Medical IoT Record Security and Blockchain: Systematic Review of Milieu, Milestones, and Momentum

Abstract

The sensitivity and exclusivity attached to personal health records make such records a prime target for cyber intruders, as unauthorized access causes unfathomable repudiation and public defamation. In reality, most medical records are micro-managed by different healthcare providers, exposing them to various security issues, especially unauthorized third-party access. Over time, substantial progress has been made in preventing unauthorized access to this critical and highly classified information. This review investigated the mainstream security challenges associated with the transmissibility of medical records, the evolutionary security strategies for maintaining confidentiality, and the existential enablers of trustworthy and transparent authorization and authentication before data transmission can be carried out. The review adopted the PRSIMA-SPIDER methodology for a systematic review of 122 articles, comprising 9 surveys (7.37%) for qualitative analysis, 109 technical papers (89.34%), and 4 online reports (3.27%) for quantitative studies. The review outcome indicates that the sensitivity and confidentiality of a highly classified document, such as a medical record, demand unabridged authorization by the owner, unquestionable preservation by the host, untainted transparency in transmission, unbiased traceability, and ubiquitous security, which blockchain technology guarantees, although at the infancy stage. Therefore, developing blockchain-assisted frameworks for digital medical record preservation and addressing inherent technological hitches in blockchain will further accelerate transparent and trustworthy preservation, user authorization, and authentication of medical records before they are transmitted by the host for third-party access.