scholarly journals Using Blockchain Technology to Mitigate Challenges in Service Access for the Homeless and Data Exchange Between Providers: Qualitative Study

10.2196/16887 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e16887
Author(s):  
Anjum Khurshid ◽  
Vivian Rajeswaren ◽  
Steven Andrews
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Data Exchange ◽  
Service Providers ◽  
Health Sector ◽  
Real Life ◽  
Homeless Population ◽  
Sensitive Information ◽  
Service Access ◽  
Blockchain Technology

Background In the homeless population, barriers to housing and supportive services include a lack of control or access to data. Disparate data formats and storage across multiple organizations hinder up-to-date intersystem access to records and a unified view of an individual’s health and documentation history. The utility of blockchain to solve interoperability in health care is supported in recent literature, but the technology has yet to be tested in real-life conditions encompassing the complex regulatory standards in the health sector. Objective This study aimed to test the feasibility and performance of a blockchain system in a homeless community to securely store and share data across a system of providers in the health care ecosystem. Methods We performed a series of platform demonstrations and open-ended qualitative feedback interviews to determine the key needs and barriers to user and stakeholder adoption. Account creation and data transactions promoting organizational efficiency and improved health outcomes in this population were tested with homeless users and service providers. Results Persons experiencing homelessness and care organizations could successfully create accounts, grant and revoke data sharing permissions, and transmit documents across a distributed network of providers. However, there were issues regarding the security of shared data, user experience and adoption, and organizational preparedness for service providers as end users. We tested a set of assumptions related to these problems within the project time frame and contractual obligations with an existing blockchain-based platform. Conclusions Blockchain technology provides decentralized data sharing, validation, immutability, traceability, and integration. These core features enable a secure system for the management and distribution of sensitive information. This study presents a concrete evaluation of the effectiveness of blockchain through an existing platform while revealing limitations from the perspectives of user adoption, cost-effectiveness, scalability, and regulatory frameworks.

scholarly journals Using Blockchain Technology to Mitigate Challenges in Service Access for the Homeless and Data Exchange Between Providers: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Anjum Khurshid ◽  
Vivian Rajeswaren ◽  
Steven Andrews
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Data Exchange ◽  
Service Providers ◽  
Health Sector ◽  
Real Life ◽  
Homeless Population ◽  
Sensitive Information ◽  
Service Access ◽  
Blockchain Technology

BACKGROUND In the homeless population, barriers to housing and supportive services include a lack of control or access to data. Disparate data formats and storage across multiple organizations hinder up-to-date intersystem access to records and a unified view of an individual’s health and documentation history. The utility of blockchain to solve interoperability in health care is supported in recent literature, but the technology has yet to be tested in real-life conditions encompassing the complex regulatory standards in the health sector. OBJECTIVE This study aimed to test the feasibility and performance of a blockchain system in a homeless community to securely store and share data across a system of providers in the health care ecosystem. METHODS We performed a series of platform demonstrations and open-ended qualitative feedback interviews to determine the key needs and barriers to user and stakeholder adoption. Account creation and data transactions promoting organizational efficiency and improved health outcomes in this population were tested with homeless users and service providers. RESULTS Persons experiencing homelessness and care organizations could successfully create accounts, grant and revoke data sharing permissions, and transmit documents across a distributed network of providers. However, there were issues regarding the security of shared data, user experience and adoption, and organizational preparedness for service providers as end users. We tested a set of assumptions related to these problems within the project time frame and contractual obligations with an existing blockchain-based platform. CONCLUSIONS Blockchain technology provides decentralized data sharing, validation, immutability, traceability, and integration. These core features enable a secure system for the management and distribution of sensitive information. This study presents a concrete evaluation of the effectiveness of blockchain through an existing platform while revealing limitations from the perspectives of user adoption, cost-effectiveness, scalability, and regulatory frameworks.

scholarly journals Enforcing Human Subject Regulations using Blockchain and Smart Contracts

2018 ◽  
Author(s):  
Olivia Choudhury ◽  
Hillol Sarker ◽  
Nolan Rudolph ◽  
Morgan Foreman ◽  
Nicholas Fay ◽  
...  
Keyword(s):  
Data Sharing ◽  
Data Exchange ◽  
Human Subjects ◽  
Secondary Data ◽  
Institutional Review Boards ◽  
Sensitive Information ◽  
Smart Contracts ◽  
Blockchain Technology ◽  
Research Activities ◽  
Genomic Study

Recent changes to the Common Rule, which govern Institutional Review Boards (IRB), require implementing new policies to strengthen research protocols involving human subjects. A major challenge in implementing such policies is an inability to automatically and consistently meet these ethical rules while securing sensitive information collected during the study. In this paper, we propose a novel framework, based on blockchain technology, to enforce IRB regulations on data collection. We demonstrate how to design smart contracts and a ledger to meet the requirements of an IRB protocol, including subject recruitment, informed consent management, secondary data sharing, monitoring risks, and generating automated assessments for continuous review. Furthermore, we show how we can employ the immutable transaction log in the blockchain to embed security in research activities by detecting malicious activities and robustly tracking subject involvement. We evaluate our approach by assessing its ability to enforce IRB guidelines in different types of human subjects studies, including a genomic study, a drug trial, and a wearable sensor monitoring study. Keywords: Blockchain, Data Sharing, Data Exchange, EHR, electronic health record, Ethereum, interplanetary filesystem, IPFS

Efficient Clinical Data Sharing Framework Based on Blockchain Technology

2021 ◽  
Author(s):  
Karamo Kanagi ◽  
Cooper Cheng-Yuan Ku ◽  
Li-Kai Lin ◽  
Wen-Huai Hsieh
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Health Care Providers ◽  
Clinical Data ◽  
Data Exchange ◽  
Access Time ◽  
Health Examination ◽  
Care Providers ◽  
Blockchain Technology ◽  
Average Access Time

Abstract Background While electronic health records have been collected for many years in Taiwan, their interoperability across different health care providers has not been entirely achieved yet. The exchange of clinical data is still inefficient and time consuming. Objectives This study proposes an efficient patient-centric framework based on the blockchain technology that makes clinical data accessible to patients and enable transparent, traceable, secure, and effective data sharing between physicians and other health care providers. Methods Health care experts were interviewed for the study, and medical data were collected in collaboration with Ministry of Health and Welfare (MOHW) Chang-Hua hospital. The proposed framework was designed based on the detailed analysis of this information. The framework includes smart contracts in an Ethereum-based permissioned blockchain to secure and facilitate clinical data exchange among different parties such as hospitals, clinics, patients, and other stakeholders. In addition, the framework employs the Logical Observation Identifiers Names and Codes (LOINC) standard to ensure the interoperability and reuse of clinical data. Results The prototype of the proposed framework was deployed in Chang-Hua hospital to demonstrate the sharing of health examination reports with many other clinics in suburban areas. The framework was found to reduce the average access time to patient health reports from the existing next-day service to a few seconds. Conclusion The proposed framework can be adopted to achieve health record sharing among health care providers with higher efficiency and protected privacy compared to the system currently used in Taiwan based on the client–server architecture.

Impact of community participation in primary health care: what is the evidence?

2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Outcomes ◽  
Community Participation ◽  
Service Providers ◽  
Developmental Process ◽  
Service Access ◽  
Primary Health ◽  
Intermediate Outcomes ◽  
The Impact

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.

A Perspective on the Corporate Transformation of Health Care

1995 ◽  
Vol 25 (1) ◽  
pp. 11-42 ◽  
Author(s):  
J. Warren Salmon
Keyword(s):  
Health Care ◽  
Service Providers ◽  
Care Delivery ◽  
Mode Of Delivery ◽  
Health Sector ◽  
The United States ◽  
Dominant Mode ◽  
For Profit ◽  
Health Service Providers ◽  
History Of

The ever-increasing ownership of health service providers, suppliers, and insurers by investor-owned enterprises presents an unforeseen complexity and diversity to health care delivery. This article reviews the history of the for-profit invasion of the health sector, linking corporate purchaser directions to the now dominant mode of delivery in managed care. These dynamics require unceasing reassessment while the United States embarks upon implementation of national health care reform.

scholarly journals A Secret data sharing Model for Agriculture Experts in Federated Cloud based on Polynomial based Encrypted Scheme

2021 ◽  
Vol 10 (4) ◽  
pp. 160-167
Author(s):  
V. Keerthi ◽  
T. Anuradha
Keyword(s):  
Data Sharing ◽  
Private Information ◽  
Data Exchange ◽  
Sensitive Information ◽  
Security Threats ◽  
Application Development ◽  
Exchange System ◽  
Secret Data ◽  
Cloud Data ◽  
Sharing Scheme

A shift in computation from PC’s to Cloud allows more number of users to involve in cooperative computation on various categories of data wish to merge their expertise and thereby gain more useful information without leaking their own sensitive information. In the case of data collected from various sensors in an agricultural farm IoT device, the cloud and customers can cooperate to provide adequate services; benefits to experts, research stations related to agriculture. Enormous Agriculture Data generated is related to Soil, weather, Research, crop, farmers, Agriculture marketing, Agri-IOT, fertilizers and pesticide makes cloud as a centralized resource.The exchange of information and research will inculcate a healthy competitive atmosphere in the country in agriculture. Sharing of data, computation, services across cloud boundaries with different clients at different places will enhance expertise suggestions and results to farming field which benefit to improve countries economy. Federation of cloud will allow resource and data sharing, but the security threats severely limit the application development as the usage of data processing or sharing mechanisms will leak private information. So in this research paper, a Polynomial Based Encryption Secret Sharing Scheme (PBESSS)is proposed as Federated cloud data exchange system with multiple cloud instances of the same cloud host or separate computing hosts.

scholarly journals The Health Care Sector’s Experience of Blockchain: A Cross-disciplinary Investigation of Its Real Transformative Potential

10.2196/24109 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e24109
Author(s):  
Karen Yeung
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Real World ◽  
Social Trust ◽  
World Health ◽  
Successful Development ◽  
Computational Trust ◽  
Fine Grained ◽  
Blockchain Technology ◽  
Health Care Applications

Background Academic literature highlights blockchain’s potential to transform health care, particularly by seamlessly and securely integrating existing data silos while enabling patients to exercise automated, fine-grained control over access to their electronic health records. However, no serious scholarly attempt has been made to assess how these technologies have in fact been applied to real-world health care contexts. Objective The primary aim of this paper is to assess whether blockchain’s theoretical potential to deliver transformative benefits to health care is likely to become a reality by undertaking a critical investigation of the health care sector’s actual experience of blockchain technologies to date. Methods This mixed methods study entailed a series of iterative, in-depth, theoretically oriented, desk-based investigations and 2 focus group investigations. It builds on the findings of a companion research study documenting real-world engagement with blockchain technologies in health care. Data were sourced from academic and gray literature from multiple disciplinary perspectives concerned with the configuration, design, and functionality of blockchain technologies. The analysis proceeded in 3 stages. First, it undertook a qualitative investigation of observed patterns of blockchain for health care engagement to identify the application domains, data-sharing problems, and the challenges encountered to date. Second, it critically compared these experiences with claims about blockchain’s potential benefits in health care. Third, it developed a theoretical account of challenges that arise in implementing blockchain in health care contexts, thus providing a firmer foundation for appraising its future prospects in health care. Results Health care organizations have actively experimented with blockchain technologies since 2016 and have demonstrated proof of concept for several applications (use cases) primarily concerned with administrative data and to facilitate medical research by enabling algorithmic models to be trained on multiple disparately located sets of patient data in a secure, privacy-preserving manner. However, blockchain technology is yet to be implemented at scale in health care, remaining largely in its infancy. These early experiences have demonstrated blockchain’s potential to generate meaningful value to health care by facilitating data sharing between organizations in circumstances where computational trust can overcome a lack of social trust that might otherwise prevent valuable cooperation. Although there are genuine prospects of using blockchain to bring about positive transformations in health care, the successful development of blockchain for health care applications faces a number of very significant, multidimensional, and highly complex challenges. Early experience suggests that blockchain is unlikely to rapidly and radically revolutionize health care. Conclusions The successful development of blockchain for health care applications faces numerous significant, multidimensional, and complex challenges that will not be easily overcome, suggesting that blockchain technologies are unlikely to revolutionize health care in the near future.

scholarly journals Secure Dynamic Groups Data Sharing with Modified Revocable Attribute-Based Encryption in Cloud

2019 ◽  
Vol 8 (4) ◽  
pp. 9508-9512
Keyword(s):  
Data Sharing ◽  
Data Exchange ◽  
Service Providers ◽  
Cloud Service ◽  
Difficult Problem ◽  
Natural Resistance ◽  
Security Issues ◽  
Shared Data ◽  
Attribute Based Encryption ◽  
User Groups

Cloud computing provides a flexible and convenient way for data sharing, which brings various benefits for both the society and individuals. But there exists a natural resistance for users to directly outsource the shared data to the cloud server since the data often contain valuable information. Although it causes many security issues, cloud service providers are not at the same level of trust as users. To preserve the privacy of data against non-trusted Cloud Service Provider (CSP) files, current solutions implement Cryptographic methods (for example, encryption methods) and deliver decryption keys only to authorized users. However, data sharing in the cloud among authorized users remains a difficult problem, especially when it comes to dynamic user groups. Most of the research on dynamic group data exchange has been done in the cloud with many algorithms, such as Attribute-Based Encryption (ABE), Ciphertext Attribute-Based Encryption (CP-ABE) to provide better security in dynamic cloud users with multiple authorities, but they still face challenges, either lack of performance or rely on a trusted server, and are not suitable for distribution with the problem of eliminating attributes. Thus, the Revocation user cannot get shared data before and after. To solve this in particular, we first suggest an effective Modified Revocable Attribute-Based Encryption (MR-ABE) system with the quality of ciphertext allocation by applying and integrating both Identity-Based Encryption (IBE) and CP-ABE techniques. It can provide confidential forward / backward of encrypted data by delivering user revocation attributes and updating encrypted text simultaneously. Next, we perform Fine-grained access control and data exchange for on-demand services with dynamic user groups on the cloud. Experimental data show that our proposed system is more efficient and scalable than the latest generation solutions

Driving Innovation Through Medicaid

2020 ◽  
pp. 185-196
Author(s):  
Alonzo L. Plough
Keyword(s):  
Health Care ◽  
Social Service ◽  
Data Exchange ◽  
Service Providers ◽  
Housing Instability ◽  
Health Coverage ◽  
Potential Barriers ◽  
New Information ◽  
Start Up ◽  
Medicaid Beneficiaries

This chapter highlights the expanding use of Medicaid to address social determinants of health, particularly housing instability and opioid addiction. Medicaid today is a core component of the nation's health care system, providing health coverage to more than 66 million people. With one in five Americans participating in Medicaid, the program has the reach and influence to play a key role in promoting health and health equity, especially through research and demonstration waivers that allow states to experiment. The chapter then offers examples of innovative programming and service delivery in three states and looks at a major insurer’s commitment to address the root causes of homelessness among its Medicaid beneficiaries. However, the significant infrastructure and start-up costs involved in implementing Medicaid reforms loom as potential barriers. Health care and social service providers will need to develop new information systems, recruit and retrain providers, and establish data-exchange protocols in order to realize the benefits from the federal infusion of new money into Medicaid.

scholarly journals Flexible, Secure, and Reliable Data Sharing Service Based on Collaboration in Multicloud Environment

2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Qiang Wei ◽  
Huaibin Shao ◽  
Gongxuan Zhang
Keyword(s):  
Data Sharing ◽  
Data Exchange ◽  
Keyword Search ◽  
Service Providers ◽  
High Reliability ◽  
Economic Benefits ◽  
Reliable Data ◽  
Third Party ◽  
Data Service ◽  
Real World Data

Due to the abundant storage resources and high reliability data service of cloud computing, more individuals and enterprises are motivated to outsource their data to public cloud platform and enable legal data users to search and download what they need in the outsourced dataset. However, in “Paid Data Sharing” model, some valuable data should be encrypted before outsourcing for protecting owner’s economic benefits, which is an obstacle for flexible application. Specifically, if the owner does not know who (user) will download which data files in advance and even does not know the attributes of user, he/she has to either remain online all the time or import a trusted third party (TTP) to distribute the file decryption key to data user. Obviously, making the owner always remain online is too inflexible, and wholly depending on the security of TTP is a potential risk. In this paper, we propose a flexible, secure, and reliable data sharing scheme based on collaboration in multicloud environment. For securely and instantly providing data sharing service even if the owner is offline and without TTP, we distribute all encrypted split data/key blocks together to multiple cloud service providers (CSPs), respectively. An elaborate cryptographic protocol we designed helps the owner verify the correctness of data exchange bills, which is directly related to the owner’s economic benefits. Besides, in order to support reliable data service, the erasure-correcting code technic is exploited for tolerating multiple failures among CSPs, and we offer a secure keyword search mechanism that makes the system more close to reality. Extensive security analyses and experiments on real-world data show that our scheme is secure and efficient.

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