Medical Design Briefs - February 2024 - 16

Utilizing Blockchain
blockchains enable faster, more accurate
regulatory audits.
Medical organizations could also use
blockchain tracking in their IoT supply
chains. This approach would let them verify
where their IoMT endpoints and components
come from. They could then hold
providers to higher standards and ensure
that they only use secure devices. Supply
chain attacks impacted 40 percent more
people than malware in 2022, so this protection
is becoming increasingly crucial.5
Best Practices for Improving IoT
Security with Blockchain
While these potential benefits are impressive,
it's important to remember that
blockchain and IoT are only tools. How
effective they are depends on their usage,
so healthcare organizations should
keep several things in mind when implementing
them.
Ensure That Sensitive Data Remains
Private. One of the most important steps
is to keep IoMT blockchains private.
Transparency is great for audits and patient
trust, but medical businesses must
also consider data privacy in light of
regu lations like HIPAA.
The key is ensuring that the visible
parts of a block don't disclose any realworld
patient data. Financial blockchains
have already exemplified how
to do this. While the blockchain wallets
involved in each crypto sale and the
transaction amount are visible, the realworld
people and accounts they represent
remain anonymous.
Early experiments have shown how to
apply this practice to a healthcare context.6
First, medical blockchains replace
patient names with a unique, anonymous
identifier known only to authorized
physicians. Next, they encrypt all
EHR data and display only the resulting
hash as a unique identifier. These steps
make it easy to pinpoint specific records
but keep the details private.
Use Smart Contracts for Access ConThe
recent rise of telehealth has led to a rising number of connected smart devices in healthcare. (Credit: National
Cancer Institute)
trol. IoMT blockchains must also be able
to verify users' identities. Restricting data
access to authorized parties is only effective
when the system can accurately determine
if people are who they say they
are. Smart contracts are the solution.
A smart contract is a blockchain feature
that automatically triggers an action
after certain conditions are met. In an
IoMT context, these protections should
work with the encryption and hashing
technique. EHRs remain visible as only a
hash until a user or device verifies their
identity, at which point the smart contract
decrypts it so they can see and use
the specifics.
These verification methods must be
more secure than a simple username
and password. Just 25 percent of people
adhere to strong password management
practices, and these credentials are relatively
easy to break past.7 Organizations
should use private cryptographic keys to
authenticate IoMT devices and multifactor
authentication (MFA) to verify users.
Consider Blockchain's Power Consumption.
Medical organizations implementing
blockchain security systems
must also consider their IT infrastructure
and its limits. Blockchains consume
considerable amounts of energy, which
could be an issue for facilities with limited
hardware or those running lots of
power-hungry equipment. Without sufficient
power, running a blockchain could
lead to costly outages.
Blockchains link records in distributed groups of blocks for transparency and security. (Credit: Shubham Dhage)
16
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One possible solution is to use proofof-stake
(PoS) blockchains instead of the
conventional proof-of-work (PoW) alternatives.
They authenticate transactions
by staking resources instead of relying
on complex mathematical equations,
resulting in far lower CPU power usage.
In a testament to this technology, the
Ethereum blockchain decreased its energy
consumption by 99.9 percent after
switching to a PoS system.8
Medical Design Briefs, February 2024

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Medical Design Briefs - February 2024

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