No Arabic abstract
Since the inception of the Bitcoin technology, its underlying data structure--the blockchain--has garnered much attention due to properties such as decentralization, transparency, and immutability. These properties make blockchains suitable for apps that require disintermediation through trustless exchange, consistent and incorruptible transaction records, and operational models beyond cryptocurrency. In particular, blockchain and its smart contract capabilities have the potential to address healthcare interoperability issues, such as enabling effective interactions between users and medical applications, delivering patient data securely to a variety of organizations and devices, and improving the overall efficiency of medical practice workflow. Despite the interest in using blockchain for healthcare interoperability, however, little information is available on the concrete architectural styles and patterns for applying blockchain to healthcare apps. This paper provides an initial step in filling this gap by showing: (1) the features and implementation challenges in healthcare interoperability, (2) an end-to-end case study of a blockchain-based healthcare app we are developing, and (3) how applying foundational software patterns can help address common interoperability challenges faced by blockchain-based healthcare apps.
Secure and scalable data sharing is essential for collaborative clinical decision making. Conventional clinical data efforts are often siloed, however, which creates barriers to efficient information exchange and impedes effective treatment decision made for patients. This paper provides four contributions to the study of applying blockchain technology to clinical data sharing in the context of technical requirements defined in the Shared Nationwide Interoperability Roadmap from the Office of the National Coordinator for Health Information Technology (ONC). First, we analyze the ONC requirements and their implications for blockchain-based systems. Second, we present FHIRChain, which is a blockchain-based architecture designed to meet ONC requirements by encapsulating the HL7 Fast Healthcare Interoperability Resources (FHIR) standard for shared clinical data. Third, we demonstrate a FHIRChain-based decentralized app using digital health identities to authenticate participants in a case study of collaborative decision making for remote cancer care. Fourth, we highlight key lessons learned from our case study.
The future of healthcare systems is being shaped by incorporating emerged technological innovations to drive new models for patient care. By acquiring, integrating, analyzing, and exchanging medical data at different system levels, new practices can be introduced, offering a radical improvement to healthcare services. This paper presents a novel smart and secure Healthcare system (ssHealth), which, leveraging advances in edge computing and blockchain technologies, permits epidemics discovering, remote monitoring, and fast emergency response. The proposed system also allows for secure medical data exchange among local healthcare entities, thus realizing the integration of multiple national and international entities and enabling the correlation of critical medical events for, e.g., emerging epidemics management and control. In particular, we develop a blockchain-based architecture and enable a flexible configuration thereof, which optimize medical data sharing between different health entities and fulfil the diverse levels of Quality of Service (QoS) that ssHealth may require. Finally, we highlight the benefits of the proposed ssHealth system and possible directions for future research.
The maturing of blockchain technology leads to heterogeneity, where multiple solutions specialize in a particular use case. While the development of different blockchain networks shows great potential for blockchains, the isolated networks have led to data and asset silos, limiting the applications of this technology. Blockchain interoperability solutions are essential to enable distributed ledgers to reach their full potential. Such solutions allow blockchains to support asset and data transfer, resulting in the development of innovative applications. This paper proposes a novel blockchain interoperability solution for permissioned blockchains based on the publish/subscribe architecture. We implemented a prototype of this platform to show the feasibility of our design. We evaluate our solution by implementing examples of the different publisher and subscriber networks, such as Hyperledger Besu, which is an Ethereum client, and two differe
As the killer application of blockchain technology, blockchain-based payments have attracted extensive attention ranging from hobbyists to corporates to regulatory bodies. Blockchain facilitates fast, secure, and cross-border payments without the need for intermediaries such as banks. Because blockchain technology is still emerging, systematically organised knowledge providing a holistic and comprehensive view on designing payment applications that use blockchain is yet to be established. If such knowledge could be established in the form of a set of blockchain-specific patterns, architects could use those patterns in designing a payment application that leverages blockchain. Therefore, in this paper, we first identify a tokens lifecycle and then present 12 patterns that cover critical aspects in enabling the state transitions of a token in blockchain-based payment applications. The lifecycle and the annotated patterns provide a payment-focused systematic view of system interactions and a guide to effective use of the patterns.
With the rising demand for protection against new risks such as loss of digital assets, novel insurance services and products emerge. In particular, token-based insurance solutions on blockchain transform the insurance business by providing cover for new risks and streamlined, (semi-)automated underwriting and claim processes. In the chapter, we present a general framework of token-based insurance solutions, delegating their fundamental building blocks that include core roles, main tokens and assets, as well as key processes and operations. We describe three major token-based insurance solutions in the market and compare them in terms of native token functionality, tokenized cover types, claim assessment process and capital model. Based on the discussion on the general framework and concrete examples of token-based insurance solutions, we summarize their advantages and point out their drawbacks. We conclude that despite being at a nascent stage, the token-based insurance space bears the promise to unseat the incumbent players with increasingly more action taking place and more use cases being explored.