CC BY
24POLITICAL SCIENCES
BLOCKCHAIN TECHNOLOGY IN HEALTHCARE MANAGEMENT
Makarenko M.
Candidate of Medical Sciences, Director of MM-Dental Clinic, candidate for the degree of Doctor of Science, Taras Shevchenko National University of Kyiv ORCID: 0000-0001-8677-8670
ABSTRACT
The article examines the use of blockchain technology in healthcare, analyzes the security of medical information networks, as data preservation is one of the main tasks of public health management, so the security of medical data must be at the highest level of cyber security.
It was found that the distributed blockchain architecture makes it impossible to interfere with the structure of the registry, because it requires simultaneous access to copies of the existing database on all nodes of the network. It has been proven that blockchain technology allows to protect the information contained in the database due to the irreversibility of the hashing process (encryption and creation of relationships).
When you try to make changes to the source document or transaction - another digital signature (signature) is formed, signaling an intervention in the data structure. It has been established that the countries of the European Union are actively implementing blockchain technology when entering medical data into medical databases, as the technology of distributed registry allows to accumulate information throughout the life of patients.
Blockchain technology has proven to be a reliable tool for ensuring the confidentiality of medical information and data integrity in hospital databases and registries.
Keywords: public administration, distributed registry technology healthcare, blockchain, healthcare management.
Formulation of the problem. Attacks by cyber-criminals or hackers in the age of the Medical Internet of Things (IoМT) are a major concern, which is why the security of medical data must be at the highest level of IT protection. In this regard, an extremely important task at the present stage is to make decisions that will ensure the security of medical information systems, strict response to data breaches, improvement of cyber security technology and appropriate financial support from the state [1].
Presentation of the main material of the study with a full justification of scientific results. Block-chain is a way of storing data or a digital register of any data, transactions, agreements, contracts, etc., and requires the use of separate independent records. Digital records are combined into "blocks", which are then cryptographically and chronologically combined into a digital "chain" using appropriate mathematical algorithms. Each existing "block" is related to the previous one and includes a certain set of digital records, but new "blocks" are always added to the end of the chain of operations (transactions). The main technological advantages of blockchain are: network decentralization; distribution of information storage; openness; crypto security; history control [2].
An important process of this technology is encryption, the purpose of which is to build unique identifiers of input data sets of arbitrary length by transforming them into an output series of fixed length, performed simultaneously by a large number of nodes (computers) of peer-to-peer network, so-called hashing. If as a result of hashing they receive the same result, then a new block of data is assigned a unique digital signature
(from the Latin signatura - definition) or a digital signature (a certain number of characters). In addition, if the transaction has pre-linked states or records, the block structure has a hash relationship with those records.
Since the registry update takes place on all network nodes simultaneously with the subsequent fixation (formation) of a new block, which cannot be deleted or changed in the future, this makes it impossible to fake its content, creating much-needed cyber protection. After the formation of a new block in the system (registry), it remains unchanged, and in the future it is only possible to add new blocks associated with it. This property provides transparency in the maintenance of medical records and registers and the necessary internal control in the provision of medical services.
The distributed blockchain architecture makes it impossible to tamper with the structure of the registry, since it requires simultaneous access to copies of the existing database on all nodes of the network. The blockchain allows you to maximally protect the information that is contained in the database due to the irre-versibility of the hashing process (encryption and creation of relationships). When you try to make changes to the original document or transaction, another digital signature (signature) is generated, signaling tampering with the data structure [3].
At the present stage, more and more industries need more and more control and protection, including the healthcare sector. Blockchains have been introduced to protect medical databases and registries, in order to prevent unauthorized access and changes in patient information [4].
The countries of the European Union are actively implementing blockchain technology when entering medical data into medical databases, as distributed registry technology allows the accumulation of information throughout the life of patients. Here are some successful examples of the implementation of Block-chain technology.
The Estonian eHealth Foundation uses Oracle technology to process and store patient records, where the KSI Guardtime system integrates into the Oracle information system, providing increased security, transparency, verification and management of the electronic system and digital patient card management, including protection against hacker attacks, system failures, malicious virus programs, etc. In case of unauthorized access and change of data, the system automatically creates an updated record, which allows you to restore the history of records. The records themselves are not stored on the blockchain, and only a series of their hash values are recorded, in which information about changes is displayed [5].
The U.S. Department of Health and Human Services (HHS) is also concerned about the global health issue of information confidentiality, data change, and reliability. The embedded BitHealth system uses Blockchain Bitcoin technology to store and securely transmit healthcare data around the world. The data is distributed internationally using peer-to-peer file sharing technology similar to Bit Torrent. In case of interruptions with the Internet, the data is obtained from the local node. Users can create public and private keys and encrypt data using a public key to store records in a blockchain.
The U.S. Department of Health and Human Services (HHS) is also concerned about the global health issue of information confidentiality, data change, and reliability. The embedded BitHealth system uses Blockchain Bitcoin technology to store and securely transmit healthcare data around the world. The data is distributed internationally using peer-to-peer file sharing technology similar to Bit Torrent. In case of interruptions with the Internet, the data is obtained from the local node. Users can create public and private keys and encrypt data using a public key to store records in a blockchain [6].
The UK National Health Service (NHS) in a joint project with Deep Mind Health, a subsidiary of the US multinational company Google, based on Google AI, began in 2017 to use a new technology based on bitcoin, which will allow British hospitals and the NHS and even keep track of what happens to patients' personal data in real time. "Verifiable Data Audit", literally "Authentic Data Audit", is the name of the created special digital register, which automatically and cryp-tographically records each transaction with patient data with the ability to verify. This means that any changes or access to the data is under control.
In an interview with The Guardian, DeepMind spoke about the possibilities of the new registry: As in the blockchain, data will only be added to the central database (main registry), and once an entry is added, it will no longer be erased. Like the blockchain, the central database will allow third parties to verify that no
one interferes with any of the records. Technology solutions will not be the only answer, but they are an important part of developing reliable systems that give people more confidence in how their data is used [7].
The opportunities of the new technology were used by the Dutch innovation company REshape Center in cooperation with SNS Bank and the auditing company Deloitte and developed a joint banking application PreScrypt. Chronic patients will be able to use the application based on the iDIN-online authentication service to purchase permanent medicines with digital prescriptions [8].
The American StartUp Gem has started cooperation with Philips, launching the Gem Health project -an initiative to create a "patient-oriented approach to health care" based on Blockchain technology. Gem Health and Philips Blockchain Lab have joined forces to provide a data infrastructure to support the "global integrated health continuum." The project brought together companies working at all levels of health care. Clinical data, application processing, pharmaceutical supply chains, Internet health, universal medical identification information, and genome data management are the areas in which Gem Health conducts research. Blockchain technology solves the trade-off between personalized assistance and costs by connecting the ecosystem to the shared infrastructure. Shared infrastructure allows global standards to be created without compromising privacy and security. Most blockchain projects in the field of the Internet of Things are at different stages of development, some of them are close to real results.
Ambrosus is one such project, providing a secure and seamless dialogue between sensors, decentralized registers and databases. This allows you to optimize the supply chain, ensuring process transparency and quality assurance. Used for the pharmaceutical business, which needs more transparency and better quality [9].
IOTA - development for maintenance and creation of Internet of Things projects based on blockchain. IOTA is not a blockchain in terms of concept. In her work, she uses the decentralized magazine Tangle, which works on the basis of the DAG system. Ether blockchain or bitcoins are created using new blocks, while IOTA uses a special transaction scheme: any new transaction (A) performs work to confirm the two previous transactions (B and C). The platform is actively developing and is already cooperating with large companies: Volkswagen, Samsung, Fujitsu, Volkswagen, Microsoft and Bosh [10].
The Slock.it project aims to ensure transparency and audit of real-world objects. With the growth of IoT technology, offering these features to objects has become much easier. More and more devices are connected to the Internet, which makes it easier to bridge the digital divide. The IoT Chain project addresses data transfer issues and a low security system. Data security is ensured by an asymmetric encryption system. Stably high exchange rates are achieved using the PBFT architectural protocol [11].
CPChain (CPC) is a project that specializes in managing the Internet of Things. Its main difference from other projects is the "depth of immersion" and
"width of coverage". For example, if you imagine a house that works on the system of "smart home", then CPChain will combine all such houses in the city. Its task will be to service and support the operation of individual system resources. CPChain aims to solve the problem of scale with the help of blockchain technologies.
Of course, when a device (such as a smartphone) interacts with a blockchain, the entire network node must work to communicate, because each of them supports the same data or performs the same tasks. In contrast, CPChain works with a parallel architecture using two parallel blockchains. For example, when a smartphone interacts with a network, one blockchain stores part of the smartphone's data, and the other blockchain ensures the operation of any transaction or creation of smart contracts. This significantly improves the speed of transactions and increases the scale of change [12].
Conclusions and prospects for further research. Thus, digital technology is a unique phenomenon that has completely changed the lifestyle of every inhabitant of the planet in recent decades. Researchers claim that the introduction of technological innovations will be faster every year. Blockchain technology has proven to be a reliable tool for ensuring the confidentiality of medical information and guaranteeing the integrity of data in hospital databases and registries. The use of blockchain systems in the field of management in the medical field will make it transparent, which not only prevents abuse, but also helps increase public confidence in modern digital technologies.
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