274
R. Ben Fekih and M. Lahami
controlled at this level. Moreover, scalability and interoperability issues represent the main focus of current and future studies in this field. Interoperability
challenge reveals the fact of missing standards for developing healthcare applications based on blockchain technology. Thus, the different developed applications
may not be able to interoperate. In addition, scalability is a major issue in
blockchain-based healthcare systems [18] especially towards the volume of medical data involved. Due to high-volume healthcare data, it is not practicable
to store it on-chain i.e. on blockchain, as this is may lead to serious performance degradation. Furthermore, there is a problem of latency caused by the
speed of transactions’ processing and off-chain data load in a blockchain-based
system. Finally, another weakness is related to blockchain immutability and selfexecution of code, since smart contracts could become vulnerable to hackers. Just
between 2016 and 2018, attacks such as the decentralized autonomous organization (DAO) attack cause a loss of millions of dollars as part of the assets held
by the smart contracts.
5 Conclusion
The present study gave an overview about the application of Blockchain in
Healthcare. In fact, due to the exponential growth of this technology, blockchain
has been applied in several use cases with the aim of enhancing the automation
of medical services.
Our study shows that the majority of researches applying blockchain in
healthcare are concentrated towards sharing Electronic Health Records. Other
investigations should be considered by blockchain researchers in domains such as
biomedical research, pharmaceutical supply chain, insurance. Furthermore, we
noticed that rarely are papers dealing with implementation details.
Even though, blockchain technology offers promising features, there is still
a need for more research to better understand, efficiently and securely develop
and evaluate this technology. Ongoing efforts have been conducted to overcome
limitations in scalability, security and privacy in order to improve stakeholders’
confidence in using this technology and to increase its adoption in healthcare.
References
1. Electronic health and medical records. https://www.healthit.gov/buzz-blog/
electronic-health-and-medical-records/emr-vs-ehr-difference
2. Ahram, T., Sargolzaei, A., Sargolzaei, S., Daniels, J., Amaba, B.: Blockchain technology innovations. In: IEEE Technology & Engineering Management Conference
(TEMSCON), pp. 137–141. IEEE (2017)
3. Bender, D., Sartipi, K.: HL7 FHIR: an agile and restful approach to healthcare
information exchange. In: Proceedings of the 26th IEEE International Symposium
on Computer-based Medical Systems, pp. 326–331. IEEE (2013)
4. Bocek, T., Rodrigues, B.B., Strasser, T., Stiller, B.: Blockchains everywhere - a
use-case of blockchains in the pharma supply-chain. In: IFIP/IEEE Symposium on
Integrated Network and Service Management (IM), pp. 772–777, May 2017
R. Ben Fekih and M. Lahami
controlled at this level. Moreover, scalability and interoperability issues represent the main focus of current and future studies in this field. Interoperability
challenge reveals the fact of missing standards for developing healthcare applications based on blockchain technology. Thus, the different developed applications
may not be able to interoperate. In addition, scalability is a major issue in
blockchain-based healthcare systems [18] especially towards the volume of medical data involved. Due to high-volume healthcare data, it is not practicable
to store it on-chain i.e. on blockchain, as this is may lead to serious performance degradation. Furthermore, there is a problem of latency caused by the
speed of transactions’ processing and off-chain data load in a blockchain-based
system. Finally, another weakness is related to blockchain immutability and selfexecution of code, since smart contracts could become vulnerable to hackers. Just
between 2016 and 2018, attacks such as the decentralized autonomous organization (DAO) attack cause a loss of millions of dollars as part of the assets held
by the smart contracts.
5 Conclusion
The present study gave an overview about the application of Blockchain in
Healthcare. In fact, due to the exponential growth of this technology, blockchain
has been applied in several use cases with the aim of enhancing the automation
of medical services.
Our study shows that the majority of researches applying blockchain in
healthcare are concentrated towards sharing Electronic Health Records. Other
investigations should be considered by blockchain researchers in domains such as
biomedical research, pharmaceutical supply chain, insurance. Furthermore, we
noticed that rarely are papers dealing with implementation details.
Even though, blockchain technology offers promising features, there is still
a need for more research to better understand, efficiently and securely develop
and evaluate this technology. Ongoing efforts have been conducted to overcome
limitations in scalability, security and privacy in order to improve stakeholders’
confidence in using this technology and to increase its adoption in healthcare.
References
1. Electronic health and medical records. https://www.healthit.gov/buzz-blog/
electronic-health-and-medical-records/emr-vs-ehr-difference
2. Ahram, T., Sargolzaei, A., Sargolzaei, S., Daniels, J., Amaba, B.: Blockchain technology innovations. In: IEEE Technology & Engineering Management Conference
(TEMSCON), pp. 137–141. IEEE (2017)
3. Bender, D., Sartipi, K.: HL7 FHIR: an agile and restful approach to healthcare
information exchange. In: Proceedings of the 26th IEEE International Symposium
on Computer-based Medical Systems, pp. 326–331. IEEE (2013)
4. Bocek, T., Rodrigues, B.B., Strasser, T., Stiller, B.: Blockchains everywhere - a
use-case of blockchains in the pharma supply-chain. In: IFIP/IEEE Symposium on
Integrated Network and Service Management (IM), pp. 772–777, May 2017