Future pHealth Ecosystem-Holistic View on Privacy and Trust.

Modern pHealth is an emerging approach to collecting and using personal health information (PHI) for personalized healthcare and personalized health management. For its products and services, it deploys advanced technologies such as sensors, actuators, computers, mobile phones, etc. Researchers have shown that today's networked information systems, such as pHealth ecosystems, miss appropriate privacy solutions, and trust is only an illusion. In the future, the situation will be even more challenging because pHealth ecosystems will be highly distributed, dynamic, increasingly autonomous, and multi-stakeholder, with the ability to monitor the person's regular life, movements, emotions, and health-related behavior in real time. In this paper, the authors demonstrate that privacy and trust in ecosystems are system-level problems that need a holistic, system-focused solution. To make future pHealth ethically acceptable, privacy-enabled, and trustworthy, the authors have developed a conceptual five-level privacy and trust model as well as a formula that describes the impact of privacy and trust factors on the level of privacy and trust. Furthermore, the authors have analyzed privacy and trust challenges and possible solutions at each level of the model. Based on the analysis performed, a proposal for future ethically acceptable, trustworthy, and privacy-enabled pHealth is developed. The solution combines privacy as personal property and trust as legally binding fiducial duty approaches and uses a blockchain-based smart contract agreement to store people's privacy and trust requirements and service providers' promises.