This research focuses on how blockchain can optimally adapt and improve the healthcare system. It proposes an analysis of the multiple blockchain solutions, proposed until the time of this research, and their technical features. Different blockchain types, as well as different consensus algorithms, result in different benefits, advantages and limitations regarding their application to the healthcare system. This research aims to find out, through a multicriteria evaluation, how these benefits change with different blockchain technologies.
Blockchain is the disruptive innovation that will change the way we exchange value. While this innovation is being considered for multiple businesses, its potential to revolutionize the healthcare system is also gaining attention. How useful would it be to access, every time we want, and we need, our full history of health records?
Moreover, what if patients could own their medical data? Healthcare system will become patient-centered. On the one hand, the overall quality of healthcare would undoubtedly rise and, on the other hand, costs, risks, and deaths will be
likely to decrease. Patients will be able to see a complete picture of their medical history maturing a broader responsibility on their daily routine.
They could be the CEO of their health. Doctors will be able to access real-time life-saving data, update records for their patients and so on, avoiding in this way data silos, extra costs and information blocking. However, ‘we do not own our data; we just visit
them from time to time’ and, interoperability between health providers is still a hurdle to overcome.
Table of Contents
1. Introduction
1.1 Motivation
1.2 Problem Definition
1.3 Aims and Objectives
1.4 Research Questions
1.4.1 Sub-Questions
1.4.2 Objectives
1.5 Subject Relevance
1.5.1 The importance of emerging technologies
1.5.2 Relevance in Healthcare System
1.6 Thesis Structure
1.7 Conclusion
2. Blockchain
2.1 Introduction
2.2 Background
2.3 Technology
2.3.1 Blockchain Evolution
2.3.2 The Anatomy of a Block
2.3.3 Blockchain Types
2.3.4 Consensus Algorithms
2.4 Conclusion
3. Literature Review
3.1 Introduction
3.2 Methodology
3.3 Problem Statement
3.4 Conclusion
3.5 Proposed Solutions
3.6 Conclusion
3.7 Contribution to the existing knowledge
4. Design & Implementation
4.1 Introduction
4.2 Theoretical Framework
4.2.1 Research Layers
4.3 Research Design
4.3.1 Quality of the Research
4.3.2 Conducting Interviews
5. Research results
5.1 Introduction
5.2 Step One: “Finding the healthcare system’s problems”
5.3 Step Two: “Blockchain effects on healthcare problems”
5.3.1 List of 15 white papers
5.4 Step Three: “Root causes of blockchain effects”
5.5 Step Four: “Evaluation of root causes”
5.6 Step Five: ”Results”
5.7 Answering the Research Questions
6. Discussion and Conclusion
6.1 Introduction
6.2 Blockchain Solution
6.2.1 Solution Architecture
6.2.2 Solution’s Stakeholders & Hurdles
6.3 Discussion
6.3.1 Future Steps to adopt a Blockchain Solution
6.3.2 Limitations
6.3.3 Future Work
6.4 Summary
6.5 Conclusion
Research Objectives and Core Themes
This research aims to perform a multicriteria evaluation of various blockchain technologies to determine which network types and consensus algorithms are most suitable for integration into the healthcare system, specifically addressing issues like interoperability, data ownership, and patient-centered information management.
- Analysis of current challenges in the healthcare system related to IT infrastructure and data silos.
- Evaluation of different blockchain architectures (Public, Private, Permissioned, Permissionless) in a medical context.
- Technical assessment of consensus mechanisms (PoW, PoS, D-PoS, PoA) regarding performance and sustainability in healthcare.
- Development of a framework for blockchain-based medical data management through expert interviews.
Excerpt from the Book
The Anatomy of a Block
The block is the heart of blockchain where all the transactions are kept. New transactions are validated continuously and added to a new block by miners; This is what orders the blocks in a linear sequence over time and forms a block-chain. A block structure generally consists of two main parts:
• Header:
A block header is an 80-byte long string composed by “4-byte long Bitcoin version number, 32-byte previous block hash, 32-byte long Merkle root, a 4-byte long timestamp of the block, 4-byte long difficulty target for the block (target hash), and 4-byte long nonce used by miners” . Each block is univocally identified by this cryptographic hash, similar to a digital signature, created by hashing the block header (the 80-byte long string) twice with the SHA256 algorithm. This is a unique identifier which means that two blocks will never have the same hash. A second way to distinguish blocks is by referring to their height as shown in Fig 2.3; The ‘height’ indicates the position of the block in the blockchain.
As mentioned before, in each block, a header 80-byte long string contains the previous block hash, the hash of the Merkle Root, the nonce, and the target hash. The previous block hash is used to create the current block’s hash, so, for every block ‘X’ we will need the hash of the block ‘X-1’.
Summary of Chapters
Introduction: Provides the motivation for integrating blockchain into medicine and defines the core problems of health record management, such as information blocking and lack of patient control.
Blockchain: Details the technical foundations of blockchain technology, explaining block anatomy, different network types, and various consensus algorithms like PoW, PoS, D-PoS, and PoA.
Literature Review: Systematically analyzes existing studies and white papers on blockchain applications in healthcare to identify current research gaps and common proposed solutions.
Design & Implementation: Describes the methodological approach of the research, including the use of an exploratory case study design and qualitative data gathered through expert interviews.
Research results: Presents the findings from the literature review and interviews, clustering blockchain benefits and evaluating consensus algorithms to identify the most effective solution for healthcare.
Discussion and Conclusion: Elaborates on the practical implementation of a private, permissioned blockchain solution, discusses stakeholder involvement, identifies implementation hurdles, and provides final conclusions.
Keywords
Blockchain, Healthcare, Electronic Health Records, Interoperability, Data Ownership, Data Security, Consensus Algorithms, Proof of Authority, Delegated Proof of Stake, Patient-Centred Care, Smart Contracts, Distributed Ledger Technology, Medical Data Management, Scalability, Information Blocking.
Frequently Asked Questions
What is the core focus of this research?
The research investigates how blockchain technology can be applied to the healthcare sector to improve data interoperability, security, and patient empowerment while addressing inefficiencies in current health IT systems.
What are the primary themes discussed?
Key themes include the technical evaluation of blockchain network types, the analysis of consensus algorithms for medical data, and the role of smart contracts in managing patient-provider relationships.
What is the primary objective of this thesis?
The main goal is to identify which specific blockchain technology and consensus mechanism best meet the criteria for a reliable, scalable, and patient-centered healthcare system.
Which research methodology does the author employ?
The author uses a multi-method exploratory research design, combining literature review with qualitative data collection through semi-structured interviews with blockchain and healthcare experts.
What does the main body of the work cover?
The main body covers a comprehensive overview of blockchain theory, a systematic review of existing white papers and prototypes, and a multi-criteria analysis of different blockchain architectures and their practical implementation in the healthcare field.
What are the key terms defining this work?
Key terms include Distributed Ledger Technology (DLT), Proof of Authority (PoA), Delegated Proof of Stake (D-PoS), Interoperability, and Electronic Health Records (EHR).
Why is a private, permissioned blockchain recommended over public alternatives?
According to the expert interviews, private, permissioned networks offer better control, scalability, and integration readiness, which are essential for enterprise-level medical applications compared to public, permissionless networks.
How do smart contracts assist in healthcare?
Smart contracts automate the execution of agreements between patients and providers, acting as data pointers and permission managers, which reduces administrative costs and enhances the transparency of data sharing.
What are the major hurdles to blockchain adoption mentioned?
Major hurdles include significant financial investment for infrastructure, the time required for institutional adaptation, the need for cross-industry consortium creation, and social resistance within medical environments.
- Citation du texte
- Nicolò De Sandre (Auteur), 2019, A Multi Criteria Evaluation of Blockchain Technologies Applied to the Healthcare System, Munich, GRIN Verlag, https://www.grin.com/document/585299
