ABSTRACT
An identity-based cryptosystem called signcryption is investigated in this study in order to efficiently and securely exchange healthcare information inside a data-sharing network, utilizing the idea of bilinear pairings. A distributed tamperproof database protects all health records and is uploaded to it and replicated over a group of nodes that are linked to form a peer-to-peer network. As a result, each health record is treated as an individual event that is time stamped and assigned a cryptographic hash. On a similar note, transaction blocks include all the record events. Every node in the network has a copy of the ledger of hashed records and events. Additional information such as user permission lists are also included in this health care blockchain network, which serve as instructions for the network. To guarantee the data integrity of EHRs, this article provides security for exchanging EHRs across medical institutions and inside the organization, and ultimately safe exchange of EHRs by removing a third-party trustworthy third-party provider. Various cryptographic methods are being utilized on the blockchain in order to ensure security for the exchange of health care data. Signcryption is utilized in the suggested design approach for secure health care data exchange.
Introduction
The blocks that are made to form a transaction of distributed ledger is known as Blockchain. In blockchain networks, validators (also known as miners) verify the transactions included in each block. Data integrity, transparency, and immutability were the interesting properties in many data structures. Hence, in the modern era, digital trust is considered as the technology of Blockchain. Blocks of each contain Merkle roots, nonce (in the network with various levels that can maintain the random number), timestamp (generation of time), and HASH (in the block data that can be generated in the digital message). A genuine transaction has to verify the validators that are well known for node certain as there will be. The network runs under the amount of money with certain data under certain credits that will incentivized in these validators. The network successfully in the block for adding that can reward in these and the transaction fee that can be collected under the rewarded in the validators in the Blockchain bitcoin for instances. A consensus that can achieve which leads and the network run in these validators under these can be incentive under the fact. The financial sector from the field apart under to many extended can be in such properties of interesting with the mechanism.
represents the accessing and requesting of EHR data in personal healthcare data that is very sensitive as many patients will be very reluctant to share health data.
Figure 1. Accessing and requesting the EHR.
By this mechanism, (Akins, Chapman, and Gordon Citation2013) Blockchain influences Healthcare data management is one such field that can be more influenced by this Blockchain mechanism. To share healthcare data, they are very reluctant with many patients, and they are very sensitive to the data of healthcare personal while dealing (Ekblaw et al. Citation2016). However, the research institute as well as the patient uses more data healthcare in sharing it (Fan and Zhang Citation2019). Discoveries of Scientific many more data used under the institution research first of all. The remote location has various access useful that can share the data with patients (Foroglou and Tsilidou Citation2015). Health institutes among different that can be shared in the data healthcare that can be provided under security which focuses the main work (Abdellatif et al. Citation2021).
The main contribution of this study is the development of a blockchain-based network for the secure exchange of medical data in the healthcare system (Ilakkiya and Rajaram Citation2023). This system utilizes an identity-based cryptosystem called signcryption to efficiently and securely exchange healthcare information within a data-sharing network (Lin and Koo Citation2016). The study evaluated the system through the evaluation of various cryptographic methods, and the results showed that the larger the block size and arrival rate, the higher the throughput (Nakamoto Citation2008).
The use of blockchain technology improves the security, privacy, and efficiency of medical data exchange in the healthcare system(Nalla and Reddy Citation2003). Additionally, the study also proposes an identity-based cryptosystem called signcryption to efficiently and securely exchange healthcare information within a data-sharing network (Noyes Citation2016).
The remaining sections of the paper are organized as follows; section 2 discusses the existing studies related to healthcare data using blockchain. Section 3 compared the proposed methodology (Peters, Panayi, and Chapelle Citation2015). Section 4 details the performance analysis of the proposed approach. The conclusions are given in section 6.
Related Work
This Section using Blockchain in the data field in healthcare under the literature work as present, the research work can be broadly categorized into the following types: 1) healthcare data sharing using blockchain, 2) health insurance claiming using blockchain, and 3) using the blockchain data healthcare under management personal (Peterson et al. Citation2016). From 2004 to 2014 data sharing healthcare was done in the research work, it can be focused on 8 main parameters transparency, auditability, authenticity data, authentication user, integrity, control access, privacy, and confidentiality. The cryptography curve using elliptical data sharing for healthcare on providing security has been done till work now. In this work, cryptography under the identity and scheme signcryption from paring the bilinear concept using data sharing healthcare is secure the Blockchain network to design under the aim. In data sharing, computationality is effective in the technologies that have been approached. shows the general EHR management without using the distributed system. The system management HER that exists observed the demerits as follows: Security, privacy lack, issue recoverability data, issue interoperability, identification for user to take more time and failure single point. In the plaintext form the central database will be stored under health record, and EHR management under the form in way of the classic. The required EHR will be requesting the user under the database that can access the data needed (Reegu, Daud, and Alam Citation2021). Kevin Peterson et al. (Citation2016), proposed Network Exchange Information Health under the approach based on Blockchain to address medical institution patients, the multiple network blockchain that can be adopted among, centralized still under Master Patient Index (MPI), the problem under EHR standardization, EHR interoperability, security, interoperability proof that can be addressed. Divya Nalla et.al proposed ID-based Signcryption based on bilinear pairings on elliptical curves that provides confidentiality, authenticity, non-repudiation and forward secrecy for the user data. They claimed the proposed method is a more efficient scheme that can be improved than the current one. ID-based group signatures are another aspect to be worked on. Anastasia Theodouli. et.al proposed the blockchain system addresses the proof of interoperability that facilitates the effective sharing the healthcare data privately and auditable the data and, handling of permission to access, centers research medical, patients, in medical field boosting in extensive., Xiao Yue. et.al proposed the Novel Privacy Risk Control on Healthcare Data using Blockchain. Their work is based on MPC (Secure Multi-Party Computing), EHR that can control the patient by privacy, and security that can be provided, with other HDGs can communicate with HDGs, institution research, hospitals and Patients.
Movassagh et al. (Citation2021), Reegu et al. (Citation2022) the neural network input coefficient is determined with the aid of ANN, which is important in this domain. The major objectives of the research being discussed were to increase the accuracy of perceptron neural networks and train neural networks using meta-heuristic methods. The neural network input coefficients were calculated using an integrated technique.
Alzubi et al. (Citation2021), Sharples, and Domingue (Citation2015). introduces a unique blockchain and artificial intelligence-enabled secure medical data transmission. The BAISMDT model’s objective is to provide security and privacy during dependable data transfer for IoT networks. The suggested strategy uses signcryption to reliably and securely transfer data across various data sources. To detect the presence of illness, a modified discrete particle swarm optimization technique with a wavelet kernel extreme learning machine model is used. To provide a safe and dependable environment for data transfer, the blockchain approach is used. In healthcare IoT networks, the BAISMDT paradigm offers a safe and dependable method of data transmission.
Alzubi et al. (Citation2022), Sugumaran and Rajaram (Citation2023) new privacy-preserving encryption with DL-based medical data transmission and classification (PPEDL-MDTC) model was presented. The proposed model used multiple key-based homomorphic encryption techniques with the Sailfish optimization algorithm to carry out an encryption process. Additionally, a cross-entropy-based Artificial Butterfly Optimization-based feature selection technique and an Optimal Deep Neural Network-based classification were used.
Lv et al. (Citation2022)explored combining different deep learning algorithms with edge computing that helps to analyze and process real-time power usage information generated by the massive number of Internet of Things being used in smart microgrids. The aim was to improve the efficiency of information transmission and processing in power systems.
Alzubi (Citation2021) proposed a blockchain-assisted highly secure system for medical IoT devices using Lamport Merkle Digital Signature, aiming to improve patients’ lifestyles and minimize time and cost by efficiently managing medical resources. The system used a Lamport Merkle Digital Signature Generation model to authenticate IoT devices by constructing a tree with the leaves symbolizing the hash function of sensitive patient medical data. A Centralized Healthcare Controller then determined the root of the LMDSG by using Lamport Merkle Digital Signature Verification. This system was designed to protect patient data from malicious users.
Proposed Work
The sharing of health data is very reluctant which will be sensitive for most of the patient’s health care data in a deal under personal record. The research institute, as well as the patient, were used to have many files of data of healthcare that have been shared. Scientific discoveries for more data have been used in all research institute. From different remote locations, the healthcare data can be accessed under the data sharing of patients. Different health institutes shared the healthcare data for providing security on the main focus on work. Multiple certifying authorities on the blockchain network offer authentication and permission. To ensure data integrity in this suggested approach, electronic health records are hacked before being stored on the blockchain. These suggested efforts are aimed at protecting the data integrity of EHRs, ensuring security for sharing EHRs across various medical institutions and inside an organization, as well as removing the trusted third party from EHR sharing transactions. Various cryptographic methods are being utilized on the blockchain to ensure security for the exchange of healthcare data. Signcryption is utilized for secure healthcare data exchange in the suggested design approach. Each step of cryptography is described in depth in this section.
shows the blockchain approach in electronic healthcare records for the security and privacy of patient data.
Figure 2. EHR process using Blockchain.
Cryptographic Primitives of the Proposed System
Identity-based cryptography (IBC): Early on in cryptography, Public Key Infrastructure (PKI) was used to link public keys with user identities. IBC was developed to streamline the certificate administration process. Public-key cryptography, IBC is a kind of IBC. In for example, the IBS (identity-based signature scheme) and IBE algorithms are included (identity-based encryption). In identity-based settings eliminate the need for public key management, simplifying the PKI needs in the process. In it is possible to create a “public key” for a person using a simple public string such as a name or e-mail address instead of using the long strings required in traditional PKI. “Public keys” become more efficient and easier to use as well as getting rid of useless “public keys.” In the user can select his private key in identity-based cryptography Private key for the user in IBC is generated using the identification string and master secret key of the PKG. However, IBC has one restriction, which is that PKG must have a high assurance level. All private keys are stored in the private key generator (PKG); thus, it needs a greater degree of assurance and availability than a certificate authority (CA) (certificate authority).
Figure 3. Chaincode for enroll Admin.
Figure 4. Creating patient in Chaincodee.
Figure 5. Register patient into the Blockchain.
Figure 6. Storing the patient EHR into the blockchain with ID.
Signcryption Using IBC
Signcryption is a public-key primitive that simultaneously performs the functions of both encryption and digital signature. This provides the features of both digital signature and encryption in a much more efficient way than signing and encrypting separately. Signcryption consists of three algorithms mainly such as setup (Key Generation), signcryption, and Unsigncryption.
Setup: this is the first step in the signcryption procedure where PKG (private key generator) runs a probabilistic algorithm. In this algorithm, a security parameter is given as an input, and “system parameters and master key” are provided as output. PKG makes system parameters public and hides the master key.
Signcrypt: The sender runs this probabilistic signcryption algorithm in which the message to be sent, the sender’s private key, receiver’s public key then outputs the cypher text.
Unsigncrypt: The receiver runs this deterministic algorithm. It takes in the cipher text, the sender’s public key and the receiver’s private key then provides the original plain text or message as the result. It may give output as a ⊥symbol of the cypher text that is not in the proper manner or invalid between the designated sender and the receiver.
Distributed Authentication and Identification Using Signcryption IBC
To improve the security and efficiency of the application, the authority of the single PKG is distributed among four kinds of CA’s here. Those CA’s are named RA, ECA, LS-CA, and TCA. All of these certificate authorities issue a variety of certificates after verifying the validity of the user’s identification credentials. All of these certificates are essential to the proposed healthcare blockchain application’s distributed authentication.
System Architecture of the Proposed Permission Healthcare Blockchain Network
This section presents the system architecture of the proposed network healthcare permission. Securely, the Electronic Health Record (EHR) has been stored more efficiently than has been provided in the Blockchain. The timestamp attached was included in EHR specific that has occurred in the previous transaction to trace back with the facilities that have also been provided. It has three modules that were proposed in the blockchain of healthcare under the overall architecture, they are users, off-chain database, and healthcare blockchain. The application of healthcare blockchain has been proposed in this, health insure or administrators pharmacists doctors or patients can be the users. The application of healthcare blockchain was permission with the responsibilities of various kinds of habits. The off-chain database presents the information and record of electric health that is defined as modified and data history that contains healthcare blockchain. Prescription and billing were regarding information, the original EHR contains the database off-chain. Data repository independent under the database off-chain. Disease prevention is under research and patient data has been analyzed for further valuable tools that would be with entire information. Sized information with the limited for dealing and suitable especially under the blockchain. The problems of data redundancy and cost management increase the blockchain on the blocks of data in having a vast amount of data. The entire HER has been used to store the database off-chain to avoid the problem. Healthcare blockchain permissions were proposed as transactions that can save and track the EHR to this performed modification. On the platform, blockchain is to keep kept number of peers with no limit. The ledger distribution is under the individual copy that will contain each peer. Eventual ledger distributed under consistency that has been useful to maintain. The transaction insider was certainly linked to having a blockchain that consists of a ledger. The database off-chain proposes any sort of query or HER that requests creation or EHR (Electronic Healthcare Record) that made the change under this transaction.
Remaining peers or not with all the matching system weather to verify and transaction in make to follow to set the rule in certain that has been defined under the control policy to access the associate each peer. The code attached the some systems under these peers inside any operation to execute it. Smart contracts in termed as technique codes that specific systems. The chain code that will be called the fabric platform hyperledger
EHR Generation and EHR Sharing in the Healthcare Blockchain
Once the Patient Registration is enrolled successfully, the issued certificate with platform blockchain healthcare to access to get permission that will be patient. The blockchain network under the EHR sharing and an EHR for the transaction to create procedure operational different represent the process to following. Onto the EHR has been stored the information related to health that provided the patient with a client application that is used specifically. Using the POST method, peers validating or endorser on the function chain code involved to the proposed transaction for request that creates the client. The client that passed the back transaction result has been produced to get executed to invoke the chain code. The transaction proposal that produced the result to verify the client application is already defined under control policy according to access. The service order to endorse transaction to send application client. Transaction block per channel generated and by channel chronological manner in the endorsed transaction to send application client. On the channel to all the peers that are broadcasted the transaction order block under validation purpose. State database onto the current to save the EHR record the chain the block to append for every peer. The client application emitted an event to create the EHR that eventually notified the function. The following figure represents the EHR creation.
Distributed Ledger Storage of the Healthcare Blockchain Application
This section presents the storage of EHR in the form of a blockchain and world state with two parts that contain a basic ledger structure. The ledger in the current state that means the world state. The time point specific to give the ledger in the transaction to snapshot with the world state. The transactions varied according to keep state world. The format of JSON (JavaScript Object Notation) has been framed as the data chain code that supports query advanced that provide the state database efficient and popular DB couch. Based on the queries, the content is implemented to order in format JSON that has been framed the data should the couch DB under the content or information to get it. The entire network has logged transactions in the entire Blockchain. That is needed to log the entire transaction to traverse the process and avoid utilizing the time efficiency to make a ledger structure in the world state. It is needed each time under the entire transaction traveling process to avoid utilizing the time efficiency that makes the structure ledger in the world state. It has been occupied under time stamps including the sequence manner to the world state to make changes and simple operations that are stored in the data structure in the Blockchain in the world state. In timely order in the form chain is linked together cryptographically in those blocks and blocks that group all the transactions in the blockchain. The blocks together linked cryptographically under those blocks. With specific that will be associated with each block key and value pair. The hash tables stored in the world state the value pair of these keys. The number of blocks that pre-decided that will be having these hash tables. To be executed will be the hash function under there the key presents the bucket number required to find. Chain code is the terms and the blockchain network in the smart contract. In the network, every node each to be distributed as a transaction that can be provided in this chain code. Generally, the validator is managed, and the sandbox is separated to keep the chaincode. The chain code to run is used to contain the docker.
Querying the EHR in Healthcare Blockchain Application
The subsection represents the querying of the EHR from the doctor by providing the input patient ID in the state database from the EHR from querying the API endpoint that requests using the GET method. The membership services to the transaction submit that would not the platform local database in their ledger to keep to the peers only under the ledger for the request queries that chain code associate. It required with no process consensus, in their database local that already presented as the information. They provide immediate under the proposed query as the result.
Implementation and Result Analysis
The section in Hyperledger that has been implemented under the proposed work presents provides our application services such as the registration of various entities and verification of those entities. In this application, user permits the network blockchain like doctors, patient hospitals, and other hospitals to enroll the entire hospital entities for authorization in private key and public, as well as a certificate in signing for creation in responsible with MSP trusted through the network and CA Certificate Authority through verification.
Registration Component and Enrollment Component
The user registration process starts with a request from the client. The client sends the registration request on the user’s behalf to the RA (registration certificate authority).
RA provides the registration form to the client.
The client fills out the registration form by providing the required identity credentials on behalf of the user and sends it back to the RA.
RA stores the user information regarding the registration form in its local storage. Then provide the client username, and password (registration id). Registration is created by hashing the client’s username as a public key.
The user enrollment process starts with the enrollment request from the client to the ECA(Enrollment CA).
ECA asks for the registration id (R.id).
Client provides the R.id. Then the ECA checks in the database whether that R.id is valid or not.
If it exists in the database, it notifies back the client that it’s enrolled and provides, the enrollment id (E.id).
The enrollment id is created by hashing the registration id with the randomly generated ECA- cert.
Here, ECA-cert is a one-time use randomly generated number.
Process of Transaction Flow in the Hyper Ledger Fabric
The client sends a “transaction proposal” through an SDK.
The same chain code will be running on all endorsement peers.
The result of each function called as RW set is sent back to the client so that each of the results of all the peers can be compared.
The client then sends back all the transactions to the “Orderer.” Orderer batches all the transactions in order and ships them to every node of the network.
Every node validates the transaction according to the endorsement policy and then writes them into the distributed ledger in a new block.
Performance Analysis
The ledger update that invokes transactions under these applications to issue using related the network that verified the overload as proposed in the system as a test (storing the EHR). The blockchain system receives messages until it is confirmed to wait for the application that is issued under the system performances to assess the important application that issus the network overload. The blockchain system that received the message confirmed to wait until the issued application has performed the system to access the important to overload the network application. By the chain code, they involved the written method to receive the information transaction to write performed application issue under the system of Blockchain. The ledger updating and mechanism consensus is based on the validation of the EHR under the hash value to generate it. EHR successfully recipient to verify the transaction that performs a query on verifying application on the conducted test. The network by chaincode involves the method of reading/query from query information to receive the read transaction that performs the verifying application. The network load that will assess the application for both time road trips in evaluation. Using hyper ledger calliper the performance test that has been performed the proposed system that evaluated and the experimental analysis. The configuration file in a calliper benchmark that initialized the genesis block that creates network blockchain in admin peer. Instantiated and installed under the EHR writing and reading for chain code, channel that contains the block file of new genesis book. For analysis the data that is delivered in the application verifying and issues under both the file that used the configuration calliper. Block size, TAR (Transaction arrival rate) under the user concurrent in the parameter that contains the configuration file as the calliper. The system is underperformance investigation that is issued to maintain these parameters.
The proposed blockchain network uses throughput and transaction latency metrics. Any network of blockchain under great impact and bottleneck that has a power processing for transaction evaluated these metrics. The blockchain network that performed the transaction numbers was referred to under the throughput process. The TPS (Transaction Per Second) were measured throughput process. During the period specified under the reading operation under the number to measure the application that verifies under the network in performing the throughput reading and during the period specification the operation committed under the writes of number that measures issuing under the network that performs the throughput transaction. The size of the network blockchain for the measured TPS, that is, the ledger under the committed transaction will update the network under all the nodes. the TPS 300 process can fabricate the hyperledger. Reliable results and stable production for 1000 will set the length of the queue transaction. TPS with 60, 70, 80, 90, and 100 were varied under the performances of TAR with the rounds of benchmark run. To prevent timeouts, the TAR is taken more than 60 TPS. represents the varying TPS under the block size and throughput transaction among them.
Figure 7. Transaction throughput (see online version for colors).
Among the string correlations that have the block size and throughput which can be observed. Further, a large size of block that increases with throughput that we observed. For instance, the blocksize of 128 TPS was flatted around and the blocksize of 128 TPS was increased linearly throughput, which can be observed in both of invoke and query transactions. As the read transactions are faster than written transactions in the network. With the TAR of TPS 100 for the blocksize that can be observed, the 256 TPS reached the throughput transaction/writing under the maximum. While minimum transaction/writing throughput is reached to ~43 TPS with an increased arrival rate of 90 TPS blocksize of 1. shows the read throughput vs. blocksize with increased arrival rates of 100, 90, 80, 70, and 60 TPS. It can be observed that for the blocksize of 512 with a TAR of 100 TPS, the maximum reaches the throughput reading of ~290TPS. The block size of TPS 100 in arrival rate increased to 49 TPS t=which reaches throughput while minimum reading. Hence, higher throughput in the resulting rate of arrival is higher with larger block sizes.
Figure 8. Read throughput (see online version for colors).
Another performance metric is transaction latency and read. The read latency is the time taken by the query transaction to read the transaction and respond to the query back to the issuer/verifier. While the network update has been across the transaction in perform the network among the time taken in transaction latency. Specifically, the network time process under all the peers in measured delay. The delay is measured in milliseconds (ms). Both show that transaction latency and read latency vary with block sizes. It is observed that, all the arrival rates for blocksize will increase it, the 32 transactions per block until the blocksize decreases quickly in transaction latency for all arrival rates. It is observed that from , the Maximum latency for writing and reading transactions is 85 ms and 78 ms with an arrival rate of 80 TPS and 100 TPS, respectively, for a block size of 1. While reading transactions and writing for latency maximum is 10 ms and 1 ms with an arrival rate of 80 TPS with a block size of 512 TPS and 60 TPS with a block size of 32 TPS.
Figure 9. Read latency (see online version for colors).
Figure 10. Transaction latency (see online version for colors).
Conclusion
The proposed system is a blockchain-based network for the secure exchange of medical data in the healthcare system. The proposed system utilizes an identity-based cryptosystem called signcryption to efficiently and securely exchange healthcare information within a data-sharing network. The study evaluated the system through the evaluation of various cryptographic methods, and the results showed that the larger the block size and arrival rate, the higher the throughput. Additionally, the transaction and read latency decreased with an increase in block size, reaching a maximum latency of 85ms for writing and 78ms for reading at 80 TPS and 100 TPS respectively. This study demonstrates the potential for blockchain technology to improve the security, privacy, and efficiency of medical data exchange in the healthcare system.
The developed model is that it requires all users to have access to the network to exchange medical data. This means that if any of the nodes in the network is offline, then the exchange of data will be affected.
For future work, it is important to investigate ways to reduce the latency of the proposed system and to test its robustness in a real-world environment. Additionally, it may be possible to use blockchain technology to improve the security, privacy, and efficiency of medical data exchange in other sectors as well.
Ethics Approval and Consent to Participate
No participation of humans takes place in this implementation process
Human and Animal Rights
No violation of Human and Animal Rights is involved.
Disclosure Statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
References
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