2021 International Conference on Decision Aid Sciences and Application (DASA)

Data Security in Healthcare

Using Blockchain Technology
Sandhiya Baskar Kaladevi Ramar Hariharan Shanmugasundaram
Associate Professor, Professor, Shadan Women’s College of
P.G student, CSE,
SaveethaEngineering College, Engineering and Technology,
Saveetha Engineering College, Chennai, India Hyderabad, India
2021 International Conference on Decision Aid Sciences and Application (DASA) | 978-1-6654-1634-4/21/$31.00 ©2021 IEEE | DOI: 10.1109/DASA53625.2021.9682300

Chennai, India [email protected] [email protected]

[email protected]

Abstract—Data are the most important assets in all kinds of access, encryption of data in all phases. There are three types
industries, as every organization is moving to cloud storage but still of records in the healthcare system, they are Personal Health
data security is a challenging one in many fields. One of the most Record (PHR) includes a complete summary of medical
important fields is Healthcare because it handles with most history, Electronic Medical Record (EMR) is supported by
sensitive information. Since the data in healthcare includes healthcare practitioners who manage healthcare delivery and
patient's medical information, prescriptions, their medical Electronic Health Record (EHR) has the complete patient
insurance, etc. Due to the sensitive nature of the information stored information that can be shared across multiple healthcare
within the EHRs(Electronic Health Records) data security is very organizations on demand[17]. Blockchain is a shared ledger
essential. Blockchain is a technology that is developed based on two technology that is stored in a decentralized network.
major mathematical concepts such as hashes and cryptography. Blockchain has various applications, especially in healthcare,
Blockchain stores data as an immutable ledger that is duplicated since it uses ledger technology that securely transfers patient's
and shared throughout all networks in a delegation from a central record details, medicine, supply-chain, healthcare development
authority. In this paper, we provide how data can securely be & researchers to break genetic code information. Blockchain's
stored and accessed in healthcare. Since one node blockchain is ability to keep transparency details of every patient data in
often used for worldwide electronic health records (EHR) it will decentralized nodes makes blockchain technology important
store and manage patient data in a very verifiable manner & for the security app. Blockchain conceals the identity of
blockchain can be in public gettable in real time by anyone within individual records with complexity and secures the codes that
the aid service supplier chain. This paper aims to discuss the issues can shield and protect important medical data. The
in the existing systems and solutions to the challenges of using decentralized technology allows patient's medical details,
blockchain technology. doctor's data, & hospital management to share information
quickly & safely. It provides members in a group to access
data securely share with each other without a second party and
Keywords—Data Security, healthcare, Blockchain, EHR. track records of what was exchanged with the timestamp.
Instead of keeping it single-cloud storage, it can maintain
I. INTRODUCTION multiple computer systems, which makes the data extremely
tough to tamper with. It also ensures that information put into
This Healthcare organizations collect information of patients the blockchain is genuine and creates faith between the
as social security number (SSN), name, age, address, blood participants.
group, account details. In healthcare organizations that get
sensitive information, the chance of cyber attacks is very high. Previously various solutions have been proposed for
This makes data security in health care an important element. achieving data security using blockchain technology. The next
According to the HIPAA (Healthcare Insurance Portability Act) generation in a blockchain-based framework was presented
journal, 91% of cyber attacks come from phishing emails. As a that provides a solution to solve the limitations of cloud service
result of growing regulations in healthcare organizations are providers (CSP) and improve the implementation of efficient
taking a proactive approach for executing the best way for and effective health technology solutions [1]. A framework
healthcare security that lowers the risk of costly data breaches. with lightweight blockchain architecture for medical data that
HIPAA has two main components for the security and has low algorithmic and connections overhead as compared to
protection of medical information. The first is HIPAA security the Bitcoin network [2]. A similar illustrative study was
rules, which focus on the creation and maintenance of developed using a framework using blockchain technology that
electronic personal health information by organizations integrates blockchain and machine learning to identify the
covered by HIPPA. The second is HIPAA privacy rules, which behavior of patient health data [3].
are designed to protect personal health data, including patient
records, insurance information, etc. In healthcare, cyber- An ideology bringing out of new idea of healthcare where
security focuses to keep pace with the advanced threats in users as full control in access data and control it has also been
healthcare industries, which need to address threats related to thought off. Here, additionally provoked protection guidelines
privacy and data protection in the cloud, and also need to for sharing records with precise hospitals or establishments,
safeguard data while data is in transit, at rest, or in use [19]. following full coverage at any time demonstrated significant
This solution should educate healthcare staff, permission-based study illustartions. The blockchain makes use of public key

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978-1-6654-1634-4/21/$31.00 ©2021 IEEE 354
 2021 International Conference on Decision Aid Sciences and Application (DASA)

cryptography to create a new node, that's immutable, add-only, information approximately the information of records, hash
timestamp records content. Our system will initially authorize values, and signatures.
the user identity using social security network, based on the
authentication data will be allowed to access and using this The authors in their work have stated that billing expense
social security number all the data of the user will link for hospitality has risen with health insurance premiums,
irrespective of the healthcare organization. which need for pro-active hospitality and wellness center [12].
This paper is organized as follows, in Section II information This turns reactive to proactive healthcare which ends up a
security intending connected works are reviewed to assess high-satisfactory of attention & care, a lower in healthcare
numerous security problems featured in healthcare. Section III expense, which in the end result in monetary increase scale
discusses the various issues in the existing systems. Section IV rise. Here, segenerations play a critical position in permit
discusses the key issues which are needed to be addressed in healthcare to step ahead.
healthcare. Section V explains our proposed architecture for
healthcare using blockchain technology. Section VI concludes The proposed system illustrating the growing technique of
the proposed work and directs it for future use. making blockchain is primarily based totally on PSN
applications. Since pervasive social networks (PSN) are
II. LITERATURE REVIEW primarily based totally healthcare operates, customers to
proportion information acquired from clinical sensors.
In healthcare, blockchain-primarily based totally answers Received healthcare information permits customers to apply
were initiated to collaborate the hospitality, with medical app access faraway hospital treatment and public fitness
doctors and sufferers with the point of interest of presenting offerings like tracking the disease. In [13] forms of protocols
advanced well-known offerings and excessive security. are designed. Protocol Type I is used for connecting stable
The authors provided an architecture for linking electronic hyperlinks for sensor nodes and contact devices within the
medical records using pseudonymization [4]. The architecture WBAN region. This protocol Type I is primarily based totally
is based on the layer model with a minimum of three security on IEEE 802.15.6. And Protocol Type II affords a blockchain-
layers act for the authorization. Each layer has one or more primarily based totally method for sharing clinical information
different symmetric & asymmetric key pairs. But the problem in the PSN region via way of means of passing it as nodes.
is data are not encrypted, security is done only using the link A new way to combine cloud storage and blockchain
between patient’s identification encryption data with a technology to get the advantage of data sharing was
pseudonymization key. Standardized data definition and introduced. This way has satisfied the requirement for data
quality of captured EHR are not available. immutability and unforgeability. Author designed a system
An approach completely focusing on different forms of that is based on OD-ABE (Outsourced Decryption Attribute-
security threats in care industries leads to interesting result and Based Encryption) and DABS (Decentralizing Attribute-
illustrations. Conjointly a number of the common encoding Based Signature), which is a scheme of sharing medical data
strategies like DES, 3DES, bluefish and AES was reviewed by Blockchain technology and attribute
because of the basis for manufacturing new follow that suit cryptosystem prevented cipher text attack(CCA) [14,15].
the dynamic IoT framework [5,6]. Even though blockchain is a potential application in the
The summary report presenting the challenges and security financial and banking sectors, it is not utilized well in
issues facing in the big data environment was outlined in healthcare industries. When we move to the blockchain, the
detail [7]. From this, illustration with standard directions to healthcare industry would face some potential challenges and
solve the big data issue and also stated the importance of the obstacles that are needed to address before moving to
act and privacy practice in healthcare industries is narrated [8] blockchain technology which addresses the challenges in
as approached in homomorphic encryption to cryptographic adopting blockchain technology [16]. The major challenge
model for Big Data Analytics in cloud storage addressing will be scalability since healthcare is going to handle huge
related to confidentiality and privacy [9,10]. Techniques for data. The completed blockchain solution is not developed yet
execution and idea on cryptographic solutions for Big Data in so developed a complete blockchain-based healthcare system
the cloud have been discussed. will have high development and operation cost.

Several authors have compared various Public Key The numerous literature that has been reviewed on this
Encryption technique's strengths and weaknesses [11]. segment does now no longer offers precise facts on how to
Universal Designated verifier Signatures (UDVS) that creates make use of the total capability of the blockchain within the
a DVS to make certain patient file utilization is constrained to healthcare industry. With the above information is from the
legal records. Few downsides within the system, that the papers, a system which utilizes the features of blockchain and
confidentiality file is compromised because the fitness records also provides security using social security number so the user
are, to begin with, constructed through a provider who has only has the permission to access and share their data was

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 2021 International Conference on Decision Aid Sciences and Application (DASA)

proposed. Inspired by the way of means of the above literature, designed an efficient data management framework called
we recommend a structure for storing and sharing digital “EdgeMediChain” [1]. Instead of traditional blockchain,
clinical information the usage of a social security number. EdgeMediChain reduces the time for the concurrent
transaction and provides higher throughput. Data will be

Fig. 1. Workflow of blockchain

shared and accessed based on a Role-based authorization

III. ISSUES IN EXISTING SYSTEM mechanism. The experiment was also conducted in the
generation of transactions of IoT device data but real-time
There are various healthcare system has been proposed and
decision-making and diagnosis on the data from IoT are not
implemented in real-time using blockchain. But every model
done yet [20].
has their own pros and cons in that. In this section, we discuss
issues in the existing system.
IV. KEY REQUIREMENTS
The introduced a new version of blockchain called the
This section should address the key requirements needed to
lightweight blockchain [2] was designed with an architecture
propose a blockchain-based healthcare system.
for lightweight blockchain which uses HBCM (Head
BlockChain Manager) to generate a blockchain and make the A. Lack of knowledge
transaction. It also creates the replication of the ledger to Since blockchain is an emerging technology knowledge
ensure data security in the authorized network. This will about the technology is very less and in the healthcare
integrate data from all kinds of systems like IoT, cloud-based, industry handle all kinds of users, we should provide solutions
and peer-to-peer. Author also analyzed the performance of the to how uneducated people access the system. This is a big
system by comparing the processing time of blockchain using concern when we deal with the healthcare industry.
bitcoin with the new architecture and stated processing time is
constant even though the number of nodes in the system B. Lack of Universal acts
increase. One major issue in this architecture is, it is not Every country has its own set of acts for medical and
completely integrated and real-time implemented to evaluate insurance handling. To build a universal solution for all
the security and performance of the system. healthcare industries have to address all the standard acts.
A new security system have been developed that provides
C. Network Infrastructure
data security and authenticity of the EHR [18]. This system
provides two types of nodes: trusted and un-trusted. During Security has to be maintained at all levels of the application.
the transaction, the peer network checks the validity of the Various users to the application include Hospitals, clinics,
node. After the check, the original node creates a new block pharmacy, patients, IoT devices, insurance companies, we
and adds the transaction to the main chain, and then sends the should assure that security is maintained at all levels.
updated ledger to the entire peer network. All nodes from the
main chain to real-time applications only depends on the D. Uniform pattern if authorization
geographic location of health areas, clinics, etc. The major user of the application will the patients, doctors
we need to authorize the user while they share the data.
For sharing the health care across the network author

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 2021 International Conference on Decision Aid Sciences and Application (DASA)

immutable. Large files, or those files that are attending to

V. PROPOSED BLOCKCHAIN BASED amendment often, are also unbroken out of the blockchain. All
ARCGITECTURE distinguishing data ought to be kept off the chain.

B. Features of Blockchain in healthcare

Fig. 2. Proposed Blockchain Framework

The continuous exchange of patient records between

A.Introduction to Blockchain
providers means that the same information is shared with
The proposed framework illustrates how blockchain others on the blockchain. It t makes it easier for individual
features can be utilized which enable users to access their data patients to unlock their health knowledge with the shareable
using social security numbers and share their data with high personal key and to share it with alternative providers. This
security in Fig 2. Since Blockchain is a shared immutable makes Health Information Technology (HIT) interoperable
record, which stores a sequence of transactions as blocks, each and collaborative between different health care users.
blocks being held collectively via way of means of Blockchain can create a unique system of storing and
cryptographic keys (hashes). These cryptographic keys are updating medical records for safe and fast data recovery by
saved in shared ledgers. Each node has a replica of the entire authorized users, avoiding the lack of communication
chain and every node can be continuously synchronized and between the different healthcare professionals involved in
stored as much as date. The benefits of blockchain generation, caring for the same patient, thus preventing errors and
in step with the National Institute of Standards and diagnosed and interventions can be performed more quickly,
Technology (NIST), consist of its tamper resistant nature, the and care can also be personalized for each patient. The
decentralized nature of the virtual ledgers, and the blockchain represents medical events as they occurred
impossibility of converting a posted transaction ultimately without the possibility of changing the data later Unique
inside the consumer network that stocks the ledger. This function of the blockchain helps with diseases in real-time to
generation is likewise known as virtual ledger generation report and research disease patterns, which in turn helps to
(DLT). DLT may be carried out to healthcare areas, however, identify their origin and their transmission parameters.
all pastime inside healthcare isn't related to transactions.
However, public blockchain cannot be accustomed to store C.Blockchain workflow
non-public info resembling characteristic health data, as a Blockchain is a peer-to-peer dispensed ledger generation
result of the info in them is widely accessible. This and has 3 predominant components,
transparency allows providers to take data protection aspects a) Distributed community: The decentralized P2P structure
into account and also guarantees the protection of medical has nodes that include community participants, wherein every
information (PHI). member stores an equal replica of the blockchain and is
Even though blockchain offers intrinsic protection, it's allowed to validate and certify virtual transactions for the
prone to some forms of attacks. Blockchain technology community.
shouldn't be used heterogeneous, since the information is

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 2021 International Conference on Decision Aid Sciences and Application (DASA)

b) Shared ledger: Each member within the each other. This section describes how various components
community will document the continued virtual transactions communicate with each other. The user plays a major role in
and convert them right into a shared ledger. They run the architecture, all the key operations will run around users.
algorithms and confirm the proposed transaction, and as soon Data security will be achieved using either OTP or biometric
as a majority of participants validate the transaction, it's far since the user will be linked to the social security number,
introduced to the shared ledger. authorization will be achieved using that model. Wherever the
c) Digital transaction: Any data or virtual asset patient uses the system it will be maintained as a centralized
which are going to store in a blockchain can be certified as a one. Initially, the user will be authorized using biometric and
digital transaction. Each transaction is a block, and every then the patient consult the healthcare, those data will be
block consists of a cryptographic hash with a view to be between patient and hospital1 when the patients visit hospital 2
brought to the transactions in a linear, chronological order. means, the patient only have the access to their history, the
patient will share the history of medical records with that
Each digital transaction or record on the ledger is stored in particular hospital. Overall admin for the patient records will
a block. The information contained in a block is dependent be the patients. It also helps to automate insurance claim
on and linked to the information in a previous block and, functions by verifying coverage between companies and
over time, forms a chain of transactions. There are four reinsurers.
types of blockchains:
VI. CONCLUSION AND FUTURE ENHANCEMENTS
1) Public Blockchains
Public blockchains are open, decentralized networks of Blockchain is a potential game-changer for the healthcare
computers accessible to anyone wanting to request or validate industry, but the path to implementation is not clear and
a transaction. easy. Several technologies and crypto currency companies are
currently focusing on blockchain and having systems launched.
2) Private Blockchains Blockchain-based systems help both practitioners and patients
Private blockchains are not open, they have access to improve the healthcare industry. Blockchain is becoming a
restrictions. The system administrator can grant permission to valuable healthcare tool that decentralizes patient health
the new member after validation. They are typically governed records, monitoring pharmaceutical products, and expanding
payment options. In this paper, we have proposed a new
by one entity, meaning they’re centralized.
architecture to maintain all patient medical records as global
3) Hybrid Blockchains or Consortiums and providing authentication using social security numbers.
Consortiums are a combination of public and private Since cryptography is used for securing all blockchain
transactions, each transaction will be encrypted using the
blockchains and contain centralized and decentralized features.
private signing key, and then it will be verified by the public
4) Sidechains key to the hash message. If the transaction is modified/ altered
A sidechain is a blockchain running parallel to the main the signature change the hash of the block header. This makes
the block headers hash to be invalid. If the block is validated
chain. It allows users to move digital assets between different
as invalid then the block will not be added to the chain and it is
blockchains, which improves the scalability and efficiency of
ignored. Patient history will be shared only by the patient to
data.
the doctor when they need to check the previous history of
Fig. 1 illustrates on how each digital transaction will medical records.
happen whatever may be the blockchain type when a user
submits a transaction, the transaction will be created as a new Even though blockchain provides more security, due to lack of
block with the current timestamp and the cryptographic hash knowledge in the blockchain and properly implemented
framework is not available yet. A future study has to
of the previous block and the medical data of the transaction.
implement the designed framework on blockchain and train
The new block created is transmitted to all network nodes.
staff of hospitals and users on this technology.
The shared algorithm used by all nodes verifies the current
block and transaction. Once a block has been verified by all
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