Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul 26;5(7):e111.
doi: 10.2196/mhealth.7938.

Tamper-Resistant Mobile Health Using Blockchain Technology

Daisuke Ichikawa  1 , Makiko Kashiyama  1 , Taro Ueno  1   2   3
Affiliations

Tamper-Resistant Mobile Health Using Blockchain Technology

Daisuke Ichikawa et al. JMIR Mhealth Uhealth. .

Abstract

Background: Digital health technologies, including telemedicine, mobile health (mHealth), and remote monitoring, are playing a greater role in medical practice. Safe and accurate management of medical information leads to the advancement of digital health, which in turn results in a number of beneficial effects. Furthermore, mHealth can help lower costs by facilitating the delivery of care and connecting people to their health care providers. Mobile apps help empower patients and health care providers to proactively address medical conditions through near real-time monitoring and treatment, regardless of the location of the patient or the health care provider. Additionally, mHealth data are stored in servers, and consequently, data management that prevents all forms of manipulation is crucial for both medical practice and clinical trials.

Objective: The aim of this study was to develop and evaluate a tamper-resistant mHealth system using blockchain technology, which enables trusted and auditable computing using a decentralized network.

Methods: We developed an mHealth system for cognitive behavioral therapy for insomnia using a smartphone app. The volunteer data collected with the app were stored in JavaScript Object Notation format and sent to the blockchain network. Thereafter, we evaluated the tamper resistance of the data against the inconsistencies caused by artificial faults.

Results: Electronic medical records collected using smartphones were successfully sent to a private Hyperledger Fabric blockchain network. We verified the data update process under conditions where all the validating peers were running normally. The mHealth data were successfully updated under network faults. We further ensured that any electronic health record registered to the blockchain network was resistant to tampering and revision. The mHealth data update was compatible with tamper resistance in the blockchain network.

Conclusions: Blockchain serves as a tamperproof system for mHealth. Combining mHealth with blockchain technology may provide a novel solution that enables both accessibility and data transparency without a third party such as a contract research organization.

Keywords: cognitive therapy; computer security; electronic health records; sleep; telemedicine.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors are members of Sustainable Medicine, Inc.

Figures

Figure 1
Figure 1
(a) The structure of the mobile health system for cognitive behavioral therapy for insomnia (b) The data update using a blockchain system (c) The structure of the blockchain (d) The virtual computing environment in the study.
Figure 2
Figure 2
The blockchain (excerpt) in the normal mobile health data update.
Figure 3
Figure 3
The user data (excerpt) queried from the state in the normal mobile health data update. (a) The initial user data after the Deploy step. (b) The updated user data after the Invoke step (newly added data were highlighted).
Figure 4
Figure 4
The blockchain in the mobile health data update test when one of validating peers (VPs) was down. The blockchain height of each VP is shown. (a) Robustness of the blockchain network against network failure. (b) Correction of the inconsistency by ledger synchronization. (c) Rejoining the Practical Byzantine Fault Tolerance consensus after another network failure.
Figure 5
Figure 5
The user mobile health data (excerpt) queried from the state in the data update test when one of the validating peers (VPs) was down. (a) The successfully added user data after the Invoke step when VP1 was down (newly added data were highlighted). (b) The user data after the Invoke step when VP1 was rebooted (newly added data were highlighted).
See this image and copyright information in PMC

References

    1. Peter S. Ama-assn. 2016. [2017-07-19]. Integration of mobile health applications and devices into practice https://www.ama-assn.org/sites/default/files/media-browser/public/about-... 6s4Fz8Rtm.
    1. Zhang R, Liu L. Security models and requirements for healthcare application clouds. IEEE 3rd International Conference on Cloud Computing; 2010; Miami, FL. 2010. - DOI
    1. Rodrigues JJ, de la Torre I, Fernández G, López-Coronado M. Analysis of the security and privacy requirements of cloud-based electronic health records systems. J Med Internet Res. 2013 Aug 21;15(8):e186. doi: 10.2196/jmir.2494. http://paperpile.com/b/RUDrOC/yFzwy - DOI - PMC - PubMed
    1. Nugent T, Upton D, Cimpoesu M. Improving data transparency in clinical trials using blockchain smart contracts. F1000Res. 2016;5:2541. doi: 10.12688/f1000research.9756.1. https://f1000research.com/articles/10.12688/f1000research.9756.1/doi - DOI - DOI - PMC - PubMed
    1. Crosby M, Nachiappan. Pattanayak P, Verma S, Kalyanaraman V. Berkeley. [2017-05-27]. BlockChain technology: beyond Bitcoin http://scet.berkeley.edu/wp-content/uploads/AIR-2016-Blockchain.pdf 6qlaKudww.