Document Type : Review Article

Authors

1 Associate Professor, Department of Biomedical Engineering, Research Center of Technology and Engineering, Standard Research Institute, Karaj, Ira

2 Associate Professor, Department of Statistics, Mathematics, and Computer Science, Allameh Tabataba’i University, Tehran, Iran

3 Master’s Degreeو Medical Care Affairs, Shiraz University of Medical Sciences, Shiraz, Iran

10.30476/smsj.2024.102258.1517

Abstract

Nowadays, medical devices are widely used around the world. In every country, the safety of these devices is inextricably related to public health and security. Despite all these sensitivities and legal oversight, issues such as lack of transparency in the medical device supply chain, lack of real feedback from incidents and clinical reports related to these devices, and consequently the failure to update risk management systems and improve the quality of these devices, resulting in increased safety risks for users/patients. Therefore, the development and implementation of an effective post-market surveillance and management system for medical devices is essential.
In this article, in addition to a review of some applications of blockchain technology in the health sector, the requirements and structural framework for an information and management system for post-market surveillance of medical devices based on this technology were also presented. This system was developed with the approach of tracking medical devices to enhance transparency, provide rapid information dissemination, and reduce the rate of adverse incidents, and clinical reports related to these devices throughout their supply chain. A blockchain-based post-market surveillance system for medical devices could provide all stakeholders with valuable and real recommendations and information in the form of smart contracts by ensuring complete informational transparency throughout the supply chain. Blockchain technology could be used by regulatory and oversight organizations to effectively monitor and manage the performance of medical devices, ensuring greater transparency, and thereby guaranteeing enhanced safety and quality for stakeholders.

Keywords

  1. Pane J, Francisca RDC, Verhamme KMC, Orozco M, Viroux H, Rebollo I, et al. EU postmarket surveillance plans for medical devices. Pharmacoepidemiol Drug Saf. 2019;28(9):1155-65.
  2. Vora P, Artime E, Soriano‐Gabarró M, Qizilbash N, Singh V, Asiimwe A. A review of studies evaluating the effectiveness of risk minimisation measures in Europe using the European Union electronic Register of Post‐Authorization Studies. Pharmacoepidemiology and drug safety. 2018;27(7):695-706.
  3. European Union- EUR-Lex [Internet]. Regulation (EU) 2017/745 of the European Parliament and of the Council. c2017. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A32017R0745
  4. Parand FA, Tavakoligolpaygani A. Implementation of blockchain standards for compliance and trust in medical implants supply chain. Advances in the Standards & Applied Sciences. 2022;1(1):1-7.
  5. Health C for D and R [Internet]. Use of Real-World Evidence to Support Regulatory Decision-Making for Medical Devices. c2019. Available from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/use-real-world-evidence-support-regulatory-decision-making-medical-devices
  6. International Medical Device Regulators Forum [Internet]. GHTF Study Group 2 - Post-market Surveillance/Vigilance. Available from: https://www.imdrf.org/documents/ghtf-final-documents/ghtf-study-group-2-post-market-surveillancevigilance
  7. The Telegraph [Internet]. Faulty medical implants investigation. Patients failed by poor implant regulation, say surgeons. 2012 Available from: https://www.telegraph.co.uk/news/health/news/9631974/Faulty-medical-implants-investigation-Patients-failed-by-poor-implant-regulation-say-surgeons.html
  8. ICIJ [Internet]. Medical Devices Harm Patients Worldwide As Governments Fail On Safety. Available from: https://www.icij.org/investigations/implant-files/medical-devices-harm-patients-worldwide-as-governments-fail-on-safety/
  9. Pane J, Verhamme KMC, Shrum L, Rebollo I, Sturkenboom M. Blockchain technology applications to postmarket surveillance of medical devices. Expert Rev Med Devices. 2020;17(10):1123-32.
  10. Amazon [Internet]. Can Blockchain Revolutionize International Trade?: Ganne, Emmanuelle. c2024 Available from: https://www.amazon.it/Can-Blockchain-Revolutionize-International-Trade/dp/928704760X
  11. Price waterhouse Coopers [Internet]. Blockchain is here. What’s your next move? - PwC Channel Islands. c2018. Available from: https://www.pwc.com/jg/en/publications/blockchain-is-here-next-move.html
  12. Wang Y, Singgih M, Wang J, Rit M. Making sense of blockchain technology: How will it transform supply chains? International Journal of Production Economics. 2019;211:221-36.
  13. Ethereum [Internet]. What is Ethereum?. Available from: https://ethereum.org/en/what-is-ethereum/
  14. Azzi R, Chamoun RK, Sokhn M. The power of a blockchain-based supply chain. Computers & industrial engineering. 2019;135:582-92.
  15. Hawlitschek F, Notheisen B, Teubner T. The limits of trust-free systems: A literature review on blockchain technology and trust in the sharing economy. Electronic commerce research and applications. 2018;29:50-63.
  16. Li Z, Kang J, Yu R, Ye D, Deng Q, Zhang Y. Consortium blockchain for secure energy trading in industrial internet of things. IEEE transactions on industrial informatics. 2017;14(8):3690-700.
  17. Sikorski JJ, Haughton J, Kraft M. Blockchain technology in the chemical industry: Machine-to-machine electricity market. Applied energy. 2017;195:234-46.
  18. Tian F, editor. An agri-food supply chain traceability system for China based on RFID & blockchain technology. 1-6 June 2016. Kunming: 13th international conference on service systems and service management (ICSSSM); 2016.
  19. Ahmed S, Broek NT. Food supply: Blockchain could boost food security. Nature. 2017;550(7674):43.
  20. Lu Q, Xu X. Adaptable blockchain-based systems: A case study for product traceability. Ieee Software. 2017;34(6):21-7.
  21. Tönnissen S, Teuteberg F. Analysing the impact of blockchain-technology for operations and supply chain management: An explanatory model drawn from multiple case studies. International Journal of Information Management. 2020;52:101953.
  22. Saberi S, Kouhizadeh M, Sarkis J, Shen L. Blockchain technology and its relationships to sustainable supply chain management. International journal of production research. 2019;57(7):2117-35.
  23. Pan X, Pan X, Song M, Ai B, Ming Y. Blockchain technology and enterprise operational capabilities: An empirical test. International Journal of Information Management. 2020;52:101946.
  24. Ejaz M, Kumar T, Kovacevic I, Ylianttila M, Harjula E. Health-BlockEdge: Blockchain-Edge Framework for Reliable Low-Latency Digital Healthcare Applications. Sensors (Basel). 2021;21(7).
  25. De Aguiar EJ, Faiçal BS, Krishnamachari B, Ueyama J. A survey of blockchain-based strategies for healthcare. ACM Computing Surveys (CSUR). 2020;53(2):1-27.
  26. Mackey TK, Kuo TT, Gummadi B, Clauson KA, Church G, Grishin D, et al. 'Fit-for-purpose?' - challenges and opportunities for applications of blockchain technology in the future of healthcare. BMC Med. 2019;17(1):68.
  27. Khatoon A. A blockchain-based smart contract system for healthcare management. Electronics. 2020;9(1):94.
  28. Abu-Elezz I, Hassan A, Nazeemudeen A, Househ M, Abd-Alrazaq A. The benefits and threats of blockchain technology in healthcare: A scoping review. Int J Med Inform. 2020;142:104246.
  29. Hussien HM, Yasin SM, Udzir NI, Ninggal MIH, Salman S. Blockchain technology in the healthcare industry: Trends and opportunities. Journal of Industrial Information Integration. 2021;22:100217.
  30. Agbo CC, Mahmoud QH, Eklund JM, editors. Blockchain technology in healthcare: a systematic review. Healthcare. 2019;7(2):56.
  31. Engelhardt MA. Hitching healthcare to the chain: An introduction to blockchain technology in the healthcare sector. Technology Innovation Management Review. 2017;7(10).
  32. Tanwar S, Parekh K, Evans R. Blockchain-based electronic healthcare record system for healthcare 4.0 applications. Journal of Information Security and Applications. 2020;50:102407.
  33. Jiang S, Cao J, Wu H, Yang Y, Ma M, He J, editors. Blochie: a blockchain-based platform for healthcare information exchange. Taormina: 2018 ieee international conference on smart computing (smartcomp); 2018.
  34. Zhang P, Walker MA, White J, Schmidt DC, Lenz G, editors. Metrics for assessing blockchain-based healthcare decentralized apps. 2017 IEEE 19th international conference on e-health networking, applications and services (Healthcom); 2017.
  35. Hathaliya J, Sharma P, Tanwar S, Gupta R, editors. Blockchain-based remote patient monitoring in healthcare 4.0. Tiruchirappalli: 2019 IEEE 9th international conference on advanced computing (IACC); 2019.
  36. Berdik D, Otoum S, Schmidt N, Porter D, Jararweh Y. A survey on blockchain for information systems management and security. Information Processing & Management. 2021;58(1):102397.
  37. Du X, Chen B, Ma M, Zhang Y. Research on the Application of Blockchain in Smart Healthcare: Constructing a Hierarchical Framework. J Healthc Eng. 2021;2021:6698122.
  38. Peterson K, Deeduvanu R, Kanjamala P, Boles K [Internet]. A Blockchain-Based Approach to Health Information Exchange Networks. Available from: https://www.healthit.gov/sites/default/files/12-55-blockchain-based-approach-final.pdf
  39. Javaid M, Haleem A. Industry 4.0 applications in medical field: A brief review. Current Medicine Research and Practice. 2019;9(3):102-9.
  40. Bhattacharya P, Tanwar S, Bodkhe U, Tyagi S, Kumar N. Bindaas: Blockchain-based deep-learning as-a-service in healthcare 4.0 applications. IEEE transactions on network science and engineering. 2019;8(2):1242-55.
  41. Al Omar A, Bhuiyan MZA, Basu A, Kiyomoto S, Rahman MS. Privacy-friendly platform for healthcare data in cloud based on blockchain environment. Future generation computer systems. 2019;95:511-21.
  42. Zarour M, Ansari MTJ, Alenezi M, Sarkar AK, Faizan M, Agrawal A, et al. Evaluating the impact of blockchain models for secure and trustworthy electronic healthcare records. IEEE Access. 2020;8:157959-73.
  43. Ray PP, Dash D, Salah K, Kumar N. Blockchain for IoT-based healthcare: background, consensus, platforms, and use cases. IEEE Systems Journal. 2020;15(1):85-94.
  44. Munoz D-J, Constantinescu D-A, Asenjo R, Fuentes L, editors. Clinicappchain: A low-cost blockchain hyperledger solution for healthcare. Blockchain and Applications: International Congress; 2020:36-44.
  45. Soltanisehat L, Alizadeh R, Hao H, Choo K-KR. Technical, temporal, and spatial research challenges and opportunities in blockchain-based healthcare: A systematic literature review. IEEE Transactions on Engineering Management. 2020;70(1):353-68.
  46. Nguyen DC, Pathirana PN, Ding M, Seneviratne A. BEdgeHealth: A decentralized architecture for edge-based IoMT networks using blockchain. IEEE Internet of Things Journal. 2021;8(14):11743-57.
  47. Gul MJ, Subramanian B, Paul A, Kim J. Blockchain for public health care in smart society. Microprocessors and Microsystems. 2021;80:103524.
  48. Saha A, Amin R, Kunal S, Vollala S, Dwivedi SK. Review on “Blockchain technology based medical healthcare system with privacy issues”. Security and Privacy. 2019;2(5):e83.
  49. Pandey P, Litoriya R. Implementing healthcare services on a large scale: challenges and remedies based on blockchain technology. Health Policy and Technology. 2020;9(1):69-78.