## 3 Challenges in Healthcare Management Systems
Interoperability among medical services suppliers, frameworks, and medical care data has been one of the most critical prerequisites in giving accurate health information;
* **Backup and Recovery Issues:** Data loss can occur for many reasons, including natural disasters, information security breaches, manual errors, and tampering with information by intruders. HMS has been facing these issues on an operational basis, where data recovery is challenging. There must be an efficient system to track the operations and actions taken by different people involved in the system. Many healthcare systems store their data on a central server where a single point of failure can lead to the failure of the entire system. Backup and recovery are significant hindrances when it comes to health information retrieval;
* **Heterogeneous Data Limitations:** Healthcare data are a combination of different information forms, including heterogeneous data formats such as prescription slips, clinical lab reports, X-rays, MRI scans, etc. These diverse-natured records are difficult to handle and manage. HMS faces many challenges due to the heterogeneity of records and data scaling. Due to the expounding of patients' health historical records, HMS has been suffering a lot while storing these heterogeneous data for a long time;
* **Inter-Organization Access Restrictions**: HMS still suffers from inter-organization access restrictions. Because the data are stored locally/centrally on the server, the system cannot access it outside a healthcare organization. Lack of trust prevails among healthcare providers, especially while sharing patient information. There is no safe connection for sharing health data throughout the health system;
* **Single-Point Failure in Centralized Frameworks:** Centralized EHRs have addressed several EMR-related issues, such as digitally managing substantial volumes of data utilizing a central server. However, the single point of failure problem still affects the system. Many healthcare systems save their data on a central server, where the loss of one component might bring down the entire system. A single point of failure is essentially a weakness in the design, configuration, or execution of a system, circuit, or component that poses a risk because it could lead to a situation in which just one issue or malfunction stops the entire system from working;* **No Global Unique Medical Record Identifier:** Identity management, which has been classified as a connected attribute that belongs to an entity, is one of the primary challenges. There are gaps because digital identity management is not widely used, and each user record exists in several copies. The provider-centric system only allows the treating physician to view patient information. Viewing health information is restricted for patients. The patient does not have the authority to manage their health information, and they are also unaware of who is authorized to access it. Patients must exchange their medical records and data throughout the healthcare ecosystem since it is a complicated system with many different actors. The exchange of patient data simultaneously cannot be prohibited, and security rules must be handled to make this possible. Over the years, security and privacy attacks on healthcare systems have occurred often. The most significant cyberattacks and the loopholes behind them are listed in Table 3.  
The cyberattacks mentioned above have harmed many individuals because they can no longer access their medical information confidentially. Figure 5 illustrates the number of persons affected by cyberattacks since 2009. These years were chosen for the study because it was 2009 when medical record digitalization became a new development that had an impact on the world, and IT expansion in healthcare systems began. BC has built-in security features since data are encrypted using the sender's private key [39], and only the proposed recipient can decode data using the sender's private key.