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F. Ellouze et al.
real time responses which require a fast consensus protocol. However, IoMT are
constrained devices and produce huge amount of data. The majority of studied
works [9] have eliminated the consensus protocol to meet IoMT requirements.
Some authors [12] use smart contract to self-verify and self-execute transactions.
These smart contracts are protected using a lightweight consensus mechanism.
Some others [6] proposed a lightweight consensus protocol: Researchers in [12,20]
modified the PoS protocol to adapt it to the IoMT requirements, other works
[5,20] grouped the nodes in clusters and chose a header for each cluster to manage transactions between nodes, validate and create the blocks. For security
requirements in healthcare domain, some existing works proposed solutions to
manage and control access rights. The majority [3,9,12,13] implement smart
contracts to allow access to only authorized users based on some attributes of
the IoMT ecosystem and their interaction with the users/stakeholders. Some
other works [5,14,20] focused on maintaining patient privacy by proposing a
lightweight privacy-preserving algorithms like ring signature scheme.
The literature review shows that there are some significant research gaps.
There are several challenges that must be addressed to reach maturity and be
efficient. These challenges include:
– Lack of standards: The proposed solutions are proprietary. They do not
define standard protocols to adapt heterogeneous technologies and promote
interoperability which prevent the adoption of such solutions. It is crucial to
provide universal and platform-agnostic solutions that govern the interaction
between IoMT devices, blockchain, cloud computing and end-users.
– Programming Abstractions: The integration of blockchain technology
into the IoMT opens the way to many relevant applications in the health
field. However, the adoption of such technology (Blockchain-IoMT) is complex and requires in-depth interdisciplinary knowledge from low-level including the management of IoMT devices and configuring blockchain to meet
IoMT requirements, to high-level knowledge including sharing, storing and
treating IoMT data. In this context, it is crucial to conceive an abstraction
layer hiding all these complexities and to provide developers with new application programming interfaces (APIs) and middleware allowing them to easily
implement decentralized and secure applications for healthcare using IoMT.
– Limited Application Scope: The majority of existing works are only focusing on healthcare applications related to remote patient monitoring and IoMT
data management including data sharing and storage. It is crucial to conceive
tracking applications that prevent counterfeit drugs and medical errors. In
this context, the use of blockchain technology accompanied by the IoMT can
be an effective solution to control the activity of doctors as well as for the
management of the drug supply chain.
– Lack of Technical Details: The integration of blockchain with the IoMT
is challenging. Most of existing solutions did not reveal any technical details.
There is a need that researchers demystify all the technical details of the
blockchain integration into IoMT.
F. Ellouze et al.
real time responses which require a fast consensus protocol. However, IoMT are
constrained devices and produce huge amount of data. The majority of studied
works [9] have eliminated the consensus protocol to meet IoMT requirements.
Some authors [12] use smart contract to self-verify and self-execute transactions.
These smart contracts are protected using a lightweight consensus mechanism.
Some others [6] proposed a lightweight consensus protocol: Researchers in [12,20]
modified the PoS protocol to adapt it to the IoMT requirements, other works
[5,20] grouped the nodes in clusters and chose a header for each cluster to manage transactions between nodes, validate and create the blocks. For security
requirements in healthcare domain, some existing works proposed solutions to
manage and control access rights. The majority [3,9,12,13] implement smart
contracts to allow access to only authorized users based on some attributes of
the IoMT ecosystem and their interaction with the users/stakeholders. Some
other works [5,14,20] focused on maintaining patient privacy by proposing a
lightweight privacy-preserving algorithms like ring signature scheme.
The literature review shows that there are some significant research gaps.
There are several challenges that must be addressed to reach maturity and be
efficient. These challenges include:
– Lack of standards: The proposed solutions are proprietary. They do not
define standard protocols to adapt heterogeneous technologies and promote
interoperability which prevent the adoption of such solutions. It is crucial to
provide universal and platform-agnostic solutions that govern the interaction
between IoMT devices, blockchain, cloud computing and end-users.
– Programming Abstractions: The integration of blockchain technology
into the IoMT opens the way to many relevant applications in the health
field. However, the adoption of such technology (Blockchain-IoMT) is complex and requires in-depth interdisciplinary knowledge from low-level including the management of IoMT devices and configuring blockchain to meet
IoMT requirements, to high-level knowledge including sharing, storing and
treating IoMT data. In this context, it is crucial to conceive an abstraction
layer hiding all these complexities and to provide developers with new application programming interfaces (APIs) and middleware allowing them to easily
implement decentralized and secure applications for healthcare using IoMT.
– Limited Application Scope: The majority of existing works are only focusing on healthcare applications related to remote patient monitoring and IoMT
data management including data sharing and storage. It is crucial to conceive
tracking applications that prevent counterfeit drugs and medical errors. In
this context, the use of blockchain technology accompanied by the IoMT can
be an effective solution to control the activity of doctors as well as for the
management of the drug supply chain.
– Lack of Technical Details: The integration of blockchain with the IoMT
is challenging. Most of existing solutions did not reveal any technical details.
There is a need that researchers demystify all the technical details of the
blockchain integration into IoMT.