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2019 ITU Kaleidoscope Academic Conference

designed to promote EHRs’ successful development and added to the Internet due to the growing popularity
sustainability across the globe. This paper revisits the issue of EHRs, medical genetic sequencing and wearable
of healthcare management to describe the design of a credible medical devices. Therefore, the protection of user
blockchain-based e-health records (CB-EHRs) platform and privacy and medical information security becomes more
its performance evaluation. The proposed platform can urgent and important.
be used to secure transactions through anonymity and
traceability of health data in cyber-healthcare systems, such 2.2 Blockchain-based EHRs related research
as those proposed in [6–10].
The rest of the paper is structured as follows: section 2 In order to address the aforementioned problems, many
presents related study on blockchain and a summary of researchers have proposed relevant solutions through strategy
challenges in the EHRs platform, highlighting the gaps and research, architectural frameworks and model designs [16–
opportunities that have been identified in the current system. 18]. For example, in 2011 Sebastian Haas [16] et
The key contribution of this paper is described in sections 3 al. proposed a privacy protection system based on data
and 4, detailing the components and related functions of the services and patient service models. Yarmand et al. [17]
proposed CB-EHRs. Section 5 details the performance of in 2013 proposed a behavior-based access control for a
the choice consensus algorithm. Finally, section 6 concludes distributed healthcare model to solve the user’s privacy
the paper and presents a possible extension to the CB-EHRs problem. Recently, with the development of blockchain
platform. technology, blockchain has not only been used in the
financial industry, but has also been adopted as a protective
2. BLOCKCHAIN-BASED RELATED WORK AND mechanism in the medical domain. In 2016, Drew lvan [18]
CHALLENGES OF EHRS PLATFORM proposed a blockchain approach to securely store patient
medical records. While the above-mentioned models used
This section presents an expository detail on blockchain, blockchain technology to facilitate data sharing and privacy
the challenges of EHRs, and related research on protection, the framework it adopted presents a large amount
blockchain-based EHRs. The section concludes by of network resource wastage or consumption. For users
highlighting the contribution of CB-EHRs platform proposed who need treatment, functionalities of these models are not
in this paper. complete and need to be improved. Hence, this research
presents a credible blockchain-based electronic health records
2.1 Challenges of EHRs platform (CB-EHRs) management platform, which is characterized by
decentralization, data tamper-proof, collective maintenance
The EHRs platform is widely recognized as an enabling mechanisms, security and credibility. This platform cannot
platform, which promotes telemedicine in the current only realize the capabilities of medical data sharing, but also
technology age [11]. However, despite its wide acceptance ensures the privacy of users.
and use, there are some challenges that remain pertinent to
the platform. Some of the known key challenges are:
3. BLOCKCHAIN TECHNOLOGY
• Difficulty in medical data sharing: In order to advance
medical research and facilitate patients, researchers 3.1 The concept of blockchain
are committed to the sharing of medical data. At
present, there are some trust issues among medical There are two basic definitions of blockchain [19, 20].
institutions around the world. Hence, the verification, In a narrow sense, blockchain is a non-tampered and
synchronization and storage of medical data are unforgeable distributed ledger that uses cryptographic
hindered. When medical institutions and patients share correlation algorithms. It is a chained data structure that
data, they need to spend a lot of time and resources links data blocks together in time order [19]. Broadly
on identity and data validation. This makes medical speaking, blockchain technology refers to a new distributed
data acquisition very difficult [12]. Moreover, data infrastructure and computing paradigm which is built on
transmission is not secure and data can be tampered with. a peer-to-peer network. It uses a chained data structure
All of these challenges seriously hinder the development to validate and store data, a distributed node consensus
of medical big data and electronic healthcare systems. algorithm to generate and update data, and a cryptography
mechanism to protect data transmission and access security
• Information security and privacy protection concerns: [20]. Alliance chain (adopted in this paper): In an alliance
Firstly, there is no complete scheme of medical privacy blockchain, the consensus process is controlled by preselected
protection in the electronic medical industry [13]. nodes. Only alliance members have permissions to read and
Secondly, big data mining technology has potential write the blockchain [21]. This type of blockchain can be
risks of linkage attacks, which attempt to re-identify seen as "partially decentralized".
individuals in an anonymized data set by merging
information from two or more datasets. Thirdly, the 3.2 PKI and digital signature
user does not fully participate in the access control
policy of the electronic health record [14,15]. However, The comprehensive technology required to provide
more and more personal health information is now being public-key encryption and digital signature services is known

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