Abstract
Delivering electronic health care (eHealth) services across multi-cloud providers to implement patient-centric care demands a trustworthy brokering architecture. Specifically, such an architecture should aggregate relevant medical information to allow informed decision-making. It should also ensure that this information is complete and authentic and that no one has tampered with it. Brokers deployed in eHealth services may fall short of meeting such criteria due to two key behaviors. The first involves violating international health-data protection laws by allowing user anonymity and limiting user access rights. Second, brokers claiming to provide trustworthy transactions between interested parties usually rely on user feedback, an approach vulnerable to manipulation by malicious users. This paper addresses these data security and trust challenges by proposing HealthyBroker, a novel, trust-building brokering architecture for multiple cloud environments. This architecture is designed specifically for patient-centric cloud eHealth services. It enables care-team members to complete eHealth transactions securely and access relevant patient data on a “need-to-know” basis in compliance with data-protection laws. HealthyBroker also protects against potential malicious behavior by assessing the trust relationship and tracking it using a neutral, tamper-proof, distributed blockchain ledger. Trust is assessed based on two strategies. First, all transactions and user feedback are tracked and audited in a distributed ledger for transparency. Second, only feedback coming from trustworthy parties is taken into consideration. HealthyBroker was tested in a simulated eHealth multi-cloud environment. The test produced better results than a benchmark algorithm in terms of data accuracy, service time, and the reliability of feedback received as measured by three malicious behavior models (naïve, feedback isolated, and feedback collective). These results demonstrate that HealthyBroker can provide care teams with a trustworthy, transparent ecosystem that can facilitate information sharing and well-informed decisions for patient-centric care.
Highlights
Modern health care employs emerging technologies such as cloud computing and blockchains to improve patient safety, health outcomes, service efficiency, and delivery models
Delivering electronic health care services across multi-cloud providers to implement patient-centric care demands a trustworthy brokering architecture that can ensure that shared patient information among multi-care providers is complete and authentic and that no one has tampered with it
Existing brokering models fall short in addressing these special requirements of patient-centered Electronic health care (eHealth) services holistically
Summary
Modern health care employs emerging technologies such as cloud computing and blockchains to improve patient safety, health outcomes, service efficiency, and delivery models. Compared to other cryptography-based solutions, blockchain uniquely provides a transparent tamper-proof trail of time-stamped block sequences that are algorithmically self-policed to support secure, private, and indelible transactions This technology can prevent malicious user feedback in health care services by tracking user credibility and sharing that information with all care-team members in the ecosystem. This would fill the security and transparency gap in traditional multi-brokering systems and meet the security requirements of modern eHealth services. Modern eHealth collaborative environments require multi-cloud brokering architectures that can identify care-team members and allow them to act as providers and consumers as needed based on a patient’s treatment plan.
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