# Blockchain-Based Internet of Medical Things
## 3 Analysis
### Blockchain Scalability
It is essential to create platform-agnostic, universal solutions that control the interaction between cloud computing, blockchain, IoMT devices, and end users. 2. Scalability is one of the significant problems that current blockchain-based IoMT applications face, causing slow transaction validation, high transaction fees, high storage memory requirements, and long synchronization times [67; 140]. Hence, scalability is an essential factor that needs more research and direction. 3. The incorporation of blockchain into the IoMT opens the door to several health-related applications. However, the implementation of such technology (blockchain-IoMT) is complex and necessitates in-depth interdisciplinary knowledge, ranging from low-level, such as managing IoMT devices and configuring blockchain to meet IoMT criteria, to high-level knowledge, such as treating, storing, and sharing IoMT data. 4. An advancement in personalized medicine, utilizing the most cutting-edge machine learning methods that computer science has to offer, would be made possible by the opportunity of freely sharing sensitive data between experts and health institutions. IoMT gathers huge amounts of information. Finding usable information from the acquired data is a challenge. The IoMT device may provide practical information when using data analytics to examine the data and find flaws, vulnerabilities, and bottlenecks in the system. IoMT data heterogeneity, however, presents difficulties for data analytics [16]. Deep learning advances in machine learning may assist in resolving these issues [141]. 5. The bulk of present works is solely concerned with healthcare applications such as IoMT data management and remote patient monitoring, such as data exchange and storage. Tracking apps that prevent counterfeit medications and medical mishaps are critical. In this context, the adoption of blockchain technology in conjunction with IoMT may be an effective solution for controlling doctor behavior as well as managing the medication supply chain. Data can be stored in the blockchain's blocks (which is challenging because of the scalability issues), data provenance can be exploited by storing the locations of data in the blockchains rather than the data itself, and distributed storage can be used in tandem with the blockchain to serve as off-chain storage. The data that could be easily accessed and utilized would never have to be sent over the network in any of the systems. It is obvious that user-centric solutions are becoming more popular, even if it is not the primary focus of the study. Despite efforts to give consumers more control over their data, developing a truly decentralized system that is user-centric for health data remains a challenge. Authorized systems that are controlled by healthcare institutions are not always clear, since they may provide consumers more control over their data but ultimately need them to comply with consortium norms around data management. Decentralized storages run the danger of being squandered because of this security issue in permissioned systems, which reduces their value. Even in the case that user data is stored in a decentralized manner on the blockchain, this does not ensure a user-centric system if the blockchain might be tampered with by participants. Several actual uses demonstrate this. If these networks can incentivize users to share personal healthcare data with the community in exchange for benefits, it would be even more astounding if a solution could be found, maybe via hybrid implementations between permissioned and permissionless implementations. No one ever receives credit for the value added by their usage of an IoMT system or an IoT device. In most cases, when people pay for expert assistance, their investment exceeds the results they see. As a matter of fact, in theory, they help advance scientific understanding. Certainly, data sharing and crowdsourcing might be made possible by the Internet of blockchains in a blockchain-enabled society.