COUNT: Blockchain framework for resource accountability in e-healthcare

The progress of sensor devices, digital communication, and computing techniques enhances the functionalities of e-healthcare, where the medical facilities are manageable based on the Internet. Now a days, e-healthcare not only helps in disease diagnosis, or tele-medicine, but also implies to general medical scope and medical resource management. Thus, Internet-of-Medical Thing (IoMT) becomes an umbrella term to connect e-healthcare, tele-medicine, and medical supply chain management. In the recent past, the outbreak of COVID-19 pandemic has shown the loopholes in the existing medical systems such as the mismanagement of medical resources and the unavailability of the basic requirements for patients. The medical infrastructure urges for the new frameworks to handle accountability and transparent governance in a medical emergency situation. This motivates us to address medical resource accountability in e-healthcare. In the present work, we introduce the first resource accountability framework to balance the demand–supply of medical facilities in an e-healthcare and IoMT ecosystem. Our solution is based on blockchain and we call it bloCkchained framework for resOUrce accouNTability (COUNT). We use a customized Proof of Vote (PoV) for consensus in COUNT. We call this consensus COUNT-PoV, which is another direction of novelty in our solution. The blocks in the proposed COUNT contain the resource requirements and their availability–production–supply status. Multiple stakeholders are involved in the process based on providing pre-attained credentials; thus, COUNT supports consortium blockchain. Existing literature shows a number of studies for blockchain-based frameworks for e-healthcare; however, those works do not address the accountability and transparency issues of medical e-governance and balancing the demand–supply of the medical facilities/resources. Therefore, our proposed COUNT is beneficial for e-healthcare and IoMTs. We use signcryption process to reduce the complexity of the cryptographic processes, which is an add-on to the contribution. We evaluate our proposed framework based on the Hyperledger Caliper benchmark test with latency, throughput, and resource consumption. Additionally, we also analyse the cost of the implementation. The comparative analysis of our consensus with other stake-based consensus protocols on the COUNT framework shows that our consensus, COUNT-PoV is efficient and suitable for the use of e-healthcare and IoMTs. Moreover, being a generic framework, COUNT is helpful for the e-governance of medical facilities, the vaccination process, and COVID passports.