Blockchain and COVID-19 pandemic: applications and challenges.

The year 2020 has witnessed the emergence of coronavirus (COVID-19) that has rapidly spread and adversely affected the global economy, health, and human lives. The COVID-19 pandemic has exposed the limitations of existing healthcare systems regarding their inadequacy to timely and efficiently handle public health emergencies. A large portion of today's healthcare systems are centralized and fall short in providing necessary information security and privacy, data immutability, transparency, and traceability features to detect fraud related to COVID-19 vaccination certification, and anti-body testing. Blockchain technology can assist in combating the COVID-19 pandemic by ensuring safe and reliable medical supplies, accurate identification of virus hot spots, and establishing data provenance to verify the genuineness of personal protective equipment. This paper discusses the potential blockchain applications for the COVID-19 pandemic. It presents the high-level design of three blockchain-based systems to enable governments and medical professionals to efficiently handle health emergencies caused by COVID-19. It discusses the important ongoing blockchain-based research projects, use cases, and case studies to demonstrate the adoption of blockchain technology for COVID-19. Finally, it identifies and discusses future research challenges, along with their key causes and guidelines.

A Blockchain-Based Regulatory Framework for mHealth

Mobile health (mHealth) is playing a key role in facilitating health services for patients. Such services may include remote diagnostics and monitoring, chronic conditions management, preventive medicine, and health promotion. While mHealth has gained significant traction during the COVID-19 pandemic, they may pose safety risks to patients. This entails regulations and monitoring of shared data and management of potential safety risks of all mHealth applications continuously and systematically. In this study, we propose a blockchain-based framework for regulating mHealth apps and governing their safe use. We systematically identify the needs, stakeholders, and requirements of the current mHealth practices and regulations that may benefit from blockchain features. Further, we exemplify our framework on a diabetes mHealth app that supports safety risk assessment and incident reporting functions. Blockchain technology can offer a solution to achieve this goal by providing improved security, transparency, accountability, and traceability of data among stakeholders. Blockchain has the potential to alleviate existing mHealth problems related to data centralization, poor data quality, lack of trust, and the absence of robust governance. In the paper, we present a discussion on the security aspects of our proposed blockchain-based framework, including limitations and challenges.

COVID-19 Contact Tracing Using Blockchain.

Contact tracing has widely been adopted to control the spread of Coronavirus-2019 (COVID-19). It enables to identify, assess, and manage people who have been exposed to COVID-19, thereby preventing from its further transmission. Today's most of the contact tracing approaches, tools, and solutions fall short in providing decentralized, transparent, traceable, immutable, auditable, secure, and trustworthy features. In this paper, we propose a decentralized blockchain-based COVID-19 contact tracing solution. Contact tracing can greatly suffice the need for a speedy response to a pandemic. We leverage the immutable and tamper-proof features of blockchain to enforce trust, accountability, and transparency. Trusted and registered oracles are used to bridge the gap between on-chain and off-chain data. With no third parties involved or centralized servers, the users' medical information is not prone to invasion, hacking, or abuse. Each user is registered using their digital medical passports. To respect the privacy of the users, their locations are updated with a time delay of 20 minutes. Using Ethereum smart contracts, transactions are executed on-chain with emitted events and immutable logs. We present details of the implemented algorithms and their testing analysis. We evaluate the proposed approach using security, cost, and privacy parameters to show its effectiveness. The smart contracts code is publicly made available on GitHub.

Blockchain-Based Forward Supply Chain and Waste Management for COVID-19 Medical Equipment and Supplies.

The year 2020 has witnessed unprecedented levels of demand for COVID-19 medical equipment and supplies. However, most of today's systems, methods, and technologies leveraged for handling the forward supply chain of COVID-19 medical equipment and the waste that results from them after usage are inefficient. They fall short in providing traceability, reliability, operational transparency, security, and trust features. Also, they are centralized that can cause a single point of failure problem. In this paper, we propose a decentralized blockchain-based solution to automate forward supply chain processes for the COVID-19 medical equipment and enable information exchange among all the stakeholders involved in their waste management in a manner that is fully secure, transparent, traceable, and trustworthy. We integrate the Ethereum blockchain with decentralized storage of interplanetary file systems (IPFS) to securely fetch, store, and share the data related to the forward supply chain of COVID-19 medical equipment and their waste management. We develop algorithms to define interaction rules regarding COVID-19 waste handling and penalties to be imposed on the stakeholders in case of violations. We present system design along with its full implementation details. We evaluate the performance of the proposed solution using cost analysis to show its affordability. We present the security analysis to verify the reliability of the smart contracts, and discuss our solution from the generalization and applicability point of view. Furthermore, we outline the limitations of our solution in form of open challenges that can act as future research directions. We make our smart contracts code publicly available on GitHub.

The role of blockchain technology in telehealth and telemedicine.

OBJECTIVE: Telehealth and telemedicine systems aim to deliver remote healthcare services to mitigate the spread of COVID-9. Also, they can help to manage scarce healthcare resources to control the massive burden of COVID-19 patients in hospitals. However, a large portion of today's telehealth and telemedicine systems are centralized and fall short of providing necessary information security and privacy, operational transparency, health records immutability, and traceability to detect frauds related to patients' insurance claims and physician credentials. METHODS: The current study has explored the potential opportunities and adaptability challenges for blockchain technology in telehealth and telemedicine sector. It has explored the key role that blockchain technology can play to provide necessary information security and privacy, operational transparency, health records immutability, and traceability to detect frauds related to patients' insurance claims and physician credentials. RESULTS: Blockchain technology can improve telehealth and telemedicine services by offering remote healthcare services in a manner that is decentralized, tamper-proof, transparent, traceable, reliable, trustful, and secure. It enables health professionals to accurately identify frauds related to physician educational credentials and medical testing kits commonly used for home-based diagnosis. CONCLUSIONS: Wide deployment of blockchain in telehealth and telemedicine technology is still in its infancy. Several challenges and research problems need to be resolved to enable the widespread adoption of blockchain technology in telehealth and telemedicine systems.

Blockchain-Based Solution for COVID-19 Digital Medical Passports and Immunity Certificates.

COVID-19 has emerged as a highly contagious disease which has caused a devastating impact across the world with a very large number of infections and deaths. Timely and accurate testing is paramount to an effective response to this pandemic as it helps identify infections and therefore mitigate (isolate/cure) them. In this paper, we investigate this challenge and contribute by presenting a blockchain-based solution that incorporates self-sovereign identity, re-encryption proxies, and decentralized storage, such as the interplanetary file systems (IPFS). Our solution implements digital medical passports (DMP) and immunity certificates for COVID-19 test-takers. We present smart contracts based on the Ethereum blockchain written and tested successfully to maintain a digital medical identity for test-takers that help in a prompt trusted response directly by the relevant medical authorities. We reduce the response time of the medical facilities, alleviate the spread of false information by using immutable trusted blockchain, and curb the spread of the disease through DMP. We present a detailed description of the system design, development, and evaluation (cost and security analysis) for the proposed solution. Since our code leverages the use of the on-chain events, the cost of our design is almost negligible. We have made our smart contract codes publicly available on Github.

Cardiovascular Care of the Oncology Patient During COVID-19: An Expert Consensus Document From the ACC Cardio-Oncology and Imaging Councils.

In response to the coronavirus disease 2019 (COVID-19) pandemic, the Cardio-Oncology and Imaging Councils of the American College of Cardiology offers recommendations to clinicians regarding the cardiovascular care of cardio-oncology patients in this expert consensus statement. Cardio-oncology patients-individuals with an active or prior cancer history and with or at risk of cardiovascular disease-are a rapidly growing population who are at increased risk of infection, and experiencing severe and/or lethal complications by COVID-19. Recommendations for optimizing screening and monitoring visits to detect cardiac dysfunction are discussed. In addition, judicious use of multimodality imaging and biomarkers are proposed to identify myocardial, valvular, vascular, and pericardial involvement in cancer patients. The difficulties of diagnosing the etiology of cardiovascular complications in patients with cancer and COVID-19 are outlined, along with weighing the advantages against risks of exposure, with the modification of existing cardiovascular treatments and cardiotoxicity surveillance in patients with cancer during the COVID-19 pandemic.

Blockchain for COVID-19: Review, Opportunities, and a Trusted Tracking System.

The sudden development of the COVID-19 pandemic has exposed the limitations in modern healthcare systems to handle public health emergencies. It is evident that adopting innovative technologies such as blockchain can help in effective planning operations and resource deployments. Blockchain technology can play an important role in the healthcare sector, such as improved clinical trial data management by reducing delays in regulatory approvals, and streamline the communication between diverse stakeholders of the supply chain, etc. Moreover, the spread of misinformation has intensely increased during the outbreak, and existing platforms lack the ability to validate the authenticity of data, leading to public panic and irrational behavior. Thus, developing a blockchain-based tracking system is important to ensure that the information received by the public and government agencies is reliable and trustworthy. In this paper, we review various blockchain applications and opportunities in combating the COVID-19 pandemic and develop a tracking system for the COVID-19 data collected from various external sources. We propose, implement, and evaluate a blockchain-based system using Ethereum smart contracts and oracles to track reported data related to the number of new cases, deaths, and recovered cases obtained from trusted sources. We present detailed algorithms that capture the interactions between stakeholders in the network. We present security analysis and the cost incurred by the stakeholders, and we highlight the challenges and future directions of our work. Our work demonstrates that the proposed solution is economically feasible and ensures data integrity, security, transparency, data traceability among stakeholders.