Blockchain in healthcare today最新文献

{"title":"Decentralized by Design, Centralized by Necessity: The Blockchain-Surveillance Dilemma.","authors":"Vahid Mirzajani Harandi","doi":"10.30953/bhty.v9.525","DOIUrl":"10.30953/bhty.v9.525","url":null,"abstract":"<p><p>Disease surveillance systems face delays in data collection, validation, and reporting at various levels, which undermines early detection and rapid response. Blockchain technology, as a transparent and immutable architecture, can accelerate the flow of epidemiological data and increase trust among actors, but the transition from idea to practical tool requires an analysis of requirements and limitations. This article examines the key challenges of applying blockchain in disease surveillance in two axes: first, governance challenges, data sovereignty, and the inherent conflict of decentralized architecture with epidemiological requirements and privacy laws; second, technical, infrastructural, and operational challenges such as digital identity, interoperability, communication limitations, economic model, and security vulnerabilities. Therefore, the conclusion shows that blockchain can only contribute to transparency and traceability in the form of permissioned/consortium networks with verified identity, and its true effectiveness depends on feasibility studies, piloting, and intelligent combination with data exchange standards and international cooperation.</p>","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities and Risks of Technology Convergence in Precision Health.","authors":"Ingrid Vasiliu-Feltes, Carlos D Bustamante, Evelyne Bischof, Stephen J Dennis","doi":"10.30953/bhty.v9.521","DOIUrl":"10.30953/bhty.v9.521","url":null,"abstract":"<p><p>This ConV2X Decentralized Health 2026 executive roundtable explores how technology convergence impacts precision health outcomes. The dialogue focuses on the main technologies supporting precision health, the latest scientific developments, technology advancements, opportunities, and risks. It is moderated by BHTY journal editor Prof. Dr. Vasiliu-Feltes. Participants emphasize the latest scientific developments, opportunities, and risks associated with precision health, enabled by converging advanced technologies.</p>","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immutability Is Not Trust: Recourse, Reversibility, and the Patient at the End of the Chain.","authors":"Nuno Galante Valério","doi":"10.30953/bhty.v9.518","DOIUrl":"10.30953/bhty.v9.518","url":null,"abstract":"<p><p>Blockchain promises records that can never be changed. In healthcare, this is often sold as a way to make data trustworthy. Here, the author argues that an unchangeable record solves only one part of the problem. It proves nobody altered the record after it was written. It does not prove the record was correct, identify who is responsible for it, or allow a patient to challenge a decision that turns out to be wrong. Using data-integrity rules already standard in regulated medicine, the author asserts that correcting mistakes and seeking a remedy are essential to the trust that blockchain in healthcare is meant to deliver.An unchangeable record proves only that data were not altered later, not that data were correct to begin with.Trustworthy medical systems must let errors be corrected while keeping a permanent, attributed trail of each correction.Europe's right to erasure and the European Union Artificial Intelligence (EU AI) Act both assume records can change and decisions can be contested.A permanent record of a wrong decision that nobody can appeal protects the record, but it does not protect the patient.Regulated medicine solved this decades ago: append the correction, attribute it, timestamp it, and leave the original visible.</p>","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A DeSci-Driven Blockchain Framework for AI-Augmented Healthcare Research.","authors":"Garima Singh, Mohd Haroon, Nudrat Fatima, Afsaruddin, Tameem Ahmad, Mohammad Husain, Mahfuzul Huda","doi":"10.30953/bhty.v9.507","DOIUrl":"10.30953/bhty.v9.507","url":null,"abstract":"<p><strong>Background: </strong>The accelerated digital revolution in healthcare has greatly enhanced data management with electronic health records. Nonetheless, challenging issues of centralized control, privacy breaches, absence of patient ownership of their data, and inability to support decentralized scientific collaboration remain barriers to scalable healthcare research ecosystems. Recent developments in decentralized science (DeSci) create a paradigm shift, using blockchain, cryptographic primitives, and decentralized governance to facilitate transparent, trust-minimized, and collaborative biomedical research. This article provides a DeSci-friendly lightweight blockchain architecture that is used to support privacy-preserving and incentive-sensitive decentralized healthcare research infrastructure.</p><p><strong>Methods: </strong>The framework combines a permissioned blockchain with a lightweight hybrid consensus protocol, off-chain storage, and zero-knowledge proof-based authentication to permit secure and privacy-preserving access to data without revealing identity. Also, a tokenomics-based governance layer is proposed to support decentralized engagement, transparent policy implementation, and incentive-based research participation. The suggested system is tested in simulation with the following different network conditions and the key performance metrics such as latency, throughput, and computational cost.</p><p><strong>Results: </strong>Experiments prove that the suggested framework offers the following advantages:lower latencygreater throughputenhanced computational efficiencywhen compared to the current blockchain-based healthcare systems such as medical records, Fast Healthcare Interoperability Resources, and HealthChain. In addition, the framework goes past traditional data management by allowing a DeSci-oriented research life cycle, such as decentralized data contribution, validation, and provenance tracking.</p><p><strong>Conclusions: </strong>The proposed framework will help build scalable, secure, and patient-centered decentralized healthcare research ecosystems. Furthermore, the framework bridges the gap between blockchain-based healthcare systems and DeSci-driven research ecosystems.</p>","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantum Threats to Bitcoin, Cryptocurrency and Blockchain.","authors":"Rubayat Khan, Mazharul Karim, Don Roosan","doi":"10.30953/bhty.v9.496","DOIUrl":"10.30953/bhty.v9.496","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The authors evaluated how quantum computing threatens the cryptographic primitives used in Bitcoin and other blockchain systems. These findings were translated into a standards-aligned post-quantum migration profile for healthcare ledgers, including consent, identity, provenance, audit, and encrypted off-chain data exchange.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology: &lt;/strong&gt;Narrative analysis, theoretical security analysis, and healthcare-oriented deployment mapping of classical public-key and hash primitives used in blockchain protocols were paired with an implementation-oriented migration profile based on finalized National Institute of Standards and Technology (NIST) post-quantum standards. We summarize the mathematical assumptions underlying RSA, Elliptic Curve Cryptography/Elliptic Curve Digital Signature Algorithm (ECC/ECDSA), and Secure Hash Algorithm (SHA-2/SHA-3-family) hash functions; analyze their susceptibility to Shor's and Grover's quantum algorithms; compare Federal Information Processing Standards (FIPS) 203 Module-Lattice-Based Key-Encapsulation Mechanism Standard (ML-KEM), FIPS 204 Module-Lattice-Based Digital Signature Standard (ML-DSA), and FIPS 205 Stateless Hash-Based Digital Signature Standard (SLH-DSA); and map their distinct roles to healthcare-ledger authorization, auditability, identity, and encrypted off-chain exchange. The term Advanced Hybrid Module-LWE & Code-Based (AHMC) is used only as shorthand for a standards-aligned hybrid post-quantum cryptography (PQC) migration profile and does not denote a proprietary product, a novel algorithm, or a new cryptographic primitive. Proposed adoption of hybrid, quantum-resistant cryptographic primitives for cryptocurrency wallets, transaction signatures, and ledger security during an interim migration period (hybrid classical + PQC, followed by PQC-only). Qualitative and implementation-oriented assessment of (1) break feasibility of RSA/ECC under Shor's algorithm, (2) effective security reduction for hash functions under Grover's algorithm, (3) security assumptions and composition requirements of a standards-aligned hybrid migration profile, (4) transaction-size and verification-cost impact, and (5) healthcare-specific implications for long-retention consent, identity, provenance, and audit records.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Shor's algorithm reduces integer factorization and discrete logarithms to polynomial time, directly compromising Rivest-Shamir-Adleman (RSA) and ECC/ECDSA once fault-tolerant, large-scale quantum computers exist. Grover's algorithm yields a quadratic speedup for brute-force search, effectively halving the security margin of symmetric keys and hash functions at fixed output sizes. The AHMC-L1/L3/L5 profiles use ML-KEM-512/768/1024 for key establishment and ML-DSA-44/65/87 for transaction authentication, with SLH-DSA as a hash-based fallback. During a hybrid ECDSA+PQC migration, verification requires one classical and one PQC verificati","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lightweight Privacy-Preserving Blockchain Framework for Healthcare: A Simulation-Based Approach to Reducing Computational Overhead.","authors":"Md Asrar Ahmed, Mohammed Abid Ali Sameer, Mousmi Ajay Chaurasia, S Nallusamy","doi":"10.30953/bhty.v9.516","DOIUrl":"10.30953/bhty.v9.516","url":null,"abstract":"<p><strong>Background: </strong>The privacy and security of electronic health records (HER) in blockchain-based systems remains a major research problem because of high computational overhead and scalability restrictions. Privacy-preserving techniques such as encryption and zero-knowledge proofs strengthen blockchain's transparency and immutability but often add significant latency and resource use. This study proposes a lightweight, simulation-based blockchain model balancing privacy protection and computational efficiency for healthcare data-sharing, incorporating hybrid encryption (AES with asymmetric-key exchange), zero-knowledge verification (zk-SNARK), and homomorphic aggregation to protect patient information while reducing processing cost.</p><p><strong>Methods: </strong>A five-stage simulation tested encryption/decryption latency, IPFS-based upload/download performance, proof generation/verification time, and scalability across key sizes, plus a sixth phase validating the framework on two real, publicly available, de-identified healthcare datasets-the Medical Information Mart for Intensive Care (MIMIC)-IV demo (100 real ICU patients) and the University of California \"Diabetes 130-US Hospitals\" dataset (101,766 real inpatient encounters). Every metric is reported as a mean with a 95% confidence interval from 15 to 20 repeated trials.</p><p><strong>Results: </strong>The AES-128 has the lowest overhead among tested key sizes (10% to 14% below AES-192/256), zk-SNARK verification averages 30.8 to 32.4 ms (<i>n</i> = 20 to 100 trials)-well within real-time requirements for on-chain access decisions-and proof generation and gas cost are statistically indistinguishable between a minimal baseline circuit and the consent-verification circuit, indicating negligible marginal overhead from the added consent logic. Computing cost scales linearly with data size: confirming lightweight scalability, withreal-data results closely tracking synthetic-data results, witha narrowly scoped comparison showing error correction code memory (ECC (memory (secp256r1) key exchange is 93.5% faster than RSA-3072 key wrapping.</p><p><strong>Conclusions: </strong>This work demonstrates that efficient cryptographic integration and optimization through simulation can produce a privacy-preserving blockchain for healthcare that streamlines EHR handling securely and at scale.</p>","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Most Dangerous Thing in Healthcare Isn't AI. It's What's Underneath It.","authors":"Jim Schwoebel, Tricia Wang","doi":"10.30953/bhty.v9.529","DOIUrl":"https://doi.org/10.30953/bhty.v9.529","url":null,"abstract":"","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking Animal Health in Zoos Using Blockchain Technology.","authors":"Annabelle Mousley, Fatima Ali, Melissa Lyons, Reza Vatankhah Barenji","doi":"10.30953/bhty.v9.403","DOIUrl":"10.30953/bhty.v9.403","url":null,"abstract":"<p><p>Animal welfare issues occasionally make headlines and are a subject for continuous improvement. Inadequate living conditions and a lack of healthcare have led to constant violations of the Animal Welfare Acts in zoos. This can be improved by using a system to accurately manage crucial animal health data and make it accessible and shared between facilities. The aim of this article is to design a Hyperledger Fabric-based system, named the \"Zoo Trust Database,\" to enable seamless sharing of zoo animal data between zoos and conservation facilities. The system ensures that accurate healthcare data and medical histories of animals are securely recorded and accessible to authorized network peers at all times. The system will provide information to the regulatory authorities limiting the instances of violations in healthcare management of animals. This system has the potential to help facilities make better-informed treatment decisions while improving animal welfare.</p>","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blockchain-Enabled Electronic Health Record Model for Managing Patients' Vital Data and Medical Reports.","authors":"Aditi Sharma, Rajesh Kumar Kaushal, Naveen Kumar Chitkara, Ekkarat Boonchieng","doi":"10.30953/bhty.v9.455","DOIUrl":"10.30953/bhty.v9.455","url":null,"abstract":"<p><p>The Internet of Medical Things is revolutionizing the concept of patient care. It is empowering the implementation of remote patient care protocols through the use of body sensors to monitor vital signs. However, it produces vast amounts of information, which raises security and privacy concerns. High-dimensional medical data are essential for diagnosis and treatment, but they are not currently connected to blockchain-based electronic health record systems. To overcome these limitations, the authors present a Hyperledger Fabric-based secure remote patient monitoring model for storing and retrieving medical imaging. The system records patient vital signs using sensors and stores medical images off-chain in the InterPlanetary File System. This model uses two organizations and a single channel, with Raft consensus, to ensure data consistency and high performance. Additionally, this study evaluates the performance of the proposed system in terms of throughput and latency. A test was conducted at 1,200 transactions with varying transfer rates. The results reveal that the throughput was near the send rate, up to 90 TPS. At a send rate of 150 TPS, the system reaches its peak throughput of 117.04 TPS. Moreover, no transactions were lost, which means that the system was able to make all its transactions, representing system reliability. The latency was noted to be 0.21 to 2.24 s, whereas the read operation was always characterized by the same latency of 0.01 s.</p>","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zero-Knowledge Process Verification: A Comprehensive Framework for a Distributed Healthcare System.","authors":"Sathya Krishnasamy","doi":"10.30953/bhty.v9.430","DOIUrl":"10.30953/bhty.v9.430","url":null,"abstract":"<p><strong>Objective: </strong>This article introduces the ZK-PRET Business Process Prover framework that integrates Object Management Group (OMG) business process standards with zero-knowledge cryptographic verification to enable privacy-preserving healthcare process compliance across distributed systems.</p><p><strong>Methods: </strong>We developed a multilayer architecture combining formal business process modeling, zero-knowledge proof generation, and regulatory compliance verification. The framework extends established OMG standards with cryptographic verification capabilities to achieve verifiable compliance, privacy preservation, and regulatory accountability. Implementation testing were conducted in synthetic data environments designed to represent real-world healthcare scenarios.¹ These environments enable comprehensive modeling and testing of multi-entity process orchestration patterns while maintaining privacy protections essential for healthcare research and development. All scenarios, clinical examples, and process expressions presented in this article utilize synthetic data to ensure no real patient data, clinical records, or identifiable health information were used.</p><p><strong>Results: </strong>The ZK-PRET Business Process Prover framework demonstrates practical applicability across many healthcare domains, including treatment planning, telemedicine coordination, healthcare administration, consumer health services, multientity clinical trials, and supply chain management. Implementation results demonstrate cryptographic verification capabilities that enable mathematical prevention of regulatory violations rather than post hoc detection. The results demonstrate configurable privacy preservation through zero-knowledge verification and consistent proof sizes suitable for modeling complex orchestrations, while leveraging already widely used Web 2 process models suitable for multiple runtime deployment topologies.</p><p><strong>Conclusions: </strong>Zero-knowledge healthcare process verification represents a foundational technology for regulatory compliance in distributed healthcare systems. While agentic AI systems present important opportunities for automation, the underlying requirement for verifiable process compliance through cryptographic means brings broader challenges. ZK-PRET Business Process Prover addresses these challenges in healthcare transformative flows, enabling safer deployment of autonomous systems while maintaining regulatory standards.</p>","PeriodicalId":72422,"journal":{"name":"Blockchain in healthcare today","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}