• Subject Name : Nursing

A Use Case of Blockchain in Healthcare

Question 1: Explain which case study you selected and why?

The case study selected is “A Use Case of Blockchain in Healthcare: Allergy”, it is because blockchain is the innovation in the health sector that ensures traceability and exchange of information by respecting regulatory frameworks for portability and confidentiality in healthcare data. Allergy card in the blockchain is used to resolve real-life problems that are used to enter, communicate, and locate the information about drug allergies (Witchey, 2019). Healthcare information systems in recent years are observed to face challenges in accessibility, traceability, and privacy of medical information. However, these are the essential elements that allow ensuring the continuity of care based on reliable information. The information about drug allergies and difficult access to patients is harmful to the patients in receiving quality care (Yue, Wang & Jin et al., 2016). This is the major interest area in information systems to optimize the patient care path and facilitate the effort of health care specialists. Blockchain is the trending topic in healthcare information systems and this case study provides the ideas on technological challenges faced in the healthcare sector (Griggs, Ossipova & Kohlios et al., 2018). The analysis of this paper will help in learning the reporting, technological, and application aspects. The other studies on the technological aspect of the healthcare system are based on the successful implementation and evaluation of block-chain systems and the way solutions meet the need of users because the studies were conducted in descriptive form. Though, this is the evidence-based study that presents technological differences faced in the current blockchain healthcare system than the others (Esposito, Santis & Tortora et al., 2018). The additional facets such as human factors are deemed for the resolution to be effective is not considered in other studies. This gap is filled in this study as the aim of the study is to know how an effective blockchain-based health system is useful in dealing with real-life problems. The study describes the structure process of a blockchain-based allergy card to identify the difficulties faced by patients. The action design research methodology was used in the paper to combine applications and theoretical development through the cases and evaluation of development (Zhang, Schmidt & White et al., 2018). Hence, this is the study that focuses on an action-oriented approach to search out evidence-based results in the healthcare sector by knowing more about technological aspects.

Question 2: Explain the business problem that the blockchain solution is attempting to solve in the case study

The business problem that is attempted to resolve in this case study is to develop an efficient blockchain-based wellbeing resolution that deals with real-life issues. Blockchain technology has an association with the financial industry but is applied to other industries also. the architecture of the system is supported by transformations in the delivery system of clinical, medical, healthcare, and life sciences (Hölbl, Kompare & Kamišalić et al., 2018). Blockchain in the health sector is used on several usages as prioritizing, inaccessible patient checking, pharmaceutical supply chain management, insurance claims, biomedical research among others. High costs in the healthcare industry, inefficient practices, and constant data breaches are affecting its efficiency and innovation. In the application of blockchain systems, there is a broad array of functions used in healthcare systems (Gordon & Catalini, 2018). The technology is used in securing the transfer of patient medical records, managing the supply of medicine, and helping healthcare researchers in using genetic codes. The current spending is deflated, the protection of data and overall improvement of healthcare experience can all be eased by the blockchain system. Technology is the emerging concept that is used to secure data of the patient and manage outbreaks of harmful diseases. The Healthcare system among the countries is faced by major challenges known as blockchain (Zhang, Walker & White et al., 2017). Although, it is a very important step that is used to secure healthcare data processes and transactions. Billing in health institutions is handled by the blockchain system with the digitalization system of prescription and health information. Medical data is important to keep safe and secure with the use of healthcare applications, but it is well known that patient records are breached by exposure. The banking information and stealing of credit card is done by perpetrators, as well as genomic and health testing records (Kumar, Ramani & Ahmad et al., 2018). To maintain the ability of blockchain as a decentralized, incorruptible, and transparent manner of all the patient data the technological advancements are necessary with security applications. So, the usage of blockchain in the healthcare system is the corporate dilemma that the blockchain resolution is trying to solve in the case study (Cyran, 2018). The action-oriented approach is useful to search out evidence-based results in the healthcare sector by knowing more about technological aspects.

Question 3: How does the blockchain solution (application) work (from a business perspective)?

Health care is the data-intensive realm that uses a huge quantity of data in a generation, access, and dissemination regularly. The process of dissemination and sorting of a large amount of data is a task these times because of the sensitivity of data and its restricting issues such as privacy and security. Clinical settings and the healthcare field are scalable, safe, and security of data distribution is extremely important for diagnosis when combined in clinical decision-making. Data sharing is followed by healthcare professionals in transferring clinical information to the concerned authority for follow-up (Al Omar, Bhuiyan & Basu et al., 2019). General practitioners and caregivers can transfer the patient data in a timely and sensitive manner by ensuring both parties have up-to-date and complete data about patient wellbeing circumstances. E-health and telemedicine are the domains that are used by experts in transferring clinical data to an expert. Blockchain is the technology that is used to help in securing, personalizing, and maintaining the reliability of the information. This method helps in combining the real-time data of patient health and introducing security of healthcare setup. The blockchain system helps in facilitating data-sharing to conduct the diagnosis of applications and describing studies. In healthcare blockchain systems storing and monitoring data is linked with Healthcare Data Gateway (HDG) method (Ramani, Kumar & Bracken et al., 2018). The patients have the access to information, monitoring, access, and management of personal clinical data and a summary of diseases and allergies. The private blockchain system is used to secure and save the data with the help of health sensors, and also eliminate the danger associated with the remote patient monitoring system. The health status of patients is tracked from far locations by maintaining secure, reliable, and up-to-date information (Jiang, Cao & Wu et al., 2018). Blockchain technology has also seen its ability in biomedical research and medical fields. The useful application of blockchain expertise is to store all the consents, protocols, and plans before starting the examination. Blockchain procedures are used by individuals, healthcare providers, the research and development sector, biomedical researchers, and healthcare entities. The successful implementation of blockchain technology in the system is used to produce advancements in work and developing strategies (Al Omar, Rahman & Basu, et al., 2017). This is the way the blockchain system works and produces advantages to the systems in operations and healthcare research.

Question 4: How can the blockchain solution in the case study solution the business problem? To what extent do you think blockchain is the right solution to solve the business problem? 

In this case study, the paper-based documentation system carries information on the risk of drugs, the identity of the patient, and alternative drugs that can be used by a person with the stamp and permission of the physician. The allergic intervention has been performed in this study to solve the problem, but before this, the potential drug allergies are also needed. The patients are seen to write or note the information to give oral information to care providers by obtaining a letter mentioned about the occurrence of an allergic reaction (Sun, Zhang & Wang et al., 2018). The paper credentials can be ignored or lost; hence, it can lead to loss of data. The information needed is not always possible to be presented on paper documentation and thus, is required to make the information available in electronic form as a solution. The solutions in the case study can be resolved as the paper-based results are not enough to contain all the information on drug allergy. In the paper-based solutions, the probability of data loss is very high since the data can be overlooked and easily missed (Fu, Wang & Cai, 2020). The standardization and uniformity of the data are not necessary, but it is needed for patient evidence and varies upon professionals in healthcare. The patient records are not interoperable, also the information is not easily exploitable outside the health facility that creates. The digital patient records are required to be maintained to share and report allergy data after the sessions and meetings with allergists (Mikula & Jacobsen, 2018). The problem identified in the case study can be solved in this way. This reflects that blockchain management is the right solution for managing and protecting data. Standardization, efficiency, up-to-date, and perfection all can be maintained with blockchain management systems. The general concerns at large-scale can be solved by engaging digital systems in healthcare for improving quality of life in a better manner (Figueroa, Añorga & Arrizabalaga, 2019).

Question 5: What are the limitations of using blockchain for the problem in the case study?

Implementation of an electronic health records system, limitations of the blockchain system is the loss of control over data, auditing, data provenance, and securing of data trailing on medical data. The limitations of this system are there such as security and safety in the blockchain system is not confirmed. Privacy is the major problem that lies due to the execution of schemes because of the services interplay among the patients and tracing of the communication relationships of the network. The legal requirements of the data are also breached because the miners and ledgers hold the responsibility of sensitivity of information regarding various network attacks (Aguiar, Faiçal & Krishnamachari et al., 2020). The anonymous communication technique is the step towards the security objective of building trust from the community members. Trust relationships are always required to have relationships with one another and requiring transitivity of information. The actual results may differ because of development and testing in a simulated network. Blockchain is the electronic cryptographic ledger that follows a decentralized network model for storing a large number of information in a single database system with conventional cloud-based applications (Ngassam, Ologeanu-Taddei & Lartigau et al., 2020). The information is synchronized and distributed within all networks. Algorithms between the networks are required to mitigate the issues of duplication. The verification of all details of patient and drug allergies is the hashed form for functioning. The characteristics in addition to the net force continuity between all nodes that make blockchain immutable and tamper-resistant. Fake drugs can be cited in the blockchain system with emerging technology to mitigate the incidence. Accessibility of information is done through mobile applications by taking the information into account the adoption of smartphones at worldwide levels for the management of drug allergies (Cyran, 2018). In this case study, the patients in France, who suffer from drug allergies have to either communicate to the physician when he/ she falls ill or directly communicate everything during the next episode of problems. The physician then either examines or directly send the patient to allergists. The record of the patient file is maintained, and recommendations are given to consult allergists directly. Whereas, the step could be improved also, by sharing allergy information directly to the allergists and preventing the patient from risky drugs. The limitation of this could be the management of the patient when he or she is unconscious by an allergy, who does not hold the information from the physician (Cyran, 2018).

Question 6: Research other examples of how the specific business problem has been resolved without a blockchain solution (could another technology solution solve the problem?). Use the library to find sources to support your views.

There are patient-friendly technologies that are responsible for hospital reputation about patient volumes. Surgical technology and health IT systems are there in the healthcare industry to shape the reputation of the hospital in accommodating the patients directly with technology. A smart hospital is the one that leverages directly impacts the patient in the principle of health consultation during allergies and other health problems (Ngassam, Ologeanu-Taddei & Lartigau et al., 2020). Eight patient-friendly technologies are there as it positively makes difference in hospital reputation, patient satisfaction, and dealing with health problems. Mobile health (health) is the system that uses mobile communication devices like tablets and computers to support the health-related data, information flow, surveillance, disease management, and patient self-management (Esposito, Santis & Tortora et al., 2018). The taskforce is used to access the state of art and future potential in the system. This is used to endorse quality, efficiency, usability, efficiency, limits, and risks of the data for allergic diseases. “General Data Protection Regulation” is designed to assess the user engagement, design, usability, content, and design of inducing credibility, accountability, privacy, and behavior change of the health concerns. The context of precision medicine is there to facilitate the changes in perspective form clinician-to-patient-centered care. The current and future potential of health services are there to examine specific areas such as allergology, dermatological diseases, including allergic rhinitis, allergen immunotherapy, asthma, aerobiology, food allergies, drug allergy, insect venom, and anaphylaxis (Ngassam, Ologeanu-Taddei & Lartigau et al., 2020). The mobile health technologies have a great impact and are associated with big data sets. The world is connected wirelessly by the number of facts with mobile subscriptions that are taken from people over the phone (Esposito, Santis & Tortora et al., 2018). The development of healthcare-related applications is there that presents the development of healthcare-related data growing within information and communication technology. This has helped in improving patient care by making it more efficient, precise, cost-effective for the remote areas. The evolution of mobile health systems has helped private companies in recording existing and new product allergies and other medical problems (Cyran, 2018).

Question 7: What are the implications of this specific blockchain solution for cybersecurity (for the case study you selected)?

The evolution and modeling of blockchain-based solutions for the case of an allergy card use a problem-driven and user-centric approach to produce concepts and interesting axes for the deployment of a solution. The case study presented a real-life use case in delivering healthcare to all to build a solution for real-life problems involving stakeholder participation in the construction of healthcare data (Zhang, Walker & White et al., 2017). Patients can easily report allergies and suspicions so that physicians could enable validation of information in application by granting access to identified users (Esposito, Santis & Tortora et al., 2018). Blockchain technology increases attention as a next-generation solution for recordkeeping and transactional problems. The innovative technologies struggle with the implementation and potential risks. The organizations following blockchain systems must consider basic technological concepts, assess the cyber risks and ways to apply them, and make reasonable implementation decisions as to its applications and technology. The users should record transactions in a shared ledger by following established policies to track the central authority and repository of data. The permissions of blockchain allow person and system to access and view the ledger to add new data blocks to the ledger. The administrative governance structures operate generally but without the central authority (Griggs, Ossipova & Kohlios et al., 2018). Governance structure and authorities allow to response to the incidents including cyber threats. Public blockchain systems support broader participation among the parties with little or low knowledge. Organizations use to collaborate without exposing transactions to public scrutiny or uninviting the applications that benefit cooperation by developing private blockchain systems (Griggs, Ossipova & Kohlios et al., 2018). The nodes of the blockchain system receive an identical copy of the updated ledger on its system to validate the data. The established systems in blockchain ensure the integrity of new data so that it can be added to the ledger. Hence, the blockchain systems validate the procedures so that agreement can take place by using algorithms in coding so that they can be implemented into proper structures.

Question 8: Explain to the executive team the benefits and challenges of adopting the blockchain solution (including if another technology would be a better fit). Your recommendations should be supported by evidence (scholarly and other credible articles) from the previous components of the report.

The blockchain system has many benefits and challenges that the executive team can face at the time of implementation.

Benefits

The blockchain system works by saving the data into multiple computers by storing a copy of the record book. The computers thus confirm the transaction by agreeing or disagreeing with the issues about transactions (Hölbl, Kompare & Kamišalić et al., 2018). The main advantages of adopting blockchain systems are lower costs, innovation, an advantage over competitors, full control over the transactions of data, high level of data security and protection against unauthorized actions, accurate recordkeeping, and transparency (Esposito, Santis & Tortora et al., 2018).

The costs are lowered as the process becomes by making online registration of patients and thus reducing paper usage and costs. The third-party is excluded in the blockchain process that allows to minimize or eliminate the counterparty risks. Man is guided by emotions, the blockchain technology will boost in promoting the use of the electronic system and solidifying a reputation as an innovator in business (Zhang, Walker & White et al., 2017). This helps in gaining an advantage over the customers by using blockchain technology as a decisive factor for a potential customer. Verification and speed are more efficient in adopting the systems of blockchain. The threat of hackers is very high in today's world, but the adoption of the blockchain system in healthcare helps in maintaining data security and protection with government and law regulations (Griggs, Ossipova & Kohlios et al., 2018). The internal database systems are diminished in blockchain systems; hence it is the most secure form for keeping records and maintaining the privacy of data. 

Challenges

There are many obstacles in maintaining the data by blockchain systems in the healthcare industry. It will take a major cultural shift as at present, doctors are still stuck to the paper. So, the shift of doctors from paperwork to electronic health records systems is a big challenge to the system. The technology is an effective tool to be used by everyone, it is also said that doctors are not interested to use technological tools in healthcare consultations.

Healthcare delivery is not in the hand of a single person, so healthcare providers and insurance players play an important role in handling records. The streamlined systems are said to be followed to put all the information collected so that resistance and usefulness of data are maintained (Hölbl, Kompare & Kamišalić et al., 2018).

Some of the insurance players and healthcare institutions are not willing to take interest in sharing the data technologically. It is a competitive advantage for hospitals to keep cost data to themselves (Griggs, Ossipova & Kohlios et al., 2018).

The government is not showing a detailed focus on adopting blockchain systems in healthcare to manage all data. Hence, this could be said that healthcare leaders and the government are not willing to adopt this system until they come across the confirmed cases. Till then no one will be willing to work and move the healthcare system forward (Zhang, Walker & White et al., 2017).

References for Allergy Card Analysis

Al Omar, A., Bhuiyan, M. Z. A., Basu, A., Kiyomoto, S., & Rahman, M. S. (2019). A privacy-friendly platform for healthcare data in cloud-based on blockchain environment. Future Generation Computer Systems95, 511-521. https://doi.org/10.1016/j.future.2018.12.044

Al Omar, A., Rahman, M. S., Basu, A., & Kiyomoto, S. (2017). Medibchain: A blockchain-based privacy-preserving platform for healthcare data. In International conference on security, privacy, and anonymity in computation, communication, and storage (pp. 534-543). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-319-72395-2_49

Cyran, M. A. (2018). Blockchain as a foundation for sharing healthcare data. Blockchain in Healthcare Today1, 1-6. https://www.middleeastmedicalportal.com/wp-content/uploads/2020/08/Blockchain-as-a-Foundation-for-Sharing-Healthcare-Data.pdf

De Aguiar, E. J., Faiçal, B. S., Krishnamachari, B., & Ueyama, J. (2020). A Survey of Blockchain-Based Strategies for Healthcare. ACM Computing Surveys (CSUR)53(2), 1-27. https://doi.org/10.1145/3376915

Esposito, C., De Santis, A., Tortora, G., Chang, H., & Choo, K. K. R. (2018). Blockchain: A panacea for healthcare cloud-based data security and privacy?. IEEE Cloud Computing5(1), 31-37. https://ieeexplore.ieee.org/abstract/document/8327543?casa_token=USWkgbTZTggAAAAA:NoqtI-oxv240m-SZmC854hxjAMGhkoBIRVL7byj083z0u7SxVU0gVO3kY0ZfrvHKG57JYjsa7A

Figueroa, S., Añorga, J., & Arrizabalaga, S. (2019). An attribute-based access control model in RFID systems based on blockchain decentralized applications for healthcare environments. Computers8(3), 57. https://doi.org/10.3390/computers8030057

Fu, J., Wang, N., & Cai, Y. (2020). Privacy-Preserving in Healthcare Blockchain Systems Based on Lightweight Message Sharing. Sensors20(7), 1898. https://doi.org/10.3390/s20071898

Gordon, W. J., & Catalini, C. (2018). Blockchain technology for healthcare: facilitating the transition to patient-driven interoperability. Computational and structural biotechnology journal16, 224-230. https://doi.org/10.1016/j.csbj.2018.06.003

Griggs, K. N., Ossipova, O., Kohlios, C. P., Baccarini, A. N., Howson, E. A., & Hayajneh, T. (2018). Healthcare blockchain system using smart contracts for secure automated remote patient monitoring. Journal of medical systems42(7), 130. https://link.springer.com/article/10.1007/s10916-018-0982-x

Hölbl, M., Kompara, M., Kamišalić, A., & Nemec Zlatolas, L. (2018). A systematic review of the use of blockchain in healthcare. Symmetry10(10), 470. https://doi.org/10.3390/sym10100470

Jiang, S., Cao, J., Wu, H., Yang, Y., Ma, M., & He, J. (2018). Bloch: a blockchain-based platform for healthcare information exchange. In 2018 IEEE international conference on smart computing (smart comp) (pp. 49-56). IEEE. https://ieeexplore.ieee.org/abstract/document/8421331

Kumar, T., Ramani, V., Ahmad, I., Braeken, A., Harjula, E., & Ylianttila, M. (2018). 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. https://ieeexplore.ieee.org/abstract/document/8531136

Mikula, T., & Jacobsen, R. H. (2018). Identity and access management with blockchain in electronic healthcare records. In 2018 21st Euromicro conference on digital system design (DSD) (pp. 699-706). IEEE. https://ieeexplore.ieee.org/abstract/document/8491888?casa_token=9t0s2qIpjpUAAAAA:sT4B9Iq8BtvuqkXvahsj70OPP36Dljm2squFXf5mw75NL0tyKcTfpxD-VoFx_6WvKRsnLK7H7Q

Ngassam, R. G. N., Ologeanu-Taddei, R., Lartigau, J., & Bourdon, I. (2020). A Use Case of Blockchain in Healthcare: Allergy Card. In Blockchain and Distributed Ledger Technology Use Cases (pp. 69-94). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-030-44337-5_4

Ramani, V., Kumar, T., Bracken, A., Liyanage, M., & Ylianttila, M. (2018). Secure and efficient data accessibility in blockchain-based healthcare systems. In 2018 IEEE Global Communications Conference (GLOBECOM), IEEE, 206-212.. https://ieeexplore.ieee.org/abstract/document/8647221?casa_token=qn0XQn6HMuIAAAAA:QNmqtgwItp3jI6zD-oKKVB7pGWflXiXLeTZNKvxw8Xlu9oeFDKuXDbhkustW-4YVCHSVJpqSbg

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Witchey, N. J. (2019). U.S. Patent No. 10,340,038. Washington, DC: U.S. Patent and Trademark Office. https://patents.google.com/patent/US10340038B2/en

Yue, X., Wang, H., Jin, D., Li, M., & Jiang, W. (2016). Healthcare data gateways: found healthcare intelligence on the blockchain with novel privacy risk control. Journal of medical systems40(10), 218. https://link.springer.com/article/10.1007/s10916-016-0574-6

Zhang, P., Schmidt, D. C., White, J., & Lenz, G. (2018). Blockchain technology use cases in healthcare. In Advances in Computers (Vol. 111, pp. 1-41). Elsevier. https://doi.org/10.1016/bs.adcom.2018.03.006

Zhang, P., Walker, M. A., White, J., Schmidt, D. C., & Lenz, G. (2017). Metrics for assessing blockchain-based healthcare decentralized apps. In 2017 IEEE 19th International Conference on e-Health Networking, Applications and Services (Healthcom) (pp. 1-4). IEEE. https://ieeexplore.ieee.org/abstract/document/8210842

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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