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works related to the integration of blockchain with the IoMT and discuss the
technical details of each work.
The remainder of this paper is structured as follows. Section 2 presents a
detailed technical analysis of existing articles dealing with the integration of
blockchain with IoMT. Section 3 provides an in-depth discussion based on our
study and presents research gaps, while Sect. 4 concludes the paper.
2 Internet of Medical Things (IoMT)-Blockchain
Challenges
Certainly, blockchain technology is beneficial to the internet of medical things
in terms of security. However, integrating both technologies is not trivial at all
and is facing several challenges due to the conflicting requirements in these two
technologies:
– Processing: Mining process and complex cryptography in blockchain are
resource-hungry, demanding intensive computation and high energy consumption which cannot be afforded by resource-constrained IoMT devices that
already suffer from resource shortage and energy limitations.
– Storage: IoMT devices generate huge amount of data with large flow. These
data must be treated and stored in the blockchain to ensure their integrity
which poses a significant challenge. In fact, blockchain technology relies on
its nodes to provide a distributed storage which is not affordable by IoMT
devices that have limited storage capabilities.
– Mobility: Blockchain was designed for a fixed network topology. However,
implantable/wearable medical devices are in movement all the time which
continuously change the topology.
– Real Time: IoMT applications are generally critical and require a real time
and immediate response. Whereas, blocks creation is time consuming. In Bitcoin [15], 1MB per block is created every 10 min. Grouping these streams of
data on blocks while respecting real time requirement is challenging.
– Traffic Overhead: Blockchain nodes communicate continuously to synchronize which creates significant overhead traffic. This is not affordable by
bandwidth-limited IoT devices.
3 Blockchain-Based Approaches in IoMT
We present in this section, the most recent researches that have applied
blockchain on IoMT. We classify these researches according to the most leading
technique used to integrate blockchain into IoMT.
3.1 Ethereum-Based Contributions
In [12], a private Ethereum-based architecture is proposed to implement smart
contracts in order to manage the users/devices requests and control access based
F. Ellouze et al.
works related to the integration of blockchain with the IoMT and discuss the
technical details of each work.
The remainder of this paper is structured as follows. Section 2 presents a
detailed technical analysis of existing articles dealing with the integration of
blockchain with IoMT. Section 3 provides an in-depth discussion based on our
study and presents research gaps, while Sect. 4 concludes the paper.
2 Internet of Medical Things (IoMT)-Blockchain
Challenges
Certainly, blockchain technology is beneficial to the internet of medical things
in terms of security. However, integrating both technologies is not trivial at all
and is facing several challenges due to the conflicting requirements in these two
technologies:
– Processing: Mining process and complex cryptography in blockchain are
resource-hungry, demanding intensive computation and high energy consumption which cannot be afforded by resource-constrained IoMT devices that
already suffer from resource shortage and energy limitations.
– Storage: IoMT devices generate huge amount of data with large flow. These
data must be treated and stored in the blockchain to ensure their integrity
which poses a significant challenge. In fact, blockchain technology relies on
its nodes to provide a distributed storage which is not affordable by IoMT
devices that have limited storage capabilities.
– Mobility: Blockchain was designed for a fixed network topology. However,
implantable/wearable medical devices are in movement all the time which
continuously change the topology.
– Real Time: IoMT applications are generally critical and require a real time
and immediate response. Whereas, blocks creation is time consuming. In Bitcoin [15], 1MB per block is created every 10 min. Grouping these streams of
data on blocks while respecting real time requirement is challenging.
– Traffic Overhead: Blockchain nodes communicate continuously to synchronize which creates significant overhead traffic. This is not affordable by
bandwidth-limited IoT devices.
3 Blockchain-Based Approaches in IoMT
We present in this section, the most recent researches that have applied
blockchain on IoMT. We classify these researches according to the most leading
technique used to integrate blockchain into IoMT.
3.1 Ethereum-Based Contributions
In [12], a private Ethereum-based architecture is proposed to implement smart
contracts in order to manage the users/devices requests and control access based