Abstract
While medical IoT data complexity surges, managing healthcare for chronic ailments like diabetes remains stagnant. Our innovative approach, DiabeticChain, not only addresses this but also introduces unique methodologies that set it apart in the realm of diabetic data management. Current healthcare architectures face significant research gaps including privacy and security concerns in sharing sensitive diabetic data, lack of patient data ownership, data fragmentation, interoperability issues, reliance on centralized authorities and ethical concerns laying the foundation for the novel solution DiabeticChain offers. Blockchain, a decentralized distributive ledger technology, can revolutionize data sharing with immutability, transparency and traceability. This paper proposes DiabeticChain, a permissioned blockchain-based, patient-centric healthcare architecture, addressing the key challenge of empowering patients to grant or revoke access to their diabetic data enabling secure sharing while safeguarding patient privacy. DiabeticChain allows data consumers to access patients’ data as per their agreed-upon consent policy, using Solidity smart contracts, developed, tested and deployed using the truffle framework. A hybrid model is used for data storage to store confidential diabetic data in an off-chain secure database while keeping only metadata on the blockchain. The study includes a proof-of-concept using Go-Ethereum to establish a permissioned blockchain and ChainLink for secure smart contract connectivity to off-chain resources. Performance was evaluated using four Azure hosted VMs and Hyperledger Caliper utilizing throughput and latency as key performance metrics to validate effectiveness. Results depict the system’s feasibility with an average Query throughput of 201.7 tps, an average Transaction throughput of 200.07 tps, an average Query latency of 0.24 s and an average Transaction latency of 1.31 s. The architecture is designed to seamlessly integrate with existing EHR systems, promoting efficient data sharing within the healthcare industry.
Similar content being viewed by others
Data availability
Not applicable.
References
IDF Diabetes Atlas | 10th edn. Accessed: Apr. 15 (2023)
Zhuo X, Zhang P, Barker L, Albright A, Thompson TJ, Gregg E (2014) The lifetime cost of diabetes and its implications for diabetes prevention. Diabetes Care 37(9):2557–2564. https://doi.org/10.2337/DC13-2484
Iyengar V, Wolf A, Brown A, Close K (2016) Challenges in diabetes care: Can digital health help address them? Clin Diabetes 34(3):133. https://doi.org/10.2337/DIACLIN.34.3.133
Heinrich E, Schaper NC, Vries NKD (2015) Self-management interventions for type 2 diabetes a systematic review. Int Diabetes Nurs 7(2):71–76. https://doi.org/10.1002/EDN.160
Azbeg K, Ouchetto O, Andaloussi SJ, Fetjah L, Sekkaki A (2018) Blockchain and IoT for security and privacy: a platform for diabetes self-management. In: 2018 4th International Conference on Cloud Computing Technologies and Applications, Cloudtech. https://doi.org/10.1109/CloudTech.2018.8713343
Uppamma P, Bhattacharya S (2023) Diabetic retinopathy detection: a blockchain and African vulture optimization algorithm-based deep learning framework. Electronics. https://doi.org/10.3390/electronics12030742
Rai B, Fatima S, Satyarth K (2022) Patient-centric multichain healthcare record. Int J E-Health Med Commun. https://doi.org/10.4018/IJEHMC.309439
Health Information Privacy | HHS.gov. Accessed: Apr. 15, (2023)
Dubovitskaya A et al (2020) ACTION-EHR: patient-centric blockchain-based electronic health record data management for cancer care. J Med Internet Res. https://doi.org/10.2196/13598
Duong-Trung N, Son HX, Le HT, Phan TT (2020) On components of a patient-centered healthcare system using smart contract. In: ACM International Conference Proceeding Series, pp 31–35. https://doi.org/10.1145/3377644.3377668
Cleveland SM, Haddara M (2021) Iot for diabetics: a user perspective, pp 161–172. https://doi.org/10.1007/978-3-030-80129-8_13
Shubrook JH, Brannan GD, Wapner A, Klein G, Schwartz FL (2018) Time needed for diabetes self-care: nationwide survey of certified diabetes educators. Diabetes Spect 31(3):267–271. https://doi.org/10.2337/DS17-0077
Benefits of Blockchain - IBM Blockchain | IBM. Accessed: Apr. 25, (2023)
Zyskind G, Nathan O, Pentland AS (2015) Decentralizing privacy: using blockchain to protect personal data. In: Proceedings - 2015 IEEE Security and Privacy Workshops, SPW 2015, pp 180–184. https://doi.org/10.1109/SPW.2015.27
Azaria A., Ekblaw A., Vieira T, Lippman A (2016) Medrec: using blockchain for medical data access and permission management. In: Proceedings—2016 2nd International Conference on Open and Big Data, OBD 2016, pp 25–30. https://doi.org/10.1109/OBD.2016.11
Liang X, Zhao J, Shetty S, Liu J, Li D (2017) Integrating blockchain for data sharing and collaboration in mobile healthcare applications. In: 2017 IEEE 28th Annual International Symposium on Personal, Indoor, and Mobile Radio Communications (PIMRC), pp 1–5. https://doi.org/10.1109/PIMRC.2017.8292361
Chen Y, Ding S, Xu Z, Zheng H, Yang S (2018) Blockchain-based medical records secure storage and medical service framework. J Med Syst. https://doi.org/10.1007/S10916-018-1121-4
Jabarulla MY, Lee HN (2021) Blockchain-based distributed patient-centric image management system. Appl Sci 11(1):1–20. https://doi.org/10.3390/app11010196
Mani V, Manickam P, Alotaibi Y, Alghamdi S, Khalaf OI (2021) Hyperledger healthchain: Patient-centric IPFS-based storage of health records. Electronics. https://doi.org/10.3390/electronics10233003
Gohar AN, Abdelmawgoud SA, Farhan MS (2022) A patient-centric healthcare framework reference architecture for better semantic interoperability based on blockchain, cloud, and iot. IEEE Access 10:92137–92157. https://doi.org/10.1109/ACCESS.2022.3202902
Taylor A, Kugler A, Marella PB, Dagher GG (2022) Vigilrx: a scalable and interoperable prescription management system using blockchain. IEEE Access 10:25973–25986. https://doi.org/10.1109/ACCESS.2022.3156015
Abutaleb RA, Alqahtany SS, Syed TA (2023) Integrity and privacy-aware, patient-centric health record access control framework using a blockchain. Appl Sci. https://doi.org/10.3390/app13021028
Rai BK (2023) PcBEHR: patient-controlled blockchain enabled electronic health records for healthcare 4.0. Health Serv Outcomes Res Methodol 23(1):80–102. https://doi.org/10.1007/s10742-022-00279-7
Grant RW et al (2006) Design and implementation of a web-based patient portal linked to an ambulatory care electronic health record: Patient gateway for diabetes collaborative care. Diabetes Technol Ther 8(5):576–586. https://doi.org/10.1089/dia.2006.8.576
Schoenberg R (2000) Internet based repository of medical records that retains patient confidentiality. BMJ 321(7270):1199–1203. https://doi.org/10.1136/bmj.321.7270.1199
Chen M et al (2021) Blockchain-enabled healthcare system for detection of diabetes. J Inf Secur Appl. https://doi.org/10.1016/j.jisa.2021.102771
Ismail L, Materwala H, Khan MAB (2020) Performance evaluation of a patient-centric blockchain-based healthcare records management framework. In: ACM International Conference Proceeding Series, pp. 39–50. https://doi.org/10.1145/3409934.3409941
Singh AP et al (2021) A novel patient-centric architectural framework for blockchain-enabled healthcare applications. IEEE Trans Industr Inform 17(8):5779–5789. https://doi.org/10.1109/TII.2020.3037889
Zhuang Y, Sheets LR, Chen YW, Shae ZY, Tsai JJP, Shyu CR (2020) A patient-centric health information exchange framework using blockchain technology. IEEE J Biomed Health Inform 24(8):2169–2176. https://doi.org/10.1109/JBHI.2020.2993072
Subramanian G, Thampy AS (2021) Implementation of blockchain consortium to prioritize diabetes patients’ healthcare in pandemic situations. IEEE Access 9:162459–162475. https://doi.org/10.1109/ACCESS.2021.3132302
Hennebelle A, Ismail L, Materwala H, Kaabi JA, Ranjan P, Janardhanan R, Hennebelle A, Ismail L, Materwala H, Kaabi JA, Ranjan P, Janardhanan R (2022) Secure and privacy-preserving automated machine learning operations into end-to-end integrated iot-edge-artificial intelligence-blockchain monitoring system for diabetes mellitus prediction. arXiv, 2211–07643 doi: https://doi.org/10.48550/ARXIV.2211.07643
Pradhan NR, Rout SS, Singh AP (2021) Blockchain based smart healthcare system for chronic -illness patient monitoring. In: 3rd International Conference on Energy, Power and Environment: Towards Clean Energy Technologies, ICEPE 2020. doi: https://doi.org/10.1109/ICEPE50861.2021.9404496
Attaran M (2022) Blockchain technology in healthcare: challenges and opportunities. Int J Healthc Manag 15(1):70–83. https://doi.org/10.1080/20479700.2020.1843887
Salmon J, Myers G (2019) Blockchain and associated legal issues for emerging markets. Technical report, World Bank Group (Jan 2019)
Bashir I (2017) Mastering blockchain vol 161, pp 335–339. Accessed: Apr. 16, 2023. https://www.packtpub.com/product/mastering-blockchain/9781787125445
What is blockchain technology? - IBM Blockchain | IBM. Accessed: Apr. 16, 2023
Bitcoin: a peer-to-peer electronic cash system. www.bitcoin.org
Lodha G, Pillai M, Solanki A, Sahasrabudhe S, Jarali A(2021) Healthcare system using blockchain. In: Proceedings - 5th International Conference on Intelligent Computing and Control Systems, ICICCS 2021, pp 274–281. https://doi.org/10.1109/ICICCS51141.2021.9432157
Szabo N (1997) Formalizing and securing relationships on public networks. First Monday. https://doi.org/10.5210/FM.V2I9.548
Designing a blockchain architecture: types, use cases, and challenges | by Svetlana Cherednichenko | Mobindustry | Medium. Accessed: Apr. 21, 2023
Everything you need to kow about blockchain architecture | Edureka. Accessed: Apr. 21, 2023
Different types of blockchain and why we need them | Edureka. Accessed: Apr. 24, 2023
Blockchain from scratch: permissioned and Permissionless blockchains | by Radovan Stevanovic | Medium. Accessed: Apr. 24, 2023
Oliveira MT et al. (2019)Towards a performance evaluation of private blockchain frameworks using a realistic workload. In: 2019 22nd Conference on Innovation in Clouds, Internet and Networks and Workshops (ICIN), pp. 180–187. doi: https://doi.org/10.1109/ICIN.2019.8685888
Albalwy F, Brass A, Davies A (2021) A blockchain-based dynamic consent architecture to support clinical genomic data sharing (consentchain): Proof-of-concept study. JMIR Med Inform. https://doi.org/10.2196/27816
Brock, Arthur C, David Braden, Jamison M Day (2021) Holochain—a framework for distributed applications. U.S. Patent 10,951,697
Hyperledger Fabric - Hyperledger Foundation. Accessed: Apr. 21, 2023
Announcing Hyperledger Besu - Hyperledger Foundation. Accessed: Apr. 21, 2023
Pedro AS, Levi D, Cuende LI Witnet: a decentralized oracle network protocol. doi: https://doi.org/10.13140/RG.2.2.28152.34560
EOS.IO Technical White Paper - Steemit. Accessed: Apr. 21, 2023
The ripple protocol consensus algorithm reasonable deviations. Accessed: Apr. 21, 2023
Karlson EW, Boutin NT, Hoffnagle AG, Allen NL (2016) Building the partners healthcare biobank at partners personalized medicine: informed consent, return of research results, recruitment lessons and operational considerations. J Personal Med 6(1):2. https://doi.org/10.3390/JPM6010002
Replacing Paper Informed Consent with Electronic Informed Consent for Research in Academic Medical Centers: A Scoping Review - PubMed. https://pubmed.ncbi.nlm.nih.gov/32477626/
What is blockchain and how does it work? | Synopsys. Accessed: Apr. 15, 2023
Wang Z, Stell A, Sinnott RO (2023) A GDPR-compliant dynamic consent mobile application for the Australasian type-1 diabetes data network. Healthcare. https://doi.org/10.3390/HEALTHCARE11040496
Wust K, Gervais A (2018) Do you need a blockchain? In: Proceedings of the 1st Crypto Valley Conference on Blockchain Technology (CVCBT 2018), pp 45–54. doi: https://doi.org/10.1109/CVCBT.2018.00011
Pedersen AB, Risius M, Beck R (2019) A ten-step decision path to determine when to use blockchain technologies. MIS Q Exec 18(2):99–115. https://doi.org/10.17705/2msqe.00010
Li C, Raghunathan A, Jha NK (2011) Hijacking an insulin pump: security attacks and defenses for a diabetes therapy system. In: 2011 IEEE 13th International Conference on e-Health Networking, Applications and Services, pp 150–156. doi: https://doi.org/10.1109/HEALTH.2011.6026732
Cyran MA (2018) Blockchain as a foundation for sharing healthcare data. Blockchain Healthc Today. https://doi.org/10.30953/bhty.v1.13
Zhao F, Yu J, Yan B Towards cross-chain access control model for medical data sharing. In: Procedia Computer Science, pp. 330–335. https://doi.org/10.1016/j.procs.2022.04.045
Reen GS, Mohandas M, Venkatesan S, Decentralized Patient Centric e- Health Record Management System using Blockchain and IPFS. In: 2019 IEEE Conference on Information and Communication Technology, Allahabad, India, pp. 1–7. https://doi.org/10.1109/CICT48419.2019.9066212
Mudaliar A, More Y, Kulkarni A, Joshi L, Chaudhari D (2022) Blockchain-based user-centric electronic health record management system. In: 2022 IEEE International Conference on Blockchain and Distributed Systems Security, ICBDS 2022. https://doi.org/10.1109/ICBDS53701.2022.9935834
Dewangan NK, Chandrakar P (2022) Patient-centric token-based healthcare blockchain implementation using secure internet of medical things. IEEE Trans Comput Soc Syst. https://doi.org/10.1109/TCSS.2022.3194872
Toshniwal B, Podili P, Reddy RJ, Kataoka K (2019) PACEX: Patient-centric EMR exchange in healthcare systems using blockchain. In: 2019 IEEE 10th Annual Information Technology, Electronics and Mobile Communication Conference, IEMCON 2019, pp 954–960. https://doi.org/10.1109/IEMCON.2019.8936258
Satamraju KP, Balakrishnan M (2022) A secured healthcare model for sensor data sharing with integrated emotional intelligence. IEEE Sens J 22(16):16306–16313. https://doi.org/10.1109/JSEN.2022.3189268
Chelladurai MU, Pandian DS, Ramasamy DK (2021) Blockchain based patient centric electronic health record storage and integrity management for e-health systems. Health Policy Technol. https://doi.org/10.1016/.hlpt.2021.100513
Alexaki S, Alexandris G, Katos V, Petroulakis EN (2018) Blockchain-based electronic patient records for regulated circular healthcare jurisdictions. In: IEEE International Workshop on Computer Aided Modeling and Design of Communication Links and Networks, CAMAD. https://doi.org/10.1109/CAMAD.2018.8514954
Kordestani H, Barkaoui K, Zahran W (2020) Hapichain: a blockchain-based framework for patient-centric telemedicine. In: 2020 IEEE 8th International Conference on Serious Games and Applications for Health, SeGAH 2020. https://doi.org/10.1109/SEGAH49190.2020.9201726
Kanagi K, Ku CCY, Lin LK, Hsieh WH (2020) Efficient clinical data sharing framework based on blockchain technology. Methods Inf Med 59(6):193–204. https://doi.org/10.1055/s-0041-1727193
Fatokun T, Nag A, Sharma S (2021) Towards a blockchain assisted patient owned system for electronic health records. Electronics 10(5):1–14. https://doi.org/10.3390/electronics10050580
Kumar M, Chand S (2021) Medhypchain: a patient-centered interoperability hyperledger-based medical healthcare system: regulation in covid-19 pandemic. J Netw Comput Appl. https://doi.org/10.1016/j.jnca.2021.102975
Nzuva S (2019) Smart contracts implementation, applications, benefits, and limitations. https://doi.org/10.7176/JIEA. www.iiste.org
Home | Go-ethereum. Accessed: May 07, 2023
Ghosh PK, Chakraborty A, Hasan M, Rashid K, Siddique AH (2023) Blockchain application in healthcare systems: a review. Systems 11(1):38. https://doi.org/10.3390/systems11010038
Singh R, Dwivedi AD, Mukkamala RR, Alnumay WS (2022) Privacy-preserving ledger for blockchain and internet of things-enabled cyber-physical systems. Comput Electr Eng 103:108290. https://doi.org/10.1016/J.COMPELECENG.2022.108290
WEF Blockchain Toolkit. Accessed: Apr. 29, 2023
George M, Chacko AM (2022) trans-patient-centric interoperability through blockchain. Int J Netw Manag. https://doi.org/10.1002/nem.2187
Razzaq A et al (2022) Blockchain-enabled decentralized secure big data of remote sensing. Electronics 11(19):3164. https://doi.org/10.3390/electronics11193164
Marinho SSC, Filho JSC, Moreira LO, MacHado JC (2020) Using a hybrid approach to data management in relational database and blockchain: A case study on the e-health domain. In: Proceedings - 2020 IEEE International Conference on Software Architecture Companion, ICSA-C 2020, pp 114–121. https://doi.org/10.1109/ICSA-C50368.2020.00030
König L, Unger S, Kieseberg P, Tjoa S (2020) The risks of the blockchain a review on current vulnerabilities and attacks. J Internet Serv Inf Secur 10(3):110–127. https://doi.org/10.22667/JISIS.2020.08.31.110
Ekparinya P, Gramoli V, Jourjon G (2018) Impact of man-in-the-middle attacks on ethereum. In: 2018 IEEE 37th Symposium on Reliable Distributed Systems (SRDS), pp 11–20. https://doi.org/10.1109/SRDS.2018.00012
DoS Attacks on Blockchain Ecosystem. Accessed: May 31, 2023
Hyperledger Blockchain Performance Metrics White Paper - Hyperledger Foundation. Accessed: May 24, 2023
Yang R et al (2020) Public and private blockchain in construction business process and information integration. Autom Constr 118:103276. https://doi.org/10.1016/J.AUTCON.2020.103276
Author information
Authors and Affiliations
Contributions
Deepak Kumar Mishra helped in conceptualization, formal analysis, writing original draft. Pawan Singh Mehra was involved in supervision, methodology, validation.
Corresponding author
Ethics declarations
Conflict of interest
None.
Ethical approval
Yes.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Mishra, D.K., Mehra, P.S. DiabeticChain: a novel blockchain approach for patient-centric diabetic data management. J Supercomput 81, 166 (2025). https://doi.org/10.1007/s11227-024-06589-6
Accepted:
Published:
DOI: https://doi.org/10.1007/s11227-024-06589-6