The Rise of the Internet of Medical Things (IoMT)
The Internet of Medical Things (IoMT) has experienced a significant surge in adoption during the COVID-19 pandemic, enabling the provision of remote healthcare services through the utilization of a wide range of medical equipment and software. This technology allows for the broadcasting of patient results over the internet, facilitating remote monitoring and care. However, the preservation of privacy and security in online medical communications continues to present a pressing challenge.
Blockchain technology has demonstrated its potential to mitigate these security concerns across various sectors, including the healthcare industry. Recent advancements have incorporated intelligent agents into patient monitoring systems by integrating blockchain technology. Yet, the conventional network configuration of the agent and blockchain introduces a degree of complexity.
Addressing the Complexity: SDN-Blockchain Integration
To address this complexity, this article presents a proposed architectural framework that combines software-defined networking (SDN) with Blockchain technology. This framework is tailored specifically for the purpose of facilitating remote patient monitoring systems within the context of a 5G environment.
The architectural design contains a Patient-Centric Agent (PCA) inside the SDN control plane, responsible for managing user data on behalf of the patients. The PCA ensures the appropriate handling of patient data by providing essential instructions to the forwarding devices.
Evaluating the Proposed Model
The suggested model is assessed using Hyperledger Fabric on a Docker-Engine environment, and its performance is compared to that of current models in fifth-generation (5G) networks. The results of the extensive study demonstrate that the performance of the proposed model surpasses current methodologies in terms of throughput, reliability, communication overhead, and packet error rate.
Sensor Networks is a leading source for the latest advancements in sensor network technologies, IoT, and related fields. By leveraging blockchain-enabled patient-centric solutions and SDN-based architectures, the healthcare industry can enhance the security, privacy, and efficiency of remote patient monitoring systems.
The Significance of IoMT in Healthcare
The Internet of Medical Things (IoMT) has become increasingly valuable in ensuring proper online-based medical services. Its successful implementation has been made possible through the utilization of various IoT device applications, including wearables, wireless sensors, and similar devices used to store and transmit physiological data of patients to secure servers, such as cloud-based systems.
Compared to traditional medical services, the secure collection and constant monitoring of patients’ physiological signs or medical data through the IoMT provide the best possible medical service, particularly advantageous for developing countries with a limited number of healthcare service providers or professionals.
Challenges in IoMT Data Management
The interconnection among medical devices and software that can communicate via the internet globally is referred to as the IoMT. While this technology enables point-to-point transmission that could be anonymous, privacy concerns have hindered patients from communicating their personal health information with hospital administrators through electronic means, leading to a lack of transparency and ineffective healthcare systems.
As complex patients seek care from multiple healthcare organizations and providers who utilize different electronic health records, the lack of connectivity becomes increasingly challenging. One potential solution for data collaboration is the adoption of a blockchain-based system, which offers numerous advantages.
Integrating Blockchain and 5G for Secure IoMT
Although the 5G networking system and Blockchain are two unique technical approaches, there are use cases and potential affinities where adding the Blockchain to the 5G networking system might improve the networking mechanism.
Blockchain authentication provides an immutable record of device authentication, making it difficult for hackers to breach the network. The key benefit of this integration is offering security and authentication processes within the 5G network system.
Network segmentation is possible in 5G networks, and in these virtual network slices, the Blockchain may be utilized to govern service-level agreements and guarantee fair compensation for the networking system. Additionally, the Blockchain technique can simplify the billing procedure in the 5G ecosystem, lowering the incidence of billing fraud.
Challenges in Remote Patient Monitoring (RPM) Systems
Remote Patient Monitoring (RPM) systems, on the other hand, ensure patient privacy while preserving a significant amount of patient medical data. Privacy entails an individual’s complete control over data streams and the ability to define access-level permissions for others.
However, RPM communication is particularly susceptible to hackers due to vulnerability threats and relatively weaker cryptographic techniques compared to wired communication. Threats can originate from insiders such as healthcare professionals and individuals related to healthcare, as well as external factors like intruders, hackers, and work environments, making the security of healthcare data a critical concern.
Limitations of Traditional eHealth Systems
Most IoT systems use a single centralized server to maintain patient medical data, rendering the architecture vulnerable to a single point of failure when providing healthcare services with a massive volume of end-to-end transmissions. Traditional eHealth systems face challenges in delivering proper healthcare due to various types of threats, including Denial of Service (DoS) and ransomware.
Some IoT architectures utilize Edge devices such as smartphone apps to transmit and store medical data on third-party cloud servers. As these systems rely on wireless technologies such as WiFi, Zigbee, or Bluetooth to maintain data streams, they become susceptible to eavesdropping, cyber-attacks such as DoS, man-in-the-middle attacks, and insider attacks.
The Need for Blockchain-Based eHealth Systems
The management of patient medical data in a cloud-based IoT architecture necessitates a high level of accountability, transparency, and adherence to numerous health data regulations. Despite the establishment of various health data regulations, it remains challenging to ascertain the compliance of Cloud service providers, posing a threat to the reliability of data management in Clouds.
The adoption of Mobile Cloud Computing (MCC) based IoT architecture has improved the capabilities of smartphone apps by enabling them to upload patient medical data to cloud servers. However, the efficiency of data processing in the cloud server primarily relies on optimizing latency and minimizing connection loss issues.
Blockchain technology offers valuable support in maintaining users’ privacy by providing secure storage, access control, and facilitating the sharing of medical data without relying on third parties. Hyperledger Fabric, a blockchain framework specifically designed for private permissioned blockchains, enables companies to restrict access to their information only to those who have been granted permission to view it.
Challenges in Blockchain Integration
When implementing the Blockchain algorithm, such as mining on resource-constrained devices like wireless sensors and other IoT devices, it becomes even more challenging at the implementation level. The consensus mechanism, a crucial component of Blockchain, refers to the overall agreement among Blockchain Miners regarding the state of blocks. However, incorporating this consensus mechanism into various Blockchain-based e-health systems requires significant computational resources.
Proposed SDN-Blockchain Patient Monitoring System
To address these challenges, this article proposes a patient monitoring system combining SDN and Blockchain to control and secure healthcare data that saves and manages patients’ medical data. This process of saving medical records is performed at the time of monitoring a remote patient on an IoT network.
The key contributions of this proposed system include:
- An IoMT architecture for a remote patient health monitoring system through the patient-centric agent in a 5G network.
- Employing three emerging technologies: SDN, Blockchain, and 5G to control different sensor networks and secure healthcare data in the IoMT.
- Utilizing a combined SDN and Blockchain technology in the 5G network to preserve the patients’ personal data.
Implementation and Performance Analysis
The proposed architecture is implemented using Hyperledger Fabric on a Docker-Engine environment. The performance analysis compares the proposed system, named SDNwPCA, with the Assistive Care Loop Framework (ACLF) and BSN-Care baseline models.
The results show that the SDNwPCA model outperforms the existing approaches in terms of reliability, throughput, communication overhead, and packet error rate. The average latency of the proposed system is also consistently better than the IMTe-Healthcare study.
Limitations and Open Challenges
Altering traditional healthcare systems is a rigorous task that requires skilled and conscious people. The lack of such resources is an open challenge to continue implementing smart systems over the internet. Moreover, security vulnerabilities are a prevalent issue, as agent-based healthcare systems use computer or computer-like devices that can be infected by malicious viruses, potentially harming the entire system through ransomware, DDoS attacks, Sybil attacks, and phishing.
To protect the health system monitoring mechanism, Blockchain can be a suitable solution to provide security to the data. Machine learning techniques can also assist in identifying abnormalities in the data and restricting unauthorized access to the system through multi-factor authentication.
Conclusion and Future Directions
This study demonstrates a patient-centric agent-based medical framework for IoMT networks, with a focus on information security. The proposed architecture, which combines SDN, Blockchain, and 5G technology, aims to enhance the security, privacy, and efficiency of remote patient monitoring systems.
In the future, the authors plan to develop a mobile application that can adapt this model and modify the smart contract process, allowing customers of IoMT networks to conveniently access services. Continuing research efforts in federated learning, AI-IoT integration, and secure key establishment protocols for IoMT devices in 5G networks will further advance the field of sensor-driven healthcare and blockchain-enabled patient-centric solutions.