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eHealth Integrity Model Based on Permissioned Blockchain

Faculty of Computer Science and Information Technology, West Pomeranian University of Technology, 70-310 Szczecin, Poland
Author to whom correspondence should be addressed.
This paper is an extended version of our paper published in International Conference on Cyber Security and Communication Systems, Melbourne Institute of Technology, Melbourne, Australia, 10–12 December 2018.
Future Internet 2019, 11(3), 76;
Received: 17 January 2019 / Revised: 18 March 2019 / Accepted: 20 March 2019 / Published: 24 March 2019
(This article belongs to the Special Issue Security and Privacy in Information and Communication Systems)
PDF [1650 KB, uploaded 24 March 2019]


(1) Background: Large eHealth systems should have a mechanism to detect unauthorized changes in patients’ medical documentation, access permissions, and logs. This is due to the fact that modern eHealth systems are connected with many healthcare providers and sites. (2) Methods: Design-science methodology was used to create an integrity-protection service model based on blockchain technology. Based on the problem of transactional transparency, requirements were specified and a model was designed. After that, the model’s security and performance were evaluated. (3) Results: a blockchain-based eHealth integrity model for ensuring information integrity in eHealth systems that uses a permissioned blockchain with off-chain information storage was created. In contrast to existing solutions, the proposed model allows information removal, which in many countries’ eHealth systems is a legal requirement, and is based on a blockchain using the Practical Byzantine Fault Tolerant algorithm. (4) Conclusion: A blockchain can be used to store medical data or only security-related data. In the proposed model, a blockchain is mainly used to implement a data-integrity service. This service can be implemented using other mechanisms, but a blockchain provides a solution that does not require trusted third parties, works in a distributed eHealth environment, and supports document removal. View Full-Text
Keywords: eHealth; blockchain; integrity; transactional transparency; proof of existence eHealth; blockchain; integrity; transactional transparency; proof of existence

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Hyla, T.; Pejaś, J. eHealth Integrity Model Based on Permissioned Blockchain. Future Internet 2019, 11, 76.

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