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

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.

A Study of Computational Trust Models in Cloud Security

The interest in cloud computing and its techniques are gaining exponentially in IT industries because of its cost-effective architecture and services. However, these flexible services of cloud bring many security and privacy challenges due to loss of control over the data. This paper focuses on an analysis of various computational trust models in cloud security environment. The computational trust models that are used to build secure cloud architectures are not available in a blended fashion to overcome security and privacy challenges. The paper aims to contribute to the literature review to assist researchers who are striving to contribute in this area. The main objective of this review is to identify and analyse the recently published research topics related to trust models and trust mechanisms for cloud with regard to research activity and proposed approaches. The future work is to design a trust mechanism for cloud security models to achieve the higher level of security.

Validation of Architecture Effectiveness for the Continuous Monitoring of File Integrity Stored in the Cloud Using Blockchain and Smart Contracts

The management practicality and economy offered by the various technological solutions based on cloud computing have attracted many organizations, which have chosen to migrate services to the cloud, despite the numerous challenges arising from this migration. Cloud storage services are emerging as a relevant solution to meet the legal requirements of maintaining custody of electronic documents for long periods. However, the possibility of losses and the consequent financial damage require the permanent monitoring of this information. In a previous work named “Monitoring File Integrity Using Blockchain and Smart Contracts”, the authors proposed an architecture based on blockchain, smart contract, and computational trust technologies that allows the periodic monitoring of the integrity of files stored in the cloud. However, the experiments carried out in the initial studies that validated the architecture included only small- and medium-sized files. As such, this paper presents a validation of the architecture to determine its effectiveness and efficiency when storing large files for long periods. The article provides an improved and detailed description of the proposed processes, followed by a security analysis of the architecture. The results of both the validation experiments and the implemented defense mechanism analysis confirm the security and the efficiency of the architecture in identifying corrupted files, regardless of file size and storage time.

Context-Aware Computational Trust Model for Recommender Systems

With increase in computing and networking technologies, many organizations have managed to place their services online with the aim of achieving efficiency in customer service as well as reach more potential customers, also with communicable diseases such as COVID-19 and need for social distancing, many people are encouraged to work from home, including shopping. To meet this objective in areas with poor Internet connectivity, the government of Kenya recently announced partnership with Google Inc for use of Google Loon. This has come up with challenges which include information overload on the side of the end consumer as well as security loopholes such as dishonest vendors preying on unsuspecting consumers. Recommender systems have been used to alleviate these two challenges by helping online users select the best item for their case. However, most recommender systems, especially common filtering recommendation algorithm (CFRA) based systems still rely on presenting output based on selections of nearest neighbors (most similar users – birds of the same feathers flock together). This leaves room for manipulation of the output by mimicking the features of their target and then picking malicious item such that when the recommender system runs, it will output the same malicious item to the target – a trust issue. Data to construct trust is equally a challenge. In this research, we propose to address this issue by creating a trust adjustment factor (TAF) for recommender systems for online services.

What the healthcare sector’s experience of blockchain reveals about its real transformative potential: A cross-disciplinary analysis (Preprint)

BACKGROUND Academic literature highlights the potential benefits of blockchain to transform healthcare, focusing on its potential seamlessly and securely to integrate existing ‘data silos’ while enabling patients to exercise automated, fine-grained control over access to their Electronic Health Records (EHRs). Yet no serious scholarly attempt has been made to assess the extent to which these technologies have in fact been applied to real-world healthcare contexts. OBJECTIVE The primary aim of this paper is to critically investigate the healthcare sector’s actual engagement and experience of blockchain technologies to date to assess the extent to which the potential for blockchain technologies to transform healthcare highlighted in academic literature is likely to be realised in healthcare practice. METHODS This mixed-methods study entailed a series of iterative, in-depth, theoretically oriented desk-based investigations and two focus-group investigations. It built on findings of a companion research study documenting real-world engagement with blockchain technologies in healthcare. Data was sourced from academic and grey literature drawn from multiple disciplinary perspectives concerned with the configuration, design and functionality of blockchain technologies. The analysis proceeded in three stages. First, it undertook a qualitative investigation of observed patterns of blockchain for healthcare engagement to identify the application domains, data-sharing problems, and the challenges encountered to date. Secondly, it critically compared these experiences of with claims about blockchain's potential benefits in healthcare. Thirdly, it developed a theoretical account of challenges that arise in implementing blockchain in healthcare contexts, thus providing a firmer foundation for appraising its future prospects for healthcare. RESULTS Healthcare organisations 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. Yet blockchain technology is yet to be implemented at scale in healthcare, remaining largely in its infancy. These early experiences of blockchain technologies have demonstrated blockchain’s potential to generate meaningful value to healthcare by facilitating data sharing between organisations in circumstances where computational trust can overcome a lack of social trust that might otherwise prevent valuable cooperation. Although there are genuine prospects of utilising blockchain to bring about positive transformation in healthcare, the successful development of blockchain for healthcare applications face a number of very significant, multi-dimensional and highly complex challenges. Early experience suggests that blockchain is unlikely to rapidly and radically revolutionise healthcare. CONCLUSIONS The successful development of blockchain for healthcare applications face numerous significant, multi-dimensional and complex challenges which will not be easily overcome, suggesting that blockchain technologies are unlikely to revolutionise healthcare in the near future. CLINICALTRIAL