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Artificial Intelligence in Health Blockchain for health-care security

Table 6. Challenges facing blockchain and guidelines to tackle them
Challenges Causes Guidelines
Security and privacy • Blockchain technology is still in its early stages of • Th e type of data shared with and among participants must be
of data development and refinement. determined since the beginning.
• There is much ambiguity when it comes to designing the • Prediction models that protect data privacy should be used.
blockchain. • It is necessary to choose a blockchain protocol – the framework
• When old corporate systems and record systems are that guides the structure of the blockchain and the development of
involved, integration issues arise. applications – and use the appropriate authorization structures.
Managing storage • Storage capacity for a large amount of data is limited. • A scalable and resilient blockchain solution is required.
capacity • Limitations in throughput capacity and storage exist. • Data storage requirements should be kept to a minimum.
Interoperability issues • Creating blockchains from a variety of communication • Evaluability should be maintained while reducing integration
services is a challenge. complicatedness.
• It is technically challenging to afford an effective • The ease of integration should be taken into consideration with
interaction platform for users and for the operations of security concerns.
medical applications.
• Gaps in communication and information sharing are
obstacles.
Decisions about • Records’ ownership • New cybersecurity risks must be addressed before patients
blockchain governance • How is permission granted? entrust a public blockchain with storing their data.
• The blockchain’s nodes, users, peers, and/or validators will
need to be defined.
Standardization • Lack of uniformity and scalability • International standardization authorities are required to
challenges • Lack of successful blockchain-based projects for reference formulate well-authenticated and approved standards.
• The standards will be treated as guidelines for inspecting the
exchanged data and as safety precautions.
Social challenges • Concerns about blockchain adoption due to cultural and • Organizations are encouraged to adopt technology and join a
trust issues shared network.
• Knowledge gap
• Hesitant social adoption of technology
Inadequate universally • No defined standards • Universal standards will help blockchain become more
defined standards • Time- and effort-consuming implementation of standards adaptable.
in the health-care sector • Data format, size, and type in blockchain will be readily
determined.

be resolved. For instance, blockchain is still vulnerable to a
compromise of mutual trust, by a degree of 51%, even though
such a trust system is built upon with consensus mechanisms.
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Data hackers can capitalize on this vulnerability to hijack the
whole system developed with blockchain. For blockchains
operating on POW mechanisms in particular, an attack with
a probability of 51% may occur if one miner’s hashing power is
more than 50% of the hashing power in total. If a user’s private
key is lost, their entire blockchain will be vulnerable to tampering
by other people. Since blockchain is decentralized and does not
rely on third-party institutions for its operations, 54,62 it would be
tough to track the whereabouts of a stolen private key and to
Figure 7. Interoperability performance of electronic health record systems
powered by blockchain technology. Source: Graph made by the authors. retrieve back the stolen private key if it has been changed by the
criminals. Therefore, solutions should be created to counteract
data verification and transmission of ultralow-latency the attacks and enhance blockchain security.
information more optimized. 48,57
10.3. Reduction of resource consumption
10.2. Blockchain security issues Given the profound resource-consuming nature of POW
Despite the huge potential, security issues of blockchain consensus algorithm used in blockchain, a more efficient
technology that could undermine its adoption remain to mechanism is urgently warranted. A prevailing idea of

Volume 1 Issue 2 (2024) 43 doi: 10.36922/aih.2580