Emergence of Healthcare 4.0 and Blockchain into Secure Cloud-based Electronic Health Records Systems: Solutions, Challenges, and Future Roadmap

Since the last decade, cloud-based Electronic Health Records (EHRs) have achieved important consideration to facilitate remote access of patient medical records. The modern evolution of Healthcare 4.0 applying the Internet of Things (IoT) elements with cloud computing reforms to obtain remote medical services has grown the researcher’s recognition with the perspective of the smart city. The Healthcare 4.0 standard has consists of different layers to perform medical operations like periodic data sensing, data storage, data sharing, and auditing. The delicate and private medical records of victims lead to numerous difficulties while defending them from hackers. Therefore saving, obtaining, and distributing the patient medical data on the remote storage requires safety attentions so that medical records should not be compromised by the authorized user’s components of E-healthcare systems. To achieve secure medical data storage, sharing, and accessing in Cloud Service Provider (CSP), various cryptography algorithms have been designed so far. But these traditional resolutions disappointed to manage the trade-off among the provisions of EHR safety in terms of computational competence, user-side verification, service-side verification, security, and without the trusted third party. Blockchain-based security techniques achieved notable recognition due to the strength to give strong security provisions for medical records storage and sharing with the least computation forces. The blockchain made focused on bitcoin technology among the researchers. Employing the blockchain in healthcare systems has been of current interest. This paper aims to present a systematic study of different blockchain-based solutions for the smart healthcare 4.0 system. The recent blockchain-based security solutions have been reviewed first and, then we presented a research gap considering the various parameters. The outcome of this paper discusses the current research gaps, the challenges of implementing the blockchain-based secure healthcare system, and the future roadmap or solutions.