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Artificial Intelligence in Health Blockchain for health-care security

9. Research gap and technical limitations of triggering system failure that could greatly affect
blockchain in health-care sector access to EHR information.
(iii) How to design massive, blockchain-based globalized
Blockchain technology has a positive impact on the health- storage systems for large volumes of confidential
care sector by facilitating the businesses of the health-care health records without compromising the efficiency of
organizations. Moreover, this technology has a unique the blockchain network.
edge in securing and upgrading patient’s data, in a cost- (iv) When and how to integrate an approved and specialized
effective fashion. One of the census mechanisms, the standards formulated by global standardization
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POW, required plenty of energy to operate. Due to the institutions into blockchain-based health-care systems
restriction in accessing sensitive information from the and into the mechanism responsible for data exchange
stored data, the public ledger system can be disrupted. in blockchain services.
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Despite its significant role in securing medical data,
blockchain is fraught with limitations and challenges in Most recent studies present the concept of the use
technology, integration, cost, regulation, culture, energy of blockchain in health-care domain, underscoring the
consumption, and data privacy. important role of blockchain in transforming the health-
care sector. However, one of the most important research
9.1. Limitations problems surrounding the application of blockchain in
A flood of software are currently employed in the health- health-care systems is the interoperability between different
care sector, but the functionalities of some of them have health systems following the adoption and integration of
not fully matured and equivalent but enhanced software is blockchain to improve security of data sharing, especially
constantly being created and added to this growing armada. in the case of wearable devices. To investigate this aspect,
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In the aspect of integration, the blockchain technology to Roehrs et al. evaluated the productivity of the blockchain
be applied must be compatible with the present financial performance when implementing a prototype that
technologies before their full integration. Furthermore, integrates and performs medical records from different
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institutions will be incurred higher initial costs due to the production databases. 59
implementation of new technology. On a separate note, The measurement of response time, central processing
regulatory concerns surrounding blockchain technology unit usage, memory and disk occupation, and network
have yet to be resolved by government agencies. One of the usage were monitored. Figure 7 depicts the performance of
prominent concerns is that distributed access to the whole blockchain in EHRs to query data and manipulate health
data set can be compromised even if the data have been records in a scenario containing data blocks running from
encrypted and de-identified within the blockchain. 48 50 to 500 concurrent sessions in the network, showing
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The two main issues about blockchain data storage are that there is an increase in the number of users who
confidentiality and scalability. Individuals who are linked simultaneously access the network, measured in terms of
on the same chain can access the data. As a result, data in the average load of records and the average response rate
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the blockchain, which might contain sensitive information obtained. These results indicate that the response time is
such as medical history and X-ray report, are vulnerable almost equivalent despite the multiplicity and abundance
to breaches and not desirable in a decentralized platform. of data, underlining the potential of merging open EHR
Storage capacity in blockchain will be highly impacted standards and blockchain technologies to create an
by the data breach vulnerability. 48,57 The summary of interoperable model for health data sharing with the aim of
challenges facing blockchain and the guidelines to tackle reducing the impact of various interoperability constraints.
each of them is shown in Table 6.
10. Future directions
9.2. Open research issues Several aspects concerning the future adoption of
Several vital issues confronting the adoption of blockchain blockchain technology in the health-care sector should be
for medical applications require investigations tailored to taken into consideration:
solving security problems prevalent in the EHR systems.
These open issues are iterated in four research questions: 10.1. Enhanced performance of blockchain
(i) How to build servers for blockchain-based health- Platforms using blockchain technology should be
care systems that are amenable to blockchain protocol technically enhanced in terms of scalability, resource
scalability. consumption, network latency, throughput, etc. Increasing
(ii) How to determine the levels of authority in blockchain scalability and building more lightweight blockchain
and safeguard the access to patient data without designs for health-care purposes are needed to make

Volume 1 Issue 2 (2024) 42 doi: 10.36922/aih.2580