Blockchain and Smart Contracts in a Decentralized e-Health

Infrastructure

Abstract - The blockchain is generally defined as a decentralized system in which transactional

or historical records are recorded, stored, and maintained across a peer-to-peer network of
personal computers called nodes. In other words, it’s an immutable, public digital ledger which
is a much akin to a database. The blockchain is indeed a powerful and disruptive technology
that can cause a seismic shift in just about any industry.

A huge amount of data, generated by different applications in computer network, is growing up

exponentially based on nonstop operational states. Such applications are generating an
avalanche of information that is disruptive for predictable data processing and analytics
functionality, which is perfectly handled by the cloud before explosion growth of Big Data.
Blockchain technology alleviates the reliance on a centralized authority to certify information
integrity and ownership, as well as mediate transactions and exchange of digital assets, while
enabling secure and pseudo-anonymous transactions along with agreements directly between
interacting parties. It possesses key properties, such as immutability, decentralization, and
transparency that potentially address pressing issues in healthcare, such as incomplete records
at point of care and difficult access to patients’ own health information. An efficient and
effective healthcare system requires interoperability, which allows software apps and technology
platforms to communicate securely and seamlessly, exchange data, and use the exchanged data
across health organizations and app vendors. Unfortunately, healthcare today suffers from
fragmented data, delayed communications, and disparate workflow tools caused by the lack of
interoperability. Blockchain offers the opportunity to enable access to longitudinal, complete,
and tamper-aware medical records that are stored in fragmented systems in a secure and
pseudo-anonymous fashion. The proposed work carried out blockchain implementation in
distributed computing environment and it also provides the automatic recovery of invalid chain.
This also determines the impact of those security issues and possible solutions, providing future
security-relevant directions to those responsible for designing, developing, and maintaining
distributed systems.
Index Terms – Blockchain Technology, Decentralization / Decentralized System, Distributed
Computing, Peer-to-Peer Network, Healthcare, etc.

Introduction

A blockchain system can be considered as a virtually incorruptible cryptographic database where

critical medical information could be recorded. The system is maintained by a network of
computers that is accessible to anyone running the software. Blockchain operates as a pseudo-
anonymous system that has still privacy issue since all transactions are exposed to the public,
even though it is tamper-proof in the sense of data-integrity. The access control of heterogeneous
patients’ healthcare records across multiple health institutions and devices needed to be carefully
designed. Blockchain itself is not designed as the large-scale storage system. In the context
healthcare, a decentralized storage solution would greatly complement the weakness of
blockchain in the perspective.

The blockchain network as a decentralized system is more resilient in that there is no single-
point attack or failure compare to centralized systems. However, since all the bitcoin transactions
are public and everybody has access, there already exist analytics tools that identify the
participants in the network based on the transaction history. With popularity analytics, similarity
or closeness among topics within large volume of data can be detected. Groups of items or topics
can be system generated using closeness relationship formulation. As information flows among
different nodes in bitcoin network, Bitcoin transaction is slow due to the fact that information
needs to be propagated across the network to synchronize the ledger replicas. The slow
dissemination of information exposes a potential security hole for the malicious attacks. Some
measures have been implemented to mitigate the number of the blockchain forks in the network
by 50%. However, a long-term solution is still needed. Like any other networks, Bitcoin network
is no exception when it comes to malicious attacks. One of the notable form of attack against
Bitcoin network topology is eclipsing attack by using information propagation knowledge.
Bitcoin peer-to-peer network topology can be inferred and utilized by malicious attackers to
perform precise attacks such as eclipsing attack. By observing the flooding process of the
information flow, a flooding network’s topology can be inferred. A network topology inference
method has been proposed along with a proof of concept in real network. The critical players of
bitcoin transactions can be identified use various network centrality metrics. Blockchain might
replace conventional methods of keeping track of valuable information such as contracts,
intellectual-property rights, and corporate accountings. Personal healthcare records need to be
protected with the highest standard. With the increasing number of data breach incidents in the
past several years, the awareness of the general public about the personal data privacy will
continue to increasing. The necessity for data privacy will grow stronger with an increasing
number of services and device collecting our personal data associated with our personal identity.
There are techniques that obfuscate the linking of pseudonymous address and the real person
such as Coin Join.

Literature Survey

1: Title: Issues and Effectiveness of Blockchain Technology on Digital Voting.

Author: Gupta A, Patel J, Gupta M, Gupta H.

Description:-System presented in the Issues and Effectiveness of Blockchain Technology on

Digital Voting that block chain is a technology that enables moving digital coins or assets from
one individual to other individual. Blockchain concept can be understand with the concept of
linked list in Data Structure, because its next key address is stored in previous key and they are
linked with each other.

Methodology: - It was first conceptualized in 2008 which implemented in the successive year as
a core component of the digital currency bitcoin, which works as a public ledger of all
transactions. Digital voting through block chain technology has some issues and effectiveness
but our concern is to focused that how much system make this technique more effective. Here,
our main focus is that how system can implement this technique in our daily life. Our country
India is deeply interested for future use and lots of efforts are being done to overcome the
security issues as early as possible.

2: Title: Electronic voting machine based on Blockchain technology and Aadhar verification
Author: Navya A., Roopini R., SaiNiranjan A. S. et. Al
Description:-Systempresented in the Electronic voting machine based on Blockchain technology
and Aadhar verification that A nation with less voting percentage will struggle to develop as
choosing a right leader for the nation is very essential. Our proposed system designed to provide
a secure data and a trustworthy election amongst the people of the democracy. Since aadhar card
is the most needed for a person identity hence deploying an election process using it is highly
recommendable. Blockchain will be publicly verifiable and distributed in a way that no one will
be able to corrupt it.

Methodology: -The proposed system is mainly designed for our country based on Aadhar
verification where the details of the persons who are above 18years are extracted from aadhar
card database since it had become mandatory in the present scenario. To ensure more security,
finger print of voter is used as the main authentication resource. The system will allow the voter
to vote through his finger print. As soon as they cast their vote, blockchain technology comes
into existence which is integrated inside EVM. By adopting Blockchain in the distribution of
databases can reduce one of the cheating sources of database manipulation. This research
discusses the recording of the voting result in blockchain algorithm from every place of election.

3: Title: E-Voting with Blockchain: An E-Voting Protocol with Decentralization and Voter
Privacy
Author: Hardwick, Freya Sheer, Raja NaeemAkram, and KonstantinosMarkantonakis

Description:- E-Voting with Blockchain: An E-Voting Protocol with Decentralization and Voter
Privacy that a potential solutionto the lack of interest in voting amongst the young tech
savvypopulation. For e-voting to become more open, transparent, and independently auditable, a
potential solution would be base it on block chain technology. This paper explores the potential
of the block chain technology and its usefulness in the e-voting scheme. an e-voting scheme,
which is then implemented.

Methodology: -The implementation and related performance measurements are given in the
paper along with the challenges presented by the block chain platform to develop a complex
application like e-voting. The paper highlights some shortcomings and presents two potential
paths forward to improve the underlying platform (block chain technology)to support e-voting
and other similar applications. Block chain technology has a lot of promise; hosystemver, in its
current state it might not reach its full potential. There needs to be concerted effort in the core
block chain technology research to improve is features and support for complex applications that
can execute within the block chain network.

4: Title: Design of Distributed Voting Systems

Author: Meter, Christian

Description:- Systempresent the Design of Distributed Voting Systems. Electronic voting

systems attempt to be as easy to use and secure as ideal traditional elections and attempt to
eliminate the human errors described.

Methodology: - This is hard to achieve, because electronic voting systems need a strong
encryption to guarantee security, integrity and anonymity of the vote. This must be ensured and
still result in a user-friendly application, which is often hard to achieve. But to assume that
traditional elections are completely secure and correct is also questionable, as system already so,
this is a good opportunity to think about reinventing elections with the help of computers and
cryptography.

5: Title: A secure end-to-end verifiable e-voting system using zero knowledge based blockchain
Author: Panja, Somnath, and Bimal Kumar Roy

Description:- Systempresented in the secure end-to-end verifiable e-voting system using zero
knowledge based blockchain that present a cryptographic technique for an authenticated, end-to-
end verifiable and secret ballot election. Voters should receive assurance that their vote is cast as
intended, recorded as cast and tallied as recorded. The election system as a whole should ensure
that voter coercion is unlikely, even when voters are willing to be influenced. Currently, almost
all verifiable e-voting systems require trusted authorities to perform the tallying process. An
exception is the DRE-i and DRE-ip system. The DRE-ip system removes the requirement of
tallying authorities by encrypting ballot in such a way that the election tally can be publicly
verified without decrypting cast ballots. Hosystemver, the DRE-ip system necessitates a secure
bulletin board (BB) for storing the encrypted ballot as without it the integrity of the system may
be lost and the result can be compromised without detection during the audit phase.
Methodology: - System have modified the DRE-ip system so that if any recorded ballot is
tempered by an adversary before the tallying phase, it will be detected during the tallying phase.
In addition, system have described a method using zero knowledge based public blockchain to
store these ballots so that it remains tamper proof. To the best of our knowledge, it is the first
end-to end verifiable Direct-recording electronic (DRE) based e-voting system using blockchain.
In our case, system assume that the bulletin board is insecure and an adversary as read and write
access to the bulletin board. System have also added a secure biometric with government
provided identity card based authentication mechanism for voter authentication. System is able
to encrypt ballot in such a way that the election tally can be publicly verified without decrypting
cast ballots maintaining end-to-end verifiability and without requiring the secure bulletin board.

Problem Statement

In the propsoed research work to design and implement a system for health care data, where user
can store all information in single blockchain without any Trusted Third Party (TTP) in fog
computing environment. The system also carried out data integrity, confidentiality as well as
eliminate the incinsistency for end user.

Objectives

 To deisign appraoch for health insurance company where system store all hostorical data
into block chain manner.
 To create a fog computing environment hierarcy for paralel data processing for end users
applications.
 To design impelement own SHA family block for whole blockchain.
 Each transaction has stored on dependant blockchain in cloud environment.
 To design and implement a new mining technique for generate new block for each
transaction.
 To imepement a varification algorithm which can validate each peer on every access
request.
Proposed System architecture

Fig.1: Proposed System Architecture

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