Blockchain and IoT based Smart Healthcare Systems

The Role of Emerging Technologies in Smart Health Care

Jaskiranjit Kaur¹, *, Parvesh Kumar²

¹ Panjab University, Chandigarh, India

² Chandigarh University, Chandigarh, Punjab, India

Abstract

Numerous technological advancements like 3-D Printing, Virtual Reality (VR), Augmented Reality (AR), Artificial Intelligence (AI), Internet of Things (IoT), Drones, Robots, and Blockchain are now being inscribed for their ability to change the health care industry and make it a more automated and effective field. Various tools related to AI, like Google, DeepMind, Atomwise, Chatbot, Enlitic, Freenome, and Buoy Health, are helpful in makingthe health industry more efficient. There is another technology which is nanomicelle that can be used for effective drug delivery to treat various cancers, including breast, colon, and lung cancer. Moreover, self-assembling peptide nanoparticles that were prepared from SARSCov-1 spike (S) protein, successfully induced neutralizing antibodies against the coronavirus, subsequently preventing infection of Vero cells. Furthermore, the application of 3D printing in medicine can provide many benefits, including the customization and personalization of medical products, drugs, and equipment; cost-effectiveness; increased productivity; democratization of design and manufacturing; and enhanced collaboration. IoT enables real-time alerting, tracking, and monitoring, which permits hands-on treatment, better accuracy, apt intervention by doctors, and improves patient care delivery results. The other most promising application isblockchain in the healthcare sector for identity management, dynamic patient consent, and management of supply chains for medical supplies and pharmaceuticals. In addition, there are several case studies that describe the benefits of emerging tools, like recently the use of Emerging Technologies for the study, diagnosis, and treatment of patients with COVID-19 by using Deep Convolutional neural networks (CNN), which is a widely used deep learning architecture, enabled distinguishing between COVID-19 and other causes of pneumonia through chest X-ray image analysis.

Keywords: AI, Blockchain, Drone, IoT, Nanotechnology, Virtual reality.

* Corresponding author Jaskiranjit Kaur: Panjab University, Chandigarh, India; E-mail: [email protected]

INTRODUCTION

There are many technologies that are worthwhile in the healthcare sector, such as artificial intelligence (AI), bioprinting, nanotechnology, virtual reality, blockchain, and robotics. With the use of these technologies, anyone, anywhere at any time, might perform medicine in aneasy way, which makes the health industry more automated. In addition, with the use of emerging technologies, many other advantages are possible such as enabling remote monitoring of patients and their access to healthcare, health statistics collection, fast patient identification, access to medical records, and information exchange with providers and other patients.

Artificial Intelligence (AI)

Most of the AI and healthcare technologies have strong relevance to the healthcare field. Artificial intelligence in healthcare combines computer science and robust datasets to enable problem-solving related to health, such as patient care, diagnosing patients, end-to-end drug discovery and development, improving communication between physicians and patients, transcribing medical credentials, such as prescriptions, and remotely treating patients, administrative processes and helping them improve upon existing solutions and overcome challenges faster [1]. It also encompasses sub-fields of machine learning and deep learning, speech recognition, computer vision, and natural language processing which are frequently mentioned in conjunction with artificial intelligence to create expert systems that make predictions or classifications based on input data [2]. These learning algorithms evolve and become more accurate, they are likely to significantly impact healthcare services to identify diseases through diagnostic approaches, treatments, and care processes, and help develop more efficient and precise interventions. There are various tools that are based on AI to be helpful in the diagnosis of patients such as medical imaging technologies like computed tomography (CT), ultrasonography, x-rays, mammography, computed tomo- graphy (CT scans), nuclear medicine, and Magnetic resonance imaging (MRI) scan of human body parts.

INITIATIVES ON AI

A number of AI start-up companies like Google, Microsoft, and IBM have also been steadily increased investing in the development of health care with AI. There are several UK-based companies collaborating with UK universities and hospitals for better implementation of AI techniques. There are many Assisted Self-Diagnosis Apps that are based on AI methods, such as Ada, Babylon, Buoy Health, Your.MD, Mediktor, HealthTap, Apotheka Patient, Sensely, Health Buddy, etc.

Such paradigms are Harvard University’s teaching hospitals advancing health care systems with artificial intelligence techniques to diagnose potential blood diseases at a very early stage.

Self-Diagnosis AI Apps

BioXcel Therapeutics, a biopharmaceutical company, combines proprietary machine learning algorithms, big data, and AI techniques to find and develop novel therapeutics in the areas of immuno-oncology and the brain. Moreover, BioXcel's firm works with two drug re-innovation programs which are BXCL501 and BXCL701.

Buoy Health employs AI-based system algorithms to accurately identify, treat, and analyse signs of sickness. Chabot asks a patient about their symptoms and health concerns, then, after making a diagnosis, directs the patient to the appropriate care [3].

BERG is a biotech company in the trial stages that uses artificial intelligence and its own platform, Interrogative Biology, to change treatments for oncology, neurology, and uncommon diseases and map diseases. Critical biomarkers can be found in BERG, which speeds up the identification and development of therapies directed at the most promising therapeutic targets and pathways. The elimination of hit-to-lead optimization and screening in Berg's method, which generates virtual models of healthy and diseased cells, results in clear time-saving. Berg avoids these procedures by selecting compounds that occur naturally and using them as the foundation for medication in its virtual model [4].

XtalPi's ID4 platform combines AI technology, cloud, and quantum physics that provide small molecule candidate chemicals and pharmaceutical compounds for drug design and development in days instead of weeks or months for quick prediction and development by maintaining a petabyte-scale database consisting of pharmaceutically active molecules [5].

Deep Genomics' AI platform handles the complexity of RNA biology, identifies new targets, evaluates thousands of opportunities, increases the number of successful clinical trials, and accelerates time to market. It also identifies the best treatment candidates to increase and reduce costs. Moreover, over 69 billion dissimilar cell connections were analyzed by Deep Genomics' Project Saturn. Headquartered in New York, Kaia Health offers AI-powered digital therapy via a mobile app for exercise routines related to chronic pain, soporific events, and learning assets for the treatment of chronic low back pain, chronic bronchitis, and emphysema (COPD). We operate a digital treatment platform that we provide [6].

Analysis of Medical Imaging: The instrument of AI is utilized for case triage. It helps a doctor review scans and photos. In order to prioritize crucial cases, avoid errors while analyzing EHRs (electronic health records), and create more accurate diagnoses, radiologists or cardiologists might use this information.

Large amounts of data and photos from a clinical trial may need to be analyzed, so AI systems can quickly examine these datasets and relate data from other studies in order to find undetectable relationships and patterns. Medical imaging specialists can immediately track critical information. Patient Synopsis provides radiologists and cardiologists with a summary that focuses on the context of these images by delving into previous diagnostics and medical procedures, lab results, medical history, and known allergies [7].

Decrease the Cost to Develop Medicines: The effectiveness of possible medications for a variety of ailments has been predicted by supercomputers using databases of molecular structures. AtomNet's technology, convolutional neural networks, could predict the binding of tiny chemicals to proteins by examining cues from millions of experimental measurements and thousands of protein shapes. Convolutional neural networks were able to find a potential drug candidate that was both safe and effective using this technique, which decreased the cost of creating new medications.

In 2015, when the Ebola virus was outbreak in the West Africa, Atomwise with IBM and the University of Toronto worked together to find the best vaccine to stop the Ebola virus entry into body cells. The cure for the Ebola virus was made possible by this AI analysis, which was completed in less than a day instead of the typical month or year.

Analyzes Unstructured Data: Due to the vast volume of health data and medical records, clinicians frequently struggle to keep up with the most recent medical advancements while still providing high-quality patient-centered treatment. ML systems can swiftly scan EHRs and biomedical data organised by healthcare organizations and medical specialists to give clinicians timely, accurate answers. Health information and patient medical records are frequently kept as complex unstructured information, which makes them challenging to access and comprehend [8].

AI can find, gather, store, and standardize medical data, assisting with repetitive tasks and assisting clinicians with quick, precise, and customized treatment plans and medications for their patients instead of being overburdened with the burden of searching, identifying, gathering, and transcribing the solutions they need.

AI is a Useful Tool for Emergency Medical Personnel

The period between dialing 911 and the ambulance's arrival is crucial for recovery from a sudden heart attack. Emergency dispatchers must be able to recognise the symptoms of cardiac arrest in order to take the necessary action and increase the patient's chance of life. AI is capable of analyzing both verbal and nonverbal cues to establish a diagnosis remotely. An artificial intelligence tool called Corti helps emergency medical professionals. In order to determine whether a heart attack is occurring, Corti analyses the caller's speech, background noise, and pertinent data from the patient's medical records. In a heart attack, Corti alerts the appropriate authorities. Same as different ML tools, Corti no longer looks for specific signals; however, it trains itself by being attentive to many calls with a view to stumble on essential points. Corti continuously develops its version based on what it has learned. Approximately 73% of the time in Copenhagen, emergency dispatchers can identify a cardiac arrest based solely on the caller's description. However, AI can do higher. A small-scale look carried out in 2019 discovered that ML fashion had been capable of diagnosing cardiac arrest calls higher than human dispatchers through the usage of the speech reputation software app, ML, and different history clues. ML has a significant role to play in aiding emergency medical professionals. Future medical devices could leverage technology to send drones equipped with automatic defibrillators or trained volunteers to respond to emergency calls, increasing the chances of survival in cardiac arrests that happen in the community.

Speeds Up the Invention and Improvement Of Genetic Remedy

With the help of altered molecular phenotypes, such as protein binding, genetic disorders are preferred. Predicting those changes involves estimating the likelihood that hereditary diseases may develop. This is feasible with the aid of gathering information on all recognized compounds and biomarkers applicable to apply on scientific trials. This information is processed, for example, with the aid of using the AI gadget of Deep Genomics. The company develops its own proprietary AI and uses it to learn new ways to fix the effects of genetic mutations while developing specially crafted treatments for people suffering from rare Mendelian and complex diseases. The organisation exams recognized compounds to broaden a quicker genetic remedy for situations with excessive unmet needs. The organisation's professionals are running on Project Saturn, a drug gadget primarily based totally on AI molecular biology that assesses extra than sixty-nine billion oligonucleotide molecules in silico (carried out or produced through pc modeling or pc simulation) towards 1 million goal web sites for you to screen mobileular biology to free up extra ability remedies and cures. By lowering the

costs associated with treating rare illnesses, the development of genetic medicine benefits both patients and medical professionals.

AI in Pandemic

It checks the improvement of COVID-19 patients and shares patient information to make the surgeon’s job easy. This helps to manage the emergency condition of the patient by demonstrating several intelligent approaches. It alerts the patient to take proper medication through the utilization of the app. This technology performs the required medical tasks with less involvement of humans. It allows us to follow more critical aspects of patient care. AI-enabled robots are used for the communication of COVID-19 patients without the physical presence of doctors. The major roles of AI during the COVID-19 pandemic are contact tracing, preventing the spread of the COVID-19 virus, better understanding the nature of this virus, fever detection, predicting future outcomes, proper management of COVID-19 cases, controlling misinformation, vaccine development, detecting the probability of symptoms and proper surveillance systems [7]. It is used for the assessment of patient images and helps to predict the results. In the upcoming days, AI will provide an excellent source to identify problems and reduce the shortage of doctors. Some AI-related tools are summarized in Table 1.

Table 1 AI tools and description.

NANOTECHNOLOGY

Nanotechnology is a branch of technology that studies materials of extremely small structures, having a size of 0.1 to 100 nm. The use of nanotechnology widely ranges from industrial and medicinal to energy use due to its unique properties such as high photostability, high level of brightness, and absorption coefficients [9]. Moreover, these materials include more durable construction materials, effective bioavailability, minimal side effects, therapeutic drug delivery, and higher-density hydrogen fuel cells that are environmentally friendly and less costly. Nanotherapeutics and nanomedicines are available for clinical use, including treatments for cancer, high cholesterol, autoimmune diseases, fungal infections, macular degeneration, hepatitis, and many other conditions. Doxorubicin HCl liposome injection (Doxil, Ortho Biotech) for ovarian cancer, daunorubicin citrate liposome injection (DaunoXome, Diatos) for advanced AIDS-related Kaposi's sarcoma, and amphotericin B liposome injection (AmBisome, Gilead) for fungus infections are among the nanomedicines currently available on the market. The following Table 2 describes the Approved Cancer Drug Therapies Based on Nanotechnology [10].

Table 2 Drug name and its description.

How Nano-medicines or Smart Pills Work?

Nano-medicines use smart nanoparticles for better drug delivery. Such systems are embedded with technological components such as microchips, cameras, or sensors that wirelessly communicate with wearable software or mobile apps and send information to computers at pharmacies or doctor’s offices. This technology diagnoses similar data as conventional diagnostic techniques such as endoscopy.

A brief explanation of the pharmaceutical nanosystem is as follows which is mentioned in Fig. (1):

Fig. (1))

Pharmaceutical Nano System.

As shown in the schematic diagram, pharmaceutical nanotechnology is divided into two basic types, which are nanomaterials and nanodevices.

Nanomaterials are materials of which a single unit is sized (in at least one dimension) between 1 and 100 nm and its some chemical properties include composition, structure, molecular weight, boiling and melting points, vapor pressure, octanol-water partition coefficient, water solubility, reactivity, and stability that are important in characterizing materials. These materials may be in the form of particles, tubes, rods, or fibres. Further, nanomaterails are categories of nanocrystalline and nanostructures. These nanostructures may be in the form of polymers or nonpolymers according to their properties. Nanostructured polymers may be nanoparticles, micelles, and drug conjugates, and nonpolymers are carbon nanotubes, silica nanoparticles, quantum dots, etc [12].

A nanocrystalline (NC) material is a polycrystalline material with a crystallite size of only a few nanometers and mostly used for treating wounds, especially burns and chronic wounds due to its effective antimicrobial properties. Other properties of nanocrystalline materials like increased strength/hardness, enhanced diffusivity, improved ductility/toughness, reduced density, reduced elastic modulus, higher electrical resistivity, increased specific heat, higher thermal expansion coefficient, and lower thermal conductivity make them more effective than conventional polycrystalline coarse-grained materials.

Nanodevices, including high electron mobility transistors, heterojunction bipolar transistors, resonant tunnelling diodes, and quantum optoelectronic devices like lasers and detectors, are also part of nanotechnology. Some nanodevices with their uses are described briefly in Tables 3 & 4.

Table 3 Uses of Nanodevices.

Table 4 List of nano mission sanctioned new projects for fy 2018-2019.

IoT

The Internet of Things (IoT) is a network of wireless systems that are connected to one another and networked digital devices like sensors and internet devices that can collect, send, and store data without the assistance of a human or computer [18], as shown in Table 5.

The Internet of Things (IoT) promises a number of benefits for streamlining and enhancing the delivery of healthcare, including the capacity to diagnose, treat, and monitor patients both within and outside of hospitals. There are more such advantages of using IoT like remote monitoring, medical data accessibility, improved treatment management, and instant and reliable treatment [19]. In 2022, during the pandemic period, IoT's sensor-based technology has the potential to lower the danger of surgery in difficult instances, which could be useful in COVID-19 [20-22]. In the medical field, IoT’s focus is to help perform the treatment of different COVID-19 cases precisely. By 2025, 75 billion IoT devices are anticipated to exist [22-24].

Table 5 IoT integrated with other techniques.

Five-Layer Architecture of IoT

All IoT-related services inevitably follow five basic steps called create, communicate, aggregate, analyze, and act. All these are done by some specific layer and each layer transfers data to the next layer in a meaningful way [25]. These 5 layers are as followed:-

The perception layer is the lowest layer of the conventional architecture of IoT and is called the recognition layer, which includes sensors (Humidity Sensors, Pressure Sensors, Proximity Sensors, and Level Sensors) for perceiving and acquiring environmental data and transform them in a digital setup [25, 26].

The transport layer is the next layer of IoT architecture which mainly focuses on transferring end-to-end sensor data from the perception layer to the processing layer and vice versa through networks such as wireless 3G, LAN(Local Area Network), Bluetooth, RFID (Radio-frequency identification), and NFC (Radio-frequency identification) with reliability, congestion avoidance. Ordering of packets, error detection, and correction in the delivery of data packets are the other main functions which this layer performs [26].

The Processing Layer is referred to as the IOT system's middleware layer. It stores, analyzes, and processes large amounts of data that come from the upper layer, that is, the transport layer. It is capable of managing and giving the lower layers a wide range of services [26, 27]. It makes use of a variety of technologies, including big data processing modules, cloud computing, and databases.

The Application Layer is responsible for delivering application-specific services to the clients with their prior requests. It describes several applications for the Internet of Things, such as smart homes, smart cities, and smart health.

The Business Layer oversees the entire Internet of Things (IoT) system, including all apps, business and revenue models, and user privacy, and it produces data-driven decision-making analysis. It is the most upper layer of IOT which interacts with the user [25]. All layers are shown in stack form in Fig. (2).

Fig. (2))

Architecture of IoT.

Sensors and Actuators: Context awareness is one of the key components of the Internet of Things and is impossible without sensor technology, and these IoT sensors are mostly capable of wired and wireless transmission, providing real-time, continuous data feed from assets and processes [28-30]. They increase accuracy while also ensuring faster transmission of measurement data, which enhances process control and asset health [31, 32].

Healthcare Monitoring Devices, Embedded Sensors

Table 6 Embedded Sensors in Health Devices.

IoT Device Trends and Anticipated Growth

The estimations for the future growth of IoT devices have been fast and furious. One of the fastest-growing segments of the IoT market is healthcare devices, as shown in Table 6. In fact, it is anticipated that the market for this industry, commonly referred to as the Internet of Medical Things (IoMT), will reach $176 billion by 2026 [33].

According to Intel's predictions, the number of internet-enabled gadgets would increase from 2 billion in 2006 to 200 billion by 2020, or approximately 26 smart devices for every person on Earth.IHS Mark predicted that there will be 75.4 billion connected devices in 2025 and 125 billion by 2030, which is a little more conservative.

Other businesses have adjusted their statistics by excluding PCs, tablets, and smartphones from the calculation. By 2020, 20.8 billion connected things are predicted to be in use by Gartner, IDC, and BI Intelligence, respectively [33].

IDC forecasts that spending on IoT devices and services will total $772.5 billion in 2018, up 14.6 percent from the $674 billion it predicted would be spent in 2017, and then $1 trillion and $1.1 trillion in 2020 and 2021, respectively. Total spending on IoT devices and services was estimated by Gartner to be close to $2 trillion in 2017.

The Global IoT estimation was USD 72.91 billion in 2020 and is expected to reach USD 89.40 billion in 2021, projected to grow at a CAGR of 22.95% reaching USD 251.90 billion by 2026 in Healthcare Market size.

In 2020, COVID-19 is anticipated to be the third most common cause of mortality in the country, and