Florida International University, Miami, FL, United States.
Troy University, Troy, AL, United States.
J Med Internet Res. 2024 Sep 25;26:e46556. doi: 10.2196/46556.
Telehealth 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.
The 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.
We 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.
Our 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.
We 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.
远程医疗在 COVID-19 大流行期间发挥了关键作用，并且仍然是医疗保健的重要组成部分。现有的平台无法确保隐私和防止网络攻击。
本研究的主要目的是了解远程医疗平台中身份管理和可信通信过程中现有的网络安全问题，并设计一个集成区块链的软件架构，以提高安全性和可信度，并具有可接受的性能。
我们通过采用设计科学、社会科学和计算机科学在医疗保健领域的创新跨学科方法，并结合原型实现，提高了现有远程医疗平台中的个人信息安全性。我们使用设计科学研究方法来实现我们的整体设计。我们通过区块链集成对现有远程医疗平台进行了创新，从而提高了医疗服务的安全性、隐私性和效率。我们采用了以用户为中心的设计方法，从用户需求收集开始，然后进行系统功能开发。总体系统实现促进了用户需求，从而促进了用户采用去中心化身份管理和访问控制机制的远程医疗平台的行为。
我们的调查确定了当前医疗保健领域中远程医疗平台中身份管理和可信通信过程的关键挑战。通过采用分布式账本技术，我们提出了一个支持身份管理和可信通信过程的去中心化远程医疗平台。我们使用智能合约驱动的远程医疗平台进行设计和原型实现，以提供去中心化的身份管理和基于令牌的访问控制的可信通信，解决了几个安全挑战。这通过在 Rahasak 区块链网络中的 5 个对等体上进行的 10000 次模拟交易测试得到了证实。所提出的设计在提供抵抗常见攻击的同时保持线性时间开销，从而提高了远程医疗服务的安全性和效率。我们根据事务吞吐量、智能合约执行时间和块生成时间评估了性能。创建包含 10000 笔交易的块平均需要 8 秒，这对于基于区块链的应用程序来说是可以接受的开销。
我们确定了当前远程医疗平台的技术限制。我们使用区块链提出了一些设计创新，以对系统进行原型设计。我们还介绍了用于可信通信系统的独特分布式架构的实现细节。我们说明了如何克服隐私、安全和可扩展性限制。此外，我们说明了如何改善这些因素为改进和标准化应用程序以及广泛采用基于区块链的远程医疗平台奠定了基础。
