A Framework for Blockchain-based Secure Management of Mobile Healthcare (mHealth) Systems
DOI:
https://doi.org/10.13052/jwe1540-9589.2431Keywords:
Blockchain, mobile computing, smart health, security, smart contractsAbstract
In recent years, several research and development initiatives have focused on developing secure and trustworthy systems for the healthcare industry via pervasive and mobile healthcare (mHealth) solutions. State-of-the-art mHealth solutions primarily rely on centralized storage, such as cloud computing servers, which may escalate the maintenance costs, require ever-increasing storage infrastructure, and pose privacy and security risks to the health-critical data produced, consumed, and transmitted over ad hoc networks. To overcome these limitations, we conducted this study intending to synergize mobile computing (devices to process health-critical data) and blockchain technology (infrastructure to secure storage and retrieval of health-critical data), specifically addressing data security and privacy using a blockchain mHealth system. The research employs an incremental method by (i) developing a framework that acts as a blueprint to architect blockchain-enabled mHealth systems, (ii) implementing a suite of algorithms as a proof-of-concept to automate the framework, and (iii) experimental evaluations to validate the scalability, computation, and energy efficiency of the proposed solution. The proposed framework has been implemented as a frontend using a mobile application interface that exploits the backend via the InterPlanetary File System (IPFS) system and Ethereum blockchain for secure management of mHealth data. We use a case-study-based approach demonstrating how health units, medics, and patients can securely access and distribute health-critical data. For evaluation, we deployed a smart contract prototype on the Ethereum TESTNET network in a Windows environment to test the proposed framework. Results of the evaluation indicate (a) scalability with query response time (range: 10–41 ms), (b) computational performance (CPU utilization: 1.5% – 2.5%), and (c) energy efficiency (gas consumption: 40000 units for 1000 bytes). The proposed solution – framework, algorithms, and experimental evaluation – aims to advance state-of-the-art architecting and implementing cybersecurity mHealth solutions using blockchain technology.
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Mazhar T, Irfan HM, Khan S, Haq I, Ullah I, Iqbal M, Hamam H. Analysis of Cyber Security Attacks and Its Solutions for the Smart grid Using Machine Learning and Blockchain Methods. Future Internet. 2023; 15(2):83. https://doi.org/10.3390/fi15020083.
Narayanan, J. Bonneau, E. Felten, A. Miller, and S. Goldfeder, Bitcoin and cryptocurrency technologies: a comprehensive introduction. Princeton University Press, 2016.
F. Tschorsch and B. Scheuermann, “Bitcoin and beyond: A technical survey on decentralized digital currencies,” IEEE Communications Surveys & Tutorials, vol. 18, no. 3, pp. 2084–2123, 2016.
T. Aste, P. Tasca, and T. Di Matteo, “Blockchain technologies: The foreseeable impact on society and industry,” 2017.
S. Kruse, B. Smith, H. Vanderlinden, and A. Nealand, “Security techniques for the electronic health records,” Journal of Medical Systems, vol. 41, no. 8, pp. 1–9, 2017.
Shah, S. F. A., Mazhar, T., Al Shloul, T., Shahzad, T., Hu, Y. C., Mallek, F., and Hamam, H. (2024). Applications, challenges, and solutions of unmanned aerial vehicles in smart city using blockchain. PeerJ Computer Science, 10, e1776.
Ghadi, Y.Y., Shah, S.F.A., Mazhar, T. et al. Enhancing patient healthcare with mobile edge computing and 5G: challenges and solutions for secure online health tools. J Cloud Comp 13, 93 (2024). https://doi.org/10.1186/s13677-024-00654-4.
G. Márquez, C. Taramasco, and H. Astudillo, “Defining security metrics to evaluate electronic health records systems: A case study in chile,” in 2020 IEEE International Conference on Software Architecture Companion (ICSA-C), pp. 173–180, IEEE, 2020.
A. H. Seh, M. Zarour, M. Alenezi, A. K. Sarkar, A. Agrawal, R. Kumar, and R. Ahmad Khan, “Healthcare data breaches: insights and implications,” in Healthcare, vol. 8, p. 133, Multidisciplinary Digital Publishing Institute, 2020.
G. Bigini, M. Zichichi, E. Lattanzi, S. Ferretti, G. D’Angelo, et al., “Decentralized health data distribution: A dlt-based architecture for data protection,” in 5th IEEE International Conference on Blockchain (Blockchain 2022), IEEE, 2022.
G. Ye, H. Yin, T. Chen, M. Xu, Q. V. H. Nguyen, and J. Song, “Personalized on-device e-health analytics with decentralized block coordinate descent,” IEEE Journal of Biomedical and Health Informatics, 2022.
Y. Psaras and D. Dias, “The interplanetary file system and the filecoin network,” in 2020 50th Annual IEEE-IFIP International Conference on Dependable Systems and Networks-Supplemental Volume (DSN-S), pp. 80–80, IEEE, 2020.
M. Nofer, P. Gomber, O. Hinz, and D. Schiereck, “Blockchain,” Business & Information Systems Engineering, vol. 59, no. 3, pp. 183–187, 2017.
A. Miller, “Permissioned and permissionless blockchains,” Blockchain for distributed systems security, pp. 193–204, 2019.
W. Zou, D. Lo, P. S. Kochhar, X.-B. D. Le, X. Xia, Y. Feng, Z. Chen, and B. Xu, “Smart contract development: Challenges and opportunities,” IEEE Transactions on Software Engineering, vol. 47, no. 10, pp. 2084–2106, 2019.
Z. Zheng, S. Xie, H.-N. Dai, W. Chen, X. Chen, J. Weng, and M. Imran, “An overview on smart contracts: Challenges, advances and platforms,” Future Generation Computer Systems, vol. 105, pp. 475–491, 2020.
G. Wood et al., “Ethereum: A secure decentralised generalised transaction ledger,” Ethereum project yellow paper, vol. 151, no. 2014, pp. 1–32, 2014.
W. Ethereum, “Ethereum whitepaper,” Ethereum. URL: https://ethereum.org [accessed 2022-09-22], 2014.
Bermúdez, A. G., Carramiñana, D., Bernardos, A. M., Bergesio, L., and Besada, J. A. (2024). A fusion architecture to deliver multipurpose mobile health services. Computers in Biology and Medicine, 173, 108344.
Sarkar, A., and Jhamb, M. (2024). Secure and portable health monitoring system for Cyber Physical Systems in Internet of Things. Engineering Research Express.
Rathore, Nitin, Aparna Kumari, Margi Patel, Alok Chudasama, Dhyey Bhalani, Sudeep Tanwar, and Abdulatif Alabdulatif. “Synergy of AI and Blockchain to Secure Electronic Healthcare Records.” Security and Privacy 8, no. 1 (2025): e463.
Vatambeti, Ramesh, ES Phalguna Krishna, M. Ganesh Karthik, and Vijay Kumar Damera. “Securing the medical data using enhanced privacy preserving based blockchain technology in Internet of Things.” Cluster Computing 27, no. 2 (2024): 1625–1637.
Tariq, M. U. (2024). Revolutionizing health data management with blockchain technology: Enhancing security and efficiency in a digital era. In Emerging Technologies for Health Literacy and Medical Practice (pp. 153–175). IGI Global.
E. Ahmed, I. Yaqoob, A. Gani, M. Imran, and M. Guizani, “Internet-ofthings-based smart environments: state of the art, taxonomy, and open research challenges,” IEEE Wireless Communications, vol. 23, no. 5, pp. 10–16, 2016.
X. Larrucea, A. Combelles, J. Favaro, and K. Taneja, “Software engineering for the internet of things,” IEEE Software, vol. 34, no. 1, pp. 24–28, 2017.
Sharma, Aashima, Sanmeet Kaur, and Maninder Singh. “A comprehensive review on blockchain and Internet of Things in healthcare.” Transactions on Emerging Telecommunications Technologies 32.10 (2021): e4333.
Pustokhin, Denis A., Irina V. Pustokhina, and K. Shankar. “Challenges and future work directions in healthcare data management using blockchain technology.” Applications of Blockchain in Healthcare (2021): 253–267.
Aljedaani, Bakheet, et al. “An empirical study on secure usage of mobile health apps: The attack simulation approach.” Information and Software Technology 163 (2023): 107285.
Aljedaani, Bakheet, et al. “End-users’ knowledge and perception about security of clinical mobile health apps: A case study with two Saudi Arabian mHealth providers.” Journal of Systems and Software 195 (2023): 111519.
Balapour, Ali, et al. “Mobile technology identity and self-efficacy: Implications for the adoption of clinically supported mobile health apps.” International Journal of Information Management 49 (2019): 58–68.
Kao, Cheng-Kai, and David M. Liebovitz. “Consumer mobile health apps: current state, barriers, and future directions.” PM&R 9.5 (2017): S106–S115.
Zhang, Peng, et al. “FHIRChain: applying blockchain to securely and scalably share clinical data.” Computational and structural biotechnology journal 16 (2018): 267–278.
Farouk, Ahmed, et al. “Blockchain platform for industrial healthcare: Vision and future opportunities.” Computer Communications 154 (2020): 223–235.
CHELLADURAI, Mrs USHARANI, Seethalakshmi Pandian, and Krishnamoorthy Ramasamy. “A blockchain based patient centric electronic health record storage and integrity management for e-Health systems.” Health Policy and Technology 10.4 (2021): 100513.
Nanda, Saroj Kumar, Sandeep Kumar Panda, and Madhabananda Dash. “Medical supply chain integrated with blockchain and IoT to track the logistics of medical products.” Multimedia Tools and Applications (2023): 1–23.
Sun, Fangmin, et al. “Gait-based identification for elderly users in wearable healthcare systems.” Information fusion 53 (2020): 134–144.
Fahmideh, Mahdi, John Grundy, Aakash Ahmad, Jun Shen, Jun Yan, Davoud Mougouei, Peng Wang et al. “Engineering blockchain-based software systems: Foundations, survey, and future directions.” ACM Computing Surveys 55, no. 6 (2022): 1–44.
Guggenberger, Tobias, Vincent Schlatt, Jonathan Schmid, and Nils Urbach. “A Structured Overview of Attacks on Blockchain Systems.” PACIS (2021): 100.

