In modern era, the internet of things (IoT) has transfigured the medical industry, empowering the unified collection and exchange of patient data. However, this increased connectivity has raised significant concerns regarding the safety and confidentiality of electronic healthcare records (EHRs). This systematic review explores the security and privacy issues surrounding IoT-based EHRs and presents an in-depth analysis of how blockchain technology can be employed as an effective countermeasure to address these challenges. The chapter provides an overview of IoT in healthcare, highlights the vulnerabilities of EHR systems, and discusses the potential threats to patient data. It then delves into the principles of blockchain technology and its applicability to enhance EHR security and privacy. Various blockchain-based solutions and implementations are reviewed, and their advantages and limitations are discussed. This systematic review investigates the incorporation of IoT with EHRs in healthcare and contributes towards better understanding of the synergy between IoT, EHRs, and blockchain in the healthcare industry and assists as a valuable supplement for academics, practitioners, and policymakers. Additionally, the survey presents case studies and real-world examples of successful blockchain integration into healthcare systems. Finally, this chapter concludes by outlining the future prospects and challenges of utilizing blockchain technology for securing IoT-based EHRs and emphasizes the importance of a holistic approach to safeguarding patient data.
Top1. Introduction
The healthcare industry is undergoing a paradigm shift from traditional to innovative technologies, for example the Internet of Things (IoT) and blockchain (Endale Mitiku Adere et.al.,2022, Geetha et al.,2024). Electronic Health Records (EHRs) have become an integral part of modern healthcare systems, enabling seamless storage and exchange of patient data (Aste T et al., 2017). IoT devices, ranging from wearable gadgets to medical sensors, have further enriched the healthcare landscape by providing real-time health monitoring and personalized patient care (P. De Filippi et al., 2020, Swan M et al., 2015).
However, the integration of IoT devices with EHRs presents several challenges, including ensuring data security, privacy, and interoperability. Traditional EHR systems are vulnerable to data breaches and tampering, raising concerns about the confidentiality and integrity of patient information (Eberhardt J et al., 2017). Moreover, the diverse nature of IoT devices poses a challenge in standardizing data formats and communication protocols for effective integration with EHRs.
1.1 Background and Motivation
Blockchain technology, renowned for its decentralized and immutable nature, proposed an effective answer to these mentioned challenges. By leveraging blockchain, healthcare providers can establish a protected system to manage IoT-generated data within EHRs (Kohli R et al., 2016, Roman-Belmonte JM et al., 2018). Blockchain ensures data integrity, enhances security through cryptographic techniques, and enables seamless data sharing among stakeholders while maintaining patient privacy.
The motivation behind this systematic review stems from the urgent need to explore the intersection of IoT, EHRs, and blockchain technology in the healthcare industry. The medical industry positions at the height of a transformative era, determined towards the convergence of innovative technologies. Among these, the Internet of Things (IoT) and blockchain technology have emerged as pivotal forces reshaping the landscape of healthcare industry. Electronic Health Records (EHRs) have long been the cornerstone of modern healthcare systems, streamlining patient data management and enabling efficient medical services. The amalgamation of IoT devices along with EHRs had unlocked unprecedented opportunities for real-time monitoring, personalized treatment plans, and data-driven decision-making (Angraal S et al., 2017). However, this integration poses significant challenges, particularly concerning data security, integrity, and interoperability.
The rapid proliferation of IoT devices, ranging from wearable health trackers to sophisticated medical sensors, has ushered in an era of continuous and remote patient monitoring. These devices generate vast amounts of real-time health data, offering invaluable insights into patient well-being (T.-T. Kuo et al., 2017). Concurrently, blockchain technology, originally devised as the underlying architecture for cryptocurrencies, has found diverse applications across various sectors. In the realm of healthcare, blockchain offers a decentralized, secure, and immutable platform for managing sensitive patient information. By integrating IoT devices with blockchain-enabled Electronic Health Records (IoT-based EHRs), healthcare providers can confirm the truthfulness and confidentiality of outpatient information while enabling seamless data sharing among authorized stakeholders.