How does the consortium blockchain model in Remote Health Monitoring address security challenges, and what are the ongoing concerns regarding its scalability and energy efficiency?
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Decoding the future: A blockchain approach to securing remote health monitoring data

How does the consortium blockchain model in RHM address security challenges, and what are the ongoing concerns regarding its scalability and energy efficiency?

Remote Health Monitoring (RHM) is changing how healthcare works, benefiting hospitals, doctors, and patients by improving patient care, promoting preventive care, and managing the quality of drugs and equipment. However, it faces challenges due to the sensitivity of healthcare data and strict privacy regulations like GDPR and HIPPA. Blockchain technology, a topic of widespread discussion in healthcare, offers substantial benefits by addressing these data privacy and security challenges. Its real-time implementation by numerous companies attests to its significance.

This research provides a comprehensive and holistic summary to address the security and privacy of healthcare data, highlighting consortium private blockchain as the most innovative and secured technology. In total, 753 studies and 10,234 references were analysed to determine potential future directions for RHM.

In the field of sensitive healthcare data management, there exists an ongoing threat to data integrity if not adequately secured and managed. This issue is particularly exacerbated in the context of Remote Health Monitoring (RHM), where data is increasingly susceptible to cyber threats during data transmission processes. The implementation of best practices for effective data management and storage is crucial in addressing these security and privacy concerns. In this light, there were several studies that have promised to solve the data security and privacy issues, but none of them were able to provide a satisfactory solution.

Blockchain technology and RHM

Blockchain technology has emerged as a widely accepted solution, offering significant value in mitigating these challenges by addressing security and privacy issues associated with RHM systems. Many studies have noted a common issue: the traditional method of storing patient data in separate databases often leads to limited compatibility and exposure to security breaches. 

Using blockchain technology in RHM management gives patients more control over their personal health data. This control includes deciding how their data is used, which helps in addressing privacy and security concerns. However, there are still challenges, especially when it comes to public blockchain-based healthcare applications. Even though advanced encryption techniques are used, there’s still a possibility of identifying a patient and their data within a public blockchain, mainly through linked metadata analysis. Additionally, public blockchain infrastructure is vulnerable to security breaches from criminal organizations, which is a significant threat to patient privacy. Public blockchain networks used in various cryptocurrencies have experienced many security breaches. This vulnerability highlights the risks of using public blockchain solutions in RHM scenarios.

Unaddressed research gaps in private blockchain-based healthcare applications

Contrarily, private blockchain-based healthcare applications have demonstrated potential in addressing these security and privacy challenges. The study discusses various models and prototypes that have shown promise in handling complex use cases within the private blockchain framework. Despite these advancements, there is a lack of research in the literature concerning private blockchain technology, particularly regarding data availability and the risk of single points of failure. Contrary to the prevailing assumption in most research, private blockchains, owing to their distributed node architecture, are not immune to network downtime. This misconception necessitates further research and solutions. Moreover, other critical areas, such as security, privacy, reliability, scalability, and energy efficiency in blockchain technology, require additional exploration and development. These challenges offer a fertile ground for future academic research.

How does the consortium blockchain model in Remote Health Monitoring address security challenges, and what are the ongoing concerns regarding its scalability and energy efficiency?
Credit. Midjourney

Security and privacy in RHM

The security and privacy concerns for RHM applications are significant, with many studies advocating the use of blockchain as a mitigating approach. A critical aspect of blockchain security, yet to be comprehensively explored, is the vulnerability of blockchain endpoints. For instance, in scenarios like Bitcoin trading, substantial amounts of Bitcoin may be stored in virtual savings accounts, posing a risk. While the blockchain blocks themselves can be secured against hackers using existing solutions, the safety of wallet accounts remains under-addressed. Additionally, the involvement of third-party blockchain vendors, such as blockchain payment platforms and smart contracts, can amplify vulnerabilities due to weaker security in applications and websites.

Single point of failures in private blockchains

The use of private blockchains for RHM applications introduces the challenge of a single point of failure. Private blockchains typically employ a centralized architecture controlled by a single entity. In such a setup, if the central coordination system fails, all connected nodes and systems within the enterprise could become disconnected, leading to network shutdown and a single point of failure. This issue necessitates further investigation to develop more resilient solutions.

Scalability issues

Blockchain technology faces scalability challenges, as the fixed size of blocks restricts the amount of information that can be stored. This limitation is particularly problematic for RHM use cases, which generate vast amounts of data. While ‘on-chain’ and ‘off-chain’ techniques have been proposed to enhance scalability, these approaches are still not fully refined.

Blockchain technology in Remote Health Monitoring enhances patient care by offering improved data security and privacy. Despite its potential, challenges like vulnerability to cyber threats, scalability, high energy consumption, and reliability issues persist. The consortium blockchain, a notable variant, promises improved security through collaborative validation processes among healthcare institutions.

Venkatesh Upadrista

High energy consumption

Blockchain technology, especially in digital currencies, is associated with high energy consumption, comparable to powering entire countries. The energy demands of processes involved in blockchain operations, such as a single Bitcoin transaction, are substantial. Although some argue that statements regarding blockchain’s energy consumption are overstated, effective solutions to address these concerns are yet to be realized.

Reliability and the role of oracles

While blockchain is often lauded for its reliability, a specific aspect that has not been adequately addressed is the reliability of oracles. Oracles are off-chain components that interact with blockchain systems and could represent points of failure. The reliability of these oracles is crucial and requires thorough investigation to ensure the overall compliance and dependability of blockchain networks.

In terms of practical applications, the majority of RHM studies focus on routine health monitoring tasks, like blood pressure or glucose level monitoring. However, the convergence of the Internet of Medical Things (IoMT) with blockchain technology harbors the potential to revolutionize the health sector. This amalgamation could lead to the development of preventative healthcare strategies for managing life-threatening conditions such as heart attacks and cancer, representing a significant leap forward in the field of RHM.

Consortium blockchain as a potential solution –

In the domain of blockchain applications within the healthcare sector, the concept of a consortium blockchain emerges as a notable variant. This form of blockchain, essentially a private network, enables multiple healthcare institutions to establish a trust-based collaborative network. Within this framework, these institutions deploy blockchain technology internally and engage in data exchange as needed.

The distinctive feature of a consortium blockchain is its validation process. Unlike a singular entity overseeing the network, a consortium blockchain involves multiple validators, each representing different participating hospitals. These validators collectively engage in the consensus mechanism to authenticate transactions, thereby enhancing the network’s resistance to tampering. In the event of data alteration at one hospital, the consensus algorithm, with validation support from other hospitals, promptly detects and corrects the discrepancy, ensuring the security and integrity of the entire blockchain network.

An additional benefit of the consortium blockchain is its reliability. In this model, the failure of a single hospital’s blockchain network does not compromise data accessibility; the network’s distributed nature allows for data retrieval from another hospital’s blockchain. This aspect is particularly crucial for Remote Health Monitoring (RHM) systems, where uninterrupted access to patient medical data is imperative.

Conclusions

Addressing the challenge of latency in healthcare applications, the integration of edge computing plays a pivotal role. Edge computing facilitates data processing at the network’s periphery, either by the device itself or a local server, thus enabling high-speed computations, reduced latency, and enhanced data security. This technological approach aligns well with the stringent computation, latency, and security demands of healthcare use cases, thereby complementing the consortium blockchain structure in effectively managing healthcare data.

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Journal reference

Upadrista, V., Nazir, S., & Tianfield, H. (2023). Secure data sharing with blockchain for remote health monitoring applications: a review. Journal of Reliable Intelligent Environments, 1-20. https://doi.org/10.1007/s40860-023-00204-w

Mr. Venkatesh Upadrista is recognised as a leading figure in the fields of artificial intelligence and blockchain. His prolific contributions include authoring over six technology-focused books and numerous scholarly articles. Notably, during his Ph.D. research and through his dedication to fostering the AI start-up ecosystem, he has pioneered innovative models addressing critical healthcare challenges that were acknowledged by large pharmaceutical companies such as Pfizer and Vifor Pharma. These models offer predictive capabilities into life-threatening conditions such as cancer, heart attacks, and brain strokes.

Mr. Upadrista has earned accolades as a Digital Talent Leader from Tech Nation UK, and throughout his illustrious career, he has spearheaded the development of over 100 AI-driven products for the healthcare and insurance sectors. Presently, he is leading the delivery strategy for the European region at a prominent IT Services corporation. Additionally, he dedicates his time to supporting esteemed academic institutions like Cambridge through guest lectures.