Design Requirements for Secured and Cost-Efficient Blockchain-Based Data Exchange Frameworks in Healthcare

In recent years cyber security attacks have become a growing concern in healthcare as it involves sensitive data. In 2021 a significant raise in the ransomware attacks has been observed in the medical sector, resulting in disruption in monitoring patients, cancelled appointments, and diverted ambulances. These incidents lead to delays in offering medication, which can potentially trigger life-threatening risks for patients. To address these alarming circumstances Blockchain is considered as the most promising technology to combat against this emergent threat because of its decentralised, immutable, and transparent nature. Therefore, this paper presents a comprehensive investigation on Blockchain applications for healthcare, including different cyber security attacks on medical data, its different types and features, the consensus algorithms, and its integration with other technologies in the healthcare sector. Additionally, a review on the existing Blockchain-based secured and cost-efficient frameworks is presented that highlights their appropriateness in exchanging medical data. In order to overcome the lacking in existing frameworks a new design has been proposed addressing several features including security, cost-efficiency, privacy, transparency, scalability, interoperability integrating several technologies like Blockchain, Edge-Fog-Cloud architecture, IoT, and AI. The aim of this work is to explore the promising potential of Blockchain for the exchange of efficient medical data. Furthermore, this work analyses the existing Blockchain-based paradigms for secure and cost-efficient healthcare data sharing, and it proposes possible directions that are required to be addressed for the seamless medical data exchange along with implementing those to improve the proposed framework.

I. Introduction

Traditional healthcare infrastructure has completely transformed with the significant progress of technological advancement. Involvement of a wide range of software, hardware, and networking technologies have created the opportunity to provide security in medical data and devices, better user experience and other features of the healthcare sector. In the current era, healthcare falls under fundamental need of every human being. To ensure healthcare for everyone Worldwide, affordable, and secure services must be provided through the use of technology. However, the significant increase of the dependency on automated systems for medical data exchange has led to the occurrence of security attacks. Several cyber security attacks have been observed in recent years. Due to cyber security attacks,the second-largest health insurance company of U. S. called Anthem Inc. has suffered consequences like compromising 80 million individuals' personal information in 2015 [46]. In 2017, the WannaCry ransomware attack affected more than 200,000 computers across 150 countries in many government organisations, companies, universities, hospitalsby locking all the computers and demanded a ransom payment [47]. Similarly, in May 2021, the Irish Health Service Executive (HSE) was targeted by a ransomware attack which significantly disrupted the medical services of Ireland by stealing and encrypting data, followed by a demand for a $20 million Bitcoin ransom to release the data [48]. These incidents represent the serious consequences of cyber security attacks on patient data privacy and the integrity of medical services.