Designing A Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach
BackgroundTelehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks. ObjectiveThe main objectives of this study are to unders...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2024-09-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2024/1/e46556 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850262483480084480 |
|---|---|
| author | Xueping Liang Nabid Alam Tahmina Sultana Eranga Bandara Sachin Shetty |
| author_facet | Xueping Liang Nabid Alam Tahmina Sultana Eranga Bandara Sachin Shetty |
| author_sort | Xueping Liang |
| collection | DOAJ |
| description |
BackgroundTelehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks.
ObjectiveThe main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication processes in telehealth platforms and to design a software architecture integrated with blockchain to improve security and trustworthiness with acceptable performance.
MethodsWe improved personal information security in existing telehealth platforms by adopting an innovative interdisciplinary approach combining design science, social science, and computer science in the health care domain, with prototype implementation. We used the design science research methodology to implement our overall design. We innovated over existing telehealth platforms with blockchain integration that improves health care delivery services in terms of security, privacy, and efficiency. We adopted a user-centric design approach and started with user requirement collection, followed by system functionality development. Overall system implementation facilitates user requirements, thus promoting user behavior for the adoption of the telehealth platform with decentralized identity management and an access control mechanism.
ResultsOur investigation identified key challenges to identity management and trustworthy communication processes in telehealth platforms used in the current health care domain. By adopting distributed ledger technology, we proposed a decentralized telehealth platform to support identity management and a trustworthy communication process. Our design and prototype implementation using a smart contract–driven telehealth platform to provide decentralized identity management and trustworthy communication with token-based access control addressed several security challenges. This was substantiated by testing with 10,000 simulated transactions across 5 peers in the Rahasak blockchain network. The proposed design provides resistance to common attacks while maintaining a linear time overhead, demonstrating improved security and efficiency in telehealth services. We evaluated the performance in terms of transaction throughput, smart contract execution time, and block generation time. To create a block with 10,000 transactions, it takes 8 seconds on average, which is an acceptable overhead for blockchain-based applications.
ConclusionsWe identified technical limitations in current telehealth platforms. We presented several design innovations using blockchain to prototype a system. We also presented the implementation details of a unique distributed architecture for a trustworthy communication system. We illustrated how this design can overcome privacy, security, and scalability limitations. Moreover, we illustrated how improving these factors sets the stage for improving and standardizing the application and for the wide adoption of blockchain-enabled telehealth platforms. |
| format | Article |
| id | doaj-art-90b397cba4d447e0af37db03066b79bd |
| institution | OA Journals |
| issn | 1438-8871 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-90b397cba4d447e0af37db03066b79bd2025-08-20T01:55:11ZengJMIR PublicationsJournal of Medical Internet Research1438-88712024-09-0126e4655610.2196/46556Designing A Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary ApproachXueping Lianghttps://orcid.org/0000-0002-8764-9966Nabid Alamhttps://orcid.org/0000-0001-5684-1528Tahmina Sultanahttps://orcid.org/0000-0002-7373-4422Eranga Bandarahttps://orcid.org/0000-0003-3214-5346Sachin Shettyhttps://orcid.org/0000-0002-8789-0610 BackgroundTelehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks. ObjectiveThe main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication processes in telehealth platforms and to design a software architecture integrated with blockchain to improve security and trustworthiness with acceptable performance. MethodsWe improved personal information security in existing telehealth platforms by adopting an innovative interdisciplinary approach combining design science, social science, and computer science in the health care domain, with prototype implementation. We used the design science research methodology to implement our overall design. We innovated over existing telehealth platforms with blockchain integration that improves health care delivery services in terms of security, privacy, and efficiency. We adopted a user-centric design approach and started with user requirement collection, followed by system functionality development. Overall system implementation facilitates user requirements, thus promoting user behavior for the adoption of the telehealth platform with decentralized identity management and an access control mechanism. ResultsOur investigation identified key challenges to identity management and trustworthy communication processes in telehealth platforms used in the current health care domain. By adopting distributed ledger technology, we proposed a decentralized telehealth platform to support identity management and a trustworthy communication process. Our design and prototype implementation using a smart contract–driven telehealth platform to provide decentralized identity management and trustworthy communication with token-based access control addressed several security challenges. This was substantiated by testing with 10,000 simulated transactions across 5 peers in the Rahasak blockchain network. The proposed design provides resistance to common attacks while maintaining a linear time overhead, demonstrating improved security and efficiency in telehealth services. We evaluated the performance in terms of transaction throughput, smart contract execution time, and block generation time. To create a block with 10,000 transactions, it takes 8 seconds on average, which is an acceptable overhead for blockchain-based applications. ConclusionsWe identified technical limitations in current telehealth platforms. We presented several design innovations using blockchain to prototype a system. We also presented the implementation details of a unique distributed architecture for a trustworthy communication system. We illustrated how this design can overcome privacy, security, and scalability limitations. Moreover, we illustrated how improving these factors sets the stage for improving and standardizing the application and for the wide adoption of blockchain-enabled telehealth platforms.https://www.jmir.org/2024/1/e46556 |
| spellingShingle | Xueping Liang Nabid Alam Tahmina Sultana Eranga Bandara Sachin Shetty Designing A Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach Journal of Medical Internet Research |
| title | Designing A Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach |
| title_full | Designing A Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach |
| title_fullStr | Designing A Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach |
| title_full_unstemmed | Designing A Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach |
| title_short | Designing A Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach |
| title_sort | designing a blockchain empowered telehealth artifact for decentralized identity management and trustworthy communication interdisciplinary approach |
| url | https://www.jmir.org/2024/1/e46556 |
| work_keys_str_mv | AT xuepingliang designingablockchainempoweredtelehealthartifactfordecentralizedidentitymanagementandtrustworthycommunicationinterdisciplinaryapproach AT nabidalam designingablockchainempoweredtelehealthartifactfordecentralizedidentitymanagementandtrustworthycommunicationinterdisciplinaryapproach AT tahminasultana designingablockchainempoweredtelehealthartifactfordecentralizedidentitymanagementandtrustworthycommunicationinterdisciplinaryapproach AT erangabandara designingablockchainempoweredtelehealthartifactfordecentralizedidentitymanagementandtrustworthycommunicationinterdisciplinaryapproach AT sachinshetty designingablockchainempoweredtelehealthartifactfordecentralizedidentitymanagementandtrustworthycommunicationinterdisciplinaryapproach |