”MediGuard”: A Comprehensive Review on Security Challenges & Attacks
on Blockchain-IoT Enabled Secure e-Healthcare System
- Shrabani Sutradhar,
- Rajesh Bose,
- Sudipta Majumder,
- Muhammad Faheem,
- Sandip Roy,
- Arfat Ahmad Khan
Abstract
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The digitalization of healthcare is being transformed through the
integration of IoT, cloud environments, and blockchain technology,
significantly enhancing security and infrastructure robustness. This
study conducts a systematic review of over 200 articles on
blockchain-enabled healthcare systems, analysing current applications,
security threats, cyber-attacks, and system challenges, along with
proposed solutions. Despite blockchain’s potential to revolutionize
medical data handling, sharing, and processing, our findings reveal
persistent issues: 17 security threats compromising privacy and data
integrity, 21 cyber-attacks impacting security and quality of service,
and 16 system problems such as node compromise, scalability, efficiency,
regulatory challenges, computation speed, and power consumption. We
propose a layered architecture for future healthcare infrastructure,
categorizing issues within this framework and evaluating existing
solutions. Our comparative analysis demonstrates the superiority of this
architecture in terms of security, trustworthiness, and efficiency over
traditional systems. Real-world case studies and a comparative
evaluation of blockchain protocols and consensus mechanisms offer deeper
insights into their applicability in IoMT and healthcare. This review
provides a comprehensive perspective on enhancing e-healthcare services
through improved security and privacy, addressing regulatory and ethical
challenges. By mapping out limitations, future scopes, and emerging
trends, we aim to foster the development of robust, trustworthy, and
privacy-preserving healthcare systems.