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Security Risk Assessment of Blockchain-Based Patient Health Record Systems

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Information Systems (EMCIS 2022)

Part of the book series: Lecture Notes in Business Information Processing ((LNBIP,volume 464))

Abstract

Blockchain technology is receiving greater attention for enhancing the security of patient records systems; however, it is not a panacea, as many security risks have been found in these healthcare applications. This study conducts a state-of-the-art analysis of emerging risks in blockchain-based patient health record systems, their severity level, impact, and the corresponding countermeasures against them. In addition, we conclude our observations and indicate how blockchain security vulnerabilities may develop in the future. This study aims to promote more research on blockchain security challenges by offering researchers insights into future security and privacy developments in blockchain-based patient health record systems.

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References

  1. Behnke, R.: How Blockchain DDoS Attacks Work (2022). Halborn.com. https://halborn.com/how-blockchain-ddos-attacks-work/

  2. Marbouh, D., et al.: Blockchain for COVID-19: review, opportunities, and a trusted tracking system. Arab. J. Sci. Eng. 45(12), 9895–9911 (2020). https://doi.org/10.1007/s13369-020-04950-4

    Article  Google Scholar 

  3. Azaria, A., Ekblaw, A., Vieira, T., & Lippman, A.: MedRec: using blockchain for medical data access and permission management. In: 2016 2nd International Conference on Open and Big Data (OBD), pp. 25–30. IEEE, August 2016

    Google Scholar 

  4. Alsunbul, A., Elmedany, W., Al-Ammal, H.: Blockchain application in healthcare industry: attacks and countermeasures. In: 2021 International Conference on Data Analytics for Business and Industry (ICDABI), pp. 621–629. IEEE, October 2021

    Google Scholar 

  5. Kumar, T., Ramani, V., Ahmad, I., Braeken, A., Harjula, E., Ylianttila, M.: Blockchain utilization in healthcare: key requirements and challenges. In: 2018 IEEE 20th International conference on e-health networking, applications and services (Healthcom), pp. 1–7. IEEE, September 2018

    Google Scholar 

  6. Attaran, M.: Blockchain technology in healthcare: challenges and opportunities. Int. J. Healthc. Manag. 15(1), 70–83 (2020). https://doi.org/10.1080/20479700.2020.1843887

    Article  Google Scholar 

  7. Onik, M.M.H., Aich, S., Yang, J., Kim, C.S., Kim, H.C.: Blockchain in Healthcare: Challenges and Solutions. Big Data Analytics for Intelligent Healthcare Management, pp. 197–226. Academic Press, Cambridge (2019)

    Google Scholar 

  8. Ismail, L., Materwala, H.: Article; a review of blockchain architecture and consensus; protocols: use cases, challenges, and solutions. Symmetry 11(10), 1198 (2019). https://doi.org/10.3390/sym11101198

  9. Nakamoto, S.: Bitcoin: A Peer-to-Peer Electronic Cash System (2008). Accessed 20 Aug 2018. https://bitcoin.org/bitcoin.pdf

  10. Rifi, N., Rachkidi, E., Agoulmine, N., Taher, N.C.: Towards using blockchain technology for eHealth data access management. In: 2017 4th International Conference on Advances in Biomedical Engineering (ICABME 2017), pp. 1–4. IEEE (2017)

    Google Scholar 

  11. Vacca, A., Di Sorbo, A., Visaggio, C., Canfora, G.: A systematic literature review of blockchain and smart contract development: techniques, tools, and open challenges. J. Syst. Softw. 174, 110891 (2021)

    Article  Google Scholar 

  12. Morkunas, V.J., Paschen, J., Boon, E.: How blockchain technologies impact your business model. Bus. Horiz. 62(3), 295–306 (2019)

    Article  Google Scholar 

  13. Noon, A.K., Aziz, O., Zahra, I., Anwar, M.: Implementation of Blockchain in Healthcare: A Systematic Review. In 2021 International Conference on Innovative Computing (ICIC), pp. 1–10. IEEE, November 2021

    Google Scholar 

  14. Chen, Y., Ding, S., Xu, Z., Zheng, H., Yang, S.: Blockchain-based medical records secure storage and medical service framework. J. Med. Syst. 43(1), 1–9 (2018). https://doi.org/10.1007/s10916-018-1121-4

    Article  Google Scholar 

  15. Abunadi, I., Kumar, R.: Blockchain and business process management in health care, especially for COVID-19 cases. Secur. Commun. Netw. 2021, 1–16 (2021). https://doi.org/10.1155/2021/2245808

    Article  Google Scholar 

  16. Khan, S.N., Loukil, F., Ghedira-Guegan, C., Benkhelifa, E., Bani-Hani, A.: Blockchain smart contracts: applications, challenges, and future trends. Peer-to-Peer Netw. Appl. 14(5), 2901–2925 (2021). https://doi.org/10.1007/s12083-021-01127-0

    Article  Google Scholar 

  17. Wang, H., Wang, Y., Cao, Z., Li, Z., Xiong, G.: An overview of blockchain security analysis. In: Cyber Security: 15th International Annual Conference, CNCERT 2018,  pp. 14–16 August (2018), Revised Selected Papers 15, pp. 55–72. Springer Singapore (2019)

    Google Scholar 

  18. Iqbal, M., Matulevičius, R.: Exploring Sybil and double-spending risks in blockchain systems. IEEE Access 9, 76153–76177 (2021)

    Article  Google Scholar 

  19. Hasanova, H., Baek, U.J., Shin, M.G., Cho, K., Kim, M.S.: A survey on blockchain cybersecurity vulnerabilities and possible countermeasures. Int. J. Netw. Manag. 29(2), e2060 (2019)

    Article  Google Scholar 

  20. Jabarulla, M., Lee, H.: A Blockchain and artificial intelligence-based, patient-centric healthcare system for combating the COVID-19 pandemic: opportunities and applications. Healthcare 9(8), 1019 (2021). https://doi.org/10.3390/healthcare9081019

    Article  Google Scholar 

  21. Mitra, D., Tauz, L., Dolecek, L.: Overcoming Data Availability Attacks in Blockchain Systems: LDPC Code Design for Coded Merkle Tree (2021). arXiv preprint arXiv:2108.13332

  22. Wang, Y., Yang, J., Li, T., Zhu, F., Zhou, X.: Anti-dust: a method for identifying and preventing Blockchain’s dust attacks. In: 2018 International Conference on Information Systems and Computer Aided Education (ICISCAE), pp. 274–280. IEEE, July 2018

    Google Scholar 

  23. Ploder, C., Spiess, T., Bernsteiner, R., Dilger, T., Weichelt, R.: A Risk Analysis on Blockchain Technology Usage for Electronic Health Records. Cloud Computing And Data Science, pp. 1–16 (2021). https://doi.org/10.37256/ccds.222021777

  24. Wright, S.: Technical and legal challenges for healthcare blockchains and smart contracts. In: 2019 ITU Kaleidoscope: ICT for Health: Networks, Standards, and Innovation (ITU K) (2019)

    Google Scholar 

  25. Panda, S.K., Jena, A.K., Swain, S.K., Satapathy, S.C. (Eds.): Blockchain Technology: Applications and Challenges. Springer International Publishing, Cham (2021). https://doi.org/10.1007/978-3-030-69395-4

  26. Griggs, K.N., Ossipova, O., Kohlios, C.P., Baccarini, A.N., Howson, E.A., Hayajneh, T.: Healthcare blockchain system using smart contracts for secure automated remote patient monitoring. J. Med. Syst. 42(7), 1–7 (2018). https://doi.org/10.1007/s10916-018-0982-x

    Article  Google Scholar 

  27. Beinke, J., Fitte, C., Teuteberg, F.: Towards a stakeholder-oriented blockchain-based architecture for electronic health records: design science research study. J. Med. Internet Res. 21(10), e13585 (2019). https://doi.org/10.2196/13585

    Article  Google Scholar 

  28. Wu, Y., Song, P., Wang, F.: Hybrid consensus algorithm optimization: a mathematical method based on POS and PBFT and its application in Blockchain. Math. Probl. Eng. 2020 (2020)

    Google Scholar 

  29. Siyal, A.A., Junejo, A.Z., Zawish, M., Ahmed, K., Khalil, A., Soursou, G.: Applications of blockchain technology in medicine and healthcare: challenges and future perspectives. Cryptography 3(1), 3 (2019)

    Article  Google Scholar 

  30. Castillo, J.: Blockchain: a decentralized solution for secure applications (doctoral dissertation, university of texas at San Antonio) (2022)

    Google Scholar 

  31. Xiong, H., Chen, M., Wu, C., Zhao, Y., Yi, W.: Research on progress of blockchain consensus algorithm: a review on recent progress of blockchain consensus algorithms. Futur. Internet 14(2), 47 (2022). https://doi.org/10.3390/fi14020047

    Article  Google Scholar 

  32. Esmaeilzadeh, P.: Benefits and concerns associated with blockchain-based health information exchange (HIE): a qualitative study from physicians’ perspectives. BMC Med. Inform. Decis. Mak. 22(1), 1–18 (2022)

    Article  Google Scholar 

  33. Gostin, L.O., Levit, L.A., Nass, S.J. (Eds.): Beyond the HIPAA privacy rule: enhancing privacy, improving health through research (2009)

    Google Scholar 

  34. Wachter, S.: Normative challenges of identification in the Internet of Things: privacy, profiling, discrimination, and the GDPR. Comput. Law Secur. Rev. 34(3), 436–449 (2018)

    Article  MathSciNet  Google Scholar 

  35. Nguyen, D., Pathirana, P., Ding, M., Seneviratne, A.: Blockchain for secure EHRs sharing of mobile cloud based E-Health systems. IEEE Access 7, 66792–66806 (2019). https://doi.org/10.1109/access.2019.2917555

    Article  Google Scholar 

  36. Min, M., et al.: Learning-based privacy-aware offloading for healthcare IoT with energy harvesting. IEEE Internet Things J. 6(3), 4307–4316 (2019). https://doi.org/10.1109/jiot.2018.2875926

    Article  Google Scholar 

  37. Bernal Bernabe, J., Canovas, J., Hernandez-Ramos, J., Torres Moreno, R., Skarmeta, A.: Privacy-preserving solutions for blockchain: review and challenges. IEEE Access 7, 164908–164940 (2019). https://doi.org/10.1109/access.2019.2950872

    Article  Google Scholar 

  38. Sookhak, M., Jabbarpour, M.R., Safa, N.S., Yu, F.R.: Blockchain and smart contract for access control in healthcare: a survey, issues and challenges, and open issues. J. Netw. Comput. Appl. 178, 102950 (2021)

    Article  Google Scholar 

  39. Lagrama, E.R.C.: Preventing Disaster: Quantifying Risks at the UP Diliman University Library (2009)

    Google Scholar 

  40. DeVore, S., Champion, R.W.: Driving population health through accountable care organizations. Health Aff. 30(1), 41–50 (2011)

    Article  Google Scholar 

  41. Ghafur, S., Grass, E., Jennings, N.R., Darzi, A.: The challenges of cybersecurity in health care: the UK national health service as a case study. Lancet Digit. Health 1(1), e10–e12 (2019)

    Article  Google Scholar 

  42. Rodrigues, B., Stiller, B.: Cooperative signaling of DDoS attacks in a blockchain-based network. In: Proceedings of the ACM SIGCOMM 2019 Conference Posters and Demos, pp. 39–41 (2019)

    Google Scholar 

  43. Zhang, R., Preneel, B.: Publish or perish: a backward-compatible defense against selfish mining in bitcoin. In: Handschuh, H. (ed.) CT-RSA 2017. LNCS, vol. 10159, pp. 277–292. Springer, Cham (2017). https://doi.org/10.1007/978-3-319-52153-4_16

    Chapter  Google Scholar 

  44. Singh, S., Sanwar Hosen, A.S.M., Yoon, B.: Blockchain security attacks, challenges, and solutions for the future distributed IoT network. IEEE Access 9, 13938–13959 (2021)

    Article  Google Scholar 

  45. Wen, Y., Lu, F., Liu, Y., Huang, X.: Attacks and countermeasures on blockchains: a survey from layering perspective. Comput. Netw. 191, 107978 (2021)

    Article  Google Scholar 

  46. Hsueh, C., Chin, C.: EPoW: solving blockchain problems economically. In: 2017 IEEE SmartWorld, Ubiquitous Intelligence Computing, Advanced Trusted Computed, Scalable Computing Communications, Cloud Big Data Computing, Internet of People and Smart City Innovation, SmartWorld/SCALCOM/UIC/ATC/CBDCom/IOP/SCI, 2017, pp. 1–8 (2017)

    Google Scholar 

  47. Pham, H.L., Tran, T.H., Nakashima, Y.: A secure remote healthcare system for a hospital using blockchain smart contract. In: Proceedings of the IEEE Globecom Workshops, pp. 1–6 (2018)

    Google Scholar 

  48. Hewa, T.M., Hu, Y., Liyanage, M., Kanhare, S.S., Ylianttila, M.: Survey on blockchain-based intelligent contracts: technical aspects and future research. IEEE Access 9, 87643–87662 (2021)

    Article  Google Scholar 

  49. Pinter, K., Schmelz, D., Lamber, R., Strobl, S., Grechenig, T.: Towards a multi-party, blockchain-based identity verification solution to implement clear name laws for online media platforms. In: Business Process Management: Blockchain and Central and Eastern Europe Forum. BPM 2019. LNBIP, vol. 361, pp. 151–165. Springer, Cham (2019). https://doi.org/10.1007/978-3-030-30429-4_11

  50. Dagher, G.G., Mohler, J., Milojkovic, M., Marella, P.B.: Ancile: privacy-preserving framework for access control and interoperability of electronic health records using blockchain technology. Sustain. Cities Soc. 39, 283–297 (2018)

    Article  Google Scholar 

  51. Zaabar, B., Cheikhrouhou, O., Jamil, F., Ammi, M., Abid, M.: HealthBlock: a secure blockchain-based healthcare data management system. Comput. Netw. 200, 108500 (2021)

    Article  Google Scholar 

  52. Papadaki, M., Karamitsos, I., Themistocleous, M.: Covid-19 digital test certificates and Blockchain. J. Enterp. Inf. Manag. 34, 993–1003 (2021). https://www.researchgate.net/publication/353272635_ViewpointCovid-19_digital_test_certificates_and_blockchain

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Author information

Authors and Affiliations

  1. Higher Colleges of Technology, Sharjah, UAE

    Nedaa B. Al Barghuthi

  2. Zayed University, Dubai, UAE

    Huwida E. Said & Shini Girija

  3. The British University in Dubai, Dubai, UAE

    Sulafa M. Badi

Authors
  1. Nedaa B. Al Barghuthi
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  2. Huwida E. Said
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  3. Sulafa M. Badi
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  4. Shini Girija
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Corresponding authors

Correspondence to Nedaa B. Al Barghuthi or Huwida E. Said .

Editor information

Editors and Affiliations

  1. British University in Dubai, Dubai, United Arab Emirates

    Maria Papadaki

  2. University of Coimbra, Coimbra, Portugal

    Paulo Rupino da Cunha

  3. University of Nicosia, Nicosia, Cyprus

    Marinos Themistocleous

  4. University of Nicosia, Nicosia, Cyprus

    Klitos Christodoulou

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Al Barghuthi, N.B., Said, H.E., Badi, S.M., Girija, S. (2023). Security Risk Assessment of Blockchain-Based Patient Health Record Systems. In: Papadaki, M., Rupino da Cunha, P., Themistocleous, M., Christodoulou, K. (eds) Information Systems. EMCIS 2022. Lecture Notes in Business Information Processing, vol 464. Springer, Cham. https://doi.org/10.1007/978-3-031-30694-5_35

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  • DOI: https://doi.org/10.1007/978-3-031-30694-5_35

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  • Online ISBN: 978-3-031-30694-5

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