HealthBlock: A Framework for a Collaborative Sharing of Electronic Health Records Based on Blockchain
Round 1
Reviewer 1 Report
Electronic Health Records (EHRs) play an essential role in our life. This manuscript proposes a new framework called HealthBlock for the collaborative sharing EHRs and their privacy-preserving with granular access control. Different technologies have been combined to achieve this goal: The InterPlanetary File System (IPFS) technology stores and shares patients’ EHRs in a distributed Off-Chain storage and ensures the record’s immutability; the Hyperledger Indy gives patients complete control over their EHRs and the Hyper-ledger Fabric store the patient access control policy and delegations. The security analysis and performance comparison of HealthBlock is not given in this manuscript. Major revisions are needed before it is finally accepted.
1. The authors should apply the information theory, and how much information the attacker obtains in the different attacks. It can dramatically enhance practicality and security.
2. The authors should add a section to discuss performance analysis. The discussion of related works makes performance analysis more comprehensive. The authors need to show more persuasive reasons for readers that their proposal offers a better solution.
Author Response
the response is attached
Author Response File: 
Author Response.docx
Reviewer 2 Report
The study is potentially interesting but currently appears to be still at an embryonic and conceptual stage. Empirical data collection is needed to prove the potential of the proposed architecture.
Improvement suggestions:
- The beginning of the Introduction section has to be improved. The authors give a very interesting contextualization but lack scientific verification. There is a lack of references to prove and verify some statements.
- Authors note “Several new building blocks (blockchains, Hyperledger, IPFS, etc.) are now available to more easily develop secure architectures for different applications and even with new highly requested features.” Did these blocks appear at the same time? A better contextualization is needed.
- This information may be considering speculative if not properly cited and based in the literature “These new emerging technologies, including blockchains, provide a better solution for protecting patient medical records, while providing accessibility, delegation, anonymity, and other valuable properties.”
- The objectives of the proposal should be well grounded in the literature and should be aligned with the research gap.
- I consider it essential to further scientific deepening of the work. The scientific introduction to the topic and exploration of the research gap should be deepened.
- The choice of architecture and technologies used must be justified. The authors only present each of them without mentioning alternatives and a technical justification that allows understanding the choices.
- Related work section should be presented before the preliminaries section.
- The column “Approach” in Table 2 is not clear. Is an example shown or the author who first addressed the topic?
- The prototype proposal is too basic. It only describes the respective scenarios without actually analyzing them in terms of security, privacy, robustness and performance. More empirical exploration of the results is needed.
- Avoid to present figures in the Conclusion section.
- The conclusion section needs to be reformulated. The theoretical and practical contributions of the work should be presented. Limitations also need to be addressed. Indications for future work have to be improved.
Author Response
the responsed is attached
Author Response File: Author Response.docx
Round 2
Reviewer 1 Report
The authors revised their manuscript according to the suggestions in my report. I recommend it for publication.
Author Response
Thank you for you effort and your comments.
Author Response File: Author Response.docx
Reviewer 2 Report
Discussion section needs to be extended. Authors need to compare their results against published works and not only say that provide more useful features. Please be more concrete and discuss it with scientific rigor.
Author Response
Thank you for your efforts and comments. We have improved the Discussion section to compare the proposed approach with related work.
Author Response File: Author Response.docx
Round 3
Reviewer 2 Report
Authors should better discuss the scalability provided by their solution in the Discussion section. Address both vertical and horizontal scalability and evaluate both perspectives.
Author Response
Thank you for your feedback. We have improved the scalability point in the Discussion section.
Author Response File: Author Response.docx
