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1. Blockchain Framework for Secured On-Demand Patient Health Records Sharing

   Abouali, Meryem; Sharma, Kartikeya; Ajayi, Oluwaseyi; Saadawi, Tarek (December 2021, IEEE UEMCON2021)

   The healthcare sector is constantly improving patient health record systems. However, these systems face a significant challenge when confronted with patient health record (PHR) data due to its sensitivity. In addition, patient’s data is stored and spread generally across various healthcare facilities and among providers. This arrangement of distributed data becomes problematic whenever patients want to access their health records and then share them with their care provider, which yields a lack of interoperability among various healthcare systems. Moreover, most patient health record systems adopt a centralized management structure and deploy PHRs to the cloud, which raises privacy concerns when sharing patient information over a network. Therefore, it is vital to design a framework that considers patient privacy and data security when sharing sensitive information with healthcare facilities and providers. This paper proposes a blockchain framework for secured patient health records sharing that allows patients to have full access and control over their health records. With this novel approach, our framework applies the Ethereum blockchain smart contracts, the Inter-Planetary File System (IPFS) as an off-chain storage system, and the NuCypher protocol, which functions as key management and blockchain-based proxy re-encryption to create a secured on-demand patient health records sharing system effectively. Results show that the proposed framework is more secure than other schemes, and the PHRs will not be accessible to unauthorized providers or users. In addition, all encrypted data will only be accessible to and readable by verified entities set by the patient. 

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2. Patient Full Control over Secured Medical Records Transfer Framework Based on Blockchain

   https://doi.org/10.1109/ICELTICs56128.2022.9932113  

   Abouali, Meryem; Sharma, Kartikeya; Saadawi, Tarek (September 2022, IEEE)

   Covid-19 outbreak represents an exceptional test of the flexibility and the efficiency of patient medical records transfer among healthcare providers which ended up in boundless interruption to the healthcare industry. This public crisis has pushed for an urgent innovation of the patient medical records transference (PMRT) system to meet the needs and provide appropriate patient care. Moreover, the drawback effects of Covid-19 changed the healthcare system forever, more patients are requesting more control, secure, and smoother experience when they want access to their health records. However, the problems stem from the lack of interoperability among the healthcare system and providers and the added burden of cyber-attacks on an already stressed system call for an immediate solution. In this work, we present a secured blockchain framework that ensures patients full ownership over their medical data which can be stored in their private IPFS and later can be shared with an authorized provider. The analysis of the proposed security and privacy aspects shows promising results in providing time savings and resulted in enhanced confidentiality and less disruption in patient-provider interactions. 

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3. Toward Secure, Privacy-Preserving, and Interoperable Medical Data Sharing via Blockchain

   https://doi.org/10.1109/ICPADS47876.2019.00126  

   Jin, Hao; Xu, Chen; Luo, Yan; Li, Peilong; Cao, Yu; Mathew, Jomol (December 2019, 2019 IEEE 25th International Conference on Parallel and Distributed Systems (ICPADS))

   In the era of cloud computing and big data analysis, how to efficiently share and utilize medical information scattered across various care providers has become a critical problem. This paper proposes a new framework for sharing medical data in a secure and privacy-preserving way. This framework holistically integrates multi-authority attribute based encryption, blockchain and smart contract, as well as software defined networking to define and enforce sharing policies. Specifically in our framework, patients' medical records are encrypted and stored in hospital databases, where strict access controls are enforced with attribute based encryption coupled with privacy level classification. Our framework leverages blockchain technology to connect scattered private databases from participating hospitals for efficient and secure data provision, smart contracts to enable the business logic of clinical data usage, and software defined networking to revoke sharing privileges. The performance evaluation of our prototype demonstrates that the associated computation costs are reasonable in practice. 

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4. Self-Sovereign Identity in Semi-Permissioned Blockchain Networks Leveraging Ethereum and Hyperledger Fabric

   https://doi.org/10.1109/ICDH60066.2023.00053  

   Sahi, Niranjan; Liang, Anda; Van Devanter, Wyn; Oikonomou, Konstantinos; Zhang, Peng (July 2023, Digital Health (ICDH), IEEE International Conference on)

   Patients often have their healthcare data stored in centralized systems, leading to challenges when reconciling or consolidating their data across providers due to centralized databases that store patient identities. The challenges disrupt the flow of patient care where time is sensitive for both patients and providers. Decentralized technologies have enabled a new identity model–Self-Sovereign Identity (SSI)–that grants individuals the right to freely control, access, and share their own data. This work proposes a system that achieves SSI in a semi-permissioned blockchain network using an open protocol as the certificate of authority and several guidelines for securely handling transactions in the network. Open protocols like Keccak can grant access to a permission-based network such as Hyperledger Fabric. The network architecture ensures data security and privacy through mechanisms of multi-signature transactions and guidelines for storing transactions locally, making this architecture ideal for privacy-centered use cases, such as healthcare data-sharing applications. The ultimate goal is to give patients full control over their identity and other data derived from their identity within a semi-permissioned network. 

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5. Apply Trust Computing and Privacy Preserving Smart Contracts to Manage, Share, and Analyze Multi-site Clinical Trial Data

   https://doi.org/10.1007/978-3-031-16035-6_1  

   Wu, Y.; Liu, C.; Sebald, L.; Nguyen, P.; Yesha, Y. (September 2022, Lecture notes in networks and systems)

   Irfan Awan; Muhammad Younas; Jamal Bentahar; Salima Benbernou (Ed.)

   Multi-site clinical trial systems face security challenges when streamlining information sharing while protecting patient privacy. In addition, patient enrollment, transparency, traceability, data integrity, and reporting in clinical trial systems are all critical aspects of maintaining data compliance. A Blockchain-based clinical trial framework has been proposed by lots of researchers and industrial companies recently, but its limitations of lack of data governance, limited confidentiality, and high communication overhead made data-sharing systems insecure and not efficient. We propose 𝖲𝗈𝗍𝖾𝗋𝗂𝖺, a privacy-preserving smart contracts framework, to manage, share and analyze clinical trial data on fabric private chaincode (FPC). Compared to public Blockchain, fabric has fewer participants with an efficient consensus protocol. 𝖲𝗈𝗍𝖾𝗋𝗂𝖺 consists of several modules: patient consent and clinical trial approval management chaincode, secure execution for confidential data sharing, API Gateway, and decentralized data governance with adaptive threshold signature (ATS). We implemented two versions of 𝖲𝗈𝗍𝖾𝗋𝗂𝖺 with non-SGX deploys on AWS blockchain and SGX-based on a local data center. We evaluated the response time for all of the access endpoints on AWS Managed Blockchain, and demonstrated the utilization of SGX-based smart contracts for data sharing and analysis. 

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