Abstract

Blockchain is a disruptive technology for shaping the next era of a healthcare system striving for efficient and effective patient care. This is thanks to its peer-to-peer, secure, and transparent characteristics. On the other hand, cloud computing made its way into the healthcare system thanks to its elasticity and cost-efficiency nature. However, cloud-based systems fail to provide a secured and private patient-centric cohesive view to multiple healthcare stakeholders. In this situation, blockchain provides solutions to address security and privacy concerns of the cloud because of its decentralization feature combined with data security and privacy, while cloud provides solutions to the blockchain scalability and efficiency challenges. Therefore a novel paradigm of blockchain-cloud integration (BcC) emerges for the domain of healthcare. In this paper, we provide an in-depth analysis of the BcC integration for the healthcare system to give the readers the motivations behind the emergence of this new paradigm, introduce a classification of existing architectures and their applications for better healthcare. We then review the development platforms and services and highlight the research challenges for the integrated BcC architecture, possible solutions, and future research directions. The results of this paper will be useful for the healthcare industry to design and develop a data management system for better patient care.

Highlights

  • The healthcare domain has been revolutionized over the last century by technological advancement [1]

  • We present the limitations of a healthcare system that is based on either cloud or blockchain and highlight the importance of implementing an integrated blockchain-cloud integration (BcC) system for better patient care

  • We present a scoping review and devise a taxonomy of existing integrated BcC healthcare system architectures into two different types based on the nature of integration

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Summary

Introduction

The healthcare domain has been revolutionized over the last century by technological advancement [1]. Healthcare organizations are required to install and maintain infrastructure with up-to-date functionalities while complying with healthcare standards and regulations for the management of Electronic Health Records (EHRs). This leads to a high total cost of ownership. Cloud computing technology offers a shared pool of configurable hardware resources and software services over the Internet [10]. These resources can be speedily allocated and released without the system administrator’s intervention. The cloud consists of three layers: (1) physical resource layer, (2) resource abstraction and control layer, and (3)

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