Blockchain in Digital Healthcare

Malaya Dutta Borah, Roberto Moro Visconti, Ganesh Chandra Deka, Malaya Dutta Borah, Roberto Moro Visconti, Ganesh Chandra Deka

• Publisher: Chapman and Hall/CRC
• Year: 2021
• ISBN:
  9781000505450
• Edition: 1
• Topic: Computer Science
• Subtopic: Cloud Computing
• Index: Computer Science

Blockchain is a series of transactions recorded in blocks and secured cryptographically. It is immutable, decentralized, and transparent and has proved to be beneficial across all domains to protect and store data. Maintaining privacy, integrity, and security, blockchain is particularly valuable to the healthcare industry. of healthcare data.

Blockchain in Digital Healthcare provides a panoramic review of prospects of blockchain technology in the healthcare domain. Users can record transactions in blocks in an immutable distributed ledger that cannot be changed once recorded and/or published. Blockchain is also decentralized, which eliminates dependency on a trusted third party to facilitate transactions, enabling clients and other users of the blockchain to take ownership of the data they push on the network. Blockchain also makes transactions more secure as clients have their own copies.

Features:

• Provides systematic and comprehensive understanding of the block chain technology and the potential in healthcare

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• Describes how security and privacy concerns of healthcare data can be addressed using Blockchain Technology

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• Discusses the concept of smart contracts for performing advanced level scripting to create a blockchain network to provide a platform for the development of decentralized applications

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• Includes a chapter on role of blockchain based insurance application using Ethereum/Hyperledger

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• Presents cases of blockchain use for various aspects of drug manufacturing and the pharma supply chain

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This book serves as a reference book for IT professionals, scientific investigators and researchers who need to analyze the prospects of blockchain technology in healthcare.

1 An Overview of Emerging Updates in Blockchain Technology: Analysis and Recommendations

Champa Joshi, Karm Veer Arya, Ashwani Kant Shukla, Raj Shree, Ravi Prakash Pandey, Vivek Shukla and Manoj Kumar Dhadwal

DOI: 10.1201/9781003133179-1

CONTENTS

1.1 Introduction

1.2 Background to Blockchain

1.2.1 Nonce

1.2.2 Timestamping

1.2.3 Hashing

1.3 Essences of the Blockchain Technology

1.3.1 Merkle Tree

1.3.2 Decentralization

1.3.3 Ledger

1.3.4 Mining

1.3.5 Smart Contracts

1.4 Consensus Model and Achievement

1.4.1 Proof of Work (PoW)

1.4.2 Proof of Stake (PoS)

1.4.3 Delegated Proof of Stake (DPoS)

1.4.4 Round Robin

1.4.5 Proof of Authority

1.4.6 Proof of Elapsed Time (PoET)

1.5 Salient Blockchain Platforms

1.5.1 Ethereum

1.5.2 Hyperledger

1.5.3 R3-Corda

1.6 Emerging Applications of Blockchain Technology

1.6.1 Financial Sector

1.6.2 Internet of Things (IoT)

1.6.3 Healthcare Sector

1.6.4 Supply Chain

1.6.5 Electronic Voting Machines (EVMs)

1.6.6 Energy Sector

1.6.7 Real Estate

1.6.8 Intellectual Property Rights

1.7 Conclusion

References

1.1 Introduction

In recent decades, blockchain technology has revolutionized the world in various sectors such as banking, finance, healthcare, etc. (Zhang, 2016). The blockchain concept gained momentum in 2008 with the introduction of the cryptocurrency bitcoin by Satoshi Nakamoto. Blockchain-powered bitcoin became the first electronic payment system, which works as a decentralized network (Anjum et al., 2017). Earlier, in online commerce, various financial entities have been working as the third party and the structure of commerce was totally trust-based. Even though that structure works well for some kinds of electronic payments, they still have some drawbacks as there are no proper ways to convince the customer about the verification and validation of all transactions by a trusted unbiased third-party financial entity. In addition, there are cost and payment uncertainties, which fluctuate with mediation costs as well. Therefore, the idea of Bitcoin came to mitigate the mistrust and lack of transparency of the third party. To reduce the drawbacks in conventional transaction methods, the system needed an electronic payment method with cryptographic proof. Generally, the use of digital signatures, which are a string of bits and tether with particular rules and parameters, make transactions successful. Digital signatures help in the verification of a signatory’s identity and the data but are not reliable in cases of double-spending (Botta et al., 2016). Therefore, Satoshi Nakamoto proposed a solution to the issue of double-spending using a peer-to-peer type of electronic cash system and proposed direct online payments from one person or party to another without any third-party intervention (Zhang, 2016). Blockchain technology is, specifically, a cryptographically secured chain of blocks, in which each block includes a hash of previous blocks, a timestamp and transaction data in a distributed ledger or database. This secures transactions and brings transparency to the digital transactions by hashing them into an ongoing chain of hash-based proof-of-work, forming a record that is tamper-proof (Zhang, 2016). Bitcoin protocol uses the principle of blockchain technology, which is a digital database for storing information in groups of blocks and is also known as digital sheets or digital ledgers. These ledgers are approved by a digital signature which validates three-purpose authentication, non-repudiation and integrity of any transaction which cannot be removed or deleted and thus are immutable in behavior. The information of transactions is a series of blocks which can hold the complete information of a total transaction or information exchanged and therefore it works like a public ledger blockchain that has only one initial parent block called a genesis block. The size of the block depends on the information it contains, such that the bigger the block the more information it contains. The authentication of the information transfer or any kind of transaction is validated by the asymmetric cryptography mechanism and is traceable. The typical digital signature algorithm used in blockchains is the elliptic curve digital signature algorithm (Fan et al., 2018). This review explores the specific characteristics of blockchain technology (BT), its operation, architecture, main platforms and its various applications in different sectors.

1.2 Background to Blockchain

There are certain things that help to provide immutability, anonymity, security and robustness to blockchain transactions, for instance hashing, which links the blocks to one another with metadata property and each new block contains hashed data of the previous block. Any changes in one block could result in changes in the whole blockchain so tampering with data is not possible. The validation of a new block depends on the information of all previous blocks; if it is valid then only the new block gets space in the chain.

The architecture of blockchain is depicted in Figure 1.1. In the request for a transaction, a block is created which represents a transaction and then that block is broadcasted in the network and it is validated by nodes in the network. Finally, the new transaction, such as blocks, is added into the pre-existing block chain which completes the transaction.

FIGURE 1.1 Depiction of blockchain transaction: 1–Request for a transaction is made by a user; 2–Block is created (record of transitions); 3–Block is broadcasted in the network; 4–Transactions (blocks) are validated by nodes in the network; 5–New block is added in already present block chain; 6–Transaction is complete

1.2.1 Nonce

This is a random number which is used in blocks to make cryptographic communication secure and to provide authentication to the transactions. It prevents replay attacks (Crosby et al., 2016) and works as a one-time password in the network in Figure 1.2.

FIGURE 1.2 Cryptographic functions in the blockchains: Cryptographic hash.

1.2.2 Timestamping

Timestamping plays a role in the authorization of any document and it proves possession of any document for a particular time period. It is a legal certificate, which assures the existence of a particular transaction period. The important attributes, such as time and date, provide time signatures to any document to prove ownership. Timestamping by a third party presents a chance of manipulation by its authority, but distributed timestamping in blockchain helps get rid of manipulation and network delay conflict. Here, each node gets its own stamp to prove the transaction. Timestamping increases the reliability of blockchain, gives an anonymous solution to generate trust and is tamper-proof (Casino et al., 2019) in Figure 1.2.

1.2.3 Hashing

A cryptographic hash is an important component of blockchain technology, as shown in Figure 1.2. Hashing is a process in which an input transaction value can be any size or length but the output comes as a fixed-length hash value (digest), for instance it has one character input value and one line input sentence or a whole library of books produce the same hash value length. Practical loading, a document or a book in blockchain will take a lot of space and time but if we convert it into a fixed-size hash value it takes far less space and time. Also, anyone can individually input any value and get and secure that value for checking any tampering of that data in the near future. In a hashing system two inputs, which produce the same output are not feasible such as the value a, b, hash(a)=hash(b) is not possible (Fanning et al., 2016). It is helpful to protect data integrity. There are no chances of data modification here. Bitcoin cryptocurrency runs with hashing security (Tan et al., 2018).

1.3 Essences of the Blockchain Technology

1.3.1 Merkle Tree

Every block in the blockchain has many transactions, and each transaction has its hash value, but we need one hash value for the entire block to get rid of space problems. Getting one out of many hashes is possible through the Merkle tree. It is a binary tree which helps combine all the hashes of the transaction or we can say one hash value for the entire block in Figure 1.3. Each block in the blockchain usually contains more than a thousand transactions, and each transaction has its hash ID which takes a minimum of 256 bits. According to that, we will need a lot more space in the block for all transaction IDs. Merkle came up with the idea which can reduce the memory space of transactions t1, t2, t3, t4, etc., representing the transaction and h1 to h12 where h1 is the first hash and h12 is the final hash for the block (Tan et al., 2018).

FIGURE 1.3 Depictions of a Merkle tree.

Merkle trees benefit both users and miners on a blockchain. Users can verify individual parts of the blocks and can also check transactions by using hashes from other branches of the Merkle tree. Miners can calculate hashes progressively as they receive transactions from their peers.

1.3.2 Decentralization

In a centralized network, one single entity has control over the whole network, but in decentralized network, the power of decision-making depends on all the users in the network and the distributed system must ensure consistency; that is, when a transaction occurs using the information supplied by one of the nodes, it must be correctly reflected in all other nodes. Decentralization is also known as distributed ledger technology, which aims to provide privacy, security and reliability to users. In this system all transactions are monitored and confirmed by all nodes in the BT network and are tamper-proof. In contrast to the centralized system, BT does not need the involvement of a third party and consensus algorithms play an important role in maintaining data integrity.

1.3.3 Ledger

A ledger is a public record of transactions. Until now pen, paper and the electronic version of sheets have been used to track various kinds of transactions. The ledger generator or holder has maintained the authority of all the information within the ledger, but the distributed nature of the ledger provides all information, including the number of participants in the network as well as all the transactions ev...