JMIR Publications

ABSTRACT

Background:

Telehealth plays a critical role faced with COVID-19 pandemic and continues to function as an essential component for healthcare. Existing platforms lack the capability to ensure privacy and prevent cyberattacks.

Objective:

The main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication process in the telehealth platforms used in current healthcare domain and suggest that a software architecture integrated with blockchain improves the security and trustworthiness with satisfying performance and acceptable overhead.

Methods:

An innovative, interdisciplinary approach combining design science, social science, and computer science in the healthcare domain, improves the telehealth platform security and performance with a prototype implementation. We used the design science research method to implement our overall design. We innovated over existing telehealth platforms with blockchain integration that improves healthcare delivery services in terms of security, privacy and efficiency. This paper adopts a user-centric design approach and starts with the user requirements collection, follows by developing the system functionalities. Overall system implementation facilitates the user requirements thus promoting user behaviors towards the adoption of the telehealth platform, with decentralized identity management and access control mechanism.

Results:

Here, we identified key challenges to identity management and trustworthy communication process in the telehealth platforms used in current healthcare domain. Next, using recent innovations in distributed ledge technology, we proposed a decentralized telehealth platform to support identity management and trustworthy communication process. Our design and prototype implementation using smart contract driven telehealth platform to provide decentralized identity management and trustworthy communication with token-based access control, helped us address several challenges. We demonstrated how our solution, which combines telehealth services and blockchain smart contract, solves the challenges of identity management and sets the stage for improving patient care with trusted communication process, using 10,000 simulated transactions in five peers in the Rahasak blockchain network.

Conclusions:

We identified technical limitations in current telehealth platforms. We presented several design innovations using blockchain to prototype a system. We also presented the implementation details of a unique distributed architecture for a trustworthy communication system. We illustrated how this design can overcome privacy, security and scalability limitations. We also illustrated how improving these factors sets the stage for improving and standardizing the application and wide adoption of blockchain enabled telehealth platforms.