals, medical labs and insurance companies) can then access EHRs stored on the blockchain with a higher level of confidence. In this paper, a blockchain based searchable encryption scheme for EHRs is proposed. The index for EHRs is constructed through complex logic expressions and stored in the blockchain, so that a data user can utilize the expressions to search the index. As only the index is migrated to the blockchain to facilitate propagation, the data owners have full control over who can see their EHRs data. The use of blockchain technology ensures the integrity, anti-tampering, and traceability of EHRs’ index. Finally, the performance of the proposed scheme is evaluated from two aspects, namely in terms of the overhead for extracting the document IDs from EHRs and the overhead associated with conducting transactions on smart contract in Ethereum.

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Chen Y, Ding S, Xu Z, Zheng H, Yang S. Blockchain-based medical records secure storage and medical service framework. J Med Syst. 2018;43(1):5. Epub 2018 Nov 22.

Reference Type: Journal Article

Available from: https://link.springer.com/article/10.1007%2Fs10916-018-1121-4 Subscription required to view.

Abstract: Accurate and complete medical data are one valuable asset for patients. Privacy protection and the secure storage of medical data are crucial issues during medical services. Secure storage and making full use of personal medical records has always been a concern for the general population. The emergence of blockchain technology brings a new idea to solve this problem. As a hash chain with the characteristics of decentralization, verifiability and immutability, blockchain technology can be used to securely store personal medical data. In this paper, we design a storage scheme to manage personal medical data based on blockchain and cloud storage. Furthermore, a service framework for sharing medical records is described. In addition, the characteristics of the medical blockchain are presented and analyzed through a comparison with traditional systems. The proposed storage and sharing scheme does not depend on any third-party and no single party has absolute power to affect the processing.

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Chernyshev M, Zeadally S, Baig Z. Healthcare data breaches: implications for digital forensic readiness. J Med Syst. 2018;43(1):7. Epub 2018 Nov 28.

Reference Type: Journal Article

Available from: https://link.springer.com/article/10.1007/s10916-018-1123-2 Subscription required to view.

Abstract: While the healthcare industry is undergoing disruptive digital transformation, data breaches involving health information are not usually the result of integration of new technologies. Based on published industry reports, fundamental security safeguards are still considered to be lacking with many documented data breaches occurring as the result of device and equipment theft, human error, hacking, ransomware attacks and misuse. Health information is considered to be one of the most attractive targets for cybercriminals due to its inherent sensitivity, but digital investigations of incidents involving health information are often constrained by the lack of the necessary infrastructure forensic readiness. Following the analysis of healthcare data breach causes and threats, we describe the associated digital forensic readiness challenges in the context of the most significant incident causes. With specific focus on privilege misuse, we present a conceptual architecture for forensic audit logging to assist with capture of the relevant digital artefacts in support of possible future digital investigations.

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Chia V, Hartel P, Hum Q, Ma S, Piliouras G, Reijsbergen D, et al. Rethinking blockchain security: position paper. arXiv [Internet]. 2018 Jun 12 [cited 2019 Feb 1]; 1806.04358:[8 p.]. Available from: https://arxiv.org/abs/1806.04358

Reference Type: Electronic Article

Abstract: Blockchain technology has become almost as famous for incidents involving security breaches as for its innovative potential. We shed light on the prevalence and nature of these incidents through a database structured using the STIX format. Apart from OPSEC-related incidents, we find that the nature of many incidents is specific to blockchain technology. Two categories stand out: smart contracts, and techno- economic protocol incentives. For smart contracts, we propose to use recent advances in software testing to find flaws before deployment. For protocols, we propose the PRESTO framework that allows us to compare different protocols within a five-dimensional framework.

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Chisolm DJ, Brook DL, Applegate MS, Kelleher KJ. Social determinants of health priorities of state Medicaid programs. BMC Health Serv Res. 2019;19(1):167. Epub 2019 Mar 14.

Reference Type: Journal Article

Available from: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-3977-5

Abstract: Growing understanding of the influence of social determinants of health (SDH) on healthcare costs and outcomes for low income populations is leading State Medicaid agencies to consider incorporating SDH into their program design. This paper explores states’ current approaches to SDH.

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Choudhury O, Fairoza N, Sylla I, Das A. A blockchain framework for managing and monitoring data in multi-site clinical trials. arXiv. 2019;1902.03975. Epub 2019 Feb 11.

Reference Type: Journal Article

Available from: https://arxiv.org/abs/1902.03975

Abstract: The cost of conducting multi-site clinical trials has significantly increased over time, with site monitoring, data management, and amendments being key drivers. Clinical trial data management approaches typically rely on a central database, and require manual efforts to encode and maintain data capture and reporting requirements. To reduce the administrative burden, time, and effort of ensuring data integrity and privacy in multi-site trials, we propose a novel data management framework based on permissioned blockchain technology. We demonstrate how our framework, which uses smart contracts and private channels, enables confidential data communication, protocol enforcement, and and an automated audit trail. We compare this framework with the traditional data management approach and evaluate its effectiveness in satisfying the major requirements of multi-site clinical trials. We show that our framework ensures enforcement of IRB-related regulatory requirements across multiple sites and stakeholders.

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Choudhury O, Sarker H, Rudolph N, Foreman M, Fay N, Dhuliawala M, et al. Enforcing human subject regulations using blockchain and smart contracts. Blockchain Healthc Today. 2018;1(10):14.

Reference Type: Journal Article

Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/10

Abstract: Recent changes to the Common Rule, which govern Institutional Review Boards (IRB), require implementing new policies to strengthen research protocols involving human subjects. A major challenge in implementing such policies is an inability to automatically and consistently meet these ethical rules while securing sensitive information collected during the study. In this paper, we propose a novel framework, based on blockchain technology, to enforce IRB regulations on data collection. We demonstrate how to design smart contracts and a ledger to meet the requirements of an IRB protocol, including subject recruitment, informed consent management, secondary data sharing, monitoring risks, and generating automated assessments for continuous review. Furthermore, we show how we can employ the immutable transaction log in the blockchain to embed security in research activities by detecting malicious activities and robustly tracking subject involvement. We evaluate our approach by assessing its ability to enforce IRB guidelines in different types of human subjects studies, including a genomic study, a drug trial, and a wearable sensor monitoring study.

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Cichosz SL, Stausholm MN, Kronborg T, Vestergaard P, Hejlesen O. How to use blockchain for diabetes health care data and access management: an operational concept. J Diabetes Sci Technol. 2019;13(2):248-53. Epub 2018 Jul 26.

Reference Type: Journal Article

Available from: https://journals.sagepub.com/doi/abs/10.1177/1932296818790281 Subscription required to view.

Abstract: Introduction: Patients with diabetes often generate large amounts of data specifically related to the disease and to their general health. Cross-institutional sharing of patient health care data is complex, and as a consequence, data are not always available to the health care provider treating the patient. Accommodating this challenge could lead to better clinical effectiveness and improve clinical research. This work aims to present an approach for a blockchain-based platform for sharing health care data. The approach considers privacy concerns, data sharing, and patients as the center for governing their own data.
Methods: The concept of this blockchain-based platform consists of using the NEM multi-signature blockchain contracts for access control of data management and the sharing and encryption of data to allow privacy and control of health care data. The architecture is built around cryptography, tokens, and multi-signature contracts. The multi-signature contract enables several entities to administrate the activity of an account and control the assets of one account. Multi-signature generates a contract that assigns the rights and powers of a certain account to other accounts; this contract can be edited to allow or remove entities.
Discussion: Using blockchain could lead to improvements in diabetes data management. In the coming years, this technology should be implemented in existing small-scale diabetes health care system to explore its real-world benefits and challenges.
Conclusion: This new approach could potentially lead to more efficient sharing of data between institutions and utilization of new types of data and research possibilities.

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Cirillo D, Valencia A. Big data analytics for personalized medicine. Curr Opin Biotechnol. 2019;58:161-7. Epub 2019 Apr 6.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S0958166918301903

Abstract: Big Data are radically changing biomedical research. The unprecedented advances in automated collection of large-scale molecular and clinical data pose major challenges to data analysis and interpretation, calling for the development of new computational approaches. The creation of powerful systems for the effective use of biomedical Big Data in Personalized Medicine (a.k.a. Precision Medicine) will require significant scientific and technical developments, including infrastructure, engineering, project and financial management. We review here how the evolution of data-driven methods offers the possibility to address many of these problems, guiding the formulation of hypotheses on systems functioning and the generation of mechanistic models, and facilitating the design of clinical procedures in Personalized Medicine.

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Cisneros JLB. Public health surveillance using decentralized technologies. Blockchain Healthc Today [Internet]. 2018 Mar 23 [cited 2018 Oct 23]; 1(17):[14 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/17

Reference Type: Electronic Article

Abstract: This article describes how blockchain technologies can be used in the context of Public Health Surveillance through decentralized sharing of genomic data. A brief analysis of why blockchain technologies are needed in public health is presented together with a distinction between public and private blockchains. Finally, a proposal for a network of blockchains, using the Cosmos framework, together with decentralized storage systems like IPFS and BigchainDB, is included to address the issues of interoperability in the health sector.

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Clauson KA, Breeden EA, Davidson C, Mackey TK. Leveraging blockchain technology to enhance supply chain management in healthcare. Blockchain Healthc Today [Internet]. 2018 Mar 23 [cited 2018 Oct 23]; 1(20):[12 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/20

Reference Type: Electronic Article

Abstract: Background: Effective supply chain management is a challenge in every sector, but in healthcare there is added complexity and risk as a compromised supply chain in healthcare can directly impact patient safety and health outcomes. One potential solution for improving security, integrity, data provenance, and functionality of the health supply chain is blockchain technology.
Objectives: Provide an overview of the opportunities and challenges associated with blockchain adoption and deployment for the health supply chain, with a focus on the pharmaceutical supply, medical device and supplies, Internet of Healthy Things (IoHT), and public health sectors.
Methods: A narrative review was conducted of the academic literature, grey literature, and industry publications, in addition to identifying and characterizing select stakeholders engaged in exploring blockchain solutions for the health supply chain.
Results: Critical challenges in protecting the integrity of the health supply chain appear well suited for adoption of blockchain technology. Use cases are emerging, including using blockchain to combat counterfeit medicines, securing medical devices, optimizing functionality of IoHT, and improving the public health supply chain. Despite these clear opportunities, most blockchain initiatives remain in proof-of-concept or pilot phase.
Conclusion: Blockchain technology has the unrealized promise to help improve the health supply chain, but further study, evaluation and alignment with policy mechanisms is needed.

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Cocco L, Marchesi M. Modeling and simulation of the economics of mining in the Bitcoin market. PLoS One. 2016;11(10):e0164603. Epub 2016 Oct 21.

Reference Type: Journal Article

Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0164603

Abstract: In January 3, 2009, Satoshi Nakamoto gave rise to the "Bitcoin Blockchain", creating the first block of the chain hashing on his computer's central processing unit (CPU). Since then, the hash calculations to mine Bitcoin have been getting more and more complex, and consequently the mining hardware evolved to adapt to this increasing difficulty. Three generations of mining hardware have followed the CPU's generation. They are GPU's, FPGA's and ASIC's generations. This work presents an agent-based artificial market model of the Bitcoin mining process and of the Bitcoin transactions. The goal of this work is to model the economy of the mining process, starting from GPU's generation, the first with economic significance. The model reproduces some "stylized facts" found in real-time price series and some core aspects of the mining business. In particular, the computational experiments performed can reproduce the unit root property, the fat tail phenomenon and the volatility clustering of Bitcoin price series. In addition, under proper assumptions, they can reproduce the generation of Bitcoins, the hashing capability, the power consumption, and the mining hardware and electrical energy expenditures of the Bitcoin network.

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Coelho FC. Optimizing disease surveillance by reporting on the blockchain. bioRxiv [Internet]. 2018 Nov 25 [cited 2018 Feb 19]. Available from: https://www.biorxiv.org/content/10.1101/278473v2

Reference Type: Electronic Article

Abstract: Disease surveillance, especially for infectious diseases, is a complex and inefficient process. Here we propose an optimized, blockchain-based monitoring and reporting system which can achieve all the desired features of an ideal surveillance system while maintaining costs down and being transparent and robust. We describe the technical specifications of such a system and discuss possibilities for its implementation. Together with a token based incentive system, it is possible to rewards data quality as well as build a marketplace for data analysis which will help finance the surveillance system. Finally, the impact of the adoption of distributed ledger technology for disease surveillance is discussed.

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Coelho FC, Brandao A. Decentralising scientific publishing: can the blockchain improve science communication? Mem Inst Oswaldo Cruz. 2019;114:e190257. Epub 2019 Aug 19.

Reference Type: Journal Article

Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762019000100851&lng=en&nrm=iso&tlng=en

Abstract: We present a decentralised solution for managing scientific communication, based on distributed ledger technologies, also called blockchains. The proposed system aims to solve incentive problems displayed by traditional systems in scientific communication and publication. A minimal working model is presented, defining roles, processes, and expected results from the novel system. The proposed solution is viable, given the current status of blockchain technology, and should lead to a rethinking of current practices and their consequences for scientific communication.

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Colón KA. Creating a patient-centered, global, decentralized health system. Blockchain Healthc Today [Internet]. 2018 Sep 14 [cited 2018 Nov 2]; 1(30):[18 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/30

Reference Type: Electronic Article

Abstract: Over the past decade, there have been many innovations in new payment and care delivery models and technology, from telemedicine to artificial intelligence (AI) to blockchain. These innovations, however, must be used in tandem to drive real change. We review each of these innovations and propose a model for how they can be combined to be greater than the sum of their parts. In doing so, we can create a global, decentralized health system that truly puts patient care at the center, while supporting and further enabling the clinicians who make this care possible, to deliver higher quality care at a fraction of the cost.

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Conard S. Best practices in digital health literacy. Int J Cardiol. 2019;In press. Epub 2019 Jun 5.

Reference Type: Journal Article

Available from: https://www.internationaljournalofcardiology.com/article/S0167-5273(19)31652-3/fulltext Subscription required to view.

Abstract: The connection between health literacy and health outcomes includes access and utilization of healthcare services, patient/provider interaction and self-care. Digital approaches can be designed to simplify or expand on a concept, test for understanding, and do not have a time constraint. New technologies, such as artificial intelligence and machine learning, virtual and augmented reality, and blockchain can move the role of technology beyond data collection to a more integrated system. Rather than being a passive participant, digital solutions provide the opportunity for the individual to be an active participant in their health. These solutions can be delivered in a way that builds or enhances the individual's belief that the plan will be successful and more confidence that they can stick with it. Digital solutions allow for the delivery of multi-media education, such as videos, voice, and print, at different reading levels, in multiple languages, using formal and informal teaching methods. By giving the patient a greater voice and empowering them to be active participants in their care, they can develop their decision making and shared decision making skills. The first step in our health literacy instructional model is to address the emotional state of the person. Once the emotional state has been addressed, and an engagement strategy has been deployed the final phase is the delivery of an educational solution. While a clear definition of health literacy and an instructional model are important, further research must be done to continually determine more effective ways to incorporate health technology in the process of improving health outcomes.

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Conte de Leon D, Stalick AQ, Jillepalli AA, Haney MA, Sheldon FT. Blockchain: properties and misconceptions. Asia Pacific J Innov Entrep. 2017;11(3):286-300. Epub 2017 Dec 4.

Reference Type: Journal Article

Available from: https://www.emeraldinsight.com/doi/full/10.1108/APJIE-12-2017-034

Abstract: Purpose: The purpose of this article is to clarify current and widespread misconceptions about the properties of blockchain technologies and to describe challenges and avenues for correct and trustworthy design and implementation of distributed ledger system (DLS) or Technology (DLT).
Design/methodology/approach: The authors contrast the properties of a blockchain with desired, however emergent, properties of a DLS, which is a complex and distributed system. They point out and justify, with facts and analysis, current misconceptions about the blockchain and DLSs. They describe challenges that these systems will need to address and possible solution avenues for achieving trustworthiness.
Findings: Many of the statements that have appeared on the internet, news and academic articles, such as immutable ledger and exact copies, may be misleading. These are desired emergent properties of a complex system, not assured properties. It is well-known within the distributed systems and critical software community that it is extremely hard to prove that a complex system correctly and completely implements emergent properties. Further research and development for trustworthy DLS design and implementation is needed, both practical and theoretical.
Research limitations/implications: This is the first known published attempt at describing current misconceptions about blockchain technologies. Further collaborative work, discussions, potential solutions, evaluations, resulting publications and verified reference implementations are needed to ensure DLTs are safe, secure, and trustworthy.
Practical implications: Interdisciplinary teams with members from academia, business and industry, and from disciplines such as business, entrepreneurship, theoretical and practical computer science, cybersecurity, finance, mathematics and statistics, must be formed. Such teams must collaborate with the objective of developing strategies and techniques for ensuring the correctness and security of future DLSs in which our society may become dependent.
Originality value: The value and originality of this article is twofold: the disproving, through fact collection and systematic analysis, of current misconceptions about the properties of the blockchain and DLSs, and the discussion of challenges to achieving adequate trustworthiness along with the proposal of general avenues for possible solutions.

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Crosby M, Nachiappan, Pattanayak P, Verma S, Kalyanaraman V. Blockchain technology: beyond bitcoin. Appl Innov Rev. 2016;2(June):6-10.

Reference Type: Journal Article

Available from: https://j2-capital.com/wp-content/uploads/2017/11/AIR-2016-Blockchain.pdf

Abstract: A blockchain is essentially a distributed database of records, or public ledger of all transactions or digital events that have been executed and shared among participating parties. Each transaction in the public ledger is verified by consensus of a majority of the participants in the system. Once entered, information can never be erased. The blockchain contains a certain and verifiable record of every single transaction ever made. Bitcoin, the decentralized peer-to-peer digital currency, is the most popular example that uses blockchain technology. The digital currency bitcoin itself is highly controversial but the underlying blockchain technology has worked flawlessly and found wide range of applications in both financial and non-financial world.

The main hypothesis is that the blockchain establishes a system of creating a distributed consensus in the digital online world. This allows participating entities to know for certain that a digital event happened by creating an irrefutable record in a public ledger. It opens the door for developing a democratic open and scalable digital economy from a centralized one. There are tremendous opportunities in this disruptive technology, and the revolution in this space has just begun.

This white paper describes blockchain technology and some compelling specific applications in both financial and non-financial sector. We then look at the challenges ahead and business opportunities in this fundamental technology that is all set to revolutionize our digital world.

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Culver K. Blockchain technologies: a whitepaper discussing how the claims process can be improved. ONC/NIST Use of Blockchain for Healthcare and Research Workshop; 2016 Sep 26-27; Gaithersburg, MD. National Institute of Standards Technology; 2016.

Reference Type: Conference Proceedings

Available from: https://www.healthit.gov/sites/default/files/3-47-whitepaperblockchainforclaims_v10.pdf

Abstract: The healthcare industry suffers from an inability to clearly communicate costs in a timely and easy-to-understand format. This problem is a symptom of interoperability issues and complex agreements between providers, patients, health plans/payers and government regulators. These agreements are encoded in legal language with the intent of being defensible in court. However, the focus on legal enforceability, instead of understandability, creates problems resulting in hundreds of billions of dollars spent annually to administer an inefficient, outdated and complex process for adjudicating and paying health plan claims. The process results in errors and often leaves the patient unclear on how much they need to pay. If these agreements were instead translated into computer code (smart contracts) leveraging Blockchain technologies, the claim process would not only be interoperable, but also drive standardization, research and innovation. Transparency and trust can be injected into the process when both the logic and the data driving these decisions is stored permanently and made available to all stakeholders through a peer-topeer distributed database like blockchain. The result will be a paradigm shift toward interoperability and transparency, enhancing the speed and accuracy of cost reporting to patients. This paper discusses how smart contracts, blockchain and other technologies can be combined into a platform that enables drastic improvements to the healthcare experience for all stakeholders.

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Culver K. Blockchain technologies: the view from a healthcare incumbent. In: Metcalf D, Bass J, Hooper M, Cahana A, Dhillon V, editors. Blockchain in healthcare: innovations that empower patients, connect professionals and improve care. 1st ed. Orlando, FL: Merging Traffic; 2019. p. 123-40.

Reference Type: Book Section

Available from: https://www.crcpress.com/Blockchain-in-Healthcare-Innovations-that-Empower-Patients-Connect-Professionals/Dhillon-Bass-Hooper-Metcalf-Cahana/p/book/9780367031084 Purchase required.

Abstract: Only a few years ago, Blockchain was little more than a background detail in the Bitcoin narrative, and certainly not on the healthcare technology agenda. However, that has changed quickly, revealing ample opportunity for innovation across industries. This chapter will look at the emergence of Blockchain, share why it's important for firms to pay attention to disruptive technologies and discuss how firms might approach capitalizing on the Blockchain opportunity in the healthcare space.

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Cunningham J, Ainsworth J. Enabling patient control of personal electronic health records through distributed ledger technology. In: Gundlapalli AV, Jaulent MC, Zhao D, editors. MedInfo 2017: Precision healthcare through informatics; 2017 Aug 21-25; Hangzhou, China. Clifton, VA: IOS Press; 2017. p. 45-8.

Reference Type: Conference Paper

Available from: http://ebooks.iospress.nl/publication/48102

Abstract: The rise of distributed ledger technology, initiated and exemplified by the Bitcoin blockchain, is having an increasing impact on information technology environments in which there is an emphasis on trust and security. Management of electronic health records, where both conformation to legislative regulations and maintenance of public trust are paramount, is an area where the impact of these new technologies may be particularly beneficial. We present a system that enables fine-grained personalized control of third-party access to patients' electronic health records, allowing individuals to specify when and how their records are accessed for research purposes. The use of the smart contract based Ethereum blockchain technology to implement this system allows it to operate in a verifiably secure, trustless, and openly auditable environment, features crucial to health information systems moving forward.

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Curbera F, Dias D, Simonyan V, Yoon W, Casella A. Blockchain: an enabler for healthcare and life sciences transformation. IBM J Res Dev. 2019:1-. Epub 2019 Apr 26.

Reference Type: Journal Article

Available from: https://ieeexplore.ieee.org/abstract/document/8700241

Abstract: Major trends in the healthcare and life sciences industries (HCLS) include the collection of large amounts of longitudinal patient data, major policy shifts including patient's rights to access and control their data, a move from fee-for-service to value-based contracting, strict regulatory and privacy requirements. Blockchain, as a distributed transactional system of record, can provide underpinnings to support these trends and enable transformative opportunities in HCLS, by providing immutable data on a shared ledger, secure and authenticated transactions, and smart contracts that can represent rules that are executed with secure transactions. We describe HCLS use cases that can leverage these facets of blockchain, including: patient consent and health data exchange, outcome-based contracts, next-generation clinical trials, supply chain traceability, and payments and claims transactions. We then describe a blockchain based architecture and platform for enabling these use cases. Finally, we outline a realization of this architecture in a case study and outline further research topics in this domain.

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Curran K. E-voting on the blockchain. J Br Blockchain Assoc. 2018;1(2). Epub 2018 Sep 14.

Reference Type: Journal Article

Available from: https://jbba.scholasticahq.com/article/4451-e-voting-on-the-blockchain

Abstract: Building a secure electronic voting system is a difficult task. The US Pentagon dropped their proposed online voting system which would have given overseas military personnel the opportunity to vote in the elections in 2005, citing the inability to ensure the legitimacy of votes as the reason. There is however a new cry in the wild to deploy a voting blockchain. The blockchain serves as a public ledger of transactions which cannot be reversed. The all-important consensus of transaction (i.e. legitimate votes) is achieved through 'miners' agreeing to validate new records being added. Whenever a new insertion is to be made e.g. votes, then a new transaction record is created by a voter adding details of their cast vote to the blockchain. Should it be deemed a valid transaction then the new vote is added to the end of the blockchain and remains there forever. What is neat about this solution is the fact that no centralized authority is needed to approve the votes but rather a majority consensus. Here everyone agrees on the final tally as they can count the votes themselves & because of the blockchain audit trail, anyone can verify that no votes were tampered with and no illegitimate votes were inserted. This paper discusses the application of blockchain to voting.

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Cyran MA. Blockchain as a foundation for sharing healthcare data. Blockchain Healthc Today [Internet]. 2018 Mar 23 [cited 2018 Oct 23]; 1(13):[6 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/13

Reference Type: Electronic Article

Abstract: Blockchain technology has the potential to transform healthcare delivery by facilitating data sharing between providers and electronic health record (EHR) systems. However, significant roadblocks stand in the way of widespread implementation of this technology across the healthcare industry. Our blockchain-based data-sharing solution addresses two of the most critical challenges associated with using blockchain for health data sharing: protecting sensitive health information and deploying and installing blockchain software across diverse hospital environments. Since transparency is a fundamental feature of blockchain, we enabled user- and group-based secret sharing by adding purpose-built software that leverages a collection of well-established cryptographic algorithms. To streamline deployment, we built a containerized solution that guarantees portability, simplifies installation, and reduces overhead maintenance costs associated with administration. To ensure ease of implementation in a hospital system, we designed our blockchain solution using a distributed microservices architecture that allows us to encapsulate core functions of our system into isolated services that can be scaled independently based on the requirements of a particular hospital system deployment. As part of this architecture, we built core components for securely handling cryptographic secrets, interacting with blockchain nodes, facilitating large file sharing, enabling secondary-index based lookups, and integrating external business logic that governs how users interact with Smart Contracts. The innovative design of our blockchain solution, which addresses critical data security, deployment, and installation challenges, provides the healthcare community with a unique approach that has the power to connect providers while protecting sensitive data.

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da Conceição AF, da Silva FSC, Rocha V, Locoro A, Barguil JM. Electronic health records using blockchain technology. arXiv [Internet]. 2018 Apr 26 [cited 2018 Oct 23]; 1804.10078:[15 p.]. Available from: https://arxiv.org/abs/1804.10078

Reference Type: Electronic Article

Abstract: Data privacy refers to ensuring that users keep control over access to information, whereas data accessibility refers to ensuring that information access is unconstrained. Conflicts between privacy and accessibility of data are natural to occur, and healthcare is a domain in which they are particularly relevant.

In the present article, we discuss how blockchain technology, and smart contracts, could help in some typical scenarios related to data access, data management and data interoperability for the specific healthcare domain. We then propose the implementation of a large-scale information architecture to access Electronic Health Records (EHRs) based on Smart Contracts as information mediators. Our main contribution is the framing of data privacy and accessibility issues in healthcare and the proposal of an integrated blockchain based architecture.

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Dagher GG, Mohler J, Milojkovic M, Marella PB. Privacy-preserving framework for access control and interoperability of electronic health records using blockchain technology. Sustain Cities Soc. 2018;39:283-97. Epub 2018 Feb 17.

Reference Type: Journal Article

Available from: http://kddlab.zjgsu.edu.cn:7200/research/blockchain/huyiyang-reference/Ancile%20Privacy-preserving%20framework%20for%20access%20control%20and%20interoperability.pdf Open access; http://www.sciencedirect.com/science/article/pii/S2210670717310685 Subscription required to view.

Abstract: Despite an increased focus on the security of electronic health records and an effort by large cities around the globe to pursue smart city infrastructure, the private information of patients is subject to data breaches on a regular basis. Previous efforts to combat this have resulted in data being mostly inaccessible to patients. Existing record management systems struggle with balancing data privacy and the need for patients and providers to regularly interact with data. Blockchain technology is an emerging technology that enables data sharing in a decentralized and transactional fashion. Blockchain technology can be leveraged in the healthcare domain to achieve the delicate balance between privacy and accessibility of electronic health records. In this paper, we propose a blockchain-based framework for secure, interoperable, and efficient access to medical records by patients, providers, and third parties, while preserving the privacy of patients’ sensitive information. Our framework, named Ancile, utilizes smart contracts in an Ethereum-based blockchain for heightened access control and obfuscation of data, and employs advanced cryptographic techniques for further security. The goals of this paper are to analyze how Ancile would interact with the different needs of patients, providers, and third parties, and to understand how the framework could address longstanding privacy and security concerns in the healthcare industry.

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Dai H, Young HP, Durant TJS, Gong G, Kang M, Krumholz HM, et al. TrialChain: a blockchain-based platform to validate data integrity in large, biomedical research studies. arXiv [Internet]. 2018 Jul 10 [cited 2019 Feb 22]; 1807.03662:[7 p.]. Available from: https://arxiv.org/abs/1807.03662

Reference Type: Electronic Article

Abstract: The governance of data used for biomedical research and clinical trials is an important requirement for generating accurate results. To improve the visibility of data quality and analysis, we developed TrialChain, a blockchain-based platform that can be used to validate data integrity from large, biomedical research studies. We implemented a private blockchain using the MultiChain platform and integrated it with a data science platform deployed within a large research center. An administrative web application was built with Python to manage the platform, which was built with a microservice architecture using Docker. The TrialChain platform was integrated during data acquisition into our existing data science platform. Using NiFi, data were hashed and logged within the local blockchain infrastructure. To provide public validation, the local blockchain state was periodically synchronized to the public Ethereum network. The use of a combined private/public blockchain platform allows for both public validation of results while maintaining additional security and lower cost for blockchain transactions. Original data and modifications due to downstream analysis can be logged within TrialChain and data assets or results can be rapidly validated when needed using API calls to the platform. The TrialChain platform provides a data governance solution to audit the acquisition and analysis of biomedical research data. The platform provides cryptographic assurance of data authenticity and can also be used to document data analysis.

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Damianides M. Sarbanes-Oxley and IT governance: new guidance on IT control and compliance. Inf Syst Manag. 2005;22(1):77-85. Epub 2006 Dec 21.

Reference Type: Journal Article

Available from: http://www.infosectoday.com/SOX/Damianides.pdf Open access; https://www.tandfonline.com/doi/abs/10.1201/1078/44912.22.1.20051201/85741.9?journalCode=uism20 Subscription required to view.

Abstract: Since the passage of the Sarbanes–Oxley Act, IS professionals are facing even greater challenges to meet raised expectations to provide accurate, visible, and timely information while ensuring their company’s information assets are secure. This article presents an IT governance framework for responding to these challenges.

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Daniel J, Sargolzaei A, Abdelghani M, Sargolzaei S, Amaba B. Blockchain technology, cognitive computing, and healthcare innovations. J Adv Inf Technol. 2017;8(3):194-8. Epub 2017 Aug 26.

Reference Type: Journal Article

Available from: http://www.jait.us/index.php?m=content&c=index&a=show&catid=180&id=1013

Abstract: Exponential growth of the impact of information technology innovation is an indispensable part of today’s industry. Blockchain technology has identified itself as an efficiency booster and service optimization for financial industries. Yet non-financial venues have gained little benefit from this new major horizon, Blockchain technology. It offers a secure way to exchange any kind of good, service, or transaction. Industrial growth increasingly depends on trusted partnerships; but increasing regulation, cybercrime and fraud are inhibiting expansion. Blockchain enables more agile value chains, faster product innovations, closer customer relationships, and faster integration with the Internet of Things (IoT) and cloud technology. Now with Cloud and Blockchain technologies providing high computing power and network capabilities, cognitive systems are available tools to deepen the relationship between humans and the world. Many problems that have been with our society for a long time can be solved. Cognitive systems are the tools to accomplish that ambitious goal. This study is continuing our effort on surveying the applicability of Blockchain technology innovation in non-finance (non-bitcoin). The study concluded with discussing opportunities and challenges of the application of two intra-horizons of Blockchain technology, Cognitive Computing and Healthcare.

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Dasaklis TK, Casino F, Patsakis C. Blockchain meets smart health: towards next generation healthcare services. 2018 9th International Conference on Information, Intelligence, Systems and Applications (IISA); 2018 Jul 23-25; Zankynthos, Greece. Piscataway, NJ: IEEE.

Reference Type: Conference Proceedings

Available from: https://ieeexplore.ieee.org/abstract/document/8633601 Subscription required to view.

Abstract: Blockchain technology is rapidly gaining traction in healthcare industry as one of the most exciting technological developments. In particular, blockchain technology presents numerous opportunities for healthcare industry such as reduced transaction costs, increased transparency for regulatory reporting, efficient healthcare data management and healthcare records universality. In the context of smart health, blockchain may provide distinct benefits, particularly from a context-aware perspective where efficient and personalised solutions may be provided to citizens and the society in general. In this article, we portray the symbiotic relationship between blockchain and smart health. Among others, we identify and analyse three individual streams of possible synergies. In addition, we discuss several challenges for actually implementing blockchain-based applications in the healthcare industry along with several opportunities for future research directions.

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Dasgupta D, Shrein JM, Gupta KD. A survey of blockchain from security perspective. J Bank Financ Technol. 2019:1-17. Epub 2019 Jan 3.

Reference Type: Journal Article

Available from: https://www.researchgate.net/profile/Kishor_Datta_Gupta/publication/330125746_A_survey_of_blockchain_from_security_perspective/links/5c341d00a6fdccd6b59af4a5/A-survey-of-blockchain-from-security-perspective.pdf Open access; https://link.springer.com/article/10.1007/s42786-018-00002-6 Subscription required to view.

Abstract: The report starts with an overview of the blockchain security system and then highlights the specific security threats and summarizes them. We review with some comments and possible research direction. This survey, we examines the security issues of blockchain model related technologies and their applications. The blockchain is considered a still growing like the internet in 1990. It has the potential to disrupt so many technology areas in the future. But as a new underdeveloped field, it is suffering many setbacks mostly resulting from the security area. Its security concerns coming not only from distributed/decentralized computing issue or Cryptography algorithm issue, from some unexpected field too. Here, in this paper, we tried to classify the security concerns for the blockchain based on our survey from recent research papers. We also tried to show which way blockchain development trends are going.

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De Filippi P, Hassan S. Blockchain technology as a regulatory technology: from code is law to law is code. First Monday [Internet]. 2016 Dec 15 [cited 2018 Oct 23]; 21(12):[23 p.]. Available from: https://firstmonday.org/ojs/index.php/fm/article/view/7113/5657

Reference Type: Electronic Article

Abstract: "Code is law" refers to the idea that, with the advent of digital technology, code has progressively established itself as the predominant way to regulate the behavior of Internet users. Yet, while computer code can enforce rules more efficiently than legal code, it also comes with a series of limitations, mostly because it is difficult to transpose the ambiguity and flexibility of legal rules into a formalized language which can be interpreted by a machine. With the advent of blockchain technology and associated smart contracts, code is assuming an even stronger role in regulating people's interactions over the Internet, as many contractual transactions get transposed into smart contract code. In this paper, we describe the shift from the traditional notion of "code is law" (i.e. code having the effect of law) to the new conception of "law is code" (i.e. law being defined as code).

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Deb DR, Sinha AK, Singh BP, Logashanmugam D. Secured decentralized archiving healthcare data using blockchain with IoT. Int J Adv Res Ideas Innov Technol. 2019;5(1):135-7. Epub 2019 Jan 24.

Reference Type: Journal Article

Available from: https://www.ijariit.com/manuscript/secured-decentralized-archiving-healthcare-data-using-blockchain-with-iot/

Abstract: Blockchain technology has unprotected its immense adaptability in hot off the press years as a departure from the norm of super convenience store sectors. In which sought ways in incorporating its abilities directed toward their operations. While so far most of the focus has been on the financial service industry, several projects in other service-related areas such as healthcare start showing innumerable change. Numerous starting points for Blockchain technology in the healthcare industry are the focus of this paper. With examples for a person in the street healthcare powers that be, user-oriented medical scan and abused substance counterfeiting in the pharmaceutical section, this tells aims to repeat possible influences, goals and potentials installed to this on a tear technology.

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Demarinis S. US health care companies exploring blockchain technologies. Explore (NY). 2018;14(6):400-1. Epub 2018 Oct 23.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S1550830718304208 Subscription required to view.

Abstract: Managing information has been troublesome for the sprawling US health care industry. Every doctor, medical office, hospital, pharmacy, therapist and insurance company needs different pieces of data to properly care for patients. Electronic health records are scattered across multiple systems which are unable to communicate with each other. Furthermore, records are not always up-to-date, and some remain in paper form in filing cabinets.

There might be a way, however, toward a health care system where patients have accurate and updated records that are secure against tampering or snooping, with data that can be shared quickly and easily with any provider who needs it: blockchain.

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Derhab A, Guerroumi M, Gumaei A, Maglaras L, Ferrag MA, Mukherjee M, et al. Blockchain and random subspace learning-based IDS for SDN-enabled industrial IoT security. Sensors (Basel). 2019;19(14). Epub 2019 Jul 15.

Reference Type: Journal Article

Available from: https://www.mdpi.com/1424-8220/19/14/3119

Abstract: The industrial control systems are facing an increasing number of sophisticated cyber attacks that can have very dangerous consequences on humans and their environments. In order to deal with these issues, novel technologies and approaches should be adopted. In this paper, we focus on the security of commands in industrial IoT against forged commands and misrouting of commands. To this end, we propose a security architecture that integrates the Blockchain and the Software-defined network (SDN) technologies. The proposed security architecture is composed of: (a) an intrusion detection system, namely RSL-KNN, which combines the Random Subspace Learning (RSL) and K-Nearest Neighbor (KNN) to defend against the forged commands, which target the industrial control process, and (b) a Blockchain-based Integrity Checking System (BICS), which can prevent the misrouting attack, which tampers with the OpenFlow rules of the SDN-enabled industrial IoT systems. We test the proposed security solution on an Industrial Control System Cyber attack Dataset and on an experimental platform combining software-defined networking and blockchain technologies. The evaluation results demonstrate the effectiveness and efficiency of the proposed security solution.

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Deshpande A, Stewart K, Lepetit L, Gunashekar S. Distributed ledger technologies/blockchain: challenges, opportunities, and prospects for standards. British Standards Institution, 2017 May. Report No.: 201706.

Reference Type: Report

Available from: https://www.bsigroup.com/LocalFiles/zh-tw/InfoSec-newsletter/No201706/download/BSI_Blockchain_DLT_Web.pdf; and https://www.rand.org/content/dam/rand/pubs/research_reports/RR2200/RR2223/RAND_RR2223.pdf

Abstract: RAND Europe was commissioned by the British Standards Institution (BSI) in January 2017 to carry out a rapid scoping study to examine the potential role of standards in supporting Distributed Ledger Technologies (DLT)/Blockchain. The current document, intended for dissemination to interested parties, aims to serve as an overview of the study, which was conducted over a 6-week period. A more comprehensive report, with more detailed results of the analysis and findings and complete descriptions of the methods, was also submitted to the BSI.

DLT/Blockchain refers to a type of database which is spread over multiple locations (i.e. a distributed database) and which can be used like a digital ledger to record and manage transactions. Although the technology is at a relatively early stage of adoption and significant challenges remain, it is becoming apparent that DLT/ Blockchain holds the potential for major opportunities across several sectors. Furthermore, standardization efforts related to DLT/Blockchain have recently gathered momentum with the setting up of the International Organization for Standardization (shortened to ISO) technical committee on Blockchain and electronic DLT.

In this report, we present an overview of the current landscape of DLT/Blockchain developments and closely examine the issues that are central to the development of DLT/Blockchain. We articulate a set of areas for further consideration by DLT/Blockchain stakeholders regarding the potential role of standardization. Rather than providing a definitive list of topics, the aim of the study is to provoke further discussion across the DLT/ Blockchain community about the potential role of standards in supporting the development and adoption of the technology. We carried out the research using a mixed methods approach involving a focused review of the literature, in-depth interviews with stakeholders from public and private organizations, and an internal workshop. Although the study is primarily intended to inform the BSI’s approach towards developing a standards strategy in relation to DLT/Blockchain, it is also likely to be of relevance to stakeholders in the DLT/Blockchain community, including policymakers, industry, other standards organizations (national and international), and academia.

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Destefanis G, Marchesi M, Ortu M, Tonelli R, Bracciali A, Hierons R. Smart contracts vulnerabilities: a call for blockchain software engineering? In: Tonelli R, Ducasse S, Fenu G, Bracciali A, editors. 2018 International Workshop on Blockchain Oriented Software Engineering (IWBOSE); 2018 Mar 20; Campobasso, Italy. IEEE Computer Society; 2018. p. 19-25.

Reference Type: Conference Paper

Available from: https://dspace.stir.ac.uk/bitstream/1893/27135/1/smart-contracts-vulnerabilities-3.pdf Open access; https://ieeexplore.ieee.org/abstract/document/8327567 Subscription required to view.

Abstract: Smart Contracts have gained tremendous popularity in the past few years, to the point that billions of US Dollars are currently exchanged every day through such technology. However, since the release of the Frontier network of Ethereum in 2015, there have been many cases in which the execution of Smart Contracts managing Ether coins has led to problems or conflicts. Compared to traditional Software Engineering, a discipline of Smart Contract and Blockchain programming, with standardized best practices that can help solve the mentioned problems and conflicts, is not yet sufficiently developed. Furthermore, Smart Contracts rely on a non-standard software life-cycle, according to which, for instance, delivered applications can hardly be updated or bugs resolved by releasing a new version of the software. In this paper we advocate the need for a discipline of Blockchain Software Engineering, addressing the issues posed by smart contract programming and other applications running on blockchains. We analyse a case of study where a bug discovered in a Smart Contract library, and perhaps "unsafe" programming, allowed an attack on Parity, a wallet application, causing the freezing of about 500K Ethers (about 150M USD, in November 2017). In this study we analyze the source code of Parity and the library, and discuss how recognised best practices could mitigate, if adopted and adapted, such detrimental software misbehavior. We also reflect on the specificity of Smart Contract software development, which makes some of the existing approaches insufficient, and call for the definition of a specific Blockchain Software Engineering.

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Dey T, Jaiswal S, Sunderkrishnan S, Katre N. HealthSense: a medical use case of Internet of Things and blockchain. In. 2017 International Conference on Intelligent Sustainable Systems (ICISS); 2017 Dec 7-8; Palladam, India. Piscataway, NJ: IEEE; 2017. p. 486-91.

Reference Type: Conference Paper

Available from: https://ieeexplore.ieee.org/abstract/document/8389459 Subscription required to view

Abstract: Blockchain and Internet of things are the most promising and upcoming technologies. Blockchain is a distributed, peer to peer database forming a chain between multiple blocks of data. The internet of things works on a similar paradigm where multiple devices are connected to the internet forming a network of networks. Combined together they offer solutions for various problems, especially in the field of healthcare where quick reporting of data or results is of utmost importance. Recent studies have proven that delays in providing healthcare are directly linked to patient confidence and chances of recovery. An unreliable storage of health records has only aggravated the problem. Our paper aims to provide a solution for these issues by proposing a Blockchain-Internet of things model where a bio-sensor measures and collects real time data with respect to a patient's medical status and stores it in the blockchain. In this way quick reporting and tamper proof storage of data occurs. By deploying a smart contract the final hospital bill can be calculated along with insurance coverage. This would negate the need of third party providers and create a transparent system. Our paper also proposes the use of Inter planetary file system to store discharged patients records thus reducing the load on the actual blockchain. Overall this will surely benefit patients and doctors alike by creating a safe and transparent environment along with quick response to a patient's need.

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Dhagarra D, Goswami M, Sarma PRS, Choudhury A. Big Data and blockchain supported conceptual model for enhanced healthcare coverage: The Indian context. Bus Process Manag J [Internet]. 2019 [cited 2019 Apr 17]; In press. Available from: https://www.emeraldinsight.com/doi/pdfplus/10.1108/BPMJ-06-2018-0164 Subscription required to view.

Reference Type: Electronic Article

Abstract: Purpose: Significant advances have been made in the field of healthcare service delivery across the world; however, health coverage particular for the poor and disadvantaged still remains a distant dream in developing world. In large developing countries like India, disparities in access to healthcare are pervasive. Despite recent progress in ensuring improved access to health care in past decade or so, disparities across gender, geography and socioeconomic status continue to persist. Fragmented and scattered health records and lack of integration are some of the primary causes leading to uneven healthcare service delivery. The devised framework is intended to address these challenges. The paper aims to discuss these issues. Design/methodology/approach: In view of such challenges, in this research a Big Data and blockchain anchored integrative healthcare framework is proposed focusing upon providing timely and appropriate healthcare services to every citizen of the country. The framework uses unique identification number (UID) system as formalized and implemented by the Government of India for identification of the patients, their specific case histories and so forth.
Findings: The key characteristic of our proposed framework is that it provides easy access to secure, immutable and comprehensive medical records of patients across all treatment centers within the country. The model also ensures security and privacy of the medical records based upon the incorporation of biometric authentication by the patients for access of their records to healthcare providers.
Originality/value: A key component of our evolved framework is the Big Data analytics-based framework that seeks to provide structured health data to concerned stakeholders in healthcare services. The model entails all pertinent stakeholders starting from patients to healthcare service providers.

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Dhillon V. Designing decentralized ledger technology for electronic health records. Telehealth Med Today. 2018;1(2):1-13. Epub 2018 May 3.

Reference Type: Journal Article

Available from: https://telehealthandmedicinetoday.com/index.php/journal/article/view/77

Abstract: A proposal to implement distributed ledger technology for electronic health records is outlined here. The rationale for integration of distributed ledgers in the healthcare domain is introduced, followed by a discussion of the features enabled by the use of a blockchain. An open source implementation of a distributed ledger is then presented. The article concludes with an examination of opportunities and challenges ahead in deploying blockchains for digital health.

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Di Francesco Maesa D, Mori P, Ricci L. A blockchain based approach for the definition of auditable access control systems. Comput Secur. 2019;84:93-119. Epub 2019 Mar 20.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S0167404818309398 Subscription required to view.

Abstract: This work proposes to exploit blockchain technology to define Access Control systems that guarantee the auditability of access control policies evaluation. The key idea of our proposal is to codify attribute-based Access Control policies as smart contracts and deploy them on a blockchain, hence transforming the policy evaluation process into a completely distributed smart contract execution. Not only the policies, but also the attributes required for their evaluation are managed by smart contracts deployed on the blockchain. The auditability property derives from the immutability and transparency properties of blockchain technology. This paper not only presents the proposed Access Control system in general, but also its application to the innovative reference scenario where the resources to be protected are themselves smart contracts. To prove the feasibility of our approach, we present a reference implementation exploiting XACML policies and Solidity written smart contracts deployed on the Ethereum blockchain. Finally, we evaluate the system performances through a set of experimental results, and we discuss the advantages and drawbacks of our proposal.

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Dimitrov DV. Blockchain applications for healthcare data management. Healthc Inform Res. 2019;25(1):51-6. Epub 2019 Jan 31.

Reference Type: Journal Article

Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372466/

Abstract: Objectives: This pilot study aimed to provide an overview of the potential for blockchain technology in the healthcare system. The review covers technological topics from storing medical records in blockchains through patient personal data ownership and mobile apps for patient outreach.
Methods: We performed a preliminary survey to fill the gap that exists between purely technically focused manuscripts about blockchains, on the one hand, and the literature that is mostly concerned with marketing discussions about their expected economic impact on the other hand.
Results: The findings show that new digital platforms based on blockchains are emerging to enabling fast, simple, and seamless interaction between data providers, including patients themselves.
Conclusions: We provide a conceptual understanding of the technical foundations of the potential for blockchain technology in healthcare, which is necessary to understand specific blockchain applications, evaluate business cases such as blockchain startups, or follow the discussion about its expected economic impacts.

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Disparte D. Blockchain could make the insurance industry much more transparent. Harv Bus Rev [Internet]. 2017 Jul 12 [cited 2017 Jul 27]:[about 7 p.]. Available from: https://hbr.org/2017/07/blockchain-could-make-the-insurance-industry-much-more-transparent

Reference Type: Electronic Article

Abstract: While Edward Lloyd is largely credited with commercializing the insurance industry, with the creation of his namesake firm, Lloyd’s, over 330 years ago, the original concept of spreading risk (or “mutualizing”) goes back even further. Hundreds of years before Lloyd’s was formed, Chinese merchants would spread their valuable cargo across multiple vessels, with each one carrying an equal share of another merchant’s goods. In this manner, no single loss would be catastrophic. This spread of risk, of course, also prevented a merchant from absconding with his ship’s goods and never reuniting with the other traders; he’d have too much to lose. In effect, they all had skin in the game, which remains one of the most elusive elements of modern finance. Both then and in 1686, when Lloyd’s was born in a London coffee house, the global insurance industry was a business of utmost good faith, as it remains today.

Thus a trust and efficiency engine like blockchain technology has the potential to drive radical change in the insurance industry while improving transparency and outcomes across the entire value chain. Intermediaries or “trust brokers” do not have to be written out of the equation — or disintermediated — as many blockchain enthusiasts argue. Rather, they can become early adopters of the technology. Admittedly, this shift will be hardest on the established monoliths in the industry, for it will require uncomfortable transparency and price corrections in their business models. This will be toughest on the portions of the industry that are the least differentiated, where consumers often decide based on price: auto, life, and homeowner’s insurance. However, even these commodity offerings can find ways to innovate and survive.

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Dorri A, Kanhere SS, Jurdak R. Blockchain in internet of things: challenges and solutions. arXiv [Internet]. 2016 Aug 18 [cited 2018 Oct 23]; 1608.05187:[13 p.]. Available from: https://arxiv.org/abs/1608.05187

Reference Type: Electronic Article

Abstract: The Internet of Things (IoT) is experiencing exponential growth in research and industry, but it still suffers from privacy and security vulnerabilities. Conventional security and privacy approaches tend to be inapplicable for IoT, mainly due to its decentralized topology and the resource-constraints of the majority of its devices. BlockChain (BC) that underpin the cryptocurrency Bitcoin have been recently used to provide security and privacy in peer-to-peer networks with similar topologies to IoT. However, BCs are computationally expensive and involve high bandwidth overhead and delays, which are not suitable for IoT devices. This position paper proposes a new secure, private, and lightweight architecture for IoT, based on BC technology that eliminates the overhead of BC while maintaining most of its security and privacy benefits. The described method is investigated on a smart home application as a representative case study for broader IoT applications. The proposed architecture is hierarchical, and consists of smart homes, an overlay network and cloud storages coordinating data transactions with BC to provide privacy and security. Our design uses different types of BC’s depending on where in the network hierarchy a transaction occurs, and uses distributed trust methods to ensure a decentralized topology. Qualitative evaluation of the architecture under common threat models highlights its effectiveness in providing security and privacy for IoT applications.

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Drosatos G, Kaldoudi E. Blockchain applications in the biomedical domain: a scoping review. Comput Struct Biotechnol J. 2019;17:229-40. Epub 2019 Feb 8.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S200103701830285X

Abstract: Blockchain is a distributed, immutable ledger technology introduced as the enabling mechanism to support cryptocurrencies. Blockchain solutions are currently being proposed to address diverse problems in different domains. This paper presents a scoping review of the scientific literature to map the current research area of blockchain applications in the biomedical domain. The goal is to identify biomedical problems treated with blockchain technology, the level of maturity of respective approaches, types of biomedical data considered, blockchain features and functionalities exploited and blockchain technology frameworks used. The study follows the PRISMA-ScR methodology. Literature search was conducted on August 2018 and the systematic selection process identified 47 research articles for detailed study. Our findings show that the field is still in its infancy, with the majority of studies in the conceptual or architectural design phase; only one study reports real world demonstration and evaluation. Research is greatly focused on integration, integrity and access control of health records and related patient data. However, other diverse and interesting applications are emerging, addressing medical research, clinical trials, medicines supply chain, and medical insurance.

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Du Y, Liu J, Guan Z, Feng H. A medical information service platform based on distributed cloud and blockchain. 2018 3rd IEEE International Conference on Smart Cloud (SmartCloud); 2018 Sep 21-23; New York, NY. Los Alamitos, CA: IEEE Computer Society.

Reference Type: Conference Proceedings

Available from: https://ieeexplore.ieee.org/abstract/document/8513712 Subscription required to view.

Abstract: Usually, medical information including physical examination results and treatment of patients is stored in the hospital's centralized database. Although sophisticated access control strategy is adopted, it is still high-risk to expose patients' privacy in complex network environment. Moreover, a practical service platform is missed to share this kind of information under patients' authentication. To solve these problem, we elaborate an efficient and secure medical information service platform based on distributed cloud and blockchain technology, simultaneously guarantee security and confidentiality by hierarchical identity-based broadcast encryption system. Within our proposed framework, medical data are stored on distributed cloud after encryption. An incentive mechanism is designed to encourage customers and miners to maintain the platform. It shows that our platform is safe and effective in practice.

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Dubovitskaya A, Xu Z, Ryu S, Schumacher M, Wang F. Secure and trustable electronic medical records sharing using blockchain. In. AMIA Annual Symposium Proceedings; Nov 4-8; Washington, DC. American Medical Informatics Association; 2017. p. 650-9.

Reference Type: Conference Paper

Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977675/

Abstract: Electronic medical records (EMRs) are critical, highly sensitive private information in healthcare, and need to be frequently shared among peers. Blockchain provides a shared, immutable and transparent history of all the transactions to build applications with trust, accountability and transparency. This provides a unique opportunity to develop a secure and trustable EMR data management and sharing system using blockchain. In this paper, we present our perspectives on blockchain based healthcare data management, in particular, for EMR data sharing between healthcare providers and for research studies. We propose a framework on managing and sharing EMR data for cancer patient care. In collaboration with Stony Brook University Hospital, we implemented our framework in a prototype that ensures privacy, security, availability, and fine-grained access control over EMR data. The proposed work can significantly reduce the turnaround time for EMR sharing, improve decision making for medical care, and reduce the overall cost.

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Dujak D, Sajter D. Blockchain applications in supply chain. In: Kawa A, Maryniak A, editors. SMART Supply Network. ed. Cham, Switzerland: Springer International Publishing AG; 2019. p. 21-46.

Reference Type: Book Section

Available from: https://www.academia.edu/38066777/Blockchain_applications Open access; https://link.springer.com/chapter/10.1007%2F978-3-319-91668-2_2 Subscription required to view.

Abstract: Blockchain is a technological concept which evolves from the first cryptocurrency, Bitcoin, and disrupts constantly enlarging areas of economy. The concept of blockchain is developing, and while the future of Bitcoin remains unclear (as it is for the most elements of the economy) it is evident that the blockchain holds enormous potential for large-scale improvements. However, being a technology that could decrease significance many of today’s large global corporations, institutions and power structures which have keen interest in preserving established hierarchies, its potential could well remain unexploited. This paper aims to introduce and present the concept of blockchain and its current applications in logistics and supply networks. Blockchain technology promises overpowering trust issues and allowing trustless, secure and authenticated system of logistics and supply chain information exchange in supply networks. The new implementations within supply chain are shifting from blockchain to a wider notion of distributed ledger technologies. Paper presents description and rationale behind current and possible future applications of blockchain in logistics and supply chain.

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Dunphy P, Garratt L, Petitcolas F. Decentralizing digital identity: open challenges for distributed ledgers. In: Piessens F, Fahl S, editors. 2018 IEEE European Symposium on Security and Privacy Workshops (EuroS&PW); 2018 Apr 23-27; London, United Kingdom. Piscataway, NJ: IEEE; 2018. p. 75-8.

Reference Type: Conference Paper

Available from: https://www.dunph.com/SB2018.pdf Open access; https://ieeexplore.ieee.org/abstract/document/8406563 Subscription required to view.

Abstract: Distributed Ledger Technology (DLT) has been proposed as a new way to incorporate decentralization into a wide range of digital infrastructures. Applications of DLT to digital identity are increasing in prevalence, with a recent survey reporting that 55% of DLT technologies in development track digital identity. However, while proofs of concept, open source software, and new ideas are readily available, it is still unclear the extent to which DLT can play a role to underpin new forms of digital identity. In this position paper, we situate this fast-moving application domain into the broader challenges faced in digital identity, with the aim to highlight the socio-technical nature of the challenge at hand, and to propose directions for future research.

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Dunphy P, Petitcolas FAP. A first look at identity management schemes on the blockchain. IEEE Secur Priv. 2018;16(4):20-9. Epub 2018 Aug 6.

Reference Type: Journal Article

Available from: https://arxiv.org/abs/1801.03294 Open access; https://ieeexplore.ieee.org/abstract/document/8425607/ Subscription required to view.

Abstract: The emergence of distributed ledger technology (DLT) based on a blockchain data structure has given rise to new approaches to identity management that aim to upend dominant approaches to providing and consuming digital identities. These new approaches to identity management (IdM) propose to enhance de-centralization, transparency, and user control in transactions that involve identity information; however, given the historical challenge to design IdM, can these new DLT-based schemes deliver on their lofty goals? We introduce the emerging landscape of DLT-based IdM and evaluate three representative proposals-uPort, ShoCard, and Sovrin-using the analytic lens of a seminal framework that characterizes the nature of successful IdM schemes.

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Dwivedi DA, Srivastava G, Dhar S, Singh R. A decentralized privacy-preserving healthcare blockchain for IoT. Sensors (Basel). 2019;19(2):326. Epub 2019 Jan 15.

Reference Type: Journal Article

Available from: https://www.mdpi.com/1424-8220/19/2/326

Abstract: Medical care has become one of the most indispensable parts of human lives, leading to a dramatic increase in medical big data. To streamline the diagnosis and treatment process, healthcare professionals are now adopting Internet of Things (IoT)-based wearable technology. Recent years have witnessed billions of sensors, devices, and vehicles being connected through the Internet. One such technology—remote patient monitoring—is common nowadays for the treatment and care of patients. However, these technologies also pose grave privacy risks and security concerns about the data transfer and the logging of data transactions. These security and privacy problems of medical data could result from a delay in treatment progress, even endangering the patient’s life. We propose the use of a blockchain to provide secure management and analysis of healthcare big data. However, blockchains are computationally expensive, demand high bandwidth and extra computational power, and are therefore not completely suitable for most resource-constrained IoT devices meant for smart cities. In this work, we try to resolve the above-mentioned issues of using blockchain with IoT devices. We propose a novel framework of modified blockchain models suitable for IoT devices that rely on their distributed nature and other additional privacy and security properties of the network. These additional privacy and security properties in our model are based on advanced cryptographic primitives. The solutions given here make IoT application data and transactions more secure and anonymous over a blockchain-based network.

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Dyson SF. Blockchain investigations - beyond the 'money'. J Br Blockchain Assoc. 2019;2(2):1-9. Epub 2019 Aug 13.

Reference Type: Journal Article

Available from: https://jbba.scholasticahq.com/article/10027-blockchain-investigations-beyond-the-money

Abstract: Cryptocurrency investigations have centeredalmost entirely around the transfer of value “money” or a cryptocurrency asset. The use of cryptocurrency for illicit purposes, especially Bitcoin, is well documented both in academic writing, media reporting and even film documentaries. The infamous SilkRoad marketplacein addition to the millions of dollars spent within dark markets on drugs, guns and assassinations have grabbed the headlines. This paper looks at how blockchain is creating new areas of investigation that areyet to be explored in detail.This scenario-based research examines the hosting of stolen data (P.I.I) personal identifiable information on a distributed blockchain host where the data is also accessible. The platform used is based on Ethereum infrastructure but demonstrates just one available platform that poses the paradigm. The paper examines the considerations through the lens of an incident responder /cyber investigator, forensics examiner and data controller. The scenario highlights distinct differences in considerations from a traditional response compared to dealing with the immutable and unstoppable distributed technology. The paper concludes that more is needed to be done to understand digital forensics in the blockchain era and the need to develop beyond track and trace in the cryptocurrency investigative toolbox. The discussion also brings forth how data retention and GDPR requires consideration when applying it blockchain systems.

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Efanov D, Roschin P. The all-pervasiveness of the blockchain technology. In: Samsonovich AV, Klimov VV, editors. 8th Annual International Conference on Biologically Inspired Cognitive Architectures; 2018 Aug 1-6; Moscow, Russia. Procedia Computer Science; 2018. p. 116-21.

Reference Type: Conference Paper

Available from: http://www.sciencedirect.com/science/article/pii/S1877050918300206

Abstract: Conceptually, the blockchain is a distributed database containing records of transactions that are shared among participating members. Each transaction is confirmed by the consensus of a majority of the members, making fraudulent transactions unable to pass collective confirmation. Once a record is created and accepted by the blockchain, it can never be altered or disappear. Nowadays the blockchain technology is considered as the most significant invention after the Internet. If the latter connects people to realize on-line business processes, the former could decide the trust problem by peer-to-peer networking and public-key cryptography. The purpose of this paper is to consider on distinct use cases at the all-pervasive impact of the blockchain technology and look at this as an inalienable part of our daily life.

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Ekblaw A, Azaria A, Halamka JD, Lippman A. A case study for blockchain in healthcare: “MedRec” prototype for electronic health records and medical research data. OBD 2016 2nd International Conference on Open and Big Data; 2016 Aug 22-24; Vienna, Austria. Future Generation Computer Systems, Elsevier.

Reference Type: Conference Proceedings

Available from: https://pdfs.semanticscholar.org/56e6/5b469cad2f3ebd560b3a10e7346780f4ab0a.pdf

Abstract: A long-standing focus on compliance has traditionally constrained development of fundamental design changes for Electronic Health Records (EHRs). We now face a critical need for such innovation, as personalization and data science prompt patients to engage in the details of their healthcare and restore agency over their medical data. In this paper, we propose MedRec: a novel, decentralized record management system to handle EHRs, using blockchain technology. Our system gives patients a comprehensive, immutable log and easy access to their medical information across providers and treatment sites. Leveraging unique blockchain properties, MedRec manages authentication, confidentiality, accountability and data sharing—crucial considerations when handling sensitive information. A modular design integrates with providers' existing, local data storage solutions, facilitating interoperability and making our system convenient and adaptable. We incentivize medical stakeholders (researchers, public health authorities, etc.) to participate in the network as blockchain “miners”. This provides them with access to aggregate, anonymized data as mining rewards, in return for sustaining and securing the network via Proof of Work. MedRec thus enables the emergence of data economics, supplying big data to empower researchers while engaging patients and providers in the choice to release metadata. The purpose of this paper is to expose, in preparation for field tests, a working prototype through which we analyze and discuss our approach and the potential for blockchain in health IT and research.

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Ekĭn A, Ünay D. [Blockchain applications in healthcare] Sağlıkta Blok Zinciri Uygulamaları. 2018 26th Signal Processing and Communications Applications Conference (SIU); 2018 May 2-5; Izmir, Turkey. Piscataway, NJ: IEEE.

Reference Type: Conference Proceedings

Available from: https://ieeexplore.ieee.org/abstract/document/8404275 Subscription required to view.

Abstract: In this paper, we present the applications of blockchain technology in healthcare. Furthermore, we evaluate the choice and deployment of Blockchain technology in such applications, review the advantages and disadvantages of such an approach. We review the Estonian system, which is the first blockchain-based health system at the national level, in detail and discuss its ramifications to Turkey. This paper is one of the first papers in this domain and, to the best of authors' knowledge, the first in Turkish.

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ElBahrawy A, Alessandretti L, Kandler A, Pastor-Satorras R, Baronchelli A. Evolutionary dynamics of the cryptocurrency market. R Soc Open Sci. 2017;4(11):170623. Epub 2017 Nov 15.

Reference Type: Journal Article

Available from: https://royalsocietypublishing.org/doi/full/10.1098/rsos.170623

Abstract: The cryptocurrency market surpassed the barrier of $100 billion market capitalization in June 2017, after months of steady growth. Despite its increasing relevance in the financial world, a comprehensive analysis of the whole system is still lacking, as most studies have focused exclusively on the behaviour of one (Bitcoin) or few cryptocurrencies. Here, we consider the history of the entire market and analyse the behaviour of 1469 cryptocurrencies introduced between April 2013 and May 2017. We reveal that, while new cryptocurrencies appear and disappear continuously and their market capitalization is increasing (super-)exponentially, several statistical properties of the market have been stable for years. These include the number of active cryptocurrencies, market share distribution and the turnover of cryptocurrencies. Adopting an ecological perspective, we show that the so-called neutral model of evolution is able to reproduce a number of key empirical observations, despite its simplicity and the assumption of no selective advantage of one cryptocurrency over another. Our results shed light on the properties of the cryptocurrency market and establish a first formal link between ecological modelling and the study of this growing system. We anticipate they will spark further research in this direction.

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Elisa N, Yang L, Chao F, Cao Y. A framework of blockchain-based secure and privacy-preserving E-government system. Wirel Networks. 2018. Epub 2018 Dec 3.

Reference Type: Journal Article

Available from: https://link.springer.com/article/10.1007/s11276-018-1883-0

Abstract: Electronic government (e-government) uses information and communication technologies to deliver public services to individuals and organisations effectively, efficiently and transparently. E-government is one of the most complex systems which needs to be distributed, secured and privacy-preserved, and the failure of these can be very costly both economically and socially. Most of the existing e-government systems such as websites and electronic identity management systems (eIDs) are centralized at duplicated servers and databases.A centralized management and validation system may suffer from a single point of failure and make the system a target to cyber attacks such as malware, denial of service attacks (DoS), and distributed denial of service attacks (DDoS). The blockchain technology enables the implementation of highly secure and privacy-preserving decentralized systems where transactions are not under the control of any third party organizations. Using the blockchain technology, exiting data and new data are stored in a sealed compartment of blocks (i.e., ledger) distributed across the network in a verifiable and immutable way. Information security and privacy are enhanced by the blockchain technology in which data are encrypted and distributed across the entire network. This paper proposes a framework of a decentralized e-government peer-to-peer (p2p) system using the blockchain technology, which can ensure both information security and privacy while simultaneously increasing the trust of the public sectors. In addition, a prototype of the proposed system is presented, with the support of a theoretical and qualitative analysis of the security and privacy implications of such system.

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Elmisery AM, Fu H. Privacy preserving distributed learning clustering of health care data using cryptography protocols. 2010 IEEE 34th Annual Computer Software and Applications Conference Workshops; 2010 Jul 19-23; Seoul, South Korea. 2010.

Reference Type: Conference Proceedings

Available from: https://ieeexplore.ieee.org/abstract/document/5615770

Abstract: Data mining is the process of knowledge discovery in databases (centralized or distributed); it consists of different tasks associated with them different algorithms. Nowadays the scenario of one centralized database that maintains all the data is difficult to achieve due to different reasons including physical, geographical restrictions and size of the data itself. One approach to solve this problem is distributed databases where different parities have horizontal or vertical partitions of the data. The data is normally maintained by more than one organization, each of which aims at keeping its information stored in the databases private, thus, privacy-preserving techniques and protocols are designed to perform data mining on distributed data when privacy is highly concerned. Cluster analysis is a frequently used data mining task which aims at decomposing or partitioning a usually multivariate data set into groups such that the data objects in one group are the most similar to each other. It has an important role in different fields such as bio-informatics, marketing, machine learning, climate and healthcare. In this paper we introduce a novel clustering algorithm that was designed with the goal of enabling a privacy preserving version of it, along with sub-protocols for secure computations, to handle the clustering of vertically partitioned data among different healthcare data providers.

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Engel A. Could blockchain technology add value to surgical outcomes research? Colorectal Dis. 2018;20(5):369-70. Epub 2018 May 2.

Reference Type: Journal Article

Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/codi.14066 Subscription required to view.

Abstract: Medline started in 1971 with 22 users who had access to 236 indexed journals and almost 150 000 indexed papers on which some 70 000 searches were performed. By 2016, celebrating Medline's 45th anniversary, these numbers had grown exponentially to a staggering 601 million users having access to over 22 million papers published in 5618 Journals on which some 2.8 billion PubMed searches were performed 1. Annual growth is well over 800 000 papers and this is testimony to a medical research industry that has grown beyond recognition and perhaps human measure in just the life span of a surgical career. If we assume a normal distribution of mean scientific quality of all papers available on PubMed than well over 500 000 papers (approximately 2.5%) are characterised by over 2 standard deviations difference to the left side of the mean scientific quality. With increasing scientific output we have seen proportional growth of papers aggregating and analysing data in systematic reviews and metanalyses but also of papers analysing basic flaws and biases of the medical research industry. Poor quality medical research has been a perennial issue and perhaps it is time to accept that less is more.

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Engelhardt MA. Hitching healthcare to the chain: an introduction to blockchain technology in the healthcare sector. Technol Innov Manag Rev. 2017;7(10):22-34.

Reference Type: Journal Article

Available from: https://timreview.ca/article/1111

Abstract: Health services must balance patient care with information privacy, access, and completeness. The massive scale of the healthcare industry also amplifies the importance of cost control. The promise of blockchain technology in health services, combined with application layers built atop it, is to be a mechanism that provides utmost privacy while ensuring that appropriate users can easily add to and access a permanent record of information. Blockchains, also called distributed ledgers, enable a combination of cost reduction and increased accessibility to information by connecting stakeholders directly without requirements for third-party brokers, potentially giving better results at lower costs. New ventures are looking to apply blockchain technology to solve real-world problems, including efforts to track public health, centralize research data, monitor and fulfill prescriptions, lower administrative overheads, and organize patient data from an increasing number of inputs. Here, concrete examples of the application of blockchain technology in the health sector are described, touching on near-term promise and challenges.

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Esmaeilzadeh P, Mirzaei T. The potential of blockchain technology for health Information exchange: experimental study from patients' perspectives. J Med Internet Res. 2019;21(6):e14184. Epub 2019 Jun 20.

Reference Type: Journal Article

Available from: https://www.jmir.org/2019/6/e14184/

Abstract: BACKGROUND: Nowadays, a number of mechanisms and tools are being used by health care organizations and physicians to electronically exchange the personal health information of patients. The main objectives of different methods of health information exchange (HIE) are to reduce health care costs, minimize medical errors, and improve the coordination of interorganizational information exchange across health care entities. The main challenges associated with the common HIE systems are privacy concerns, security risks, low visibility of system transparency, and lack of patient control. Blockchain technology is likely to disrupt the current information exchange models utilized in the health care industry. OBJECTIVE: Little is known about patients' perceptions and attitudes toward the implementation of blockchain-enabled HIE networks, and it is still not clear if patients (as one of the main HIE stakeholders) are likely to opt in to the applications of this technology in HIE initiatives. Thus, this study aimed at exploring the core value of blockchain technology in the health care industry from health care consumers' views. METHODS: To recognize the potential applications of blockchain technology in health care practices, we designed 16 information exchange scenarios for controlled Web-based experiments. Overall, 2013 respondents participated in 16 Web-based experiments. Each experiment described an information exchange condition characterized by 4 exchange mechanisms (ie, direct, lookup, patient-centered, and blockchain), 2 types of health information (ie, sensitive vs nonsensitive), and 2 types of privacy policy (weak vs strong). RESULTS: The findings show that there are significant differences in patients' perceptions of various exchange mechanisms with regard to patient privacy concern, trust in competency and integrity, opt-in intention, and willingness to share information. Interestingly, participants hold a favorable attitude toward the implementation of blockchain-based exchange mechanisms for privacy protection, coordination, and information exchange purposes. This study proposed the potentials and limitations of a blockchain-based attempt in the HIE context. CONCLUSIONS: The results of this research should be of interest to both academics and practitioners. The findings propose potential limitations of a blockchain-based HIE that should be addressed by health care organizations to exchange personal health information in a secure and private manner. This study can contribute to the research in the blockchain area and enrich the literature on the use of blockchain in HIE efforts. Practitioners can also identify how to leverage the benefit of blockchain to promote HIE initiatives nationwide.

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Esposito C, De Santis A, Tortora G, Chang H, Choo KR. Blockchain: a panacea for healthcare cloud-based data security and privacy? IEEE Cloud Comput. 2018;5(1):31-7. Epub 2018 Mar 28.

Reference Type: Journal Article

Available from: https://pdfs.semanticscholar.org/7f8f/4ff1377ebf0a084c44dbf6926af03dd2cdd8.pdf Open access; https://ieeexplore.ieee.org/abstract/document/8327543/ Subscription required to view.

Abstract: One particular trend observed in healthcare is the progressive shift of data and services to the cloud, partly due to convenience (e.g. availability of complete patient medical history in real-time) and savings (e.g. economics of healthcare data management). There are, however, limitations to using conventional cryptographic primitives and access control models to address security and privacy concerns in an increasingly cloud-based environment. In this paper, we study the potential to use the Blockchain technology to protect healthcare data hosted within the cloud. We also describe the practical challenges of such a proposition and further research that is required.

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Fabiano N. Internet of things and blockchain: legal issues and privacy. The challenge for a privacy standard. In: Wu Y, Min G, Georgalas N, IEEE International Conference on Internet of Things, editors. 2017 IEEE International Conference on Internet of Things (iThings) and IEEE Green Computing and Communications (GreenCom) and IEEE Cyber, Physical and Social Computing (CPSCom) and IEEE Smart Data (SmartData); June 21-23; Exeter, United Kingdom. IEEE International Conference on Internet of Things; 2017. p. 727-34.

Reference Type: Conference Paper

Available from: https://fardapaper.ir/mohavaha/uploads/2018/08/Fardapaper-Internet-of-Things-and-Blockchain-legal-issues-and-privacy.-The-challenge-for-a-privacy-standard.pdf Open access; https://ieeexplore.ieee.org/abstract/document/8276831 Subscription required to view.

Abstract: The IoT is innovative and important phenomenon prone to several services and applications, but it should consider the legal issues related to the data protection law. However, should be taken into account the legal issues related to the data protection and privacy law. Technological solutions are welcome, but it is necessary, before developing applications, to consider the risks which we cannot dismiss. Personal data is a value. In this context is fundamental to evaluate the legal issues and prevent them, adopting in each project the privacy by design approach. Regarding the privacy and security risks, there are some issues with potential consequences for data security and liability. The IoT system allows us to transfer data on the Internet, including personal data. In this context, it is important to consider the new European General Data Protection Regulation (GDPR) - already in force from 24 May 2016 - that will be applicable on 25 May 2018. The GDPR introduces Data Protection Impact Assessment (DPIA), data breach notification and very hard administrative fines in respect of infringements of the Regulation. A correct law analysis allows evaluating risks preventing the wrong use of personal data. The IoT ecosystem is evolving quickly, developing several applications in different sectors. The main topics for the last time are Big Data and the blockchain. People are paying attention to the latest one because of its potential concrete use for services and applications, increasing the security measures to guarantee a secure system. However, it is equally important to analyse the legal issues related to them. Everyone has the right to the protection of personal data concerning him or her. In this context, we cannot dismiss to guarantee an adequate protection of personal data designing any application. The contribution describes the main legal issues related to privacy and data protection especially regarding the blockchain, focusing on the Privacy by Design approach, a- cording to the GDPR. Furthermore, I resolutely believe that is possible to develop a worldwide privacy standard framework that organisations can use for their data protection activities.

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Fagherazzi G, Ravaud P. Digital diabetes: perspectives for diabetes prevention, management and research. Diabetes Metab. 2018;In Press. Epub 2018 Sep 19.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S126236361830171X Subscription required to view.

Abstract: Digital medicine, digital research and artificial intelligence (AI) have the power to transform the field of diabetes with continuous and no-burden remote monitoring of patients’ symptoms, physiological data, behaviours, and social and environmental contexts through the use of wearables, sensors and smartphone technologies. Moreover, data generated online and by digital technologies – which the authors suggest be grouped under the term ‘digitosome’ – constitute, through the quantity and variety of information they represent, a powerful potential for identifying new digital markers and patterns of risk that, ultimately, when combined with clinical data, can improve diabetes management and quality of life, and also prevent diabetes-related complications. Moving from a world in which patients are characterized by only a few recent measurements of fasting glucose levels and glycated haemoglobin to a world where patients, healthcare professionals and research scientists can consider various key parameters at thousands of time points simultaneously will profoundly change the way diabetes is prevented, managed and characterized in patients living with diabetes, as well as how it is scientifically researched. Indeed, the present review looks at how the digitization of diabetes can impact all fields of diabetes – its prevention, management, technology and research – and how it can complement, but not replace, what is usually done in traditional clinical settings. Such a profound shift is a genuine game changer that should be embraced by all, as it can provide solid research results transferable to patients, improve general health literacy, and provide tools to facilitate the everyday decision-making process by both healthcare professionals and patients living with diabetes.

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Fan K, Wang S, Ren Y, Li H, Yang Y. MedBlock: efficient and secure medical data sharing via blockchain. J Med Syst. 2018;42(8):136. Epub 2018 Jun 21.

Reference Type: Journal Article

Available from: https://link.springer.com/article/10.1007/s10916-018-0993-7 Subscription required to view.

Abstract: With the development of electronic information technology, electronic medical records (EMRs) have been a common way to store the patients' data in hospitals. They are stored in different hospitals' databases, even for the same patient. Therefore, it is difficult to construct a summarized EMR for one patient from multiple hospital databases due to the security and privacy concerns. Meanwhile, current EMRs systems lack a standard data management and sharing policy, making it difficult for pharmaceutical scientists to develop precise medicines based on data obtained under different policies. To solve the above problems, we proposed a blockchain-based information management system, MedBlock, to handle patients' information. In this scheme, the distributed ledger of MedBlock allows the efficient EMRs access and EMRs retrieval. The improved consensus mechanism achieves consensus of EMRs without large energy consumption and network congestion. In addition, MedBlock also exhibits high information security combining the customized access control protocols and symmetric cryptography. MedBlock can play an important role in the sensitive medical information sharing.

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Fawcett JP. Bitcoin regulations and investigations: a proposal for U.S. policies [Master's Thesis]: Utica College; 2016.

Reference Type: Thesis

Available from: https://infoskirmish.com/wp-content/uploads/2017/11/BITCOIN-REGULATIONS-AND-INVESTIGATIONS.pdf

Abstract: Bitcoins were conceptualized in 2008, which revolutionized the digital transfers of value within payment systems (Nakamoto, 2008). The advent of digital currencies revealed problems concerning anonymity embedded in bitcoins, consequently raising money laundering concerns. Regulators and law enforcement agencies struggle with addressing the money laundering issues inherent with bitcoin and digital currencies (Ajello, 2025). In response to these threats, agencies have issued various opinions regarding defining digital currencies within a financial framework. Regulator opinions concerning the applicability of bitcoins existing as currency, property, a commodity and commodity money contradict each other. Moreover; prosecutorial agencies attempt to fit digital currency exchangers under the regulations pertinent to money service businesses (MSB) (Mandjee, 2015; Sonderegger, 2015). This project provided an analysis of scholarly material, government publications, case law, and current trade information to examine a solution to the problem of money laundering through digital currency. This project revealed a need for a clear definition of bitcoin and digital currency within the context of U.S. laws and regulation to assist with investigations concerning illicit uses of digital currency. Furthermore, a need exists for new U.S. legislation specific to digital currency, which addresses money laundering and terrorist finance risks. Research revealed that digital currency regulations should mirror MSB regulations to curb peer-to-peer digital currency exchanges (Kirby, 2014). Additionally, FinCENs purview with financial crimes provides a unique position to assist law enforcement with digital currency investigations (FinCEN, 2014). A need exists for FinCEN to develop a blockchain analysis tool for law enforcement agencies and to assist with complex digital currency investigations (DHS, 2014).

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Fedorov AK, Kiktenko EO, Lvovsky AI. Quantum computers put blockchain security at risk. Nature. 2018;563(7732):465. Epub 2018 Nov 19.

Reference Type: Journal Article

Available from: https://www.nature.com/articles/d41586-018-07449-z/

Abstract: [FIRST FEW PARAGRAPHS] By 2025, up to 10% of global gross domestic product is likely to be stored on blockchains1. A blockchain is a digital tool that uses cryptography techniques to protect information from unauthorized changes. It lies at the root of the Bitcoin cryptocurrency2. Blockchain-related products are used everywhere from finance and manufacturing to health care, in a market worth more than US$150 billion.

When information is money, data security, transparency and accountability are crucial. A blockchain is a secure digital record, or ledger. It is maintained collectively by users around the globe, rather than by one central administration. Decisions such as whether to add an entry (or block) to the ledger are based on consensus — so personal trust doesn’t come into it. Any party inside or outside the network can check the integrity of the ledger by making a simple calculation.

But within a decade, quantum computers will be able to break a blockchain’s cryptographic codes. Here we highlight how quantum technology makes blockchains vulnerable — and how it could render them more secure.

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Feng Q, He D, Zeadally S, Khan MK, Kumar N. A survey on privacy protection in blockchain system. J Netw Comput Appl. 2019;126:45-58. Epub 2018 Nov 13.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S1084804518303485 Subscription required to view.

Abstract: Blockchain, as a decentralized and distributed public ledger technology in peer-to-peer network, has received considerable attention recently. It applies a linked block structure to verify and store data, and applies the trusted consensus mechanism to synchronize changes in data, which makes it possible to create a tamper-proof digital platform for storing and sharing data. It is believed that blockchain can be utilized in diverse Internet interactive systems (e.g., Internet of Things, supply chain systems, identity management, and so on). However, there are some privacy challenges that may hinder the applications of blockchain. The goal of this survey is to provide some insights into the privacy issues associated with blockchain. We analyze the privacy threats in blockchain and discuss existing cryptographic defense mechanisms, i.e., anonymity and transaction privacy preservation. Furthermore, we summarize some typical implementations of privacy preservation mechanisms in blockchain and explore future research challenges that still need to be addressed in order to preserve privacy when blockchain is used.

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Fernandez-Carames TM, Blanco-Novoa O, Froiz-Miguez I, Fraga-Lamas P. Towards an autonomous industry 4.0 warehouse: a UAV and blockchain-based system for inventory and traceability applications in big data-driven supply chain management. Sensors (Basel). 2019;19(10):2394. Epub 2019 May 25.

Reference Type: Journal Article

Available from: https://www.mdpi.com/1424-8220/19/10/2394

Abstract: Industry 4.0 has paved the way for a world where smart factories will automate and upgrade many processes through the use of some of the latest emerging technologies. One of such technologies is Unmanned Aerial Vehicles (UAVs), which have evolved a great deal in the last years in terms of technology (e.g., control units, sensors, UAV frames) and have significantlyr educed their cost. UAVs can help industry in automatable and tedious tasks, like the ones performed on a regular basis for determining the inventory and for preserving item traceability. In such tasks, especially when it comes from untrusted third parties, it is essential to determine whether the collected information is valid or true. Likewise, ensuring data trustworthiness is a key issue in order to leverage Big Data analytics to supply chain efficiency and effectiveness. In such a case, blockchain, another Industry 4.0 technology that has become very popular in other fields like finance, has the potential to provide a higher level of transparency, security, trust and efficiency in the supply chain and enable the use of smart contracts. Thus, in this paper, we present the design and evaluation of a UAV-based system aimed at automating inventory tasks and keeping the traceability of industrial items attached to Radio-Frequency IDentification (RFID) tags. To confront current shortcomings, such a system is developed under a versatile, modular and scalable architecture aimed to reinforce cyber security and decentralization while fostering external audits and big data analytics. Therefore, the system uses a blockchain and a distributed ledger to store certain inventory data collected by UAVs, validate them, ensure their trustworthiness and make them available to the interested parties. In order to show the performance of the proposed system, different tests were performed in a real industrial warehouse, concluding that the system is able to obtain the inventory data really fast in comparison to traditional manual tasks, while being also able to estimate the position of the items when hovering over them thanks to their tag's signal strength. In addition, the performance of the proposed blockchain-based architecture was evaluated in different scenarios.

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Fernández-Caramés TM, Fraga-Lamas P. A review on the use of blockchain for the internet of things. IEEE Access. 2018;6:32979-3001. Epub 2018 May 31.

Reference Type: Journal Article

Available from: https://ieeexplore.ieee.org/abstract/document/8370027

Abstract: The paradigm of Internet of Things (IoT) is paving the way for a world, where many of our daily objects will be interconnected and will interact with their environment in order to collect information and automate certain tasks. Such a vision requires, among other things, seamless authentication, data privacy, security, robustness against attacks, easy deployment, and self-maintenance. Such features can be brought by blockchain, a technology born with a cryptocurrency called Bitcoin. In this paper, a thorough review on how to adapt blockchain to the specific needs of IoT in order to develop Blockchain-based IoT (BIoT) applications is presented. After describing the basics of blockchain, the most relevant BIoT applications are described with the objective of emphasizing how blockchain can impact traditional cloud-centered IoT applications. Then, the current challenges and possible optimizations are detailed regarding many aspects that affect the design, development, and deployment of a BIoT application. Finally, some recommendations are enumerated with the aim of guiding future BIoT researchers and developers on some of the issues that will have to be tackled before deploying the next generation of BIoT applications.

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Fernández-Caramés TM, Froiz-Miguez I, Blanco-Novoa O, Fraga-Lamas P. Enabling the internet of mobile crowdsourcing health things: a mobile fog computing, blockchain and IoT based continuous glucose monitoring system for diabetes mellitus research and care. Sensors (Basel). 2019;19(15). Epub 2019 Jul 28.

Reference Type: Journal Article

Available from: https://www.mdpi.com/1424-8220/19/15/3319

Abstract: Diabetes patients suffer from abnormal blood glucose levels, which can cause diverse health disorders that affect their kidneys, heart and vision. Due to these conditions, diabetes patients have traditionally checked blood glucose levels through Self-Monitoring of Blood Glucose (SMBG) techniques, like pricking their fingers multiple times per day. Such techniques involve a number of drawbacks that can be solved by using a device called Continuous Glucose Monitor (CGM), which can measure blood glucose levels continuously throughout the day without having to prick the patient when carrying out every measurement. This article details the design and implementation of a system that enhances commercial CGMs by adding Internet of Things (IoT) capabilities to them that allow for monitoring patients remotely and, thus, warning them about potentially dangerous situations. The proposed system makes use of smartphones to collect blood glucose values from CGMs and then sends them either to a remote cloud or to distributed fog computing nodes. Moreover, in order to exchange reliable, trustworthy and cybersecure data with medical scientists, doctors and caretakers, the system includes the deployment of a decentralized storage system that receives, processes and stores the collected data. Furthermore, in order to motivate users to add new data to the system, an incentive system based on a digital cryptocurrency named GlucoCoin was devised. Such a system makes use of a blockchain that is able to execute smart contracts in order to automate CGM sensor purchases or to reward the users that contribute to the system by providing their own data. Thanks to all the previously mentioned technologies, the proposed system enables patient data crowdsourcing and the development of novel mobile health (mHealth) applications for diagnosing, monitoring, studying and taking public health actions that can help to advance in the control of the disease and raise global awareness on the increasing prevalence of diabetes.

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Figorilli S, Antonucci F, Costa C, Pallottino F, Raso L, Castiglione M, et al. A blockchain implementation prototype for the electronic open source traceability of wood along the whole supply chain. Sensors (Basel). 2018;18(9):3133. Epub 2018 Sep 17.

Reference Type: Journal Article

Available from: https://www.mdpi.com/1424-8220/18/9/3133

Abstract: This is the first work to introduce the use of blockchain technology for the electronic traceability of wood from standing tree to final user. Infotracing integrates the information related to the product quality with those related to the traceability [physical and digital documents (Radio Frequency IDentification-RFID-architecture)] within an online information system whose steps (transactions) can be made safe to evidence of alteration through the blockchain. This is a decentralized and distributed ledger that keeps records of digital transactions in such a way that makes them accessible and visible to multiple participants in a network while keeping them secure without the need of a centralized certification organism. This work implements a blockchain architecture within the wood chain electronic traceability. The infotracing system is based on RFID sensors and open source technology. The entire forest wood supply chain was simulated from standing trees to the final product passing through tree cutting and sawmill process. Different kinds of Internet of Things (IoT) open source devices and tags were used, and a specific app aiming the forest operations was engineered to collect and store in a centralized database information (e.g., species, date, position, dendrometric and commercial information).

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Finck M. Blockchains and data protection in the European Union. Eur Data Prot Law Rev. 2018;4(1):17-35.

Reference Type: Journal Article

Available from: https://doi.org/10.21552/edpl/2018/1/6

Abstract: This article examines data protection on blockchains and other forms of distributed ledger technology. Whereas the General Data Protection Regulation was fashioned for centralised methods of data collection, storage and processing, blockchains decentralise each of these processes. We engage with the resulting tensions in the below analysis.

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Firdaus A, Anuar NB, Razak MFA, Hashem IAT, Bachok S, Sangaiah AK. Root exploit detection and features optimization: mobile device and blockchain based medical data management. J Med Syst. 2018;42(6):112. Epub 2018 May 4.

Reference Type: Journal Article

Available from: https://umexpert.um.edu.my/file/publication/00006193_161638_73389.pdf Open access; https://link.springer.com/article/10.1007/s10916-018-0966-x Subscription required to view.

Abstract: The increasing demand for Android mobile devices and blockchain has motivated malware creators to develop mobile malware to compromise the blockchain. Although the blockchain is secure, attackers have managed to gain access into the blockchain as legal users, thereby comprising important and crucial information. Examples of mobile malware include root exploit, botnets, and Trojans and root exploit is one of the most dangerous malware. It compromises the operating system kernel in order to gain root privileges which are then used by attackers to bypass the security mechanisms, to gain complete control of the operating system, to install other possible types of malware to the devices, and finally, to steal victims' private keys linked to the blockchain. For the purpose of maximizing the security of the blockchain-based medical data management (BMDM), it is crucial to investigate the novel features and approaches contained in root exploit malware. This study proposes to use the bio-inspired method of practical swarm optimization (PSO) which automatically select the exclusive features that contain the novel android debug bridge (ADB). This study also adopts boosting (adaboost, realadaboost, logitboost, and multiboost) to enhance the machine learning prediction that detects unknown root exploit, and scrutinized three categories of features including (1) system command, (2) directory path and (3) code-based. The evaluation gathered from this study suggests a marked accuracy value of 93% with Logitboost in the simulation. Logitboost also helped to predicted all the root exploit samples in our developed system, the root exploit detection system (RODS).

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Florea BC. Blockchain and internet of things data provider for smart applications. In: Stojanović R, Jóźwiak L, Jurišić D, Lutovac B, editors. 2018 7th Mediterranean Conference on Embedded Computing (MECO); 2018 Jun 10-14; Budva, Montenegro. Piscataway, NJ: IEEE; 2018.

Reference Type: Conference Paper

Available from: https://fardapaper.ir/mohavaha/uploads/2018/08/Fardapaper-Blockchain-and-Internet-of-Things-Data-Provider-for-Smart-Applications.pdf Open access; https://ieeexplore.ieee.org/abstract/document/8406041 Subscription required to view.

Abstract: This paper describes the use of blockchain technology as a data provider in Internet of Things (IoT) applications. Blockchain is a novel technology, which has gained a lot of attention in the last years, mainly due to its use as a backbone for cryptocurrencies. The main purpose of blockchain technology is to provide anonymous transactions between participants, over a peer-to-peer network, using a decentralized distributed ledger. The goal of this novel approach is to eliminate any 3^rd party validation and replace the trust of a central authority for transaction validation with cryptographic proof. While most applications of the blockchain revolve around cryptocurrencies, the blockchain can be used in many other fields, such as finance, distributed data storage, health and medicine, automation, etc. By creating an open, decentralized network, the blockchain can be used to develop decentralized applications and enable data access and sharing on a much higher level than the common implementations of client-server architectures which are in use today. In this paper, we will present a proof of concept method for field devices to store and share data using a distributed ledger built on the IOTA tangle, as well as provide means of access to the data which can be used in IoT and decentralized applications.

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Francisco K, Swanson D. The supply chain has no clothes: technology adoption of blockchain for supply chain transparency. Logistics. 2018;2(1). Epub 2018 Jan 5.

Reference Type: Journal Article

Available from: https://www.mdpi.com/2305-6290/2/1/2

Abstract: Blockchain technology, popularized by Bitcoin cryptocurrency, is characterized as an open-source, decentralized, distributed database for storing transaction information. Rather than relying on centralized intermediaries (e.g., banks) this technology allows two parties to transact directly using duplicate, linked ledgers called blockchains. This makes transactions considerably more transparent than those provided by centralized systems. As a result, transactions are executed without relying on explicit trust [of a third party], but on the distributed trust based on the consensus of the network (i.e., other blockchain users). Applying this technology to improve supply chain transparency has many possibilities. Every product has a long and storied history. However, much of this history is presently obscured. Often, when negative practices are exposed, they quickly escalate to scandalous, and financially crippling proportions. There are many recent examples, such as the exposure of child labor upstream in the manufacturing process and the unethical use of rainforest resources. Blockchain may bring supply chain transparency to a new level, but presently academic and managerial adoption of blockchain technologies is limited by our understanding. To address this issue, this research uses the Unified Theory of Acceptance and Use of Technology (UTAUT) and the concept of technology innovation adoption as a foundational framework for supply chain traceability. A conceptual model is developed and the research culminates with supply chain implications of blockchain that are inspired by theory and literature review.

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Friebe S, Sobik I, Zitterbart M. DecentID: decentralized and privacy-preserving identity storage system using smart contracts. In: IEEE Computer Society, editor. 2018 17th IEEE International Conference on Trust, Security and Privacy in Computing and Communications ; the 12th IEEE International Conference on Big Data Science and Engineering; 2018 Jul 31-Aug 3; New York, NY. Los Alamitos, CA: IEEE Computer Society; 2018. p. 37-42.

Reference Type: Conference Paper

Available from: https://ieeexplore.ieee.org/abstract/document/8455884 Subscription required to view.

Abstract: Many Internet services require the registration of an account before permitting use of their services. Over time, many Internet users end up with a multitude of accounts with separated identities. A solution to this problem is offered by single-sign-on (SSO) providers, where a user can create a single identity and use this identity for multiple services. However it requires the user to trust the SSO provider. When the provider blocks access to the identities the users lose access to their subscribed services. To avoid this problem, we propose DecentID, a completely decentralized identity storage system that does not require a centralized trusted third party. Instead, a public blockchain is used as trust anchor. Identities can be created and used for different services. Each service can only read the identity attributes disclosed for it without being able to read attributes the user wants to keep secret.

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Funk E, Riddell J, Ankel F, Cabrera D. Blockchain technology: a data framework to improve validity, trust, and accountability of information exchange in health professions education. Acad Med. 2018;93(12):1791-4. Epub 2018 Dec 1.

Reference Type: Journal Article

Available from: https://journals.lww.com/academicmedicine/Fulltext/2018/12000/Blockchain_Technology___A_Data_Framework_to.21.aspx Subscription required to view.

Abstract: Health professions educators face multiple challenges, among them the need to adapt educational methods to new technologies. In the last decades, multiple new digital platforms have appeared in the learning arena, including massive open online courses and social-media-based education. The major critique of these novel methods is the lack of the ability to ascertain the origin, validity, and accountability of the knowledge that is created, shared, and acquired. Recently, a novel technology based on secured data storage and transmission, called blockchain, has emerged as a way to generate networks where validity, trust, and accountability can be created. Conceptually, blockchain is an open, public, distributed, and secure digital registry where information transactions are secured and have a clear origin, explicit pathways, and concrete value. Health professions education based on blockchain will potentially allow improved tracking of content and the individuals who create it, quantify educational impact on multiple generations of learners, and build a relative value of educational interventions. Furthermore, institutions adopting blockchain technology would be able to provide certification and credentialing of health care professionals with no intermediaries. There is potential for blockchain to significantly change the future of health professions education and radically transform how patients, professionals, educators, and learners interact around safe, valid, and accountable information.

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Furlanello C, De Domenico M, Jurman G, Bussola N. Towards a scientific blockchain framework for reproducible data analysis. arXiv [Internet]. 2017 Jul 20 [cited 2018 Nov 2]; 1707.06552:[8 p.]. Available from: https://arxiv.org/abs/1707.06552

Reference Type: Electronic Article

Abstract: Publishing reproducible analyses is a long-standing and widespread challenge for the scientific community, funding bodies and publishers. Although a definitive solution is still elusive, the problem is recognized to affect all disciplines and lead to a critical system inefficiency. Here, we propose a blockchain-based approach to enhance scientific reproducibility, with a focus on life science studies and precision medicine. While the interest of encoding permanently into an immutable ledger all the study key information–including endpoints, data and metadata, protocols, analytical methods and all findings–has been already highlighted, here we apply the blockchain approach to solve the issue of rewarding time and expertise of scientists that commit to verify reproducibility. Our mechanism builds a trustless ecosystem of researchers, funding bodies and publishers cooperating to guarantee digital and permanent access to information and reproducible results. As a natural byproduct, a procedure to quantify scientists’ and institutions’ reputation for ranking purposes is obtained.

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Gagnon ML, Stephen G. A pragmatic solution to a major interoperability problem: using blockchain for the nationwide patient index. Blockchain Healthc Today [Internet]. 2018 Aug 16 [cited 2019 Mar 12]; 1(18):[9 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/28

Reference Type: Electronic Article

Abstract: Associating the health-related records and transactions of patients with their numerous “identities” as they interact with different healthcare providers, payers, pharmacy benefit managers and other entities is an expensive and complex problem. With many years of experience addressing this issue in different healthcare systems and Health Information Exchanges (HIEs), it is apparent that there is now a compelling and relatively straightforward technical solution for this problem. Presented here is a broadly feasible and technically compelling argument for a blockchain-based approach to addressing these issues. At the same time, challenges ahead and potential strategies to address them are discussed.

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Gallersdörfer USS. Analysis of use cases of blockchain technology in legal transactions [Master's Thesis]: Technical University of Munich; 2017.

Reference Type: Thesis

Available from: https://wwwmatthes.in.tum.de/file/1i46ejaad8w5j/Sebis-Public-Website/-/Master-s-Thesis-Ulrich-Gallersdoerfer/170508%20Gallersdoerfer%20MT.pdf

Abstract: The interest in blockchain technology of enterprises and startups is rising. The technology itself, up today mostly found in cryptocurrencies, promises to be a decentralized platform for storing data or transferring assets preventing any manipulation. The decentralized database cuts out a trusted third party (TTP), guaranteeing the integrity only with its underlying cryptographic promises. While cryptocurrencies clearly benefit from this technology, it is difficult to see the benefits and usages of this technology in other areas of interest. Varying industries are researching the potentials behind blockchain, proposing a range of different use case scenarios.

We give an insight into the technology itself behind cryptocurrencies and explain in detail, how the functionality of Blockchain is established and how it is set up. Upon that knowledge, different views describing the blockchain architecture are created, giving an overview about the technical layers, the roles, and its life cycle. The different views allow users and developers to comprehensively access the technology. Additionally, a blockchain ontology is created, explaining connections between single components within the network.

Furthermore, this thesis provides an overview of different use cases and proposes a topology. In this topology, use cases are classified in categories, showing the potentials of Blockchain technology. Additionally, we give a detailed description of existing parameters for the blockchain, explaining which influence they have on the overall network. With this, a mapping is facilitated between these categories and the different parameters, giving a detailed overview about the blockchain and its potentials. It informs about all varying abilities and enables decision makers to properly find and select use cases within this technology. In interviews with over 15 experts from different companies, an insight is given into the recent developments in this technology and the advancements of it.

Additionally, we prototypically implemented a use case, enabling lawyers to collaboratively create a contract in which all changes are recorded on a Blockchain. Thereby, Blockchain is effectively used to prevent manipulation of content or attribution to authors.

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Gammon K. Experimenting with blockchain: can one technology boost both data integrity and patients' pocketbooks? Nat Med. 2018;24(4):378-81. Epub 2018 Apr 10.

Reference Type: Journal Article

Available from: https://www.nature.com/articles/nm0418-378 Subscription required to view.

Abstract: [FIRST FEW PARAGRAPHS] Lucy Ojomoko eyes her selfie. She is young, tall and slender, and her dark hair is pulled back in a ponytail. She clicks 'upload' and waits. Her picture is soon accepted to the system she helped to create, and five LifePounds are deposited in her online account.

While she waits for the LifePounds to deposit, she clicks through to add her current health information--height, weight, blood pressure, resting pulse--and adds updated data in these fields. More sensitive information, like blood tests or pictures of her skin, face, back or chest, earn more LifePounds. The company says that their digital currency can eventually be traded for discounts on health tests or products like toothpaste and shampoo--and exchanged for cold, hard cash. The LifePound is a brand of cryptocurrency, a new form of digital currency that operates without a bank. The government, as well as private companies and drug developers aiming to develop drugs and antiaging products, can buy the data linked to the currency through the Longenesis marketplace.

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Gassner UM. Blockchain in EU e-health - blocked by the barrier of data protection? Compliance Elliance J. 2018;4(3):3-20.

Reference Type: Journal Article

Available from: http://ul.qucosa.de/api/qucosa%3A32042/attachment/ATT-0/

Abstract: Compliance with data protection requirements is always a tricky business and even more intricate when it comes to cutting-edge technologies such as distributed ledger technology (DLT), better known as Block Chain Technology (BCT). These difficulties increase even more when the personal data concerned is accorded a special level of protection, as is the case with health data. The following article aims to describe and analyze the legal issues associated with this scenario. The focus here is on the European Union's (EU) General Data Protection Regulation (GDPR), which took effect on May 25, 2018. Furthermore, the functionality of BCT and its possible fields of application in healthcare will be outlined.

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Gatteschi V, Lamberti F, Demartini C, Pranteda C, Santamaría V. To blockchain or not to blockchain: that is the question. IT Prof. 2018;20(2):62-74. Epub 2018 Apr 16.

Reference Type: Journal Article

Available from: https://ieeexplore.ieee.org/abstract/document/8338007 Subscription required to view.

Abstract: Blockchain has been considered a breakthrough technology-but does your company need it? In this article, the authors discuss the advantages and disadvantages of blockchain technology using examples from the insurance sector, which can be generalized and applied to other sectors.

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Gebremedhin TA. Blockchain as a technology to facilitate privacy and better health record management. The University of Bergen: Western Norway University of Applied Science; 2018.

Reference Type: Thesis

Available from: http://bora.uib.no/handle/1956/19621

Abstract: Fear of stigmatization and discrimination from colleagues, friends and family drives patients with various type of mental health problems away from a traditional face-to-face therapy and enforces them to look for an alternative treatment methods. Internet-based mental health therapy helps patients to get their needed therapies and support from healthcare professional and peers, or as a part of automated online form of therapy. Conducting Internet based therapy anonymously is vital for the patient privacy. However, lack of trust, access permission, ownership control and traceability undermines patient safety and security. Blockchain technology is an innovative technology initially designed for a cryptocurrency. However, with the introduction of programming blockchain and smart contracts, the technology has extended its importance to other areas for developing decentralized application (DApp), such as mental health related information management, which is the primary focus of this thesis. Privacy and security are very crucial for patient safety and to preserve patient’s medical history from adversaries. Sharing of private medical information online between the patient and their respective provider contains sensitive information that can easily be compromised if a proper security measure is not put in place. Blockchain is consensus-based peer-to-peer distributed ledger technology that stores and maintains an updated copy of all transactions within the network. It makes trust more transparent and traceable by keeping auditable-logs of all transactions in the form of blocks. In this thesis, Blockchain and its underlying technology are studied, and a prototype has been developed to explore the potential of the blockchain technology. Furthermore, we explore alternative distributed ledger technologies and their respective security models such as consensus protocols, cryptographic techniques, privacy and scalability. The prototype was proposed based on Ethereum blockchain.

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Giancaspro M. Is a ‘smart contract’ really a smart idea? Insights from a legal perspective. Comput Law Secur Rev. 2017;33(6):825-35. Epub 2017 Jun 5.

Reference Type: Journal Article

Available from: https://www.researchgate.net/profile/Mark_Giancaspro/publication/317354410_Is_a_%27smart_contract%27_really_a_smart_idea_Insights_from_a_legal_perspective/links/5c2d5891a6fdccfc707902d8/Is-a-smart-contract-really-a-smart-idea-Insights-from-a-legal-perspective.pdf Open access; http://www.sciencedirect.com/science/article/pii/S026736491730167X Subscription required to view.

Abstract: Swift developments in the emerging field of blockchain technology have facilitated the birth of ‘smart contracts’: computerised transaction protocols which autonomously execute the terms of a contract. Smart contracts are disintermediated and generally transparent in nature, offering the promise of increased commercial efficiency, lower transaction and legal costs, and anonymous transacting. The business world is actively investigating the use of blockchain technology for various commercial purposes. Whilst questions surround the security and reliability of this technology, and the negative impact it may have upon traditional intermediaries, there are equally significant concerns that smart contracts will encounter considerable difficulty adapting to current legal frameworks regulating contracts across jurisdictions. This article considers the potential issues with legal and practical enforceability that arise from the use of smart contracts within both civil and common law jurisdictions.

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Giordanengo A. Possible usages of smart contracts (blockchain) in healthcare and why no one is using them. In: Ohno-Machado L, Séroussi B, editors. MEDINFO 2019: Health and Wellbeing e-Networks for All; Lyon, France. Clifton, VA: International Medical Informatics Association and IOS Press; 2019. p. 596-600.

Reference Type: Conference Paper

Available from: http://ebooks.iospress.nl/publication/52057

Abstract: Security, privacy, transparency, consent, and data sharing are major challenges that healthcare institutions must address today. The explosion of the Internet of Things (IoT), the enactment of the General Data Protection Regulation (GDPR), the growing trend of patients self-managing their diseases, and the eagerness of patients to share their self-collected health data with primary and secondary health organisations further increase the complexity of these challenges. Smart contracts, based on blockchain technology, can be a legitimate approach for addressing these challenges. Smart contracts define rules and penalties in an agreement, enforce those rules, and render them irrevocable. This paper presents a state-of-the-art review (as of May 2018) of the possible usages of smart contracts in healthcare and focuses on data sharing between patients, doctors, and institutions.

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Glover DG, Hermans J. Improving the traceability of the clinical trial supply chain. Appl Clin Trials. 2017;26(12):36-8. Epub 2017 Dec 1.

Reference Type: Journal Article

Available from: http://www.appliedclinicaltrialsonline.com/print/347703?page=full

Abstract: The Drug Supply Chain Security Act (DSCSA) and similar global regulations were designed to help protect the integrity of the medication supply chain by gathering data at each step of a medication’s journey. While the focus is on the “Approved Drug” supply chain, there has been little conversation or focus on the clinical drug supply chain. Blockchain technology has the potential to positively impact clinical trial supply chains by improving the traceability of medications from active pharmaceutical ingredient (API) to patient, while facilitating the gathering of patient-level data in a HIPAA-compliant manner. This is done by having patients and other individuals participating in the network record data to the blockchain, which then moves that information to the appropriate system and groups with access to view that data. The data is auditable, immutable, and can help create a longitudinal record of a patient’s health status.

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Gökalp E, Gökalp MO, Çoban S, Eren PE. Analysing opportunities and challenges of integrated blockchain technologies in healthcare. In: Wrycza S, Maślankowski J, editors. Information Systems: Research, Development, Applications, Education; 2018 Sept 20; Gdansk, Poland. Cham, Switzerland: Springer International Publishing; 2018. p. 174-83.

Reference Type: Conference Paper

Available from: https://www.researchgate.net/profile/Ebru_Goekalp/publication/327229059_Analysing_Opportunities_and_Challenges_of_Integrated_Blockchain_Technologies_in_Healthcare/links/5c0421a592851c63cab5cb96/Analysing-Opportunities-and-Challenges-of-Integrated-Blockchain-Technologies-in-Healthcare.pdf Open access; https://link.springer.com/chapter/10.1007%2F978-3-030-00060-8_13 Subscription required to view.

Abstract: Blockchain is a disruptive technology with the potential to have a significant impact on business models and industries, similar to the adoption of Internet. Blockchain promotes distributed, open, inclusive, immutable, and secure architectural approaches, instead of centralized, hidden, exclusive, and alterable alternatives. The adoption of blockchain in the healthcare domain offers promising solutions for securing communications among stakeholders, efficient delivery of clinical reports, and integrating various kinds of private health records of individuals on a secure infrastructure. Accordingly, the main aim of this study is to propose a holistic blockchain structure covering all stakeholders in the healthcare domain and to analyse opportunities and challenges by presenting an integrated blockchain architecture. The comprehensive view of blockchain based healthcare system consists of services as follows: personal medical health record storage and access, personal genomic data storage and access, inventory tracking and buy-sell mechanism, health research commons, health document notary services, doctor services, digital health wallet, peer-to peer insurance. The opportunities of using blockchain in the healthcare domain are considered with respect to several viewpoints such as transparency, accountability, decentralization, record accuracy, secure transactions, interoperability, lower costs, collaboration, agility, individualized care with specialized treatment, improved diagnosis methods, risk of insurance contract, prevention of counterfeit drugs and improved quality of medical research. Challenges associated with the implementation of blockchain in the healthcare domain are also highlighted, such as governance, lack of legacy, privacy, sustainability, scalability, adoption of participation, and cost of operations.

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Goldwater JC. The use of a blockchain to foster the development of patient-reported outcome measures. Washington, DC: National Quality Forum, 2016.

Reference Type: Report

Available from: https://www.healthit.gov/sites/default/files/6-42-use_of_blockchain_to_develop_proms.pdf

Abstract: Patient-related outcome measures (PROMs), which focus on outcomes that are directly related to the patient, have taken on added importance and significance over the past several years. This is due, in part, to the increased attention focused on the patient experience of care and to provide a patient-focused assessment on the burden and impact of disease. PROMs can include symptoms and other aspects of health –related quality of life indicators such as physical or social function, treatment adherence, and satisfaction with treatment. They can also facilitate more accurate patient-physician communication in terms of the burden of treatment-related morbidities by providing a more detailed and complete evaluation of treatments for specific conditions, such as cancer or multiple sclerosis.

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Gordon WJ, Catalini C. Blockchain technology for healthcare: facilitating the transition to patient-driven interoperability. Comput Struct Biotechnol J. 2018;16:224-30. Epub 2018 Aug 03.

Reference Type: Journal Article

Available from: https://www.sciencedirect.com/science/article/pii/S200103701830028X

Abstract: Interoperability in healthcare has traditionally been focused around data exchange between business entities, for example, different hospital systems. However, there has been a recent push towards patient-driven interoperability, in which health data exchange is patient-mediated and patient-driven. Patient-centered interoperability, however, brings with it new challenges and requirements around security and privacy, technology, incentives, and governance that must be addressed for this type of data sharing to succeed at scale. In this paper, we look at how blockchain technology might facilitate this transition through five mechanisms: (1) digital access rules, (2) data aggregation, (3) data liquidity, (4) patient identity, and (5) data immutability. We then look at barriers to blockchain-enabled patient-driven interoperability, specifically clinical data transaction volume, privacy and security, patient engagement, and incentives. We conclude by noting that while patient-driving interoperability is an exciting trend in healthcare, given these challenges, it remains to be seen whether blockchain can facilitate the transition from institution-centric to patient-centric data sharing.

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Greenberger M. Block what? The unrealized potential of blockchain in healthcare. Nurs Manage. 2019;50(5).

Reference Type: Journal Article

Available from: https://journals.lww.com/nursingmanagement/Fulltext/2019/05000/Block_what__The_unrealized_potential_of_blockchain.3.aspx Subscription required to view

Abstract: [FIRST PARAGRAPH] merging technology is a constant—just like change—in industries like healthcare where scenarios shift at a moment’s notice. Healthcare leaders recognize that innovations and novel ways of addressing today’s healthcare challenges continue to be developed yet understand that new solutions can bring unintended consequences. And clinicians are used to the latest technologies entering the marketplace and being advertised as the answer to complicated problems. Alternatively, disruptive technology is a fresh way of solving old problems. Blockchain is one such technology that’s quietly challenging the way businesses and individuals think about accessing and sharing information among different stakeholders. But why should we care about blockchain in healthcare?

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Griggs KN, Ossipova O, Kohlios CP, Baccarini AN, Howson EA, Hayajneh T. Healthcare blockchain system using smart contracts for secure automated remote patient monitoring. J Med Syst. 2018;42(7):130. Epub 2018 Jun 6.

Reference Type: Journal Article

Available from: https://www.researchgate.net/profile/Alessandro_Baccarini/publication/325605811_Healthcare_Blockchain_System_Using_Smart_Contracts_for_Secure_Automated_Remote_Patient_Monitoring/links/5b22803baca272277fab615b/Healthcare-Blockchain-System-Using-Smart-Contracts-for-Secure-Automated-Remote-Patient-Monitoring.pdf Open access; https://link.springer.com/article/10.1007/s10916-018-0982-x Subscription required to view.

Abstract: As Internet of Things (IoT) devices and other remote patient monitoring systems increase in popularity, security concerns about the transfer and logging of data transactions arise. In order to handle the protected health information (PHI) generated by these devices, we propose utilizing blockchain-based smart contracts to facilitate secure analysis and management of medical sensors. Using a private blockchain based on the Ethereum protocol, we created a system where the sensors communicate with a smart device that calls smart contracts and writes records of all events on the blockchain. This smart contract system would support real-time patient monitoring and medical interventions by sending notifications to patients and medical professionals, while also maintaining a secure record of who has initiated these activities. This would resolve many security vulnerabilities associated with remote patient monitoring and automate the delivery of notifications to all involved parties in a HIPAA compliant manner.

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Grishin D, Obbad K, Estep P, Quinn K, Wait Zaranek S, Wait Zeranek A, et al. Accelerating genomic data generation and facilitating genomic data access using decentralization, privacy-preserving technologies and equitable compensation. Blockchain Healthc Today [Internet]. 2018 Dec 17 [cited 2019 Mar 12]; 1(34):[23 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/34

Reference Type: Electronic Article

Abstract: In the years since the first human genome was sequenced at a cost of over $3 billion, technological advancements have driven the price below $1,000, making personal genome sequencing affordable to many people. Personal genome sequencing has the potential to enable better disease prevention, more accurate diagnoses, and personalized therapies. Furthermore, sharing genomic data with researchers promises identification of the causes of many diseases and the development of new therapies. However, sequencing costs, data privacy concerns, regulatory restrictions, and technical challenges impede the growth of genomic data and hinder data sharing. In this article, we propose that these challenges can be addressed by combining decentralized system design, privacy-preserving technologies, and an equitable compensation model in a platform that vests control over data with individual owners; ensures transparency and privacy; facilitates regulatory compliance; minimizes expensive data transfers; and shifts the sequencing costs from consumers, patients, and biobanks to researchers in industry and academia. We exemplify this by describing the implementation of Nebula, a distributed genomic data generation, sharing, and analysis platform.

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Gropper A. Powering the physician-patient relationship with HIE of One Blockchain Health IT. ONC/NIST Use of Blockchain for Healthcare and Research Workshop; 2016 Sep 26-27; Gaithersburg, MD. National Institute of Standards Technology.

Reference Type: Conference Proceedings

Available from: https://www.healthit.gov/sites/default/files/7-29-poweringthephysician-patientrelationshipwithblockchainhealthit.pdf

Abstract: Physicians steer treatment together with patients and are responsible for the vast majority of decisions, and therefore expenditures, in healthcare. Yet the technology that mediates the physician­patient relationship today is not directly purchased or controlled by either the physicians or the patients. Electronic health records and health information exchange technology are sold as strategic assets to institutions, typically very large businesses, that currently have incentives to maximize institutional growth. We seek a better balance of institutional needs with the needs of physicians and patients.

It is widely accepted that reducing healthcare cost growth requires genuine practice reform. Few institutions, however, are planning to reduce their own size. By focusing health information technology and interoperability on the physician­patient relationship we bypass the inertia of institutions, fertilize the environment for value­based payment, and optimize care options among hospitals, the community, and home, as appropriate.

Blockchain is widely recognized for its ability to empower innovators and individuals on a large scale in an environment that includes the necessity of institutions. The appropriate application of blockchain technology to health IT can shift the balance to the physician­patient relationship. It’s hard to imagine a more effective lubricant for innovation in our complex privatized healthcare system.

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Gross MS, Miller RC. Ethical implementation of the learning healthcare system with blockchain technology. Blockchain Healthc Today [Internet]. 2019 Jun 12 [cited 2019 Jul 8]; 2(113):[9 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/113

Reference Type: Electronic Article

Abstract: We propose that blockchain technology complemented by secure computation methods can foster implementation of a learning healthcare system (LHCS) by minimizing upfront patient-facing compromises with unsurpassed data security and privacy, and by optimizing the system’s fulfillment of its obligations to respect patients through transparency, engagement, and accountability. We demonstrate how a blockchain-enabled LHCS could foster patient willingness to contribute to learning by providing desired security and control over health data. In addition, secure computation methods could enable meta-analysis without exposing individual-level data, thus allowing the system to protect patients’ privacy while simultaneously learning from their data. The transparency and immutability of blockchain ledgers would also support the public’s trust in the system by allowing patients to audit and oversee which of their data are used, how they are used, and by whom. Furthermore, blockchain communities are community-governed peer-to-peer networks in which sharing builds mutually beneficial value, offering a model for engaging patients as LHCS stakeholders. Smart contracts could be used to ensure accountability of the system by embedding feedback mechanisms by which patients directly and automatically realize benefits of sharing their data.

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Gruson D. New solutions for the sample transport and results delivery: a digital lab. Electron J Int Fed Clin Chem Lab Med. 2018;29(3):210-4. Epub 2018 Nov 7.

Reference Type: Journal Article

Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247134/

Abstract: The consolidation of laboratories, the evolution to integrated care network as well as an environment of consumerization are disrupting laboratory services and operations. The switch to SMART (Speed Metrics Automation Remote Technologies) digital laboratories based health ecosystems depends on several prerequisites for successes. Intelligent processes, integration of big data and real-time data management, automation, blockchain, Internet of things and enhancement of user experiences are key element of the smart digital laboratory. Safety, security and cost-effectiveness are pillars for the credibility and transferability of such smart digital laboratory environment. This transforming ecosystem will also trigger novel human - machine interfaces and we will be the gatekeepers for this new "click to brick" ecosystem.

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Gu J, Sun B, Du X, Wang J, Zhuang Y, Wang Z. Consortium blockchain-based malware detection in mobile devices. IEEE Access. 2018;6:12118-28. Epub 2018 Feb 13.

Reference Type: Journal Article

Available from: https://ieeexplore.ieee.org/abstract/document/8290934

Abstract: To address the problem of detecting malicious codes in malware and extracting the corresponding evidences in mobile devices, we construct a consortium blockchain framework, which is composed of a detecting consortium chain shared by test members and a public chain shared by users. Specifically, in view of different malware families in Android-based system, we perform feature modeling by utilizing statistical analysis method, so as to extract malware family features, including software package feature, permission and application feature, and function call feature. Moreover, for reducing false-positive rate and improving the detecting ability of malware variants, we design a multi-feature detection method of Android-based system for detecting and classifying malware. In addition, we establish a fact-base of distributed Android malicious codes by blockchain technology. The experimental results show that, compared with the previously published algorithms, the new proposed method can achieve higher detection accuracy in limited time with lower false-positive and false-negative rates.

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Guo R, Shi R, Zhao Q, Zheng D. Secure attribute-based signature scheme with multiple authorities for blockchain in electronic health records systems. IEEE Access. 2018;6:11676-86. Epub 2018 Feb 2.

Reference Type: Journal Article

Available from: https://ieeexplore.ieee.org/abstract/document/8279429/

Abstract: Electronic Health Records (EHRs) are entirely controlled by hospitals instead of patients, which complicates seeking medical advices from different hospitals. Patients face a critical need to focus on the details of their own healthcare and restore management of their own medical data. The rapid development of blockchain technology promotes population healthcare, including medical records as well as patient-related data. This technology provides patients with comprehensive, immutable records, and access to EHRs free from service providers and treatment websites. In this paper, to guarantee the validity of EHRs encapsulated in blockchain, we present an attribute-based signature scheme with multiple authorities, in which a patient endorses a message according to the attribute while disclosing no information other than the evidence that he has attested to it. Furthermore, there are multiple authorities without a trusted single or central one to generate and distribute public/private keys of the patient, which avoids the escrow problem and conforms to the mode of distributed data storage in the blockchain. By sharing the secret pseudorandom function seeds among authorities, this protocol resists collusion attack out of N from N -1 corrupted authorities. Under the assumption of the computational bilinear Diffie-Hellman, we also formally demonstrate that, in terms of the unforgeability and perfect privacy of the attribute-signer, this attribute-based signature scheme is secure in the random oracle model. The comparison shows the efficiency and properties between the proposed method and methods proposed in other studies.

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Gupta M. Blockchain for dummies [Internet]. Hoboken, NJ: John Wiley & Sons, Inc. 2018 [updated 2018 Aug 3; cited 2018 Nov 2]. 44 p. Available from: https://www.ibm.com/downloads/cas/36KBMBOG

Reference Type: Electronic Book

Abstract: [FIRST FEW PARAGRAPHS] Welcome to Blockchain For Dummies, 2nd IBM Limited Edition, your guide to all things blockchain for business. It’s been said that blockchain will do for transactions what the Internet did for information. What that means is that blockchain allows increased trust and efficiency in the exchange of almost anything.

Blockchain can profoundly change how the world works. If you’ve ever bought a house, you’ve probably had to sign a huge stack of papers from a variety of different stakeholders to make that transaction happen. If you’ve ever registered a vehicle, you likely understand how painful that process can be. I won’t even get started on how challenging it can be to track your medical records.

Blockchain— most simply defined as a shared, immutable ledger— has the potential to be the technology that redefines those processes and many others. To be clear, when I talk about blockchain, I’m not talking about Bitcoin. I’m talking about the underlying digital foundation that supports applications such as Bitcoin. But the reaches of blockchain extend far beyond Bitcoin.

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Halamka JD. Separating signal from noise: advice for blockchain startups. Blockchain Healthc Today [Internet]. 2018 Jun 4 [cited 2019 Feb 17]; 1(29):[2 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/29

Reference Type: Electronic Article

Abstract: How many startups have you discovered that promise to solve every outstanding computer science and informatics challenge with blockchain? As a Harvard Medical School Professor of Innovation, Beth Israel Deaconess Chief Information Officer, and mentor to several accelerators/incubators, I listen to startup pitches virtually every day. An increasing number of them sound like this. “We’ve got a cloud-hosted, big-data, machine learning, API-driven (application program interface) mobile app, with blockchain!”

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Halamka JD, Alterovitz G, Buchanan WJ, Cenaj T, Clauson KA, Dhillon V, et al. Top 10 blockchain predictions for the (near) future of healthcare. Blockchain Healthc Today [Internet]. 2019 Feb 7 [cited 2019 Mar 12]; 2(106):[9 p.]. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/view/106

Reference Type: Electronic Article

Abstract: To review blockchain lessons learned in 2018 and near-future predictions for blockchain in healthcare, Blockchain in Healthcare Today (BHTY) asked the world's blockchain in healthcare experts to share their insights. Here, our internationally-renowned BHTY peer-review board discusses their major predictions. Based on their responses, ten major themes for the future of blockchain in healthcare will emerge over the 12 months.

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Halamka JD, Lippman A, Ekblaw A. The potential for blockchain to transform electronic health records. Harv Bus Rev [Internet]. 2017 Mar 3 [cited 2018 May 22]:[about 6 p.]. Available from: https://hbr.org/2017/03/the-potential-for-blockchain-to-transform-electronic-health-records

Reference Type: Electronic Article

Abstract: A vexing problem facing health care systems throughout the world is how to share more medical data with more stakeholders for more purposes, all while ensuring data integrity and protecting patient privacy.

Traditionally, the interoperability of medical data among institutions has followed three models: push, pull, and view (discussed below), each of which has its strengths and weaknesses. Blockchain offers a fourth model, which has the potential to enable secure lifetime medical record sharing across providers.

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Hanebeck HC, Hewett N, McKay PA. Inclusive deployment of blockchain for supply chains: Part 3 – public or private blockchains – Which one is right for you? Geneva, Switzerland: World Economic Forum, 2019 Aug 2.

Reference Type: Report

Available from: https://www.weforum.org/whitepapers/inclusive-deployment-of-blockchain-for-supply-chains-part-3-public-or-private-blockchains-which-one-is-right-for-you

Abstract: For supply chain organizations launching new blockchain projects, one of the most fraught considerations typically is whether to use a public or private ledger and what permission models. This decision affects functionality, security, compatibility with other stakeholders’ systems and, perhaps most important, competitive positioning for companies. It is important that supply chain decisionmakers can sort through the marketing hype to pick the best solution for their particular requirements. This paper explores important considerations in making the publicversusprivate decision and demystify elements of the public-versus-private debate. The findings in this paper were gleaned from research as well as detailed interviews with blockchain users across diverse industries, geographies and applications. This paper is the third in a series covering the cocreation of new tools for the responsible deployment of distributed ledger technology (DLT) in supply chains.

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Hang L, Kim DH. Design and implementation of an integrated IoT blockchain platform for sensing data integrity. Sensors (Basel). 2019;19(10). Epub 2019 May 14.

Reference Type: Journal Article

Available from: https://www.mdpi.com/1424-8220/19/10/2228

Abstract: With the rapid development of communication technologies, the Internet of Things (IoT) is getting out of its infancy, into full maturity, and tends to be developed in an explosively rapid way, with more and more data transmitted and processed. As a result, the ability to manage devices deployed worldwide has been given more and advanced requirements in practical application performances. Most existing IoT platforms are highly centralized architectures, which suffer from various technical limitations, such as a cyber-attack and single point of failure. A new solution direction is essential to enhance data accessing, while regulating it with government mandates in privacy and security. In this paper, we propose an integrated IoT platform using blockchain technology to guarantee sensing data integrity. The aim of this platform is to afford the device owner a practical application that provides a comprehensive, immutable log and allows easy access to their devices deployed in different domains. It also provides characteristics of general IoT systems, allows for real-time monitoring, and control between the end user and device. The business logic of the application is defined by the smart contract, which contains rules and conditions. The proposed approach is backed by a proof of concept implementation in realistic IoT scenarios, utilizing Raspberry Pi devices and a permissioned network called Hyperledger Fabric. Lastly, a benchmark study using various performance metrics is made to highlight the significance of the proposed work. The analysis results indicate that the designed platform is suitable for the resource-constrained IoT architecture and is scalable to be extended in various IoT scenarios.

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Hashemi SH, Faghri F, Campbell RH. Decentralized user-centric access control using pubsub over blockchain. arXiv [Internet]. 2017 Sep 28 [cited 2018 Oct 23]; 00110:[15 p.]. Available from: https://arxiv.org/abs/1710.00110

Reference Type: Electronic Article

Abstract: We present a mechanism that puts users in the center of control and empowers them to dictate the access to their collections of data. Revisiting the fundamental mechanisms in security for providing protection, our solution uses capabilities, access lists, and access rights following well-understood formal notions for reasoning about access. This contribution presents a practical, correct, auditable, transparent, distributed, and decentralized mechanism that is well-matched to the current emerging environments including Internet of Things, smart city, precision medicine, and autonomous cars. It is based on well-tested principles and practices used in distributed authorization, cryptocurrencies, and scalable computing.

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Hawig D, Zhou C, Fuhrhop S, Fialho AS, Ramachandran N. Designing a distributed ledger technology system for interoperable and General Data Protection Regulation-compliant health data exchange: a use case in blood glucose data. J Med Internet Res. 2019;21(6):e13665. Epub 2019 Jun 14.

Reference Type: Journal Article

Available from: https://www.jmir.org/2019/6/e13665/

Abstract: BACKGROUND: Distributed ledger technology (DLT) holds great potential to improve health information exchange. However, the immutable and transparent character of this technology may conflict with data privacy regulations and data processing best practices. OBJECTIVE: The aim of this paper is to develop a proof-of-concept system for immutable, interoperable, and General Data Protection Regulation (GDPR)-compliant exchange of blood glucose data. METHODS: Given that there is no ideal design for a DLT-based patient-provider data exchange solution, we proposed two different variations for our proof-of-concept system. One design was based purely on the public IOTA distributed ledger (a directed acyclic graph-based DLT) and the second used the same public IOTA ledger in combination with a private InterPlanetary File System (IPFS) cluster. Both designs were assessed according to (1) data reversal risk, (2) data linkability risks, (3) processing time, (4) file size compatibility, and (5) overall system complexity. RESULTS: The public IOTA design slightly increased the risk of personal data linkability, had an overall low processing time (requiring mean 6.1, SD 1.9 seconds to upload one blood glucose data sample into the DLT), and was relatively simple to implement. The combination of the public IOTA with a private IPFS cluster minimized both reversal and linkability risks, allowed for the exchange of large files (3 months of blood glucose data were uploaded into the DLT in mean 38.1, SD 13.4 seconds), but involved a relatively higher setup complexity. CONCLUSIONS: For the specific use case of blood glucose explored in this study, both designs presented a suitable performance in enabling the interoperable exchange of data between patients and providers. Additionally, both systems were designed considering the latest guidelines on personal data processing, thereby maximizing the alignment with recent GDPR requirements. For future works, these results suggest that the conflict between DLT and data privacy regulations can be addressed if careful considerations are made regarding the use case and the design of the data exchange system.

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Heinrich M, Scotti F, Booker A, Fitzgerald M, Kum KY, Lobel K. Unblocking high-value botanical value chains: is there a role for blockchain systems? Front Pharmacol. 2019;10:396. Epub 2019 Apr 24.

Reference Type: Journal Article

Available from: https://www.frontiersin.org/articles/10.3389/fphar.2019.00396/full

Abstract: Blockchain systems are a fast emerging and a currently widely discussed novel strategy for a decentralized cryptographically enhanced digital ledger recording transactions among stakeholders. This perspective paper looks at its potential uses in the context of high value and mostly low volume botanical material traded globally and used as medicines, health foods, in cosmetics and other applications. We offer a perspective on key areas in the supply of such products globally and how blockchain systems may help in sustainable sourcing, quality assurance, and in tackling supply problems in cases of complex multiherbal preparations. Both open and closed blockchain systems are feasible, and it seems likely that, at least in the initial development, closed ones are the main ones to be utilized. While blockchain's potential is not yet clear, the examples presented here highlight the opportunities of this new technology.

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Herian R. Regulating disruption: blockchain, GDPR, and questions of data sovereignty. J Int Law. 2018;22(2):1-16. Epub 2018 Dec 7.

Reference Type: Journal Article

Available from: http://oro.open.ac.uk/56264/

Abstract: Radicalism is to be found in the apparent attempt within the blockchain ecosystem to forge a linkage between a metaphysic of "the good" and the instrumental performativity inherent to contractual status.
* that this connection should be made by machines and software automatically and autonomously rather than as a precondition of human needs, rights and desires, thus skewing and intertwining the logic of "the good" and contract.
* regulating blockchain as it is defined here asks whether blockchain is a necessary technology in a given context versus alternative technologies or even, perhaps, whether the option of no technology at all is or might be the most appropriate response. "The goal of GDPR is to 'give citizens back the control of their personal data, whilst imposing strict rules on those hosting and 'processing' this data, anywhere in the world," says Van Humbeeck, and "one of the things GDPR states is that data 'should be erasable. Since throwing away your encryption keys is not the same as 'erasure of data', GDPR prohibits us from storing personal data on a blockchain level. Overcoming the Hype 43-51 (Inte Gloerich et al. eds., Institute of Network Cultures, 2018).
* as Lana Swartz has argued, the "incorporative blockchain" of back-office functions is no longer pursuing the libertarian dream of holistically remaking society, but is in in fact quite "boring" (Swartz, Lana, Blockchain Dreams: Imagining Techno-economic Alternatives after Bitcoin, in Another Economy Is Possible, 96 (Manuel Castells, ed., Polity Press, 2017), in the sense that it has very quickly fallen into step with the needs and desires of big business.

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Herian R. Taking blockchain seriously. Law & Critique. 2018;29(2):163-71. Epub 2018 May 12.

Reference Type: Journal Article

Available from: https://link.springer.com/article/10.1007/s10978-018-9226-y

Abstract: In the present techno-political moment it is clear that ignoring or dismissing the hype surrounding blockchain is unwise, and certainly for regulatory authorities and governments who must keep a grip on the technology and those promoting it, in order to ensure democratic accountability and regulatory legitimacy within the blockchain ecosystem and beyond. Blockchain is telling (and showing) us something very important about the evolution of capital and neoliberal economic reason, and the likely impact in the near future on forms and patterns of work, social organization, and, crucially, on communities and individuals who lack influence over the technologies and data that increasingly shape and control their lives. In this short essay I introduce some of the problems in the regulation of blockchain and offer counter-narratives aimed at cutting through the hype fueling the ascendency of this most contemporary of technologies.

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Heston T. A case study in blockchain healthcare innovation. Int J Curr Res. 2017;9(11):60587-8. Epub 2017 Nov 30.

Reference Type: Journal Article

Available from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3077455

Abstract: Healthcare complexity and costs can be decreased through the application of blockchain technology to medical records and insurance companies. Estonia has taken a leadership role in blockchain based services both in the commercial sector and in government. The Estonian government’s innovation strategy was to create GovTech partnerships to implement blockchain based technologies throughout the country, and become a global leader in the technology. Starting in 2011, just 3 years after Satoshi Nakamoto published the first description of distributed ledgers and blockchain technology, the Estonian Government started partnering with the private technology startup company Guardtime to use blockchains to secure public and internal records. Then in 2016, Estonia once again reinforced its global leadership in blockchain technology when it announced it would use blockchain technology to secure the health records of over a million citizens. Estonia’s systematic method of applying blockchain technologies through GovTech partnerships demonstrates how innovation is a process. Estonia also identified early the value of the blockchain as a disruptive platform innovation. The application of blockchain technology to healthcare is a radical innovation given that nearly all previous applications have been in the financial and legal sectors.

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Hewett N, Lehmacher W, Wang Y. Inclusive deployment of blockchain for supply chains: Part 1 – introduction. Geneva, Switzerland: World Economic Forum, 2019 Apr 8.

Reference Type: Report

Available from: https://www.weforum.org/whitepapers/inclusive-deployment-of-blockchain-for-supply-chains-part-1-introduction

Abstract: Distributed ledger and blockchain technology promise to have far-reaching implications for global trade and supply chains. However, the extent to which this new technology realizes its potential depends upon how well supply chain actors steward this development. To that end, the World Economic Forum has convened a multi-stakeholder community to design a framework to guide decision-making towards inclusivity, interoperability, and integrity. This highlights the most pressing concerns of a wide group of supply-chain decision-makers with blockchain deployment. It is the starting point for a series of white papers and the framework.

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Hölbl M, Kompara M, Kamišalić A, Nemec Zlatolas L. A systematic review of the use of blockchain in healthcare. Symmetry (Basel). 2018;10(10). Epub 2018 Oct 10.

Reference Type: Journal Article

Available from: https://www.mdpi.com/2073-8994/10/10/470

Abstract: Blockchain technology enables a decentralized and distributed environment with no need for a central authority. Transactions are simultaneously secure and trustworthy due to the use of cryptographic principles. In recent years, blockchain technology has become very trendy and penetrated different domains, mostly due to the popularity of cryptocurrencies. One field where blockchain technology has tremendous potential is healthcare, due to the need for a more patient-centric approach to healthcare systems and to connect disparate systems and increase the accuracy of electronic healthcare records (EHRs). In this systematic review, an analysis of state-of-the-art blockchain research in the field of healthcare is conducted. The aim is to reveal the potential applications of the technology and to highlight the challenges and possible directions of blockchain research in healthcare. First, background information is discussed, followed by a description of the exact methodology used in this paper. Next, an analysis of the results is given, which includes a bibliometric overview, an analysis of gathered data and its properties, and the results of a literature quality assessment. Lastly, there is a discussion of the results from the analysis. The findings indicate that blockchain technology research in healthcare is increasing and it is mostly used for data sharing, managing health records and access control. Other scenarios are very rare. Most research is aimed at presenting novel structural designs in the form of frameworks, architectures or models. Findings also show that technical details about the used blockchain elements are not given in most of the analyzed publications and that most research does not present any prototype implementation or implementation details. Often even with a prototype implementation, no details about blockchain elements are given.

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Hoy MB. An introduction to the blockchain and its implications for libraries and medicine. Med Ref Serv Q. 2017;36(3):273-9. Epub 2017 Jul 17.

Reference Type: Journal Article

Available from: https://www.tandfonline.com/doi/abs/10.1080/02763869.2017.1332261 Subscription required to view.

Abstract: The blockchain is a relatively new technology used to verify and store transaction records for online cryptocurrencies like Bitcoin. The system is redundant and distributed, making it difficult for transactions to be rescinded, duplicated, or faked. Beyond online currencies, the blockchain has potential uses in health care, education, and many other fields. This column will briefly describe what the blockchain is and how it is being used, potential future uses that may be of interest to librarians and medical practitioners, and some of the problems with the system.

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Huckle S, White M. Fake news: a technological approach to proving the origins of content, using blockchains. Big Data. 2017;5(4):356-71. Epub 2017 Dec 1.

Reference Type: Journal Article

Available from: http://sro.sussex.ac.uk/id/eprint/71051/3/BigDataFakeNewsAccepted.pdf Open access; https://www.liebertpub.com/doi/pdf/10.1089/big.2017.0071 Subscription required to view.

Abstract: In this article, we introduce a prototype of an innovative technology for proving the origins of captured digital media. In an era of fake news, when someone shows us a video or picture of some event, how can we trust its authenticity? It seems that the public no longer believe that traditional media is a reliable reference of fact, perhaps due, in part, to the onset of many diverse sources of conflicting information, via social media. Indeed, the issue of "fake" reached a crescendo during the 2016 U.S. Presidential Election, when the winner, Donald Trump, claimed that The New York Times was trying to discredit him by pushing disinformation. Current research into overcoming the problem of fake news does not focus on establishing the ownership of media resources used in such stories-the blockchain-based application introduced in this article is technology that is capable of indicating the authenticity of digital media. Put simply, using the trust mechanisms of blockchain technology, the tool can show, beyond doubt, the provenance of any source of digital media, including images used out of context in attempts to mislead. Although the application is an early prototype and its capability to find fake resources is somewhat limited, we outline future improvements that would overcome such limitations. Furthermore, we believe that our application (and its use of blockchain technology and standardized metadata) introduces a novel approach to overcoming falsities in news reporting and the provenance of media resources used therein. However, while our application has the potential to be able to verify the originality of media resources, we believe that technology is only capable of providing a partial solution to fake news. That is because it is incapable of proving the authenticity of a news story as a whole. We believe that takes human skills.

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Hughes F, Morrow MJ. Blockchain and health care. Policy Polit Nurs Pract. 2019;20(1):1-4. Epub 2019 Mar 8.

Reference Type: Journal Article

Available from: https://journals.sagepub.com/doi/full/10.1177/1527154419833570

Abstract: Nursing informatics as defined by the American Nurses Association is “the specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice” (Lippincott Solutions, 2016). Today, nursing informatics play an integral role in health care delivery and influencing health care information system features and functions (Murphy, 2010). By the end of 2020, there will be over 50 billion connected devices, all of which set the stage for millions of data transactions. As we move forward in this connected, digital first world, data are becoming a new kind of currency, or more specifically, we are moving into a data economy. In this new data economy, privacy, which is a fundamental human right, becomes increasingly difficult to maintain. With the Internet of Things, defined as “a network of physical and virtual objects, devices, or things that are capable of collecting surrounding data and exchanging it between them or through the internet” and applications such as wearable personal health trackers, consumers are becoming the center of their own personal care management (Sembroiz, Ricciardi, & Careglio, 2018, p. 215).

Privacy and security are foundational to the safety of health care data, especially given the epidemic of data breaches, generally, and health care data breaches, specifically. The latter have been traced to actors who have access to health records—so called insiders.

What then does this mean for nurses? Are we sufficiently engaged in discussions to support our patients? What aspects of the impact of this technology do we need to understand?

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Hughes K. Blockchain, the greater good, and human and civil rights. Metaphilosophy. 2017;48(5):654-65. Epub 2017 Oct 10.

Reference Type: Journal Article

Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/meta.12271 Subscription required to view.

Abstract: Abstract The central theme of this paper is that the development of a technology that is predicted to have a major impact on the way we transact with each other should be a matter where the needs of society at large are taken into account. Where the technology is one that emerges from the domain of the Internet, inclusivity becomes even more acute in order to avoid widening the already existing gap in reaping the ?digital dividend.? With blockchain, the obligation could even be seen as a moral one, as blockchain is said to have the potential to negate the scope for the abuse of trust by states and institutions. This could be a game changer in areas such as public procurement and the conduct of elections where abuse can lead to the denial of essential resources and a concomitant loss of life, or to conflict and mass killings. Blockchain presents an opportunity for the Internet development community to claim a degree of recognition in the human rights realm by aiding civil intervention in areas where military intervention has been deemed inappropriate.

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Hughes L, Dwivedi YK, Misra SK, Rana NP, Raghavan V, Akella V. Blockchain research, practice and policy: applications, benefits, limitations, emerging research themes and research agenda. Int J Inf Manage. 2019;49:114-29. Epub 2019 Apr 1.

Reference Type: Journal Article

Available from: https://www.sciencedirect.com/science/article/pii/S0268401219302014 Subscription required to view.

Abstract: The blockchain has received significant attention from technology focused researchers, highlighting its perceived impact and emerging disruption potential, but has been slow to engender any significant momentum within the Information Systems (IS) and Information Management (IM) literature. This study approaches the subject through an IS/IM lens developing the key themes from the blockchain based research via a comprehensive review. This analysis of the body of literature highlights that although few commercial grade blockchain applications currently exist, the technology demonstrates significant potential to benefit a number of industry wide use cases. This study expands on this point articulating through each of the key themes to develop a detailed narrative on the numerous potential blockchain applications and future direction of the technology, whilst discussing the many barriers to adoption. The study asserts that blockchain technology has the potential to contribute to a number of the UN Sustainability Development Goals and engender widespread change within a number of established industries and practices.

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Hussein AF, ArunKumar N, Ramirez-Gonzalez G, Abdulhay E, Tavares JMRS, de Albuquerque VHC. A medical records managing and securing blockchain based system supported by a genetic algorithm and discrete wavelet transform. Cogn Syst Res. 2018;52:1-11. Epub 2018 May 30.

Reference Type: Journal Article

Available from: https://web.fe.up.pt/~tavares/downloads/publications/artigos/COGSYS_2018_105.pdf Open access; http://www.sciencedirect.com/science/article/pii/S1389041718301177 Subscription required to view.

Abstract: The privacy of patients is jeopardised when medical records and data are spread or shared beyond the protected cloud of institutions. This is because breaches force them to the brink that they start abstaining from full disclosure of their condition. This type of condition has a negative effect on scientific research, patients and all stakeholders. A blockchain-based data sharing system is proposed to tackle this issue, which employs immutability and autonomy properties of the blockchain to sufficiently resolve challenges associated with access control and handle sensitive data. Our proposed system is supported by a Discrete Wavelet Transform to enhance the overall security, and a Genetic Algorithm technique to optimise the queuing optimization technique as well. Introducing this cryptographic key generator enhances the immunity and system access control, which allows verifying users securely in a fast way. This design allows further accountability since all users involved are already known and the blockchain records a log of their actions. Only when the users’ cryptographic keys and identities are confirmed, the system allows requesting data from the shared queuing requests. The achieved execution time per node, confirmation time per node and robust index for block number of 0.19 s, 0.17 s and 20 respectively that based on system evaluation illustrates that our system is robust, efficient, immune and scalable.

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Hyland-Wood D, Khatchadourian S. A future history of international blockchain standards. J Br Blockchain Assoc. 2018;1(1). Epub 2018 Jun 29.

Reference Type: Journal Article

Available from: https://jbba.scholasticahq.com/article/3724-a-future-history-of-international-blockchain-standards

Abstract: Blockchain and blockchain-related technologies are being rapidly invented to the point that it is difficult to define specifically which properties are necessary to constitute a blockchain. It may therefore seem far too early to meaningfully discuss the creation of international blockchain standards. This article will argue the opposite by summarizing some existing international standards work related to blockchains and propose directions for additional standards development that could meaningfully be explored in the near future without negatively impacting additional invention.

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Hylock RH, Zeng X. A blockchain framework for patient-centered health records and exchange (HealthChain): evaluation and proof-of-concept study. J Med Internet Res. 2019;21(8):e13592. Epub 2019 Aug 31.

Reference Type: Journal Article

Available from: http://www.jmir.org/2019/8/e13592/

Abstract: Background: Blockchain has the potential to disrupt the current modes of patient data access, accumulation, contribution, exchange, and control. Using interoperability standards, smart contracts, and cryptographic identities, patients can securely exchange data with providers and regulate access. The resulting comprehensive, longitudinal medical records can significantly improve the cost and quality of patient care for individuals and populations alike. Objective: This work presents HealthChain, a novel patient-centered blockchain framework. The intent is to bolster patient engagement, data curation, and regulated dissemination of accumulated information in a secure, interoperable environment. A mixed-block blockchain is proposed to support immutable logging and redactable patient blocks. Patient data are generated and exchanged through Health Level-7 Fast Healthcare Interoperability Resources, allowing seamless transfer with compliant systems. In addition, patients receive cryptographic identities in the form of public and private key pairs. Public keys are stored in the blockchain and are suitable for securing and verifying transactions. Furthermore, the envisaged system uses proxy re-encryption (PRE) to share information through revocable, smart contracts, ensuring the preservation of privacy and confidentiality. Finally, several PRE improvements are offered to enhance performance and security. Methods: The framework was formulated to address key barriers to blockchain adoption in health care, namely, information security, interoperability, data integrity, identity validation, and scalability. It supports 16 configurations through the manipulation of 4 modes. An open-source, proof-of-concept tool was developed to evaluate the performance of the novel patient block components and system configurations. To demonstrate the utility of the proposed framework and evaluate resource consumption, extensive testing was performed on each of the 16 configurations over a variety of scenarios involving a variable number of existing and imported records. Results: The results indicate several clear high-performing, low-bandwidth configurations, although they are not the strongest cryptographically. Of the strongest models, one’s anticipated cumulative record size is shown to influence the selection. Although the most efficient algorithm is ultimately user specific, Advanced Encryption Standard–encrypted data with static keys, incremental server storage, and no additional server-side encryption are the fastest and least bandwidth intensive, whereas proxy re-encrypted data with dynamic keys, incremental server storage, and additional server-side encryption are the best performing of the strongest configurations. Conclusions: Blockchain is a potent and viable technology for patient-centered access to and exchange of health information. By integrating a structured, interoperable design with patient-accumulated and generated data shared through smart contracts into a universally accessible blockchain, HealthChain presents patients and providers with access to consistent and comprehensive medical records. Challenges addressed include data security, interoperability, block storage, and patient-administered data access, with several configurations emerging for further consideration regarding speed and security.

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Iansiti M, Lakhani KR. The truth about blockchain. Harv Bus Rev. 2017 Jan-Feb:118-27.

Reference Type: Magazine Article

Available from: https://hbr.org/2017/01/the-truth-about-blockchain

Abstract: Contracts, transactions, and the records of them are among the defining structures in our economic, legal, and political systems. They protect assets and set organizational boundaries. They establish and verify identities and chronicle events. They govern interactions among nations, organizations, communities, and individuals. They guide managerial and social action. And yet these critical tools and the bureaucracies formed to manage them have not kept up with the economy’s digital transformation. They’re like a rush-hour gridlock trapping a Formula 1 race car. In a digital world, the way we regulate and maintain administrative control has to change.

Blockchain promises to solve this problem. The technology at the heart of bitcoin and other virtual currencies, blockchain is an open, distributed ledger that can record transactions between two parties efficiently and in a verifiable and permanent way. The ledger itself can also be programmed to trigger transactions automatically.

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IBM Corporation. Why new off-chain storage is required for blockchains. Armonk, NY: 2018.

Reference Type: Report

Available from: https://www.ibm.com/downloads/cas/RXOVXAPM

Abstract: In pursuing the storage point of view for blockchain technology, the test team has come up against a recurrent theme. This recurrent theme is that no new storage is needed for off-chain data as most companies are already using the data to be utilized by the blockchain. Because the companies are already using the data, it already exists somewhere in their storage environment and only needs to be referenced by the blockchain application programming interface (API). This paper examines this to see if it is valid.

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Ichikawa D, Kashiyama M, Ueno T. Tamper-resistant mobile health using blockchain technology. JMIR Mhealth Uhealth. 2017;5(7):e111. Epub 2017 Jul 28.

Reference Type: Journal Article

Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550736/

Abstract: 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.

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Ienca M, Ferretti A, Hurst S, Puhan M, Lovis C, Vayena E. Considerations for ethics review of big data health research: a scoping review. PLoS One. 2018;13(10):e0204937. Epub 2018 Oct 11.

Reference Type: Journal Article

Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204937

Abstract: Big data trends in biomedical and health research enable large-scale and multi-dimensional aggregation and analysis of heterogeneous data sources, which could ultimately result in preventive, diagnostic and therapeutic benefit. The methodological novelty and computational complexity of big data health research raises novel challenges for ethics review. In this study, we conducted a scoping review of the literature using five databases to identify and map the major challenges of health-related big data for Ethics Review Committees (ERCs) or analogous institutional review boards. A total of 1093 publications were initially identified, 263 of which were included in the final synthesis after abstract and full-text screening performed independently by two researchers. Both a descriptive numerical summary and a thematic analysis were performed on the full-texts of all articles included in the synthesis. Our findings suggest that while big data trends in biomedicine hold the potential for advancing clinical research, improving prevention and optimizing healthcare delivery, yet several epistemic, scientific and normative challenges need careful consideration. These challenges have relevance for both the composition of ERCs and the evaluation criteria that should be employed by ERC members when assessing the methodological and ethical viability of health-related big data studies. Based on this analysis, we provide some preliminary recommendations on how ERCs could adaptively respond to those challenges. This exploration is designed to synthesize useful information for researchers, ERCs and relevant institutional bodies involved in the conduction and/or assessment of health-related big data research.

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Ilinca D. Applying blockchain and artificial intelligence to digital health. In: Wulfovich S, Meyers A, editors. Digital Health Entrepreneurship. ed. Cham, Switzerland: Springer Nature Switzerland AG; 2019.

Reference Type: Book Section

Available from: https://smile.amazon.com/Digital-Health-Entrepreneurship-Informatics/dp/3030127184/ref=sr_1_1

Abstract: A blockchain is a decentralized, distributed and tamper-proof cryptographic database most suitable for storing transaction information. It is maintained by multiple parties in a distributed fashion. Each record is timestamped, encrypted and linked to previous records.

Records are immutable, can only be added, never removed. Once added, a record can't be changed. Adding a record can only be done through a mechanism called consensus, where most or all parties maintaining the blockchain have to agree to adding it.

Since all records are cryptographically linked to previous records, if a party tries to manipulate previous records or maliciously add a new record, that action will break the overall consistency of the database and is easily detectable.

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Notice 2014-21: Taxation of virtual currency. Internal Revenue Service. (2014).

Reference Type: Government Document

Available from: https://www.irs.gov/pub/irs-drop/n-14-21.pdf

Abstract: SECTION 1. PURPOSE
This notice describes how existing general tax principles apply to transactions using virtual currency. The notice provides this guidance in the form of answers to frequently asked questions.

SECTION 2. BACKGROUND
The Internal Revenue Service (IRS) is aware that “virtual currency” may be used to pay for goods or services, or held for investment. Virtual currency is a digital representation of value that functions as a medium of exchange, a unit of account, and/or a store of value. In some environments, it operates like “real” currency -- i.e., the coin and paper money of the United States or of any other country that is designated as legal tender, circulates, and is customarily used and accepted as a medium of exchange in the country of issuance -- but it does not have legal tender status in any jurisdiction.

SECTION 3. SCOPE
In general, the sale or exchange of convertible virtual currency, or the use of convertible virtual currency to pay for goods or services in a real-world economy transaction, has tax consequences that may result in a tax liability. This notice addresses only the U.S. federal tax consequences of transactions in, or transactions that use, convertible virtual currency, and the term “virtual currency” as used in Section 4 refers only to convertible virtual currency. No inference should be drawn with respect to virtual currencies not described in this notice.

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Irving G, Holden J. RETRACTED: How blockchain-timestamped protocols could improve the trustworthiness of medical science. F1000Res. 2016;5:222. Epub 2016 Feb 26.

Reference Type: Journal Article

Available from: https://f1000research.com/articles/5-222/v3

Abstract: Trust in scientific research is diminished by evidence that data are being manipulated. Outcome switching, data dredging and selective publication are some of the problems that undermine the integrity of published research. Methods for using blockchain to provide proof of pre-specified endpoints in clinical trial protocols were first reported by Carlisle. We wished to empirically test such an approach using a clinical trial protocol where outcome switching has previously been reported. Here we confirm the use of blockchain as a low cost, independently verifiable method to audit and confirm the reliability of scientific studies.

Editorial note:
Concerns have been raised about the overlap between Version 1 of this article and a previously published blog by Carlisle, who proposed the method 2 years earlier [Carlisle, Benjamin Gregory. “Proof of prespecified endpoints in medical research with the bitcoin blockchain”, 25 August 2014], and that the correction (Version 2) published soon after the original was not sufficient to rectify the overlap.

The case has since been discussed in a Committee of Publication Ethics (COPE) Forum, and COPE advised that the correction was sufficient to correct the scientific literature.

The case has been referred to the University of Cambridge for consideration.
31st March 2017: Due to concerns raised about the methods and scientific validity of this paper, as well as the completeness of the peer review process (see reader comments on this article), advice from an additional independent peer reviewer with expertise in blockchain technology and cryptography is being sought. We will update this note in due course.
24th May 2017: Due to the methodological concerns raised by a peer reviewer during the post-publication open peer review process, the authors will retract this article. The formal retraction note will be posted in due course.
22nd August 2017: The University of Cambridge has completed an investigation into this matter and has not found a case of research misconduct against Dr. Irving. Following its investigation the University will be updating its guidance and training for staff, with regard to best practice in citing blogs within scholarly publications.

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Islam N, Faheem Y, Din IU, Talha M, Guizani M, Khalil M. A blockchain-based fog computing framework for activity recognition as an application to e-Healthcare services. Futur Gener Comput Syst. 2019;100:569-78. Epub 2019 May 23.

Reference Type: Journal Article

Available from: http://www.sciencedirect.com/science/article/pii/S0167739X19309860 Subscription required to view.

Abstract: In modern e-Healthcare systems, human activity recognition (HAR) is one of the most challenging tasks in remote monitoring of patients suffering from mental illness or disabilities for necessary assistance. One of the major issues is to provide security to a number of different connected devices to the Internet, known as Internet of Things (IoT). A potential solution to this problem is the blockchain-based architecture. In addition, the complex nature of activities performed by humans in diverse healthcare environments reduces the qualitative measures for extracting distinct features representing various human actions. To answer this challenge, we propose an activity monitoring and recognition framework, which is based on multi-class cooperative categorization procedure to improve the activity classification accuracy in videos supporting the fog or cloud computing-based blockchain architecture. In the proposed approach, frame-based salient features are extracted from videos consisting of different human activities, which are further processed into action vocabulary for efficiency and accuracy. Similarly, the classification of activities is performed using support vector machine (SVM) based on the error-correction-output-codes (ECOC) framework. It has been observed through experimental results that the proposed approach is more efficient and achieves higher accuracy regarding human activity recognition as compared to other state-of-the-art action recognition approaches.

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Ivan D. Blockchain-based method for secure storage of patient records. ONC/NIST Use of Blockchain for Healthcare and Research Workshop; 2016 Sep 26-27; Gaithersburg, MD. National Institute of Standards Technology.

Reference Type: Conference Proceedings

Available from: https://www.healthit.gov/sites/default/files/9-16-drew_ivan_20160804_blockchain_for_healthcare_final.pdf

Abstract: Today’s methods of recording and sharing patient data have a number of limitations that restrict patients’ access to their clinical records, reduce availability of essential data to care providers, and ultimately present a barrier to transforming U.S. healthcare into a learning health system. Storing patient healthcare data in a blockchain-based storage scheme can remediate these shortcomings. This paper discusses blockchain as a novel approach to secure health data storage, implementation obstacles, and a plan for transitioning incrementally from current technology to a blockchain solution.

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Jackson NM. Transcripts transformed: incorporating blockchain to verify academic credentials. University Business. 2018 Nov:27-30.

Reference Type: Magazine Article

Available from: https://universitybusiness.com/college-transcripts-transformed

Abstract: Every week at the University of Washington in Seattle, the registrar’s office staff comes across at least three fraudulent diplomas. Every month, they uncover about two fraudulent transcripts. “And these are just the ones we see,” says Helen Garrett, registrar and chief officer for enrollment information services. “Our student database has not been hacked and is secure, but people pretend to have UW credentials who never attended or graduated from the university, and they try to pass doctored diplomas by employers, when applying for scholarships or grants, and even when applying to academic programs.”

U.S.-based colleges and universities rely on transcripts to prove a student attended or graduated, and international institutions rely on diplomas. Both types of documents, frequently requested by former students seeking a job or additional academic credentials, are not easily copied. They are also difficult to obtain, often requiring former students to remember an old ID number or portal access code, and typically take three to five days to process.

Growing numbers of institutions want to revamp this antiquated process to provide academic credentials more quickly and securely with blockchain. The technology, which underlies bitcoin virtual currency, is a bookkeeping method that “chains” together entries so they’re difficult to modify later. It allows large groups of unrelated organizations—including colleges and universities—to keep a secure, common record.

Steps to blockchain adoption involve understanding the work required to make the switch, how the technology will improve service for students seeking academic records, and how it could disrupt the register’s office status quo.

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Jacobovitz O. Blockchain for identity management. Beer Sheva, Isreal: Ben-Gurion University, Lynne and William Frankel Center for Computer Science Department of Computer Science; 2016. Report No.: 16-02.

Reference Type: Report

Available from: https://www.cs.bgu.ac.il/~frankel/TechnicalReports/2016/16-02.pdf

Abstract: We are living in a world that is rapidly undergoing a fundamental change, it is becoming driven by data. This transformation is about all societal systems: traffic, health, government, logistics, and defense; being more quantified and efficient, but also more transparent and accountable. This changes not only the economics of systems, but their management as well. It also blurs the lines between customer, citizen, company, and government. Everyone gets to see what is happening, and so everyone gets to have a role in shaping these new systems. As a consequence, businesses and governments are struggling to understand what the changing landscape means and how they can participate. In this paper, I discusses the state of the art in Blockchain technology and its applications, focusing on applications and solutions in identity management

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