The recent approval of the General Data Protection Regulation (GDPR) imposes new data protection requirements on data controllers and processors with respect to the processing of European Union (EU) residents' data. These requirements consist of a single set of rules that have binding legal status and should be enforced in all EU member states. In light of these requirements, we propose in this paper the use of a blockchain-based approach to support data accountability and provenance tracking. Our approach relies on the use of publicly auditable contracts deployed in a blockchain that increase the transparency with respect to the access and usage of data. We identify and discuss three different models for our approach with different granularity and scalability requirements where contracts can be used to encode data usage policies and provenance tracking information in a privacy-friendly way. From these three models we designed, implemented, and evaluated a model where contracts are deployed by data subjects for each data controller, and a model where subjects join contracts deployed by data controllers in case they accept the data handling conditions. Our implementations show in practice the feasibility and limitations of contracts for the purposes identified in this paper.
Applied to the same field but with a more comprehensive approach is MedRec @cite_6 . The authors propose to give patients control over their Electronic Health Records (EHRs) through the use of Ethereum blockchain and smart contracts, which manage authentication, confidentiality, accountability and sharing of the data. The latter are referenced in the chain using their hashes but are stored externally. Miners are rewarded with anonymized aggregated data useful for research. Although the proposed approach addresses many issues, considerations about costs and scalability on a large scale deployment are not mentioned.
@cite_6
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Years of heavy regulation and bureaucratic inefficiency have slowed innovation for electronic medical records (EMRs). We now face a critical need for such innovation, as personalization and data science prompt patients to engage in the details of their healthcare and restore agency over their medical data. In this paper, we propose MedRec: a novel, decentralized record management system to handle EMRs, using blockchain technology. Our system gives patients a comprehensive, immutable log and easy access to their medical information across providers and treatment sites. Leveraging unique blockchain properties, MedRec manages authentication, confidentiality, accountability and data sharing -- crucial considerations when handling sensitive information. A modular design integrates with providers' existing, local data storage solutions, facilitating interoperability and making our system convenient and adaptable. We incentivize medical stakeholders (researchers, public health authorities, etc.) to participate in the network as blockchain &#x0022;miners&#x0022;. This provides them with access to aggregate, anonymized data as mining rewards, in return for sustaining and securing the network via Proof of Work. MedRec thus enables the emergence of data economics, supplying big data to empower researchers while engaging patients and providers in the choice to release metadata. The purpose of this short paper is to expose, prior to field tests, a working prototype through which we analyze and discuss our approach. Privacy concern is arguably the major barrier that hinders the deployment of electronic health record (EHR) systems which are considered more efficient, less error-prone, and of higher availability compared to traditional paper record systems. Patients are unwilling to accept the EHR system unless their protected health information (PHI) containing highly confidential data is guaranteed proper use and disclosure, which cannot be easily achieved without patients' control over their own PHI. However, cautions must be taken to handle emergencies in which the patient may be physically incompetent to retrieve the controlled PHI for emergency treatment. In this paper, we propose a secure EHR system, HCPP (Healthcaresystem for Patient Privacy), based on cryptographic constructions and existing wireless network infrastructures, to provide privacy protection to patients under any circumstances while enabling timelyPHI retrieval for life-saving treatment in emergency situations. Furthermore, our HCPP system restricts PHI access to authorized (not arbitrary) physicians, who can be traced and held accountable if the accessed PHI is found improperly disclosed. Last but not least, HCPP leverages wireless network access to support efficient and private storage retrieval of PHI, which underlies a secure and feasible EHR system. This paper addresses privacy issues in managing electronic health records by a third party cloud based service. Compared to traditional authentication-authorization mechanisms, the proposed approach minimizes the leakage of identity information of involved participants through unlinkability. Furthermore, it gives the ability to health record owners for making access control decisions. This solution employs an identity management scheme that enhances consumer privacy by preventing consumer profiling based on the credentials used to satisfy the service provider policies. The paper proposes a set of mechanisms to allow authenticated unlinkable access to electronic health records, while giving the record owners ability to make access control decisions. The security evaluation for accessing data in the cloud is detailed, and the implementation of the system is evaluated in this paper. In the Internet of Things (IoT) scenario, the block-chain and, in general, Peer-to-Peer approaches could play an important role in the development of decentralized and dataintensive applications running on billion of devices, preserving the privacy of the users. Our research goal is to understand whether the blockchain and Peer-to-Peer approaches can be employed to foster a decentralized and private-by-design IoT. As a first step in our research process, we conducted a Systematic Literature Review on the blockchain to gather knowledge on the current uses of this technology and to document its current degree of integrity, anonymity and adaptability. We found 18 use cases of blockchain in the literature. Four of these use cases are explicitly designed for IoT. We also found some use cases that are designed for a private-by-design data management. We also found several issues in the integrity, anonymity and adaptability. Regarding anonymity, we found that in the blockchain only pseudonymity is guaranteed. Regarding adaptability and integrity, we discovered that the integrity of the blockchain largely depends on the high difficulty of the Proof-of-Work and on the large number of honest miners, but at the same time a difficult Proof-of-Work limits the adaptability. We documented and categorized the current uses of the blockchain, and provided a few recommendations for future work to address the above-mentioned issues.