Blockchain in healthcare today最新文献

WEB3 technologies on network architectures, distributed ledgers and decentralised artificial intelligence represent a transformative shift in how data are handled, stored and shared. These innovations promise to significantly enhance consumer data privacy rights by addressing fundamental vulnerabilities associated with traditional centralised systems and self-custody wallets. Data breaches in traditional systems operated mainly by third parties are more common, resulting in significant data leaks because of centralised storage and excessive data movement, sometimes unnecessarily. Healthcare data breaches have been a growing concern globally. Several hospitals faced operational halts on account of the impact of ransomware on patient care and privacy. WEB3 Wallets are a vital component emerging as a significant force for global financial inclusion, especially in developing economies. They promote inclusion, reduce costs and empower individuals through self-custody. Though major improvements are needed in these wallets, their use is rising steadily. The global cryptocurrency user base is expected to reach over 500 million by 2025, with substantial growth in emerging markets, according to a report by Statista in 2023. This paper introduces a concept beyond cryptocurrencies and finance into everyday real-world use cases that need combinatorial access to a person's holistic data, including financial and health records, genomic data, advanced directives, among others, that need to be privacy protected and shared with specific actors identified for their roles in the WEB3 ecosystem through decentralised identifiers and non-fungible token badges identifying particular recipients. The author introduced the concept at ETHBoston in April 2024, won accolades for a primitive implementation using underlying threshold cryptography technologies, and enhanced it into a conceptual holistic data share application for global healthcare as presented in this paper.

Context: The digitalization of the healthcare sector faces significant challenges due to the diverse representation of data and their distribution across various hospitals. Moreover, security is a key concern as healthcare-related data are subject to the legal obligations of General Data Protection Regulation (GDPR) and similar data protection legislation. Standardization efforts like Health Level Seven (HL7) have been implemented to enhance data interoperability. However, authentication still remains a critical issue with significant challenges.

Aim: This research aims to improve and strengthen the authentication process by introducing a novel architecture for decentralized authentication. Additionally, it proposes a new approach to decentralized data management, which is crucial for handling sensitive medical data efficiently.

Methodology: The proposed architecture adopts a user-centric approach, utilizing Self-Sovereign Identity (SSI). It introduced a new non-fungible token (NFT) type called soulbound token (SBT) in the medical context, which will facilitate user authentication across different hospitals, effectively creating a federation of interconnected institutions.

Results: The implementation of the proposed architecture demonstrated a significant reduction in authentication time across multiple hospitals. The use of SBT ensured secure and seamless user authentication, enhancing overall system interoperability and data security. The decentralized approach also mitigated the risks associated with centralized authentication servers.

Conclusion: This study successfully presents a novel decentralized authentication architecture for the healthcare domain, leveraging SSI and SBTs. This approach accelerates the authentication process and enhances data security and interoperability among hospitals. Future research should explore the scalability of this architecture and its application in other sectors requiring stringent data security measures.

Web 3.0 represents the next significant evolution of the internet that embodies the underlying decentralized network architectures, distributed ledgers, and advanced AI capabilities. Though the technologies are maturing rapidly, considerable barriers exist to high-scale adoption. The author discusses the barriers and the mitigations through specific technologies maturing to solve those issues in an earlier paper titled Moving Beyond POCs and Pilots, published in 2023 in Blockchain in Healthcare Today. These include privacy-preserving technologies, off-chain and on-chain design optimizations, and the multi-dimensional approach needed in planning and adopting these technologies. As an extension, this paper discusses one such enabler, zero knowledge machine learning (ZKML), which merges two streams of technology in unique ways to address problems in privacy and the cost of inference. Zero-knowledge proofs (ZKP) allow one party to prove the validity of a statement to another party without revealing any additional information about the statement itself. The ZKML combines the cryptographic principle of ZKP with machine learning (ML) techniques. It is still a maturing technology and needs baselines for applications in global healthcare. In this effort, the authors conceptualize the technical and operational feasibility of using ZKML and implement a reference healthcare implementation using the synthetic International Consortium for Health Outcomes Measurement (ICHOM) in the evaluation phase in a global healthcare setting for high-volume data collection, including patient-reported outcomes. Model complexity reduction is researched and reported for the ICHOM diabetes dataset to advance the usage of ML models in global standards of healthcare data collection in network decentralized architectures for increased data protection and efficiencies.

Blockchain's transformative potential, its current applications, and the path forward for its integration into the healthcare ecosystem are all explored in the journal Blockchain in Healthcare Today. The healthcare industry is facing significant challenges and opportunities after COVID-19. As we navigate the complexities of increasing healthcare costs and technological updates for better patient outcomes, innovative technologies are emerging as pivotal tools for healthcare transformation. Healthcare digital platforms have witnessed revolutionizing the dynamics of healthcare systems using disruptive technologies. However, while these technologies have garnered extensive attention for their transformative potential, there remains a critical gap in our understanding of the impact of digital technology on the healthcare industry. Population health management has critical challenges in data protection, sharing, and interoperability, where personalized medicines and wearable devices are highlighted as a concern. Patients and medical personnel need a safe and simple way to record, transmit, or access information through networks without concern for their safety. Using blockchain technology can help address these problems. Blockchain technology enhances medical data security by providing a decentralized, immutable ledger that ensures data integrity, transparency, and privacy. It enables fine-grained access control, improves interoperability, and resists cyber-attacks. Streamlining regulatory compliance allows patients and medical personnel to safely record, transmit, and access sensitive information across networks.

Decentralized clinical trials (DCTs) recently gained attention in research necessary for drug development. While the COVID-19 pandemic proved to be a challenging time in this arena, drug development was a critical area of emphasis in the rapid advancement of vaccines. The DCTs were necessary to allow research activities to occur across many locations. The use of DCTs can profoundly impact reshaping healthcare by enabling participants to partake in clinical trials remotely; however, implementation challenges must be considered as technology expands. A working group of participants was assembled during an interactive learning exercise at the Conv2X conference (2023) to explore challenges related to the diffusion of innovation among key stakeholders. Pain points experienced with using and implementing technologies were identified, and an innovative solution using a blockchain-anchored option was presented. Participants were divided into three stakeholder groups: patients, payers, and pharmaceutical sponsors. After a time of discussion, the groups reconvened for review. Several themes that can be supported by blockchain technology emerged. These include enhanced efficiencies, patient experience, and demographic diversity, as well as data integrity, privacy, security, and cost-effectiveness. Future research might focus on strategies to facilitate the adoption of the idea across key stakeholder groups.

In an era dominated by digital advancements, cybersecurity plays a pivotal role in safeguarding information and systems from evolving threats. The escalating sophistication of cyber threats necessitates a critical examination of the efficacy of contemporary defenses. Recognizing the limitations and gaps in current solutions, this research introduces a pioneering framework aimed at fortifying cyber defenses. Motivated by a comprehensive exploration of research articles, surveys, online media, and practical studies, this study scrutinizes the intricacies of cyber threats and assesses the strengths and weaknesses of existing solutions. The proposed frameworks emerge from a meticulous feasibility and practicality study, leveraging insights garnered from diverse online sources. The "how" encompasses a comparative analysis, evaluating the novel framework against established solutions to delineate their respective merits and shortcomings. The impetus behind this research lies in offering valuable insights to researchers, practitioners, and policymakers grappling with the multifaceted challenges of cybersecurity. By navigating through the complexities of existing solutions and introducing innovative frameworks, this paper aims to guide efforts in bolstering cyber defenses. Ultimately, this research envisions a continuous cycle of improvement and evolution in the realm of cybersecurity as stakeholders collectively strive to adapt to the ever-changing digital threat landscape.

Introduction: Scientists use donated biospecimens to create organoids, which are miniature copies of patient tumors that are revolutionizing precision medicine and drug discovery. However, biobanking platforms remove donor identifiers to protect privacy, precluding patients from benefiting from their contributions or sharing information that may be relevant to research outcomes. Decentralized biobanking (de-bi) leverages blockchain technology to empower patient engagement in biospecimen research. We describe the creation of the first de-bi prototype for an organoid biobanking use case.

Methods: We designed and developed a proof-of-concept non-fungible tokens (NFTs) framework for an organoid research network of patients, physicians, and scientists within a synthetic dataset modeled on a real-world breast cancer organoid ecosystem. Our implementation deployed multiple smart contracts on Ethereum test networks, minting NFTs representing each stakeholder, biospecimen, and organoid. The system architecture was designed to be composable with established biobanking programs.

Results: Our de-bi prototype demonstrated how NFTs representing patients, physicians, scientists, and organoids may be united in a privacy-preserving platform that builds upon relationships and transactions of existing biobank research networks. The mobile application simulated key features, enabling patients to track their biospecimens, view organoid images and research updates from scientists, and allow physicians to participate in peer-to-peer communications with basic scientists and patients alike, all while ensuring compliance with de-identification requirements.

Discussion: We demonstrate proof-of-concept for a web3 platform engaging patients, physicians, and scientists in a dynamic research community, unlocking value for a model organoid ecosystem. This initial prototype is a critical first step for advancing paradigm-shifting de-bi technology that provides unprecedented transparency and suggests new standards for equity and inclusion in biobanking. Further research must address feasibility and acceptability considering the ethical, legal, economic, and technical complexities of organoid research and clinical translation.