Decentralized Identity Management for E-Health Applications: State-of-the-Art and Guidance for Future Work

BACKGROUND: The increasing use of various online services requires an efficient digital identity management (DIM) approach. Unfortunately, the original Internet protocols were not designed with built-in identity management, which creates challenges related to privacy, security, and usability. There is an increasing societal concern regarding the management of these sensitive data, access to it, and where it is stored. Blockchain technology can potentially offer a secure solution to address these issues in a decentralized manner without centralized authority. This is important for e-health services where the patient and the healthcare provider often are required to prove their identity. Blockchain technology can be utilized for creating digital identities and making its management easier, thus giving a higher degree of control to the user than what current solutions offer. It can be used to create a digital identity on the blockchain, making it easier for individuals and entities to manage, giving them greater control over who has their personal information and how they handle it. In addition, it might be utilized to create a higher degree of trust and security for e-health applications. OBJECTIVE: The aim of this research work was to review the state-of-the-art regarding blockchain-based decentralized identity management for healthcare applications. Based on this summary, we provide a viewpoint on how blockchain-based decentralized identity frameworks might be utilized for virtualized healthcare applications. METHODS: This research study applied a scoping, semi-systematic review approach to summarize the state-of-the-art. Included identity management systems were evaluated based on seven criteria: autonomy, authority, availability, approval, confidentiality, tenacity, and Interoperability. RESULTS: Seven blockchain-based identity management systems were included and evaluated in this work: these include solutions built with Ethereum, Hyperledger Indy, Hyperledger Fabric, Hedera, and Sovrin blockchains. CONCLUSIONS: DIM is crucial for virtual health care. Decentralized identity management for healthcare purposes is currently being explored in both academia and the private sector. More work is needed with the aim of improving the efficiency of current DIM solutions and to fully understand what technical frameworks are best suited for e-health applications.