Designing a Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach

Authors

Xueping Liang, Florida International University
Nabid Alam, Troy University
Tahmina Sultana, Troy University
Eranga Bandara, Old Dominion University
Sachin Shetty, Old Dominion UniversityFollow

Document Type

Article

Publication Date

2024

DOI

10.2196/46556

Publication Title

Journal of Medical Internet Research

Volume

26

Pages

e46556 (1-24)

Abstract

Background: Telehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks.

Objective: The main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication processes in telehealth platforms and to design a software architecture integrated with blockchain to improve security and trustworthiness with acceptable performance.

Methods: We improved personal information security in existing telehealth platforms by adopting an innovative interdisciplinary approach combining design science, social science, and computer science in the health care domain, with prototype implementation. We used the design science research methodology to implement our overall design. We innovated over existing telehealth platforms with blockchain integration that improves health care delivery services in terms of security, privacy, and efficiency. We adopted a user-centric design approach and started with user requirement collection, followed by system functionality development. Overall system implementation facilitates user requirements, thus promoting user behavior for the adoption of the telehealth platform with decentralized identity management and an access control mechanism.

Results: Our investigation identified key challenges to identity management and trustworthy communication processes in telehealth platforms used in the current health care domain. By adopting distributed ledger technology, we proposed a decentralized telehealth platform to support identity management and a trustworthy communication process. Our design and prototype implementation using a smart contract–driven telehealth platform to provide decentralized identity management and trustworthy communication with token-based access control addressed several security challenges. This was substantiated by testing with 10,000 simulated transactions across 5 peers in the Rahasak blockchain network. The proposed design provides resistance to common attacks while maintaining a linear time overhead, demonstrating improved security and efficiency in telehealth services. We evaluated the performance in terms of transaction throughput, smart contract execution time, and block generation time. To create a block with 10,000 transactions, it takes 8 seconds on average, which is an acceptable overhead for blockchain-based applications.

Conclusions: We identified technical limitations in current telehealth platforms. We presented several design innovations using blockchain to prototype a system. We also presented the implementation details of a unique distributed architecture for a trustworthy communication system. We illustrated how this design can overcome privacy, security, and scalability limitations. Moreover, we illustrated how improving these factors sets the stage for improving and standardizing the application and for the wide adoption of blockchain-enabled telehealth platforms.

Rights

© 2024 Xueping Liang, Nabid Alam, Tahmina Sultana, Eranga Bandara, Sachin Shetty.

Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 25.09.2024. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research (ISSN 1438-8871), is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

Data Availability

Article states: "Data will be provided upon reasonable request."

Original Publication Citation

Liang, X., Alam, N., Sultana, T., Bandara, E., & Shetty, S. (2024). Designing a blockchain-empowered telehealth artifact for decentralized identity management and trustworthy communication: Interdisciplinary approach. Journal of Medical Internet Research, 26, 1-24, Article e46556. https://doi.org/10.2196/46556

ORCID

0000-0003-3214-5346 (Bandara), 0000-0002-8789-0610 (Shetty)

Repository Citation

Liang, Xueping; Alam, Nabid; Sultana, Tahmina; Bandara, Eranga; and Shetty, Sachin, "Designing a Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach" (2024). VMASC Publications. 129.
https://digitalcommons.odu.edu/vmasc_pubs/129