Blockchain-IoT Healthcare Applications and Trends A Review

Received 14 December 2023, accepted 29 December 2023, date of publication 2 January 2024,
date of current version 10 January 2024.

Digital Object Identifier 10.1109/ACCESS.2023.3349187
Blockchain-IoT Healthcare Applications

and Trends: A Review
WAFAA A. N. A. AL-NBHANY 1, AMMAR T. ZAHARY 1,3 , (Senior Member, IEEE),
AND ASMA A. AL-SHARGABI 2,3
1 Department of Information Technology, Faculty of Computer and Information Technology, Sana’a University, Sana’a, Yemen
2 Department of Information Technology, College of Computer, Qassim University, Buraydah 51452, Saudi Arabia
3 Department of Computer Science, Faculty of Computing and Information Technology, University of Science and Technology, Sana’a, Yemen
Corresponding author: Wafaa A. N. A. Al-Nbhany (Waf.Al_nbhany@su.edu.ye)
ABSTRACT Despite the increasing reliance on the Internet of Things (IoT) as a basic infrastructure for
future applications. Integrating blockchain technology with IoT extensively helps provide basic security
requirements owing to the built-in security structure of the blockchain. Healthcare IoT applications are one
of the industries that will be revolutionized by using IoT-blockchain technology. This review aims to provide
an integrated understanding of blockchain IoT healthcare applications. The methodology of our paper is to
review the literature from 2018 to 2023, paying more attention to research that intersects and integrates IoT,
Blockchain, and healthcare applications. This review addresses IoT-based blockchain types and technologies,
healthcare applications, sensors, hardware tools, application databases, programming languages, software
tools, challenges and open issues, and solutions with their advantages and limitations. We then compared
our work with existing works on common metrics. The study in this paper includes 14 blockchain IOT
healthcare applications: remote patient monitoring, patient tracking, disease prediction, tracking COVID-19,
image retrieval, security of medical records, smart telemedicine, securing the Internet of Medical Things,
big data, blockchain and sensors, accurate medical decisions, health monitoring, tracking soldiers, and solar
energy.
INDEX TERMS Internet of Things (IoT), blockchain, integrating blockchain and IoT, blockchain-IoT
(BIoT), COVID-19, IoT healthcare applications, Internet of Medical Things (IoMT), healthcare sensors.
I. INTRODUCTION of data. Blockchain is used with the Internet of Things to

Currently, healthcare is witnessing significant development maintain confidentiality and trust data owing to the nature of
as a result of the development of the Internet of Things blockchain operations such as decentralization, distribution,
(IoT), blockchain, and wearable sensor technologies, which and encryption [1].
has led to improvements in the health sector in many Healthcare is defined as mental, physical, and social well-
applications, such as patient tracking, disease prediction, being, not just the absence of disease or disability.
infectious disease-fighting (COVID-19), electronic medical The healthcare sector is considered one of the most crit-
record management, remote patient monitoring, and drug ical sectors. Humanity’s demand in the modern era is to
traceability. obtain good healthcare, as receiving appropriate healthcare
The increased use of IoT devices has led to increased and access to the best health facilities is of great importance in
amounts of data and, thus, the emergence of challenges society and a primary goal through which sharing is achieved
related to confidentiality and privacy. between digital devices that collect data and its production-
For this reason, the authors used blockchain with the Inter- advanced-formatted information shared by doctors, patients,
net of Things to maintain the confidentiality and security and caregivers [2].
There have been many changes in healthcare in a short
The associate editor coordinating the review of this manuscript and period owing to modern technologies; what used to be done
approving it for publication was Angelo Trotta . in weeks can now be done in just one day [3].
2024 The Authors. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
4178 For more information, see https://creativecommons.org/licenses/by-nc-nd/4.0/ VOLUME 12, 2024
W. A. N. A. Al-Nbhany et al.: Blockchain-IoT Healthcare Applications and Trends: A Review
Advanced technologies have been used in the health field from different nodes. Blockchain and big data technolo-
because of the importance of healthcare, as artificial intel- gies are growing. We can efficiently store data using big
ligence algorithms and wearable sensors are used to detect data tools, and the combination of these two technologies
pathological conditions and abnormalities and help diagnose meets the requirements of security and efficiency, which are
diseases [4]. among the most essential requirements for extensive data
Communication with the outside world generates new analysis [4].
challenges regarding data confidentiality and information Integrating Blockchain with the healthcare IoT will bring
technology, which require careful study to obtain the desired about significant transformations. This integration will create
benefits in the medical field, as the medical aspect is consid- new paradigms and force us to reevaluate current systems and
ered essential, and there is no place for error in it [5]. processes. In addition to securing user data and protecting
The Internet of Medical Things (IoMT) is a framing struc- privacy, blockchains can boost IoT adoption by improving
ture for smart medical devices, as these devices are linked security and privacy [5].
to health services, applications, and systems via the Internet. Blockchain has revolutionized the sharing of medical and
Many challenges associated with IoT must be considered e-health information through secure applications [6].
regarding health data privacy and security, availability, ease Healthcare IoT applications are an industry that will be rev-
of data access, and scalability [6]. olutionized using blockchain technology. This integration has
IoMT devices are wearable devices that collect private and emerged as a cutting-edge technology for the decentralized
sensitive data about the human body, which enables health- sharing of medical records, ensuring the privacy of patient
care service providers to make appropriate decisions at the records, and monitoring of patients. In general, blockchains
right time. Because of the sensitivity and confidentiality of can be utilized for data management, specifically to improve
data, they must be treated securely and confidentially so that data security, which includes data integrity, access control,
users can be assured of their safety [7]. and privacy preservation.
Blockchain is a technology that stores data in a ledger so Blockchain capabilities such as immutability, encryption,
that the data are saved in blocks. Each block is linked to others transparency, auditability, and operational resilience can help
so that a blockchain is formed, and the data are transferred solve most shortcomings of the IoT architecture.
through a peer-to-peer network. The methodology of our paper is to review the litera-
Finance and banking were considered the first fields to ture from 2018 to 2023, paying more attention to research
use blockchain technology, and today, blockchain is used in that intersects and integrates IoT, Blockchain, and health-
energy, industry, insurance, healthcare, and others. care applications. This review addresses blockchain types,
Many features of blockchain make it useful in all fields, technology, healthcare applications, sensors, hardware tools,
as it is distributed, decentralized, and secured, so there is no application databases, programming languages, software
need for a central authority, as a consensus algorithm is used tools, challenges, open issues, and solutions with advan-
to archive data and reach agreement between nodes, where tages and limitations. We then compared our work with
the ledger is distributed and maintained by agreement among existing works on standard metrics. To implement a BIOT
all nodes within the network [8]. healthcare application, blockchain types, technologies, sen-
Because the blockchain is duplicated throughout a network sors, hardware platforms, databases, software languages,
of nodes, and each node has a stake in it, it is also known as software tools, challenges, and solutions should be known,
state machine replication. and most survey papers have yet to focus on the software
The two categories of permission and permissionless languages, databases, tools, and hardware platforms used in
blockchains are widely separated; in a permissionless BIOT healthcare applications.
blockchain, anyone can validate transactions, but only spe- This paper reviews blockchain-IoT healthcare applications
cific groups can. Although speedier and more scalable, and analyzes them in terms of blockchain types, technologies,
permission systems are more centralized. By contrast, public sensors, hardware platforms, database applications, software
access to permissionless blockchain systems is possible [9]. tools, programming languages used, challenges, solutions,
Ethereum and Hyperledger Fabric are two types of and research trends. Figure 1 shows the structure of the BIOT
blockchain technologies that serve different purposes. healthcare applications.
Ethereum is a public blockchain, meaning that all information We present the merging of these two technologies by pro-
is accessible to the public, making it ideal for applications that viding examples of Blockchain IOT healthcare applications,
require interactions with the global community. In contrast, namely remote patient monitoring, patient tracking, disease
Hyperledger Fabric is designed for private use cases, such as prediction, tracking the COVID-19 pandemic, image retrieval
supply chains, to ensure confidentiality and control access to for medical IoT systems, security of medical records, smart
sensitive information [10]. telemedicine, securing the Internet of Medical Things, Big
By integrating the IoT with Blockchain in healthcare data, blockchain and sensors, accurate medical decisions,
applications, we can control patient data in real-time while health monitoring, tracking systems for soldiers, blockchain,
storing data more securely and collecting patient data and solar energy.
VOLUME 12, 2024 4179

Our contributions can be summarized as follows: participate in the consensus process. Permission blockchain
• Present different software languages, databases, and types such as Hyper-ledger and Quorum need prior autho-
tools used in Blockchain IoT healthcare applications, rization to join the network and participate in the consensus
which most researchers have not focused on, to facilitate process. These are also referred to as private or consortium
the selection of appropriate software languages and tools blockchains, respectively. Permission is helpful when we
for implementing Blockchain IoT healthcare applica- need to restrict participation and access to data, especially
tions. when dealing with sensitive information, as is the case in the
• Present different hardware and sensors used in medical and healthcare industries. Table 1 shows a compari-
Blockchain BIOT healthcare applications, which most son between permissionless and permissioned blockchains.
researchers have not focused on, to facilitate the imple- As shown in Table 1, a permissionless blockchain is public,
mentation of Blockchain BIOT healthcare applications meaning that anyone can participate in the data validation and
• Current challenges and relevant solutions in blockchain access processes. By contrast, a permission blockchain is a
IoT healthcare applications. private or consortium, meaning that only permission entities
• Finally, we review the blockchain types, technologies, can participate in data validation and access.
healthcare applications, hardware, and software used in
articles that integrate blockchain with BIOT in health- A. PUBLIC BLOCKCHAIN
care applications. Anyone can join and participate in the consensus process on
In this paper, a review of BIOT healthcare applications is a public blockchain, such as Bitcoin or Ethereum, without
conducted, and it is organized as follows. permission [1].
• Section II: Blockchain Types.
• Section III: Blockchain technology. B. PRIVATE BLOCKCHAIN
• Section IV: BIOT Healthcare Applications. Because it is entirely under the control of one entity, this type
• Section V describes the sensors and hardware platforms of blockchain is considered a centralized network. A reg-
of IOT devices. ulatory body certifies the addition of new members and
• Section VI presents the various BIOT databases for provides write-and-read permission in a private blockchain.
healthcare applications. This power may be exercised solely or collaboratively by all
• Section VII, BIOT healthcare programming languages the participants.
and software tools. Therefore, only specific actors are allowed access to and
• Section VIII, Challenges and Solutions. use it, yet everyone may consult it. Companies such as banks
• Section IX presents the trends in BIOT healthcare appli- are primary users of this type of blockchain. Hyperledger
cations. Fabric and Multichain can be used for private blockchains [4].
• Section X, discussion.
• Section XI presents the conclusions. C. CONSORTIUM BLOCKCHAIN
Our study answers the following questions: The consortium blockchain is private, and a group, rather than
1. What are the different types of blockchain? a single organization, is responsible. A consortium between
2. How can blockchain impact healthcare? Names known businesses is formed to select those who have access
of successful healthcare applications of blockchain to the blockchain ledger, whose transactions may remain
technology. public, and who must be restricted to a smaller group of
3. What are the most popular wearable IoT sensors and members [5].
their applications? Health data are stored both on- and off-chains. On-chain
4. Which hardware platforms are the most commonly data means On-chain data are data with identity features and
used in healthcare blockchain IoT applications? with the hash of all health data, but off-chain data means data
5. What are the most commonly used databases for stored in the form of document-oriented databases [11]
blockchain IoT healthcare applications? The following is a collection of authors who used
6. What are the most commonly used programming blockchain types in their research.
languages and tools for Blockchain IoT healthcare The application type in [2] is the security of medical
applications? records and remote patient monitoring by using a consortium
7. In IoT applications in healthcare, what are the most blockchain. While the authors in [13] and [14] presented
common challenges and their associated solutions? the application type of medical record deposits using only a
private blockchain, the authors in [3], [4], [5], [8], and [12]
II. BLOCKCHAIN TYPES presented the application type of medical record security and
This section will address Question 1 in our study. remote patient monitoring using a private blockchain. On the
As shown in Table 1, blockchain is divided into two types other hand, the application type in [17] is the security of
(permission and permissionless). Blockchain types such as medical records using a public blockchain, the application
Bitcoin and Ethereum do not require approval to join and type in [18] is medical image retrieval with privacy protection
4180 VOLUME 12, 2024

FIGURE 1. Structure of BIOT healthcare applications.
VOLUME 12, 2024 4181

TABLE 1. Compare between permissionless and permissioned blockchains.
using a public blockchain, and the application type in [19] in 2013. The goal is to provide end developers with access
is remote patient monitoring and diabetic disease prediction to a tightly integrated end-to-end system.
using a public blockchain. In [20], authors conducted the This enables software development using a trustworthy
authors applied an Accurate Medical Decision using a private object messaging computing architecture, a hitherto unex-
blockchain. plored computing paradigm. Ethereum is an example of a
Authors in [15] introduced the application type of blockchain with integrated decentralized transactions and a
diabetic-cardio disease prediction in fog computing using complete execution environment that allows the system to
a consortium blockchain. In contrast, the authors in [16] carry out calculations. However, every node in the blockchain
introduced the application type of diabetic-cardio disease must have access to all records [2].
prediction in fog computing using a public blockchain.
The authors in [20] and [21] introduced an application for B. DISTRIBUTED LEDGER
tracking the COVID-19 pandemic, securing medical records, The ledger is shared among all blockchain participants in
and remote patient monitoring using a private blockchain. a distributed ledger blockchain, which can span numerous
The authors in [22] presented an application for healthcare businesses. Records are kept in a distributed ledger contin-
monitoring using a public blockchain. The authors in [23] uously rather than in sorted blocks, and can be either private
addressed the application type of healthcare monitoring, or public [24].
securing the Internet of Medical Things, and security of
medical records using a private blockchain. These studies are C. HYPERLEDGER FABRIC
summarized according to blockchain and application types in Developed by consensus, the hyperledger is a distributed
Table 2. peer-to-peer ledger.
Most healthcare applications use private blockchains A new generation of transactional applications that estab-
and only authorized entities can participate in access and lish trust, accountability, and transparency at their core while
processing. streamlining business processes and legal restraints can be
built using Hyperledger, a blockchain combined with a sys-
III. BLOCKCHAIN TECHNOLOGY tem for ‘‘smart contracts’’ and other supporting technologies.
With the creation of Bitcoin in 2008, blockchain technology By protecting intellectual property rights and imple-
has become increasingly popular [3]. menting necessary standards, hyperledgers promote the
The system enables transaction transmission and storage community-based development of blockchain technolo-
by relying on a peer-to-peer network. Without centralized gies [2].
authority, transactions are organized into blocks and kept in a
distributed ledger. D. IMMUTABILITY
Technically stated, blockchain is a system that incorporates Blockchain immutability occurs because their transaction
many other concepts and technologies, including Ethereum, data are tamper-proof, which means they cannot be altered
a Distributed Ledger system, Hyperledger Fabric, Immutabil- or withdrawn [25].
ity, Transparency, Cryptography, Consensus Algorithm,
and Smart Contract [1]. Figure 2 illustrates blockchain E. TRANSPARENCY
technologies. The primary benefit of blockchain is transparency, which
allows the creation of an unchangeable public record of trans-
A. ETHEREUM actions and the ability to trace them from their origin to their
To provide generalized blockchain technology in which destination [26].
all transaction-based state-machine concepts may be con- Additionally, transparency provides financiers, policymak-
structed, the project Ethereum was released as a platform ers, and investors with the knowledge they need to be
4182 VOLUME 12, 2024

TABLE 2. Blockchain types used in recent research.
FIGURE 2. Blockchain technologies.
accountable for and make responsible decisions about the Finding new cryptographic strategies to enhance
sustainability of supply chains [27]. blockchain solutions is always possible because cryptography
is a large area of study [29].
F. CRYPTOGRAPHY
The conversion of data and files from a well-known for- G. CONSENSUS ALGORITHM
mula to other types of files is a component of encryption in Owing to its decentralized nature, the blockchain has scat-
terms of information technology. There are various encryp- tered nodes throughout the network. The Byzantine Generals
tion algorithms with different characteristics. Depending on (BG) problem is analogous to the problem in which all net-
the application, the correct algorithm can be selected [28]. work nodes establish consensus (i.e., general agreement).
VOLUME 12, 2024 4183

The BG dilemma arises when the generals in charge of the the application type was Diabetic-Cardio Disease Prediction
Byzantine army disagree with one another during the assault. in Fog Computing, using Ethereum blockchain technology.
Failure results from certain generals preferring assault, while In [17], the application type was the Security of medi-
others do not. Owing to the absence of a central node that cal records, using Distributed ledger blockchain technology.
maintains the ledger of all nodes, it is difficult for nodes in a In [18], the application type was medical image retrieval
dispersed network to reach a consensus. with privacy protection, using Ethereum and Smart Contract
Blockchain can use different methods to reach consensus; blockchain technologies. In [19], the application type was
further, consensus algorithms are classified as proof-based remote patient monitoring and diabetic disease prediction,
and voting-based consensus algorithms [30]. using Ethereum, Distributed ledger, Transparency, and Smart
Contract blockchain technologies. In [21], the application
type was TrackingCOVID-19Pandemic, Security of medical
H. SMART CONTRACT records and remote patient monitoring, using Hyperledger
A set of computer programs, called smart contracts, is used to Fabric, Distributed ledger, and Smart Contract blockchain
simplify the exchange of money, assets, or data. It becomes technologies.
autonomous and impossible for a third party to stop or In [22], the application type was healthcare monitoring,
interfere with it once it is connected to the blockchain. using distributed ledger blockchain technologies. In [23],
In healthcare, smart contracts and blockchain technology are the application type was healthcare monitoring, securing the
regarded as a secure way to transfer data from remote patient Internet of Medical Things, and securing medical records
monitoring devices or to share the patient’s record electron- using Hyperledger Fabric, consensus algorithms, and smart
ically. This is because smart contracts are distinguished by contract blockchain technologies. In [31], the application
allowing only authorized devices or people to access the type addressed the COVID-19 crisis and telemedicine, using
patient’s history and attachments. distributed ledger, immutability, Consensus algorithm, and
Additionally, they support interoperability through coop- smart contract blockchain technologies. In [32], using Smart
erative version control to keep the record consistent. [3]. Contract blockchain technology, the application type was
Below is a collection of authors who have used blockchain secure medical data management, telemedicine, and disease
technologies in their research. In [2], the application type prediction. In [33], the application type was fast Internet of
was secure data management and remote patient monitor- Things (IoT) and remote patient monitoring systems; authors
ing, using Ethereum and Hyperledger Fabric blockchain used lightweight cryptographic techniques. They used ARX
technologies. In [3], the application type was the secu- and double encryption to enhance symmetric critical secu-
rity of medical records and remote patient monitoring, rity across the network. Moreover, they used Diffie-Hellman
using Ethereum and Smart Contract blockchain technologies. key exchange technology for the blockchain-based network,
In [4], the application type was the security of medi- which protects the public key from unauthorized access and
cal records and remote patient monitoring using Ethereum smart contracts. In [34], the application type was Smart
blockchain technology. In [5], the application type was Telemedicine, remote patient monitoring, and prediction of
Security of medical records and remote patient monitoring, diseases using transparent blockchain technology.
using Hyperledger Fabric blockchain technology. In [6], the In [35], the application type was healthcare data security,
application type was the security of medical records using using Consensus algorithm blockchain technology.
Distributed ledger blockchain technology. In [7], the Inter- In [36], the application type was a healthcare moni-
net of Medical Things application type was secure using toring and tracking system for soldiers, using Distributed
Elliptic Curve Cryptography (ECC) blockchain technology. Ledger, Cryptography, hashing, and Immutable blockchain
In [8], the application type was Security of medical records technologies.
and remote patient monitoring, using Cryptography, Smart In [37], the application type was the security of medi-
Contract, and Consensus algorithm blockchain technologies. cal records and remote patient monitoring, using Ethereum,
In [9], the application type was the Security of medical RSA, and DES Cryptography algorithms, Immutable, and
records, using a cryptographic hash of the papers. In [12], smart contact blockchain technologies.
the application type was the security of medical records In [38], the application type was healthcare monitoring,
and remote patient monitoring, using Ethereum, Immutable, solar energy, and blockchain, using smart contract blockchain
Transparency, and smart contract blockchain technologies. technologies. In [39], the application type was the security
In [13], the application type was the security of medical of medical records and smart telemedicine, using a Hyper-
records, using Ethereum and Smart Contract blockchain ledger fabric blockchain platform, transparency, and smart
technologies. In [14], the application type was the secu- contract blockchain technologies. In [40], the application
rity of medical records using Ethereum, distributed ledgers, type was Security, high-speed medical records, and brain dis-
and innovative contract blockchain technologies. In [15], ease prediction, using smart contracts and distributed ledger
the application type was Diabetic-Cardio Disease Prediction blockchain technologies. In [41], the application type was
in Fog Computing, using Distributed ledger, Transparency, healthcare monitoring, using Ethereum, distributed ledger,
and Consensus algorithm blockchain technologies. In [16], and smart contract blockchain technologies.
4184 VOLUME 12, 2024
These studies are summarized according to blockchain E. IMAGE RETRIEVAL FOR MEDICAL IOT SYSTEMS
technology and application type, as shown in Table 3. The variety and quantity of medical images have greatly
Many blockchain technologies are used in blockchain IOT expanded with the introduction of IoT devices for the medical
healthcare applications like Ethereum, Distributed ledger, industry.
Hyperledger Fabric, immutability, Transparency, Consensus Medical image retrieval facilitates disease diagnosis and
algorithm, Smart Contract, and cryptography. enhances medical image processing. However, as medical
Furthermore, many algorithms are used in cryptogra- photos contain patients’ private and sensitive information,
phy technologies like Elliptic Curve Cryptography (ECC), it can cause them to worry about their privacy [18].
lightweight ARX encryption, double encryption, Diffie-
Hellman key exchange technology, RSA and DES Cryptog- F. SECURITY OF MEDICAL RECORDS
raphy algorithms, and cryptographic hash of the records. Healthcare is one of the most sensitive industries since it
deals with sensitive data, and privacy, security, access con-
IV. BIOT HEALTHCARE APPLICATIONS
trol, and the accessibility of medical records are significant
This section will solve Question 2 of our paper; there has
concerns. Transmission, storage, and manipulation are three
been a growing interest in healthcare issues recently due to the
main stages where security in this industry must be guaran-
search for safer and faster ways to serve patients and monitor
teed. There are numerous studies using blockchain to secure
patients remotely using Internet of Things technology. As the
medical records [8].
number of IoT devices increases, security and privacy issues
arise. To solve these problems, many studies have presented
using blockchain technology to ensure the security of device G. SMART TELEMEDICINE
data and patient information [3]. In this section, we have tried Modern telemedicine technology uses communication to help
to collect most of the healthcare applications of Blockchain doctors virtually visit their patients by using recorded video,
IOT technology; Figure 3 shows the Blockchain IOT health- email, or live video and obtaining patient information about
care applications we will discuss. their illnesses.
A way to instantly exchange resources with any hospital or
A. REMOTE PATIENT MONITORING (RPM) doctor worldwide is through telemedicine [34].
A subtype of telemedicine called remote patient monitoring
(RPM) enables people to use portable medical equipment to H. SECURE THE INTERNET OF MEDICAL THINGS
gather and transmit patient-generated health data (PGHD) to Beyond 50 billion devices across a wide range of application
healthcare professionals. domains are expected to be connected through the Internet of
These devices include typical physiological data that can Things.
be gathered utilizing a remote patient monitoring system, However, user security and privacy remain significant
such as weight, blood pressure, and heart rate. IoMT concerns [7].
Once patient information has been gathered, it is delivered
to the doctor’s office using a software program that can be I. HEALTHCARE AND BIG DATA
downloaded and installed on desktops or mobile devices. [3]. Generating enormous amounts of medical big data by intel-
ligent Internet of Things (IoT) devices makes this another
B. PATIENT TRACKING
massive industry to investigate [70]
Inside a hospital or healthcare facility, a system for keeping
track of patients is an integrated system with a base station
(coordinator), tracking routers (placed at critical locations J. SENSORS AND BLOCKCHAIN
inside the facility), sensor pendants for patients and caregiver A sensor is a piece of equipment that receives a signal or
units, and other peripheral devices [74]. Aids caregivers in stimulus and reacts to it by producing an electrical signal.
recognizing specific behaviors or areas as risky so they can The output signals represent various electrical signals, such
get alarm messages when these behaviors are found [1]. as current or voltage. A sensor is a tool that receives multiple
signals, such as physical, chemical, or biological signals and
C. DISEASE PREDICTION transforms them into an electric signal. Based on the uses,
The system used to Predict Disease Prediction utilizing input signal, conversion method, and material properties of
machine learning models is a method that uses symptoms the sensor, such as price, accuracy, or range, the sensors are
provided by patients or other users to forecast diseases. The divided into many types [51].
system analyzes the user’s signs as input and returns the
likelihood that the disease will occur as the output [69]. K. ACCURATE MEDICAL DECISION
Non-communicable illness diagnoses are sometimes incom-
D. FIGHTING COVID-19 PANDEMIC plete, undesired, or unnecessary. Therefore, we need accurate
An IoT and AI-based method for remotely detecting the medical decisions to lessen the burden of sickness, promote
COVID-19 disease so that it can be stopped early [1]. public health, and effectively treat any disease.
VOLUME 12, 2024 4185

TABLE 3. Research in blockchain technologies.
4186 VOLUME 12, 2024

TABLE 3. (Continued.) Research in blockchain technologies.
FIGURE 3. Blockchain IoT healthcare applications.
Many problems that electronic health records (EHR) or M. TRACKING SYSTEM FOR SOLDIERS
health information exchange (HIE) have yet to be able to Various studies have been done on military tracking systems.
solve will be resolved by accurate medical decisions [20] The application can be installed on the soldier’s body using
GPS and other sensors to monitor their condition and current
location [36].
L. HEALTHCARE MONITORING
A system for monitoring healthcare that would deliver the
greatest possible medical care to everyone, everywhere, at all N. BLOCKCHAIN AND SOLAR ENERGY
times. Many contemporary technologies are combined to Solar energy is used to provide a power supply to the sen-
address the growing need for solutions to health-related sors. Many applications use blockchain technology with solar
issues. There are numerous current studies in this area [38]. energy to ensure the accuracy of data blockchain can be
VOLUME 12, 2024 4187

TABLE 4. Research in BIOT healthcare applications. A. ELECTROGRAM SENSORS

An Electrogram sensor records the electrical activity of many
organs, including the heart and brain, by keeping track of
variations in electric potential [42]. Electroencephalogram
(EEG), electrocardiogram (ECG), and Electromyography
(EMG) are the three electrogram sensors that are typically
used.
1) ELECTROENCEPHALOGRAM (EEG)
Monitoring and storing data regarding the electrical activity
of the human brain is done via an EEG.
EEG signals comprise the rhythmic and spontaneous firing
of brain cells. It has been hypothesized in neuroscience and
psychology that EEG signals can characterize human behav-
ior and affective brain states and aberrant brain conditions and
cognitive impairments like epilepsy, Parkinson’s disease, and
Alzheimer’s [4].
2) ELECTROCARDIOGRAM (ECG)
The transmission of impulses via the heart, which ultimately
spreads throughout the body, generates electric currents.
An electrocardiograph can be used to record these impulses
and detect them on the body’s surface. The electrical changes
during the cardiac cycle are depicted visually on an electro-
cardiogram (ECG or EKG) (Figure 6). Three different waves,
known as deflection waves, comprise the typical EKG; for
instance, the tiny P wave shows that the atria depolarized right
before atrial contraction—figure 6. Electrocardiogram [43]
The massive QRS complex resulting from ventricular
depolarization has a convoluted form because of the differ-
ences in size between the two ventricles and the time delays
necessary for both chambers to depolarize. Before ventricular
contraction, it happens. The T wave is produced by currents
that spread during ventricular repolarization. The massive
QRS complex hides the atria’s repolarization, which takes
place during the QRS gap.
Understanding what an EKG does and does not reveal is
used [38]. Table 4 displays a group of articles and BIOT essential. An EKG is just a time and voltage log.
healthcare applications. Although we can and often do infer it, muscle contraction
Based on Table 4, the primary blockchain IoT healthcare does not always occur after excitement. Second, nodal tissue
applications are securing medical records, remote patient activity, which can only be assumed as a muscular contrac-
monitoring, disease prediction, and others. Additionally, tion, is not captured by an EKG; instead, it only records
Figure 4 displays various healthcare applications. electrical events in relatively considerable volumes of muscle
tissue (i.e., the majority of the heart muscle).
V. SENSORS AND IOT HARDWARE PLATFORM DEVICES However, variations in the EKG’s time intervals and
This section will solve Question 4 of our paper. anomalies in the deflection help identify problems with the
IoT enables incorporating sensors into real-world objects hepatic conduction system [43].
to gather health information like vital signs. Due to their
Internet connectivity, these gadgets may exchange data and 3) ELECTROMYOGRAPHY (EMG)
give the medical staff a real-time update on a patient’s health. EMG is a medical procedure that analyzes and tracks skele-
Sensors and IoT devices make it possible to gather patient tal muscle electrical impulses. A diagnostic tool called an
data and share it with healthcare professionals so they can electromyogram is used to perform electromyography, and it
analyze it [1]. produces an electromyogram report [44].
Figure 5 shows the sensors and IOT hardware platforms we Below is a group of authors who used electrogram sen-
will discuss. sors in their research. In [4], the application type was the
4188 VOLUME 12, 2024

FIGURE 4. BIOT healthcare applications.
FIGURE 5. Sensors and IoT hardware platform devices.
security of medical records and remote patient monitoring, sensors. In [13], the application type was the security of
using EEG, ECG, and EMG electrogram IOT sensors.In [5], medical records using ECG electrogram IOT sensors.
the application type was the security of medical records and In [17], the application type was the security of medical
remote patient monitoring, using EEG and ECG electrogram records using ECG IOT sensors. In [23], the application type
IOT sensors. was healthcare monitoring, securing the Internet of Medical
In [7], the application type was secured to the Internet of Things, and securing medical records using EEG, ECG, and
Medical Things using EEG electrogram IOT sensors. In [8], EMG electrogram IOT sensors.In [35], the application type
the application type was the security of medical records was the security of medical records using EEG, ECG, and
and remote patient monitoring using EEG electrogram IOT EMG electrogram IOT sensors.In [45], the application type
VOLUME 12, 2024 4189

FIGURE 6. Electrocardiogram.
was cardio disease prediction, using EEG, ECG, and EMG TABLE 5. Research used electrogram IoT devices.
electrogram IOT sensors. In [46], the application type was
cardio disease prediction, using the ECG IOT sensors. These
studies are summarized according to electrogram sensors and
blockchain IOT application type, as shown in Table 5.
According to Table 5, most healthcare applications use
electrocardiogram (ECG), electroencephalogram (EEG), and
electromyogram (EMG) sensors to record the electrical activ-
ity of various organs, including the heart and brain.
B. VITAL SIGNS
The body’s most calculated functions, which are of utmost
importance, are vital signs. Body temperature, pulse, res-
piration rate, blood pressure, and oxygen saturation level
are the four main signs that doctors and other healthcare
professionals frequently monitor [38].
1) BLOOD PRESSURE
A blood pressure sensor provides accurate blood pressure
readings in the veins [34].
2) RESPIRATION RATE
The rate of respiration can be observed using standard pulse
oximeters. It detects flow rates of several hundred l/min and
measures minute flow rates near the respiratory flow’s zero
point. [45].
3) TEMPERATURE SENSORS
Human body temperature sensor.
5) HEART PULSE RATE
4) PLUS OXIMETER A sensor that measures the heart rate.
It is a medical instrument that subtly checks a patient’s Below is a group of authors who used vital sign sensors in
blood’s oxygen saturation [45]. their research. In [4], the application type was the security
4190 VOLUME 12, 2024

of medical records and remote patient monitoring, using a 1) ROOM TEMPERATURE AND HUMIDITY SENSORS
blood pressure vital sign sensor. In [5], the application type It is an Internet of Things (IoT) gadget that gives data for reg-
was the security of medical records and remote patient moni- ulating the humidity and temperature in the server room; this
toring, using blood pressure, Temperature sensors, and pulse device can be used to monitor the temperature and humidity
oximeter vital sign sensors. In [8], the application type was of a space or other area [47].
the security of medical records and remote patient monitor-
ing, using a blood pressure vital sign sensor. In [16], the 2) AIR QUALITY INDEX SENSOR
application type was diabetic-cardio disease prediction, using The air quality index (MQ135) Gas Sensors are used to iden-
blood pressure vital sign sensors. In [22], the application type tify dangerous gases and smoke, including ammonia (NH3),
was healthcare monitoring, using heat rate, temperature, and sulphur (S), benzene (C6H6), and CO2. This MQ series gas
blood pressure vital sign sensors. In [23], the application type sensor includes a digital and analog output pin. The digital
was healthcare monitoring, security of the Internet of Medical pin swings high when the amount of these gases in the air
Things, and security of medical records, using temperature reaches a specific limit. [41].
and vital sign sensors.
In [31], the application type addressed the COVID-19 crisis 3) AIR PRESSURE
and telemedicine, using blood pressure and temperature vital
Pressure is an external force applied in a single direc-
sign sensors. In [32], the application type was the security
tion to a surface. The pressure of liquid, air, and other
of medical records, telemedicine, and prediction of diseases
gases is frequently measured. This pressure is monitored
using blood pressure and heart pulse rate vital sign sensors.
by a pressure sensor, also known as a pressure trans-
In [33], the application type was the security of medical
mitter, since it transforms the pressure into an electrical
records and remote patient monitoring using blood pressure
signal [48].
vital sign sensors. In [34], the application type was smart
Below is a collection of authors who have used air and
telemedicine, remote patient monitoring, and prediction of
temperature sensors in their research. In [23], the application
diseases. I used IoT, the Neural Network (NN), blood pres-
type was Healthcare monitoring, security of the Internet of
sure, temperature sensors, pulse oximeter, and heart pulse
Medical Things, and Security of medical records, using air
rate vital sign sensors. In [35], the application type was the
pressure, room temperature, and humidity sensors. In [36],
security of medical records, using blood pressure, Tempera-
the application type was a healthcare monitoring and tracking
ture sensors, pulse oximeters, and heart pulse rate vital sign
system for soldiers, using GPS, GSM, room temperature, and
sensors. In [36], the application type was a healthcare mon-
humidity sensors.
itoring and tracking system for soldiers, using temperature,
In [41], the application type was healthcare monitoring,
heartbeat, oxygen level, and vital sign sensors.
using quality index (MQ135), room temperature, and humid-
ity sensors. In [50], the application type was sensors and
records and remote patient monitoring, using temperature,
Blockchain, using room temperature and humidity sensors.
heartbeat, blood pressure, and vital sign sensors. In [39],
These studies are viewed in Table 7.
the application type was the security of medical records and
Table 7 shows Air temperature sensors used in blockchain
intelligent telemedicine, using oxygen and blood pressure
IOT healthcare applications: room temperature, air quality,
vital sign sensors. In [41], the application type was healthcare
and air pressure sensors.
monitoring, using Temperature and pulse vital sign sensors.
In [45], the application type was cardio disease Prediction,
D. BODY POSITIONING SENSORS
using blood pressure, Respiratory rate, Temperature sensors,
and pulse oximeter vital sign sensors. In [49], the appli- The body positioning sensors consist of Body positioning
cation type was security of medical records and remote (MEMS), GPS and GSM sensors, Accelerometer sensors, and
patient monitoring, using Temperature sensors and heart Motion sensors.
pulse rate vital sign sensors. These studies are summarized in
Table 6 according to vital sign sensors and BIOT application 1) BODY POSITIONING (MEMS)
type. The sensor changes the patient’s position ratio, allowing for
Table 6 shows that vital sign sensors, including body tem- easy evaluation of the patient’s stand-by and felt-down posi-
perature, pulse, respiration rate, blood pressure, and oxygen tions [49].
saturation level, are commonly used in healthcare applica-
tions to measure key signs frequently monitored by healthcare 2) ACCELEROMETER
professionals. This sensor senses the acceleration of gravity and deter-
mines the direction of the object to detect the acceleration
C. AIR TEMPERATURE SENSORS of an object. These sensors use piezoelectric, piezo-resistive,
Devices that measure the air, such as room temperature and and capacitive components to transform the mechanical
humidity sensors, air quality index sensors, and air pressure motion generated by an accelerometer into an electrical
sensors, are called air and temperature sensors. signal [51].
VOLUME 12, 2024 4191

TABLE 6. The research used vital sign sensor IoT devices.
3) MOTION SENSOR application type was Healthcare monitoring, security of the

Motion sensors, also known as motion tracking sensors, are Internet of Medical Things, and Security of medical records
used to track various motions, such as walking, standing, and using motion and Accelerometer sensors. In [35], the applica-
sitting. tion type was the security of medical records of accelerometer
sensors. In [36], the application type was a healthcare mon-
4) GPS AND GSM itoring and tracking system for soldiers using GPS and
Serves as a wireless communications system. For tracking GSM sensors. In [49], the application type was Security of
location and observing health indicators [36]. In [23], the medical records and remote patient monitoring using Body
4192 VOLUME 12, 2024

Positioning Identification (MEMS) sensors. These studies are

summarized according to body positioning sensors and BIOT
application type, as shown in Table 8.
Table 8 shows body positioning sensors used in blockchain
IOT healthcare applications: body positioning identification,
accelerometer, GPS, GSM, and motion sensors.
E. GLUCOSE LEVEL
An instrument for blood tests that measure blood glucose
levels.
F. BODY WEIGHT
A scale that measures body weight.
G. SMARTPHONE
a laptop that resembles a phone and combines the capabilities
of both a computer and a mobile device. FIGURE 7. IoT sensors [52].
H. SMARTWATCHES
An electronic device that can be worn, like a watch. Table 9 displays the IoT sensor devices used in blockchain
IOT healthcare applications, including glucose monitors,
I. WRISTBANDS wristbands, smartwatches, smartphones, and body weight.
It is a medical instrument that counts the number of pulses An array of IoT sensors is shown in Figure 7.
and steps [4].
Below is a collection of authors who have used IOT sen- J. IoT HARDWARE PLATFORMS
sors in their research. In [4], the application type was the
Platforms are defined very differently in both broad and
security of medical records and remote patient monitoring,
specific contexts. Media are referred to more generally as
using wristbands, smartwatches (SPO2), and smartphone sen-
‘‘technological building blocks that serve as the foundation
sors. In [6], the application type was the security of medical
upon which other businesses can develop complementary
records, using smartwatches (SPO2) and smartphone sensors.
products, technologies, or services.’’ A platform can also refer
In [7], the application type was to secure the Internet of med-
to any other common entity that runs related components or
ical things using Smartphone sensors. In [8], the application
services, such as a hardware configuration, operating system,
type was the security of medical records and remote patient
software framework, or any combination [53].
monitoring, using glucose level sensors and body weight.
In [19], the application type was remote patient monitoring
and diabetic disease prediction using glucose level sensors. 1) ESP-01 WI-FI MODULE
In [21], the application type addressed the COVID-19 crisis, The ESP-01 is a Wi-Fi service that makes it simple for an
security of medical records, and remote patient monitoring Arduino to connect to a Wi-Fi network. It is one of the
using wristband sensors. In [22], the application type was market’s most often utilized Wi-Fi chips since it includes an
healthcare monitoring, using glucose and weight sensors. antennae switch, a radiofrequency balun, a power amplifier,
In [31], the application type addresses the COVID-19 crisis a low noise reception amplifier, and a power executive [41].
and telemedicine using glucose level and wristband sensors. A microcontroller-based design can provide wireless inter-
In [33], the application type was the security of medical net access by acting as a Wi-Fi adapter, with straightforward
records and remote patient monitoring, using glucose level communication through the UART interface or the CPU
and smartphone sensors. In [34], the application type was AHB bridge interface [54]. Doctors may view the patient
smart telemedicine, remote patient monitoring, and predic- at any time and location by entering their login information
tion of diseases using Glucose level sensors. In [35], the using this microcontroller and a Wi-Fi module, which we’re
application type was the security of medical records using utilizing to broadcast sensor data to the Thing Speak web
glucose level sensors. In [39], the application type was the server [41].
security of medical records and smart telemedicine using Figure 8 shows the ESP-01 Photon device [54].
Glucose sensors. In [45], the application type was cardio
disease Prediction, using Glucose level sensors. In [50], the K. ARDUINO
application type was sensors and blockchain, using Glucose Arduino is a company that provides open-source hardware
level sensors, wristbands, and Smartwatches. and software to create the project’s microprocessor and
These studies are summarized according to sensors, IOT controller and a community-based service for producing
devices, and BIOT application type, as shown in Table 9. intelligent digital gadgets [55].
VOLUME 12, 2024 4193

TABLE 7. The research used air temperature sensor IoT devices.
TABLE 8. The research used body positioning sensor IoT devices.
Arduino uses hardware called the Arduino development

board and software called the Arduino IDE (Integrated Devel-
opment Environment) to create its code.
Contrary to other microcontroller boards in India, the
Arduino boards were only allowed for small-scale projects
when they first debuted on the electronic market a few years
ago.
Electronics-related individuals are already emerging and
accepting the role of Arduino for their initiatives.
FIGURE 8. ESP -01 module.
Built with an Atmel 32-bit ARM or an 8-bit AVR micro-
controller, these devices are easily programmable using the
The Arduino platform, first introduced in 2005, was cre- Arduino IDE’s C or C++ programming languages [56].
ated to give professionals, students, and amateurs a simple Figure 9 shows the Arduino shield – ethernet, wireless, and
and affordable way to build gadgets that use sensors and actu- motor driver.
ators to interact with their surroundings. It is an open-source
computer platform based on basic microcontroller boards for L. RASPBERRY PI
building and programming electronic devices. The Raspberry Pi is a small computer capable of carrying out
Like other microcontrollers, it may also function as a tiny tasks well.
computer by accepting inputs and directing the outputs of The module uses various processors; hence, it can only run
various electronic devices. open-source operating systems and applications.
4194 VOLUME 12, 2024

TABLE 9. Research used sensors IoT devices.
The Raspberry Pi supports Python, C, C++, BASIC, Perl,

and Ruby.
Eben Upton, Jack Lang, Rob Mullins, and Alan Mycroft
were the researchers who created the first model of Raspberry
Pi.
The goal of Raspberry Pi, founded in 2009, is to produce
an affordable computer that young people may use to learn
the fundamentals of computer programming.
FIGURE 9. Arduino shields – ethernet, wireless and motor driver [56]. The United Kingdom Raspberry Pi Foundation introduced
the original Raspberry Pi, model B, in 2012. It was initially
Pi also allows users to send emails, utilize word processors equipped with a Broadcom BCM2835 Soc with 512 MB
to create papers, and much more. memory storage capacity, a 700 MHz ARM ARM1176JZF-S
VOLUME 12, 2024 4195

FIGURE 12. BIOT healthcare databases.
Below is a collection of authors who have used hardware

platforms in their research.
records and remote patient monitoring using the Raspberry
Pihardware platform. In [8], the application type was the
security of medical records and remote patient monitor-
FIGURE 10. Orange PI zero plus [58].
ing using the Raspberry Pihardware platform. In [19], the
application type was remote patient monitoring and diabetic
disease Prediction, using the orange Pi Zero Plus Platform.
In [21], the application type tracked the COVID-19 Pan-
demic, secured medical records, and enabled remote patient
monitoring using the Raspberry Pihardware platform. In [22]
and [41], the application type was healthcare monitoring,
using the Arduino hardware platform.
In [23], the application type was Healthcare monitoring,
security of the Internet of Medical Things, and security
of medical records, usingtheRaspberry Pihardware plat-
form.In [34], the application type was smart telemedicine,
remote patient monitoring, and prediction of diseases using
the Arduino hardware platform. In [36], the application type
was a healthcare monitoring and tracking system for soldiers
using the Raspberry Pihardware platform. In [37], the appli-
cation type was the security of medical records and remote
FIGURE 11. Raspberry PI [47].
patient monitoring using the Raspberry Pihardware platform.
In [38], the application type was healthcare monitoring, solar
energy, and blockchain, using the Arduino hardware plat-
processor, and a Video Core IV graphics processing unit form. In [39], the application type was the security of medical
(GPU). records and smart telemedicine using the Raspberry Pihard-
Later, the foundation released a less expensive edition with ware platform.
less memory storage, a single USB port, and no Ethernet These studies are summarized according to hardware plat-
controller. The firm has sold over 19 million units as of 2019, forms and BIOT application type, as shown in Table 10.
ranking it the third best-selling ‘‘general-purpose computer’’ Table 10 shows Hardware Platforms used in blockchain
[57]. Figure 10 shows Raspberry Pi. healthcare applications, including Wi-Fi Module, Arduino,
Raspberry Pi, and Orange Pi Zero Plus.
M. ORANGE PI ZERO PLUS
An open-source single-board computer with Gigabit Ethernet VI. BIOT HEALTHCARE DATABASES APPLICATIONS
is the Orange Pi Zero Plus. It is tiny, measuring 45 × 48 mm. This section will solve Question 5 of our paper; in this section,
The All Winner H2 SoC, featuring Quad-core 32-bit we have tried to collect database software used in BIOT
Cortex-A7 and 256 MB/512 MB DDR3 (shared with GPU), healthcare applications.
is used by Orange Pi Zero Plus. Figure 12 shows the BIOT healthcare application databases
It includes 26 pin headers, a TF card slot, a USB 2.0 con- we will discuss.
nector, and more. It receives electricity via USB OTG.
Furthermore, it offers a nice balance between price and A. MONGODB
value (presently available for less than $20) [19]. Figure 11 A leading NoSQL database and open-source document store
shows orange pi zero. plus. is MongoDB. C++ is used to write MongoDB.
4196 VOLUME 12, 2024

TABLE 10. Research in hardware platform.
TABLE 11. Database applications used in BIOT healthcare applications.
A document-oriented, cross-platform database called In Table 11, you can see the database applications utilized
MongoDB offers excellent performance, high availability, in blockchain IoT healthcare applications, which include
and simple scalability. MongoDB utilizes the collection and MongoDB and Orbit DB.
document concepts.
VII. PROGRAMMING LANGUAGES AND
B. IPFS
SOFTWARE TOOLS
Extension data is stored using the Interplanetary File System
This section will solve Question 6 of our paper. In this section,
(IPFS) [39].
we have tried to collect programming languages used in BIOT
healthcare applications.
C. ORBITDB
Figure 13 shows the BIOT healthcare programming lan-
A distributed, serverless, peer-to-peer database is called guages and tools we will discuss.
OrbitDB. OrbitDB stores data on IPFS and automatically
syncs databases with peers using Libp2p Pubsub.
Below is a collection of authors who have used database A. JAVASCRIPT
software applications in their research. In [4], the application JavaScript is a popular object-oriented programming lan-
type was the security of medical records and remote patient guage for building interactive web browser effects, includ-
monitoring using MongoDB. In [8], the application type was ing creating dynamically updated content and managing
the security of medical records and remote patient monitoring multimedia.
using IPFS. In [17], the application type was the security JavaScript can be divided into several categories:
of medical records using IPFS. In [19], the application type JavaScript, REST API, Node.js, ReactJS, JSON, and Web3.
was remote patient monitoring and diabetic disease prediction
using OrbitDB. In [39], the application type was the security 1) JAVASCRIPT
of medical records and smart telemedicine using IPFS. These A computer programming language with object-oriented syn-
studies are summarized according to database applications tax that’s frequently used to produce interactive effects in web
and BIOT application type, as shown in Table 11. browsers.
VOLUME 12, 2024 4197

FIGURE 13. BIOT healthcare programming languages and tools.
2) REACTJS Resources are the system’s entities in the resource-oriented

React is a free and open-source JavaScript package for creat- architecture known as REST. These resources provide the
ing user interfaces (UI) for online applications. basis of the API implementation.
A straightforward, feature-rich, component-based The REST architecture is also stateless because neither
JavaScript UI library is ReactJS. Both tiny and large, compli- the client nor the server stores data. RESTful services return
cated applications can be created with it; it offers a minimum resources in a representation format. REST is a means by
and reliable feature set to get a web application off the ground. which a business offers a way to use its services. Many
The React community supports the React library by offering SOAP-oriented websites switched to REST implementation
a sizable collection of pre-made components to construct web to streamline and update their workflows. It was discovered
applications quickly, that APIs lacked headers and used straightforward HTTP
Facebook creates and distributes React By addressing verbs. The HTTP protocol is used in the development of
issues and adding new features, Facebook is constantly REST web APIs. As a result, it utilizes all the HTTP features,
improving the React library. including HTTP verbs, HTTP replies, and header data [61].
On top of the React library, the React community offers
advanced concepts like state management, routing, etc. [59]. 5) JSON
An open standard file called JSON, or JavaScript Object
3) NODE.JS
Notation, employs human-readable language to store and
Built on Google Chrome’s JavaScript V8 Engine, Node.js is
transfer data objects of attribute-value pairs and arrays (or
a JavaScript-based framework and platform.
other serializable values).
It is used to create online applications that require a lot of
It is a widely used data format for electronic data exchange,
I/O, such as single-page programs and websites that stream
notably between servers and online applications.
video. Numerous developers use the open-source, cost-free
JSON is a data format that is not language-specific;
Node.js platform worldwide [60].
although many contemporary computer languages have code
to generate and parse JSON-format data, it was initially
4) REST API
derived from JavaScript.
The number of web services offered by different businesses in The extension is used in JSON filenames. JSON.
the form of other APIs (Application Programming Interfaces)
has dramatically expanded recently.
Message exchange protocols like SOAP (Simple Object 6) WEB3
Access Protocol) and service-oriented architectures (SOA) Web3 is used as a JavaScript API [19].
have gained popularity to facilitate the data-sharing process Below is a collection of authors who have used JavaScript
for web services. in their research.
4198 VOLUME 12, 2024

TABLE 12. Javascript software applications used in BIOT healthcare applications.
In [2], the application type was Secure Data Management B. PYTHON

for Remote Patient Monitoring, using API JavaScript. In [4] Python is a general-purpose, interpreted programming lan-
and [5], the application type was Secure Data Management guage. The Python design philosophy, which Guido van
for Remote Patient Monitoring, using Node.js JavaScript. Rossum developed and initially released in 1991, strongly
In [8], the application type was Secure Data Management emphasizes code readability. Its language constructs and
for Remote Patient Monitoring, using API, JSON, and web3 object-oriented methodology are designed to aid program-
JavaScript. In [13], the application type was Security of mers in creating clean, understandable code for small and big
medical records, using web3 JavaScript. In [15], the appli- projects [62].
cation type was diabetic-cardio disease Prediction, using API
JavaScript. In [16], the application type was diabetic-cardio C. FLUTTER
disease Prediction using API JavaScript. In [19], the applica- Flutter is an open-source framework for developing top-
tion type was remote patient monitoring and diabetic disease notch, fast mobile applications for Android and iOS devices.
Prediction, using OrbitDB, IPFS, web3, and Node.js. In [20], It offers a straightforward, strong, practical, and simple SDK
the application type was an accurate medical decision using that makes it simple to create mobile applications in Dart,
JSON JavaScript. Google’s programming language.
In [23], the application type was Healthcare monitoring, The Dart-based Flutter framework is easy to use. It per-
security of the Internet of Medical Things, and Security of forms impressively by drawing the user interface (UI) directly
medical records, using Node.js JavaScript. In [31], the appli- on the operating system’s canvas rather than using a native
cation type addressed the COVID-19 crisis and telemedicine framework [63].
using API JavaScript. In [39], the application type was the
security of medical records and smart telemedicine, using
D. JAVA
REST API JavaScript. In [41], the application type was
Provides a mechanism for creating application software and
healthcare monitoring, using Solidity, JavaScript, web3, and
delivering it in a cross-platform computing environment.
API software. In [45], the application type was cardio disease
James Gosling made it at Sun Microsystems.
prediction, using API JavaScript. These studies are summa-
rized according to JavaScript Software applications and BIOT
application type, as shown in Table 12. E. MATLAB
Table 12 shows JavaScript software applications used Matlab, a programming language created by Math Works,
in blockchain IOT healthcare applications, which include can be used to analyze and handle Internet of Things (IoT)
JavaScript, API, Node.js, Web3, and JSON. services [44].
VOLUME 12, 2024 4199

TABLE 13. Programming languages us ed in BIOT healthcare applications.
F. SOLIDITY Prediction, using Matlab software languages. These stud-

The programming language Solidity is used to create highly ies are summarized according to programming languages in
secure smart contracts that manage operation communica- Table 13.
tions between nodes on the one side and IoT devices and Table 13 shows the programming languages used in
conventional PC devices on the other [14]. blockchain IOT healthcare applications: Python, Flutter, Java,
Below is a collection of authors who have used software Matlab, and Solidity.
languages in their research. In [3], the application type was
the security of medical records and remote patient monitoring G. SOFTWARE TOOLS
using Python and Solidity software languages. In [4], the There are several software tools used in BIOT healthcare
application type was the security of medical records and applications.
remote patient monitoring, using flutter and solidity software
languages. In [8], the application type was the security of
1) VISPA
medical records and remote patient monitoring, using Java
and Solidity software languages. In [9], the application type VISPA is a robust physics analysis development environment
was the security of medical records using the Python soft- that enables scientists to blend graphical and textual work.
ware language. In [12] and [37], the application type was The analysis is prototyped, carried out, and verified in a cycle
the security of medical records and remote patient moni- in physics. The centerpiece of VISPA is a multifunctional
toring using solidity software languages. In [13] and [14], window for the visual analysis step steering, analysis tem-
the application type was the security of medical records plate building, and browsing physics event data at various
using solidity software languages. In [16], the application analysis stages. VISPA adopts an experiment-independent
type was diabetic-cardio disease prediction, using solidity methodology, including some steering and controlling tools
software languages. In [23], the application type was Health- necessary for a typical study. It is possible to connect to
care monitoring, security of the Internet of Medical Things, many high-energetics experiment frameworks using various
and Security of medical records, using Matlab software lan- interfaces [64].
guages. In [34], the application type was smart telemedicine,
remote patient monitoring, and prediction of diseases using 2) AWS CLOUD HSM API
Python software languages. It gives the module seclusion by establishing a distinct Virtual
In [35], the application type was the Security of Private Network and makes it simple to generate and use
medical records, using Java and Matlab software lan- necessary encryption keys on the AWS cloud. FIPS 140-2
guages. In [40], the application type was Security and Level 3 approved HSMs can manage keys. It allows users to
high-speed medical records and brain disease prediction, be created and HSM policies to be specified while controlling
using Python software languages. In [41], the application encryption keys over a secure channel. AWS manages the
type was Healthcare monitoring, using solidity software lan- HSM appliance but does not have access to the data—keys—
guages. In [45], the application type was Cardio Disease that are kept inside. AWS also offers role-based access to the
4200 VOLUME 12, 2024

HSM. This demonstrates that it is a safe method of crucial In [4], the application type was the security of medical
storage [37]. records and remote patient monitoring, using Metamask,
Truffle, and Ganache software tools.
3) METAMASK In [7], the application type was secured on the Internet of
The Metamask Chrome extension is a crypto-wallet for Medical Things using VISPA software tools.
Ethereum that enables you to manage your Ethereum In [8], the application type was the security of medical
accounts; it is a crucial tool for creating and testing smart records and remote patient monitoring using Remix software
contracts [65]. tools. In [12], the application type was the security of medical
records and remote patient monitoring, using Remix and
Metamask software tools. In [14], the application type was the
4) REMIX
security of medical records using AWS and Solidity software
Remix lets you concentrate on the user interface and move
applications. In [19], the application type was remote patient
backward through web standards to offer a quick and reliable
Monitoring and Diabetic Disease Prediction, using Truffle
user experience. People will adore using your products [66]. software tools.
In [21], the application type was TrackingCOVID-19
5) THINGSPEAK Pandemic, security of medical records, and remote patient
ThingSpeak is an open-source HTTP-based IoT application monitoring, using Docker platform tools. In [23], the appli-
and API for storing and retrieving data from devices via cation type was Healthcare monitoring, protection of the
the Internet or a local area network. Additionally, it offers Internet of Medical Things, and Security of medical records,
status updates, the ability to create apps for sensor tracking, using docker and caliper software tools. In [37], the appli-
and monitoring of application locations. Furthermore, it pro- cation type was the security of medical records and remote
motes the mathematical computer program MATLAB, which patient monitoring using cloud HSM tools. In [38], the appli-
enables academics to examine and analyze the uploaded data cation type was healthcare monitoring, solar energy, and
without purchasing a licensed copy of MATLAB [38]. blockchain, using ThingSpeak software tools. In [41], the
application type was healthcare monitoring, using Remix,
6) TRUFFLE SUITE Metamask, ThingSpeak, truffle, and Ganache software
The ecosystem known as the Truffle Suite is used to create tools.
DApps. A truffle suite has the subcategories Ganache, Truf- These studies are summarized according to Software tools
fle, and Drizzle. The techniques and resources that must be and BIOT application type, as shown in Table 14.
used before deploying smart contracts with the Truffle suite Table 14 shows software platforms and tools used
are divided into two groups: in blockchain IOT healthcare applications, which include
1. Smart contracts: solidity, meta mask, ganache, and VISPA, AWS cloud, HSM, Remix, Metamask, ThingSpeak,
truffle. Truffle suite, Docker, Caliper, and Ganache.
2. Front end: Web3.js and a live server [67].
VIII. BIoT HEALTHCARE APPLICATIONS CHALLENGES
7) CALIPER AND SOLUTIONS
Caliper is a free benchmarking tool; Users can assess the This section will solve Question 7 of our paper; in this section,
effectiveness of various blockchain platforms and consensus we have tried to present the most prominent challenges and
algorithms using the Linux Foundation’s Caliper platform in solutions facing the use of blockchain technology with the
a uniform setting [23] Internet of Things in healthcare applications [1] and [3].
Figure 14 shows the BIOT healthcare challenges and solu-
8) DOCKER tions we will discuss.
A software platform called Docker makes developing, testing,
and deploying applications simple. Docker packages soft- A. SECURITY AND PRIVACY
ware into standardized units called containers that contain all The most crucial problem with the information system is
the necessary code, libraries, system tools, and runtime. You security. The security model is a formal approach to verifying
can swiftly deploy and scale applications with Docker into and describing complex information. It is critical to secure
any environment while being confident that your code will privacy and message integrity from unauthorized users [71];
work [68]. a tamper-proof audit log makes identifying fraudulent data
and users and managing data access simple [70].
9) GANACHE
Ganache is used to create the personal Ethereum Blockchain B. CONFIDENTIALITY
and test Solidity contracts [4]. Data confidentiality is a significant issue on the Internet of
Below is a collection of authors who have used software Things, as it means that data can be modified or accessed only
tools in their research by parties authorized to access and modify it [77].
VOLUME 12, 2024 4201

TABLE 14. Software tools used in BIOT healthcare applications.
FIGURE 14. BIOT healthcare applications challenges and solutions.
C. ACCESS CONTROL E. IMMUTABILITY

Multiple sources are handled by computers, including mem- The immutability property protects data from being altered or
ory, disk, network interface, and printer (object access). The tampered with, ensuring security and privacy features [1].
user (subject of access) has access to the computer system’s
resources [71]. F. DECENTRALIZATION
Access control can be used to detect unauthorized access Decentralization is a reality that enables parties to conduct
and control people’s entrance to restricted areas [78] transactions without using intermediaries. Compared to using
Controlling access to IoT devices is complex because IoT intermediaries or centralized systems, this increases the trans-
devices have limited battery life, processing power, storage, parency of commerce [26]; higher levels of security, parallel
and network capacity [79]. data processing, and cooperative version control are available
to everyone [70].
D. INTEGRITY G. DATA STORAGE

Integrity is the promise that the data is reliable and cor- Data is kept locally in local storage or in the cloud, where
rect [29]. it can be accessed by clients or service providers located
4202 VOLUME 12, 2024

elsewhere. To allow the stowage procedure and for the stent to needs to be defined for an open standard for the Blockchain
be preserved in the block, the device must authenticate with to be communicated and accepted in a functioning health-
the stand in the event of local storage. Personal information care environment. Open standards guarantee communication
authentication should be performed before submitting the between multiple Blockchain components [72].
data to a cloud storage service [7].
O. COST
H. SCALABILITY Making blockchain more affordable in terms of processing
Scalability is becoming a significant issue in the blockchain power, computational cost, memory needs, and security is the
space due to the constant growth in blockchain size. The focus of academic and industrial research [29].
architecture, underlying consensus, and network synchro-
nization all affect scalability. Each blockchain node should P. UNSTRUCTURED DATA
have high processing and bandwidth capabilities to scale the Unstructured data that cannot be processed by a computer,
network [29]. such as clinical notes or discharge summaries [20].
I. MODIFIABILITY Q. RELIABILITY
Data modification: On the one hand, the immutability of data The system should be able to prevent potential threats from
provided by blockchain technology secures the system, but on deleting or altering shared data. It should also store data
the other, it eliminates the option of data deletion and makes replicas to provide dependable services in the event of a single
data modification and modifications inevitable. point of failure [18].
As a result, the creation of blockchain applications must be
done to minimize the need for data alteration [70]. R. AVAILABILITY
An assurance of dependable access to the information by
J. LATENCY authorized individuals is available [29].
The time elapsed between the start of a transaction and its
commitment is known as latency [23]. S. INTEROPERABILITY
Interoperability refers to the ability of different informa-
K. THROUGHPUT tion systems, software, or hardware to link data frameworks
It measures the number of blocks added to the blockchain between stakeholders across organizational boundaries in a
each second, essentially the number of transactions car- synchronized manner, improving individual safety [15].
ried out each second. Throughput is influenced by several
variables, including the underlying consensus process, the T. REGULATORY COMPLIANCE
number of participating nodes, the network architecture, Refers to the commitment of service provider entities, orga-
node behavior, block parameters, and the complexity of the nizations, and institutions to a complex framework of laws
contract (in the case of blockchains supporting smart con- and regulations to provide safe, high-quality health services,
tracts) [29]. protect patient confidentiality, support the overall safety of
healthcare, and prevent fraud.
L. EFFICIENCY Below is a group of authors who discussed BIOT chal-
Through theoretical study and tests, the scheme’s accuracy lenges and solutions in their research.
and effectiveness are demonstrated [23]. Authors in [2] discussed how Blockchain technology is
The advanced certified tool ‘‘Caliper’’ is used to assess crucial due to its immutable nature, which could result in
the effectiveness and performance of smart contracts by reduced regulatory compliance costs, greater transparency,
evaluating their fundamental operations: Query, Open, and improved traceability, increased speed, and efficiency.
Transfer [14]. Authors in [8] discussed various security and confidential-
ity issues that they were able to resolve by utilizing the proxy
M. ACCURACY encryption technique and the security characteristics of the
Accuracy is defined as the ability to forecast events cor- Blockchain.
rectly [16]. Authors in [14] discussed some difficulties related to
The most common categorization performance parameter scalability, performance, network processing speed, data
is accuracy. It indicated the quantity of positive instances and management on remote nodes, security breaches, and attacks.
displayed the proportion of these instances. The authors also displayed some blockchain-based solutions,
The classification accuracy should be near 100% for including support for granular-level access mechanisms,
improved performance [34]. permission-based blockchain networks, supported intelligent
contracts, distributed blockchain consensus, and immutable
N. INTERACTION blocks, which maintain data integrity. These solutions allow
Recent patterns show that developers are concentrating on data to be shared and controlled in a transparent, patient-
Blockchain model test attributes. It implies that interaction centric manner.
VOLUME 12, 2024 4203

Authors in [18] explored several issues relating to the the safe movement of information utilizing a series of cryp-
efficiency and accuracy of picture retrieval for medical IoT tographically secure keys throughout a healthcare system.
systems and several potential solutions to enhance security in Authors in [36] examined the difficulties of reducing net-
image retrieval on cloud platforms. They provide users con- work security performance. The authors also discussed the
venient data storage and query services with great scalability blockchain as a possible tool to address issues with IoT secu-
and large storage capacities. The primary method for safe rity. Authors in [37] proposed a centralized, decentralized
picture retrieval in the cloud is to encrypt the extracted image structure that provides complete integrity and security of
characteristics to protect the privacy of the original image. medical data.
Authors used blockchain techniques for privacy-preserving Blockchain technology provides indistinguishable avail-
image retrieval over photos obtained from many data owners ability of information when and where it is needed, balancing
to increase the efficiency and accuracy of image retrieval. server load during high traffic periods. Increased data security
Each data owner can encrypt image characteristics with their is provided by double encryption in medical data and the pub-
private using a method they developed for encryption. lication of produced keys. Because blockchain transactions
Authors in [20] discussed challenges and solutions related typically involve massive amounts of data and large dollar
to anonymity and peer-to-peer communication. In response, amounts, the authors published only a modest amount of the
the Office of the National Coordinator for Health Information chain, resulting in a low cost.
Technology (ONC) of the US Department of Health and Authors in [38] explained the issue of patient data’s
Human Services (HHS) announced the ‘‘Use of Blockchain compassionate nature and the sensors’ short battery life.
in Health IT and Health-Related Research’’ challenge in To solve these problems, a system combining solar energy
July 2016. From more than 70 entries, 15 were selected and blockchain technology was developed in the study.
as the best ones. The authors also explored the difficulty Authors in [39] proposed a blockchain system to address
with using medical or clinical data, including unstructured data security, privacy, sharing, and storage issues. In addition,
data like clinical notes or discharge summaries that could be the proposed solution uses blockchain technology to ensure
more computer-understandable. Natural language processing the highest level of transparency in medical data security
system (NLP)-assisted evidence-based medicine is needed to within the healthcare system.
promote this and analytics on massive data actively. Authors in [50] discussed several issues and potential solu-
Authors in [21] discussed a set of challenges related to tions for ensuring sample and sensor performance. Sensors
detecting the prevalence of COVID-19 before symptoms that continuously generate large data sets would call for a
manifest, security vulnerability challenges, scalability chal- quick blockchain that is not only computationally cheap to
lenges, and interoperability challenges. The authors also reach consensus but also able to store large amounts of data.
discussed a set of solutions, The Web of Things (Wot) According to the authors, vast amounts of ‘‘raw’’ data
paradigm, as an attempt to solve the scalability and interoper- will probably require secured off-chain storage in the cloud,
ability challenges of IoT by using the Web as an application where only metadata or ‘‘fingerprints’’ are stored onto a
layer for IoT, using blockchain technologies as a mechanism blockchain.
to monitor the traffic generated by wearables while providing Investigating energy harvesting for self-powered sensors
tools to preserve privacy within smart homes. like biofuel cells (converting glucose in sweat using enzymes
Authors in [22] discussed Some difficulties with IoT or utilizing microbial fuel cells) and human motion could
systems, such as Big Data, energy consumption, security, help address the problem of continuous monitoring using
dependability, and availability. Additionally, the authors cov- wearables. Instead of Bluetooth, Lora WAN technology may
ered a few options that employed blockchain technology and be used to build a low-power, high-coverage wireless digital
solar or wind power. infrastructure enabling remote sensors to communicate with
Authors in [31] discussed several issues and potential solu- the blockchain network.
tions about the TrackingCOVID-19Pandemic applications; Additionally, near-field communication and other low-
they discussed several possible solutions to improve the scal- cost, high-security wireless and battery-free technologies can
ability of blockchains, including be integrated with blockchain and sensors to expand capabil-
1) designing more scalable consensus algorithms like Del- ities and gather data over extended periods from regions that
egated Proof of Stake (DPoS), Practical Byzantine Fault would otherwise be inaccessible.
Tolerance (PBFT), and Proof-of-Authority (PoA). New technologies can further reduce the carbon footprint
2) looking into off-chain solutions of blockchain networks and IoT-enabled sensors by signifi-
3) turning to new blockchain structures. cantly lowering their energy consumption.
They also discussed some challenges, such as the issue of Authors in [70] discussed several issues and potential
poor scalability, exhibiting low transactional throughput, and solutions relating to the Internet of Things and blockchain
high latency. applications in big data for health applications. They high-
Authors in [35] examined various blockchain-related diffi- lighted many benefits of using blockchain technology,
culties, including processing power, storage, and scalability. including immutability, non-intermediation, cost reduction,
Authors suggested blockchain and keyless signatures to ease decentralization, security, system interoperability, scalability,
4204 VOLUME 12, 2024

transparency, secure distribution, and decentralization. They

also talked about various difficulties, including the issues of
storage, scalability, modifiability, privacy, and rules.
Authors in [72] examined numerous issues with and
solutions for Latency, Scalability, Interaction, Security, and
Privacy. Latency: The validation procedure, which takes
longer than typical in shared Blockchains, involves the nodes.
A few Blockchain nodes must participate in the validation
process to solve the delay issue. Time is saved, and the
system’s processing speed and effectiveness are improved.
Scalability is an issue that pertains to the limiting power of
the Bitcoin organization to manage enormous information
exchange on its foundation in a constrained amount of time.
Various solutions, including a hard fork (Bitcoin cur-
rency), a soft fork (Segwit), a lighting organization network,
and plasma currency, are available and have been used
to address issues. Interaction: Current patterns show that FIGURE 15. BIOT healthcare applications.
engineers are concentrating on testing Blockchain model
properties. It implies that interaction needs to be defined
for an open standard for the Blockchain to be communi-
cated and accepted in a functioning healthcare environment.
In these circumstances, open standards ensure communi-
cation between multiple Blockchain components. Security
and privacy: An outsider can attack a company and cause
serious issues if any unauthorized activity occurs within a
Blockchain. A permission blockchain, such as a consortium
or private Blockchain, should be used to overcome these
difficulties.
These studies are summarized according to BIOT applica-
tion type, Challenges, and solutions, as shown in Table 15.
IX. RESEARCH TREND IN BIOT HEALTHCARE

APPLICATION
Several types of research in BIOT healthcare applications are
shown in Table 16 with publishers.
FIGURE 16. BIOT healthcare publisher.
Publishers like IEEE, ScienceDirect, Hindawi, MDPI,
Scopus-Elsevier, Springer, and others.
Figure 15 shows BIOT healthcare applications, and accord-
ing to the figure, the most popular BIOT healthcare appli- shown in Table 4, which include Remote Patient Monitor-
cations are the security of medical records, remote patient ing, Patent Tracking, Disease prediction (Diabetic Disease,
monitoring, disease prediction, and healthcare monitoring, Cardio Disease, Bain Disease), COVID-19 pandemic, image
among others. retrieval for Medical IoT Systems, Security of medical
Figure 16 shows that most BIOT healthcare publishers like records, Smart Telemedicine, Secure the Internet of Medical
IEEE, ScienceDirect, Hindawi, MDPI, Scopus-Elsevier, and Things, Healthcare and Big data, Sensors and Blockchain,
Springer. Accurate Medical Decisions, Health Monitoring, Tracking
System for Soldiers, Blockchain and Solar Energy. Electro-
X. DISCUSSION gram sensors are shown in Table 5, consisting of EMG, EEG,
This paper presents a review of BIOT healthcare applications. and ECG. Vital sign sensors are shown in Table 6, consisting
Blockchain types are shown in Table 2, which are public, of Blood pressure, Respiration, Temperature Sensors, Pulse
private, and consortium, and the most common blockchain Oximeter, and Heart Pulse Rate.
type used was a private blockchain. Blockchain technolo- Air and Temperature sensors are shown in Table 7,
gies shown in Table 3 were Ethereum, Distributed ledger, which consist of room temperature and humidity, air
Hyperledger Fabric, Immutability, Transparency, Cryptogra- quality index, and air pressure. Body Positioning sen-
phy, Consensus algorithm, and Smart Contract, and the most sors are shown in Table 8 consisting of Body Position-
blockchain technologies used were Ethereum, Distributed ing (MEMS), Accelerometer, Motion Sensors, GPS, and
ledger and Smart Contract. BIOT healthcare applications are GSM. Other Sensors’ IOT devices are Glucose levels,
VOLUME 12, 2024 4205

TABLE 15. Some research in BIOT healthcare applications challenges and solutions.
4206 VOLUME 12, 2024

TABLE 15. (Continued.) Some research in BIOT healthcare applications challenges and solutions.
Body weight, Smartphones, Smartwatches, and Wristbands, JavaScript’s software technologies used in BIOT health-
as shown in Table 9. The IOT hardware platforms shown care applications are shown in Table 12, which consists
in Table 10 consist of the Wi-Fi module, development of JavaScript, Rest API, Node.js, ReactJS, JSON, and
boards, Arduino, Raspberry Pi, and Orange Pi Zero Plus. The web3.
IOT hardware platforms most used were Raspberry Pi and Programming Languages used in BIOT healthcare appli-
Arduino. cations are shown in Table 13, such as Python, Flutter,
BIOT healthcare database applications are shown in Java, MATLAB, and Solidity; according to Table 13, the
Table 11, which consists of MongoDB, IPFS, and Orbit most common software language applications used in BIOT
DB; the most used BIOT healthcare Database is IPFS. healthcare applications is Solidity. Software tools used in
VOLUME 12, 2024 4207

TABLE 16. Researches in BIOT healthcare applications and publishers.
BIOT healthcare applications are shown in Table 14, which Challenges and solutions in BIOT healthcare applica-
are VISPA, AWS Cloud HSM API, MetaMask, Remix, tions are shown in Table 14, which are Security and Pri-
ThingSpeak, Truffle, Caliper, Docker, and Ganache. vacy, Confidentiality, Access control, integrity, Immutability,
4208 VOLUME 12, 2024

TABLE 17. Components covered compared with other review papers.
Decentralization, Data Storage, Scalability, Modifiability, patient tracking, disease prediction, tracking the COVID-19
Throughput, Latency, Efficiency, Accuracy, Interaction, Cost, pandemic, image retrieval for medical IoT systems, security
Unstructured data, Reliability, and Availability. of medical records, smart telemedicine, securing the Internet
We have been compared between our review paper and of Medical Things, Big data, blockchain and sensors, accurate
reviews in [1], [80], [81], and [82] regarding components medical decisions, health monitoring, tracking systems for
covered in the reviews. soldiers, blockchain, and solar energy.
Table 16 presents our review structure compared with other Furthermore, we focused on determining the software
review papers [1], [80], [81], [82]. language databases and tools used with blockchain IOT
As shown in Table 17, Our paper comprehensively ana- healthcare applications. This information can help choose the
lyzes software languages, databases, and tools used in most appropriate software language and tools for implement-
Blockchain IoT healthcare applications. This information can ing Blockchain IoT healthcare applications, an area that most
help choose the most appropriate software language and tools researchers still need to explore thoroughly.
for implementing Blockchain IoT healthcare applications, We also focused on presenting the challenges associated
an area that most researchers still need to explore thoroughly. with Blockchain IOT healthcare applications and existing
Our paper presents various hardware and sensors used solutions to create a complete understanding that facilitates
in Blockchain IoT healthcare applications that have yet to the design and implementation of Blockchain healthcare
be focused on by most researchers, aimed at facilitating applications and provides an extensive state-of-the-art for
the choice of appropriate hardware platforms to implement further research. We believe that the review presented in this
Blockchain IoT healthcare applications. paper will be helpful for developers and researchers as a
Our paper presents different challenges and relevant solu- reference guide to fully understand the structure of BIOT
tions in blockchain IoT healthcare applications. healthcare applications and facilitate the choosing of appro-
Furthermore, we review the blockchain types, technolo- priate software language, tools, and hardware for the design
gies, healthcare applications, hardware, and software used in and implementation of blockchain IOT healthcare applica-
articles that integrate blockchain with IoT. tions.
Future work is to leverage this review to build a healthcare
BIOT application model using best-in-class technologies,
XI. CONCLUSION
platforms, sensors, and a combination of databases and soft-
This paper reviews and analyzes blockchain-IoT healthcare
ware tools and leverage most of the features of this review.
applications regarding blockchain types, technologies, sen-
sors, hardware platforms, database application programming
languages, hardware platforms, challenges, and solutions. REFERENCES
Using blockchain technology with IoT greatly helps pro- [1] K. Azbeg, O. Ouchetto, S. J. Andaloussi, and L. Fetjah, ‘‘A taxonomic
vide basic security requirements due to the built-in security review of the use of IoT and blockchain in healthcare applications,’’ IRBM,
vol. 43, no. 5, pp. 511–519, Oct. 2022, doi: 10.1016/j.irbm.2021.05.003.
structure of blockchain.
[2] M. J. H. Faruk, H. Shahriar, M. Valero, S. Sneha, S. I. Ahamed,
The decentralized architecture of blockchain can provide and M. Rahman, ‘‘Towards blockchain-based secure data manage-
secure and scalable, low-cost, and fast transactions for IoT ment for remote patient monitoring,’’ in Proc. IEEE Int. Conf. Digit.
devices. Health (ICDH), Chicago, IL, USA, Sep. 2021, pp. 299–308, doi:
10.1109/ICDH52753.2021.00054.
In this review, we present the merging of these two
[3] R. Mohammed, R. Alubady, and A. Sherbaz, ‘‘Utilizing blockchain tech-
technologies by providing examples of Blockchain IOT nology for IoT-based healthcare systems,’’ J. Phys., Conf. Ser., vol. 1818,
healthcare applications, namely remote patient monitoring, no. 1, Mar. 2021, Art. no. 012111.
VOLUME 12, 2024 4209

[4] J. Ktari, T. Frikha, N. B. Amor, L. Louraidh, H. Elmannai, and M. Hamdi, [22] D. Vidya, M. Vani, V. Pradeepa, and R. Vinoprabha, ‘‘Blockchain and IoT
‘‘IoMT-based platform for E-health monitoring based on the blockchain,’’ based medical workflows distributed ledger technology in health monitor-
Electronics, vol. 11, no. 15, p. 2314, Jul. 2022. ing,’’ Int. J. Innov. Res. Sci., Eng. Technol., vol. 9, no. 3, pp. 1–4, Mar. 2020.
[5] O. Attia, I. Khoufi, A. Laouiti, and C. Adjih, ‘‘An IoT-blockchain [23] F. Pelekoudas-Oikonomou, J. C. Ribeiro, G. Mantas, G. Sakellari, and
architecture based on hyperledger framework for healthcare monitor- J. Gonzalez, ‘‘Prototyping a hyperledger fabric-based security architecture
ing application,’’ in Proc. 10th IFIP Int. Conf. New Technol., Mobil- for IoMT-based health monitoring systems,’’ Future Internet, vol. 15, no. 9,
ity Secur. (NTMS), Canary Islands, Spain, Jun. 2019, pp. 1–5, doi: p. 308, Sep. 2023, doi: 10.3390/fi15090308.
10.1109/NTMS.2019.8763849. [24] S. S. Sarmah, ‘‘Understanding blockchain technology,’’ Comput. Sci. Eng.,
[6] A. Abbas, R. Alroobaea, M. Krichen, S. Rubaiee, S. Vimal, and vol. 8, no. 2, pp. 23–29, Aug. 2018.
F. M. Almansour, ‘‘Blockchain-assisted secured data management frame- [25] E. Politou, F. Casino, E. Alepis, and C. Patsakis, ‘‘Blockchain
work for health information analysis based on Internet of Medical Things,’’ mutability: Challenges and proposed solutions,’’ IEEE Trans. Emerg.
Pers. Ubiquitous Comput., pp. 1–14, Jun. 2021. Topics Comput., vol. 9, no. 4, pp. 1972–1986, Oct. 2021, doi:
[7] M. Seliem and K. Elgazzar, ‘‘BIoMT: Blockchain for the Internet of 10.1109/TETC.2019.2949510.
Medical Things,’’ in Proc. IEEE Int. Black Sea Conf. Commun. Netw. [26] G. Trujillo, A. Maria, V. Ocampo, Juan, G. Perez, and M. Alejandra,
(BlackSeaCom), Sochi, Russia, Jun. 2019, pp. 1–4. ‘‘Trust, transparency, and technology: Blockchain and its relevance in the
[8] K. Azbeg, O. Ouchetto, and S. J. Andaloussi, ‘‘BlockMedCare: A health- 2030 agenda,’’ in The Palgrave Handbook of Corporate Sustainability in
care system based on IoT, blockchain and IPFS for data management the Digital Era, 1st ed. London, U.K.: Palgrave Macmillan, 2021, ch. 28,
security,’’ Egyptian Informat. J., vol. 23, no. 2, pp. 329–343, Jul. 2022. pp. 91–107.
[9] R. Johari, V. Kumar, K. Gupta, and D. P. Vidyarthi, ‘‘BLOSOM: [27] J. Andrade and V. Voora, ‘‘Traceability systems a powerful tool for agri-
BLOckchain technology for security of medical records,’’ ICT Exp., vol. 8, cultural voluntary sustainability standards,’’ SSI, Tech. Rep., Dec. 2016,
no. 1, pp. 56–60, Mar. 2022. pp. 1–4.
[10] Z. Zhao, ‘‘Comparison of hyperledger fabric and ethereum blockchain,’’ [28] W. A. N. A. Al-Nbhany and A. Zahary, ‘‘A comparative study among
in Proc. IEEE Asia–Pacific Conf. Image Process., Electron. cryptographic algorithms: Blowfish, AES, and RSA,’’ in Proc. Int. Arab
Comput. (IPEC), Dalian, China, Apr. 2022, pp. 584–587, doi: Conf. Inf. Technol., 2016, pp. 1–7.
10.1109/IPEC54454.2022.9777292. [29] M. Raikwar, D. Gligoroski, and K. Kralevska, ‘‘SoK of used cryptogra-
[11] F. A. Reegu, H. Abas, Y. Gulzar, Q. Xin, A. A. Alwan, A. Jabbari, phy in blockchain,’’ IEEE Access, vol. 7, pp. 148550–148575, 2019, doi:
R. G. Sonkamble, and R. A. Dziyauddin, ‘‘Blockchain-based framework 10.1109/ACCESS.2019.2946983.
for interoperable electronic health records for an improved health- [30] R. K. Rama, ‘‘Overview of blockchain technology: Consensus algorithms,
care system,’’ Sustainability, vol. 15, no. 8, p. 6337, Apr. 2023, doi: applications,’’ Tech. Rep., 2021, doi: 10.13140/RG.2.2.17450.75205.
10.3390/su15086337. [31] H.-N. Dai, Y. Wu, H. Wang, M. Imran, and N. Haider, ‘‘Blockchain-
[12] H. S. Z. Kazmi, F. Nazeer, S. Mubarak, S. Hameed, A. Basharat, and empowered edge intelligence for Internet of Medical Things against
N. Javaid, ‘‘Trusted remote patient monitoring using blockchain-based COVID-19,’’ IEEE Internet Things Mag., vol. 4, no. 2, pp. 34–39,
smart contracts,’’ in Proc. Int. Conf. Broadband Wireless Comput., Com- Jun. 2021, doi: 10.1109/IOTM.0011.2100030.
mun. Appl., in Lecture Notes in Networks and Systems, 2019, pp. 765–776, [32] M. Wang, H. Zhang, and H. Wu, ‘‘Blockchain-based secure medical data
doi: 10.1007/978-3-030-33506-9_70. management and disease prediction,’’ in Proc. BSCI, Nagasaki, Japan,
[13] M. H. Chinaei, H. H. Gharakheili, and V. Sivaraman, ‘‘Optimal witnessing May 2022, pp. 1–12.
of healthcare IoT data using blockchain logging contract,’’ IEEE Internet [33] G. Srivastava, J. Crichigno, and S. Dhar, ‘‘A light and secure healthcare
Things J., vol. 8, no. 12, pp. 10117–10130, Jun. 2021. blockchain for IoT medical devices,’’ in Proc. IEEE Can. Conf. Electr.
[14] M. A. K. M. Elgendy, M. Aborizka, and A. M. N. Allam, ‘‘A blockchain- Comput. Eng. (CCECE), Edmonton, AB, Canada, May 2019, pp. 1–5, doi:
based model for securing IoT transactions in a healthcare environment,’’ 10.1109/CCECE.2019.8861593.
Int. J. Adv. Comput. Sci. Appl., vol. 13, no. 9, pp. 1–9, 2022. [34] K. Hameed, I. S. Bajwa, N. Sarwar, W. Anwar, Z. Mushtaq, and T. Rashid,
[15] P. G. Shynu, V. G. Menon, R. L. Kumar, S. Kadry, and Y. Nam, ‘‘Integration of 5G and block-chain technologies in smart telemedicine
‘‘Blockchain-based secure healthcare application for diabetic- using IoT,’’ J. Healthcare Eng., vol. 2021, pp. 1–18, Mar. 2021.
cardio disease prediction in fog computing,’’ IEEE Access, vol. 9, [35] M. T. Quasim, F. Algarni, A. A. E. Radwan, and G. M. M. Alshmrani,
pp. 45706–45720, 2021, doi: 10.1109/ACCESS.2021.3065440. ‘‘A blockchain based secured healthcare framework,’’ in Proc. Int. Conf.
[16] H. Hasanova, M. Tufail, U.-J. Baek, J.-T. Park, and M.-S. Kim, ‘‘A novel Comput. Perform. Eval. (ComPE), Shillong, India, Jul. 2020, pp. 386–391,
blockchain-enabled heart disease prediction mechanism using machine doi: 10.1109/ComPE49325.2020.9200024.
learning,’’ Comput. Electr. Eng., vol. 101, Jul. 2022, Art. no. 108086. [36] S. Somani, N. Choure, S. Jadhav, and S. Gurav, ‘‘Blockchain based soldier
[17] S. Sabu, H. M. Ramalingam, M. Vishaka, H. R. Swapna, and S. Hegde, health monitoring $tracking system,’’ Int. J. Advance Sci. Res. Eng. Trends,
‘‘Implementation of a secure and privacy-aware E-health record and IoT vol. 4, no. 8, pp. 1–6, 2019-2020.
data sharing using blockchain,’’ Global Transitions Proc., vol. 2, no. 2, [37] K. S. Reddy, M. Balaraju, H. Shah, and J. Agarwal, ‘‘E-health monitoring
pp. 429–433, Nov. 2021. using a centralized—Decentralized system,’’ Int. J. Sensor Netw. Data
[18] M. Shen, Y. Deng, L. Zhu, X. Du, and N. Guizani, ‘‘Privacy- Commun., vol. 8, no. 2, pp. 1–5, 2019, doi: 10.4172/2090-4886.1000165.
preserving image retrieval for medical IoT systems: A blockchain-based [38] R. Khabya, S. Goel, and M. Singh, ‘‘Solar energy based blockchain-
approach,’’ IEEE Netw., vol. 33, no. 5, pp. 27–33, Sep. 2019, doi: enabled healthcare monitoring using IoT,’’ Int. Res. J. Eng. Technol.,
10.1109/MNET.001.1800503. vol. 09, no. 06, pp. 1–7, Jun. 2022.
[19] T. M. Fernández-Caramés, I. Froiz-Míguez, O. Blanco-Novoa, and [39] T. Hewa, A. Braeken, M. Ylianttila, and M. Liyanage, ‘‘Multi-access
P. Fraga-Lamas, ‘‘Enabling the Internet of mobile crowdsourcing health edge computing and blockchain-based secure telehealth system connected
things: A mobile fog computing, blockchain and IoT based continuous glu- with 5G and IoT,’’ in Proc. IEEE Global Commun. Conf. (GLOBE-
cose monitoring system for diabetes mellitus research and care,’’ Sensors, COM), Taipei, Taiwan, Dec. 2020, pp. 1–6, doi: 10.1109/GLOBE-
vol. 19, no. 15, p. 3319, Jul. 2019, doi: 10.3390/s19153319. COM42002.2020.9348125.
[20] A. K. Talukder, M. Chaitanya, D. Arnold, and K. Sakurai, ‘‘Proof of [40] S. Hannah, A. J. Deepa, V. S. Chooralil, S. BrillySangeetha, N. Yuvaraj,
disease: A blockchain consensus protocol for accurate medical decisions R. A. Raja, C. Suresh, R. Vignesh, YasirAbdullahR, K. Srihari, and
and reducing the disease burden,’’ in Proc. IEEE SmartWorld, Ubiquitous A. Alene, ‘‘Blockchain-based deep learning to process IoT data acquisition
Intell. Comput., Adv. Trusted Comput., Scalable Comput. Commun., in cognitive data,’’ BioMed Res. Int., vol. 2022, pp. 1–7, Feb. 2022.
Cloud Big Data Comput., Internet People Smart City Innov. (Smart- [41] R. Satam, D. Kongere, P. Chauhan, and V. Pandey, ‘‘Blockchain-enabled
World/SCALCOM/UIC/ATC/CBDCom/IOP/SCI), Guangzhou, China, IoT based intelligent health monitoring system,’’ J. Emerg. Technol. Innov.
Oct. 2018, pp. 257–262, doi: 10.1109/SMARTWORLD.2018.00079. Res., vol. 9, no. 4, pp. 1–7, Apr. 2022.
[21] S. H. Kembo, P. Mpofu, B. T. Mukorera, and S. Jacques, ‘‘Blockchain- [42] Wikipedia Contributors. (2023). Electrogram. [Online]. Available:
secured health wearables in smart homes utilising raspberry Pi web of https://en.wikipedia.org/wiki/Electrogram
things gateways,’’ in Proc. Afr. Int. Conf. Ind. Eng. Oper. Manag., Harare, [43] H. A. Naseer, ‘‘Electrocardiogram,’’ Tech. Rep., Jan. 2022, doi:
Zimbabwe, Dec. 2020. 10.13140/RG.2.2.27465.42088.
4210 VOLUME 12, 2024

[44] B. J. Janney, S. Divakaran, K. George, H. Chandana, and C. L. Chriselda, [68] A. Mouat and R. Tamagawa, ‘‘Docker,’’ Amazon, Tech. Rep., 2016.
‘‘Wearable EMG sensor for gait rehabilitation using IoT,’’ Int. J. Res. Accessed: Sep. 22, 2023. [Online.] Available: https://aws.amazon.
Pharmaceutical Sci., vol. 11, no. SPL4, pp. 2675–2680, Dec. 2020. com/docker/
[45] K. B. Raju, S. Dara, A. Vidyarthi, V. M. Gupta, and B. Khan, ‘‘Smart heart [69] V. Kulkarni, S. Surwase, K. Pingale, S. Sarage, and A. Karve, ‘‘Predic-
disease prediction system with IoT and fog computing sectors enabled tion of disease using machine learning,’’ Irjet, vol. 7, no. 5, pp. 56–72,
by cascaded deep learning model,’’ Comput. Intell. Neurosci., vol. 2022, May 2020.
pp. 1–22, Jan. 2022. [70] M. M. H. Onik, S. Aich, J. Yang, C. Kim, and H. Kim, ‘‘Blockchain in
[46] A. Jagtap, A. Bebal, N. Bhatnagar, P. Kamthe, and P. G. Arsalwad, healthcare: Challenges and solutions,’’ in Big Data Analytics for Intelligent
‘‘Blockchain-based secure healthcare for cardio disease prediction,’’ Int. Healthcare Management. New York, NY, USA: Academic, 2019, ch. 8,
J. Res. Appl. Sci. Eng. Technol., vol. 10, no. 5, pp. 1187–1193, May 2022. pp. 197–226.
[47] K. J. Shamang, M. I. Chukwuma-Uchegbu, and A. S. El-Nafaty, ‘‘Indoor [71] T. Mudarri and S. A. Al-Rabeei, ‘‘Security fundamentals: Access control
temperature and humidity monitoring system,’’ J. Sci. Eng. Technol. Man- models,’’ Interdisciplinarity Theory Pract., pp. 1–4, Aug. 2015.
age., vol. 2, no. 5, pp. 50–58, 2020. [72] C. J. Godly, V. Balasubramanian, and B. Y. Jinila, ‘‘Blockchain adaptation
[48] B. C. Patel, G. R. Sinha, and N. K. Goel, ‘‘Introduction to sen- of remote patient monitoring with Internet of Medical Things,’’ in Proc.
sors,’’ in Advances in Modern Sensors Physics, Design, Simulation and Int. Conf. Comput., Commun., Secur. Intell. Syst. (IC3SIS), Kochi, India,
Applications. Bristol, U.K.: IOP Publishing, 2020, doi: 10.1088/978-0- Jun. 2022, pp. 1–7, doi: 10.1109/IC3SIS54991.2022.9885298.
7503-2707-7ch1. [73] S. Vyas, M. Shabaz, P. Pandit, L. R. Parvathy, and I. Ofori, ‘‘Integration of
[49] G. S. Gunanidhi and R. Krishnaveni, ‘‘An experimental analysis of artificial intelligence and blockchain technology in healthcare and agricul-
blockchain enabled intelligent healthcare monitoring system using IoT ture,’’ J. Food Qual., vol. 2022, pp. 1–11, May 2022.
based deep learning principles,’’ Ann. Romanian Soc. Cell Biol., vol. 25, [74] H. Gamboa, F. Silva, and H. Silva, ‘‘Patient tracking system,’’ in Proc.
no. 5, pp. 353–362, May 2021. 4th Int. Conf. Pervasive Comput. Technol. Healthcare, Munich, Germany,
Mar. 2010, pp. 1–2.
[50] A. Altay, R. Learney, F. Güder, and C. Dincer, ‘‘Sensors in blockchain,’’
[75] B. S. Egala, A. K. Pradhan, V. Badarla, and S. P. Mohanty,
Trends Biotechnol., pp. 1–4, 2021.
‘‘IBlock: An intelligent decentralised blockchain-based pandemic
[51] B. C. Patel, G. R. Sinha, and N. K. Goel, ‘‘Introduction to sen-
detection and assisting system,’’ J. Signal Process. Syst., vol. 94, no. 6,
sors,’’ in Advances in Modern Sensors Physics, Design, Simulation and
pp. 595–608, Oct. 2021, doi: 10.1007/s11265-021-01704-9.
Applications. Bristol, U.K.: IOP Publishing, 2020, doi: 10.1088/978-0-
[76] A. Haleem, M. Javaid, R. P. Singh, R. Suman, and S. Rab, ‘‘Blockchain
7503-2707-7ch1.
technology applications in healthcare: An overview,’’ Int. J. Intell. Netw.,
[52] Stack Path. Accessed: Jun. 20, 2023. [Online]. Available: vol. 2, pp. 130–139, Jan. 2021.
https://www.todaysmedicaldevelopments.com/news/medi cal-device-
[77] E. Shammar and A. Zahary, ‘‘The Internet of Things (IoT): A survey of
sensor-market-globally-1617
techniques, operating systems, and trends,’’ Library Hi Tech, vol. 38, no. 1,
[53] S. Gregor and B. Keating, ‘‘Information technology platforms: Definition pp. 5–66, 2020, doi: 10.1108/LHT-12-2018-0200.
and research directions,’’ in Australas. Conf. Inf. Syst., Adelaide, SA, [78] E. A. Shammar, A. T. Zahary, and A. A. Al-Shargabi, ‘‘An attribute-
Australia, Dec. 2015, pp. 1–17. based access control model for Internet of Things using hyperledger fabric
[54] T. Perets, ‘‘Investigation of Wi-Fi (ESP8266) module and application to an blockchain,’’ Wireless Commun. Mobile Comput., vol. 2022, pp. 1–25,
audio signal transmission,’’ Tech. Rep., Aug. 2019. Jul. 2022, doi: 10.1155/2022/6926408.
[55] D. Singh and A. Thakur, ‘‘An overview of IoT hardware development [79] E. A. Shammar, A. T. Zahary, and A. A. Al-Shargabi, ‘‘A survey of IoT
platforms,’’ Int. J. Emerg. Technol., vol. 11, no. 5, pp. 155–163, Aug. 2020. and blockchain integration: Security perspective,’’ IEEE Access, vol. 9,
[56] L. Louis, ‘‘Working principle of Arduino and using it as a tool for study and pp. 156114–156150, 2021, doi: 10.1109/ACCESS.2021.3129697.
research,’’ Int. J. Control, Autom., Commun. Syst., vol. 1, no. 2, pp. 21–29, [80] A. Alsunbul and W. Elmedany, ‘‘Blockchain for IoT-based health-
Apr. 2016, doi: 10.5121/ijcacs.20161203. care applications: A review on security issues and challenges,’’ in
[57] H. Ghael, ‘‘A review paper on raspberry Pi and its applications,’’ Int. J. Adv. Proc. 6th Smart Cities Symp. (SCS), Bahrain, 2022, pp. 480–488, doi:
Eng. Manag., vol. 2, no. 12, pp. 225–227, Jan. 2020, doi: 10.35629/5252- 10.1049/icp.2023.0648.
0212225227. [81] A. Al Sadawi, M. S. Hassan, and M. Ndiaye, ‘‘A review on the integration
[58] Orange PI Zero Plus—Orangepi. Accessed: Sep. 1, 2023. [Online.] of blockchain and IoT,’’ in Proc. Int. Conf. Commun., Signal Process.,
Available: http://www.orangepi.org/html/hardWare/computerAnd Their Appl. (ICCSPA), Sharjah, United Arab Emirates, Mar. 2021, pp. 1–6,
Microcontrollers/details/Orange-Pi-Zero-Plus.html doi: 10.1109/ICCSPA49915.2021.9385757.
[59] React JS Tutorial, Tutorials Point (I) Pvt. Ltd., Telangana, India, 2021, [82] N. Chauhan and R. K. Dwivedi, ‘‘Designing a secure smart
pp. 1–220. healthcare system with blockchain: A review,’’ in Proc. 1st Int.
[60] NodeJS Tutorial, Tutorials Point (I) Pvt. Ltd., Telangana, India, vol. 1, Conf. Informat. (ICI), Noida, India, Apr. 2022, pp. 214–219, doi:
2016, pp. 1–41. 10.1109/ICI53355.2022.9786895.
[61] K. Kumar, A. K. Jain, R. G. Tiwari, N. Jain, V. Gautam, and N. K. Trivedi,
‘‘Analysis of API architecture: A detailed report,’’ in Proc. IEEE 12th Int.
Conf. Commun. Syst. Netw. Technol. (CSNT), Bhopal, India, Apr. 2023,
pp. 880–884, doi: 10.1109/CSNT57126.2023.10134658.
[62] S. Siadati, ‘‘Fundamentals of Python programming,’’ Tech. Rep.,
Apr. 2018, doi: 10.13140/RG.2.2.13071.20642.
[63] Flutter Tutorial, Tuts. Point (I) Pvt. Ltd, Telangana, India, 2019, pp. 1–180.
[64] O. Actis, Oxana, M. Brodski, M. Erdmann, R. Fischer, A. Hinz-
mann, T. Klimkovich, G. Müller, T. Münzer, M. Plum, G. Stegge-
WAFAA A. N. A. AL-NBHANY received the B.Sc.
mann, and T. Winchen, ‘‘Visual physics analysis VISPA,’’ J. Phys.,
Conf. Ser., vol. 219, Apr. 2010, Art. no. 042041, doi: 10.1088/1742-
degree in electrical engineering-major: computer
6596/219/4/042041. and control from Sana’a University, in 2009, and
[65] W.-M. Lee, ‘‘Using the MetaMask Crypto-Wallet,’’ Apress eBooks, the master’s degree in computer information sys-
Tech. Rep., 2023, pp. 111–144, doi: 10.1007/978-1-4842-9271-6_5. tems from the Arab Academy for Banking and
[66] E. Stern, ‘‘Remix: The framework you should learn about,’’ Financial Sciences, Sana’a, Yemen, in 2016. She
Medium.com, Tech. Rep. Accessed: Aug. 1, 2023. [Online]. has been a Lecturer with the Department of Infor-
Available: https://medium.com/@evanstern_94664/remix-the-framework- mation Systems, Sana’a University, since October
you-should-learn-about-928d4060e8ad/ 2020. From October 2022 to April 2023, she was
[67] R. Verma, N. Dhanda, and V. Nagar, ‘‘Application of truffle suite in a with the University of Science and Technology
blockchain environment,’’ in Proc. 3rd Int. Conf. Comput., Communica- (UST), Sana’a. Her research interests include the IoT, AI, networking,
tions, Cyber-Secur., in Lecture Notes in Networks and Systems, vol. 421, cryptographic algorithms, database management, web design, and GIS infor-
2023, pp. 693–702. mation systems.
VOLUME 12, 2024 4211

AMMAR T. ZAHARY (Senior Member, IEEE) ASMA A. AL-SHARGABI received the B.Sc. and M.Sc. degrees in computer
received the B.Eng. degree in electronics and science from UST, in 1999 and 2006, respectively, and the Ph.D. degree
electrical communication engineering from Cairo from De Montfort University, U.K., in 2015. She has been an Assistant
University, Egypt, in 1997, the M.Sc. degree in Professor with the Department of Information Technology, Qassim Uni-
computer engineering from the University of Sci- versity, Saudi Arabia, since December 2019. She was with the University
ence and Technology, Yemen, in 2001, and the of Science and Technology (UST), Sana’a, Yemen, from June 2015 to
Ph.D. degree in data communication and network- October 2019. Her research interests include the IoT, AI, cybersecurity, data
ing from De Montfort University, U.K., in 2008. science, ubiquitous computing, software engineering, and Arabic language
He is currently an Associate Professor in data processing.
communication and networking and the Dean of
E-Learning with the University of Science and Technology, Sana’a, Yemen.
He has many published research articles in high-quality journals (H-index
= 10 and Scopus H-index = 7). Furthermore, he has supervised many
master’s and Ph.D. theses. His research interests include the Internet of
Things and cybersecurity, MANETs, VANETs, cloud and fog computing,
mobile edge computing, and artificial intelligence. In addition, he is also an
Editorial Board Member, a Technical Committee Member, and a Reviewer
of many esteemed journals with ISI and Scopus Q1 and Q2 journals, such as
IEEE ACCESS, CMC-Computers, Materials & Continua, Frontiers of Internet
of Things, and Library Hi Tech (Emerald). He received the E-Learning
Lecturer Certified. Finally, he is one of the founders of the IEEE Yemen
Subsection and the first elected Chair, from November 2018 to December
2023. He was the elected Vice Chair of the IEEE Yemen Subsection, until
December 2024.
4212 VOLUME 12, 2024

Blockchain-IoT Healthcare Applications and Trends A Review

Uploaded by

Copyright:

Available Formats

Blockchain-IoT Healthcare Applications and Trends A Review

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Blockchain-IoT Healthcare Applications and Trends A Review

Uploaded by

Copyright:

Available Formats

Received 14 December 2023, accepted 29 December 2023, date of publication 2 January 2024,

date of current version 10 January 2024.

Blockchain-IoT Healthcare Applications

Corresponding author: Wafaa A. N. A. Al-Nbhany (Waf.Al_nbhany@su.edu.ye)

I. INTRODUCTION of data. Blockchain is used with the Internet of Things to

VOLUME 12, 2024 4179

4180 VOLUME 12, 2024

FIGURE 1. Structure of BIOT healthcare applications.

VOLUME 12, 2024 4181

TABLE 1. Compare between permissionless and permissioned blockchains.

4182 VOLUME 12, 2024

TABLE 2. Blockchain types used in recent research.

FIGURE 2. Blockchain technologies.

VOLUME 12, 2024 4183

VOLUME 12, 2024 4185

TABLE 3. Research in blockchain technologies.

4186 VOLUME 12, 2024

TABLE 3. (Continued.) Research in blockchain technologies.

FIGURE 3. Blockchain IoT healthcare applications.

VOLUME 12, 2024 4187

TABLE 4. Research in BIOT healthcare applications. A. ELECTROGRAM SENSORS

4188 VOLUME 12, 2024

FIGURE 4. BIOT healthcare applications.

FIGURE 5. Sensors and IoT hardware platform devices.

VOLUME 12, 2024 4189

4190 VOLUME 12, 2024

VOLUME 12, 2024 4191

TABLE 6. The research used vital sign sensor IoT devices.

3) MOTION SENSOR application type was Healthcare monitoring, security of the

4192 VOLUME 12, 2024

Positioning Identification (MEMS) sensors. These studies are

VOLUME 12, 2024 4193

TABLE 7. The research used air temperature sensor IoT devices.

TABLE 8. The research used body positioning sensor IoT devices.

Arduino uses hardware called the Arduino development

4194 VOLUME 12, 2024

TABLE 9. Research used sensors IoT devices.

The Raspberry Pi supports Python, C, C++, BASIC, Perl,

VOLUME 12, 2024 4195

FIGURE 12. BIOT healthcare databases.

Below is a collection of authors who have used hardware

4196 VOLUME 12, 2024

TABLE 10. Research in hardware platform.

TABLE 11. Database applications used in BIOT healthcare applications.

VOLUME 12, 2024 4197

FIGURE 13. BIOT healthcare programming languages and tools.

2) REACTJS Resources are the system’s entities in the resource-oriented

4198 VOLUME 12, 2024

TABLE 12. Javascript software applications used in BIOT healthcare applications.

In [2], the application type was Secure Data Management B. PYTHON

VOLUME 12, 2024 4199

TABLE 13. Programming languages us ed in BIOT healthcare applications.

F. SOLIDITY Prediction, using Matlab software languages. These stud-

4200 VOLUME 12, 2024

VOLUME 12, 2024 4201

TABLE 14. Software tools used in BIOT healthcare applications.

FIGURE 14. BIOT healthcare applications challenges and solutions.

C. ACCESS CONTROL E. IMMUTABILITY

D. INTEGRITY G. DATA STORAGE