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Towards developing a secure medical image sharing system based on zero trust principles and blockchain technology

ABSTRACT: Background Data security has been a critical topic of research and discussion since the onset of data sharing in e-health systems. Although digitalization of data has increased efficiency and speed, it has also made data vulnerable to cyber attacks. Medical records in particular seem to be the regular victims of hackers. Several data breach incidents throughout history have warranted the invention of security measures against these threats. Although various security procedures like firewalls, virtual private networks, encryption, etc are present, a mix of these approaches are required for maximum security in medical image and data sharing. Methods Relatively new, blockchain has become an effective tool for safeguarding sensitive information. However, to ensure overall protection of medical data (images), security measures have to be taken at each step, from the beginning, during and even after transmission of medical images which is ensured by zero trust security model. In this research, a number of studies that deal with these two concepts were studied and a decentralized and trustless framework was proposed by combining these two concepts for secured medical data and image transfer and storage. Results Research output suggested blockchain technology ensures data integrity by maintaining an audit trail of every transaction while zero trust principles make sure the medical data is encrypted and only authenticated users and devices interact with the network. Thus the proposed model solves a lot of vulnerabilities related to data security. Conclusions A system to combat medical/health data vulnerabilities has been proposed. The system makes use of the immutability of blockchain, the additional security of zero trust principles, and the scalability of off chain data storage using Inter Planetary File Systems (IPFS). The adoption of this system suggests to enhance the security of medical or health data transmission.

SUBMITTER: Sultana M

PROVIDER: S-EPMC7542122 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Project description:BackgroundIn the collaborative business environment, blockchain coupled with smart contract removes the reliance on a central system and offers data integrity which is crucial when the transacting parties rely on the shared data. The acceptance of such blockchain-based systems is necessary for the continued use of the services. Despite many extensive studies evaluating the performance of blockchain-based systems, few have focused on users' acceptance of real-life applications.ObjectiveThe main objective of this research is to evaluate the user acceptance of a real-life blockchain-based system (BBS) by observing various latent variables affecting the development of users' attitudes and intention to use the system. It also aims to uncover the dimensions and role of trust, security and privacy alongside the primary Technology Acceptance Model (TAM)-based predictors and their causal relationship with the users' behavior to adopt such BBS.MethodsWe tested the augmented TAM with Trust Model on a BBS that comprises two subsystems: a Shopping Cart System (SCS), a system oriented towards end-users and a Data Sharing System (DSS), a system oriented towards system administrators. We set research questions and hypotheses, and conducted online surveys by requesting each participant to respond to the questionnaire after using the respective system. The main study comprises two separate sub-studies: the first study was performed on SCS and the second on DSS. Furthermore, each study data comprises initial pre-test and post-test data scores. We analyzed the research model with partial least square structural equation modelling.ResultsThe empirical study validates our research model and supports most of the research hypotheses. Based on our findings, we deduce that TAM-based predictors and trust constructs cannot be applied uniformly to BBS. Depending on the specifics of the BBS, the relationships between perceived trust antecedents and attitudes towards the system might change. For SCS, trust is the strongest determinant of attitudes towards system, while DSS has perceived privacy as the strongest determinant of attitudes towards system. Quality of system shows the strongest total effect on intention to use SCS, while perceived usefulness has the strongest total effect on intention to use DSS. Trust has a positive significant effect on users' attitudes towards both BSS, while security does not have any significant effect on users' attitudes toward BBS. In SCS, privacy positively affects trust, but security has no significant effect on trust, whereas, in DSS, both privacy and security have significant effects on trust. In both BBS, trust has a moderating effect on privacy that correlates with attitudes towards BBS, whereas security does not have any mediating role between privacy and attitudes towards BBS. Hence, we recommend that while developing BBS, particular attention should be paid to increasing user trust and perceived privacy.

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Towards developing a secure medical image sharing system based on zero trust principles and blockchain technology

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