Smart Contract enabled in Telehealth and Medicines

System

Apoorv Jain1 and Arun Kumar Tripathi2

1
Chegg India, New Delhi, India
apoorvjain911@gmail.com
2 KIET Group of Institutions, Delhi-NCR, Ghaziabad, India

mailtoaruntripathi@gmail.com

Abstract. Healthcare system is one of the most prime concern for mankind. The
pandemic compelled to search new alternative solutions for present healthcare
system and results in telehealth. The paper proposed a model for the “Telehealth
and Medicine System” based on one of the most powerful transparent, decentral-
ized, and secured technology i.e., “Blockchain”. The basic aim of the proposed
system is to provides the best remote healthcare facilities to people speedily and
securely. The model also supports for managing the healthcare resources infor-
mation for controlling the huge load of patients in hospitals. Present centralized
system fails to maintain security, confidentiality, functional transparency, health-
records immutableness, and traceability of medical apparatus and medicines. The
present centralized system is also unable to detect scams correlated to patient’s
transaction prerogatives and doctor authorized prescription data. In this paper we
explore the possible techniques and opportunities of health care system using
blockchain technology in telehealth and medicine area. This paper provides the
illustration of blockchain technology which gives essential data safety and con-
fidentiality to this model. Moreover, the paper deals with secure functioning-
transparency, health-records immutableness, and traceability of medical appa-
ratus and medicines information. Smart Contract is one of the most popular and
secure application of ‘Blockchain’. It is based on public-blockchain framework.
Blockchain technology can improve telehealth and medicine system by offering
distant healthcare facilities on a decentralized platform along with tamper-proof
transactions, transparency of data, flexible traceability of records, reliability to
patients, and high security. This model identifies whole scenario of medicine and
apparatus production from initial to final stage of delivery to the patient. This
model also leads health specialists and doctors for treating patients correctly and
share the prescriptions securely over the network. At the last, paper discuss nu-
merous opportunities and techniques needs to be resolute the present system by
acceptance of power decentralized technology ‘Blockchain’ in telehealth and
health-care systems.

Keywords: First Keyword, Second Keyword, Third Keyword.

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1 Introduction

The current pandemic of Coronavirus (COVID-19) teaches to review our current

health system and requirements for establishing a consistent, strong, and full-bod-
ied patientcare and health-service system. This coronavirus-pandemic lifts the in-
terest of tele-health and distant-medicine tech. This system provides securely em-
power interaction with doctors and wellbeing experts over virtual networks for
minimizing the blowout of infection. This system also able to provides better ad-
vise treatment of any issue as well as provide the full contact less medicine ser-
vices. In current time many big corporations and organizations are working in this
direct and provide the telehealth services. Companies and organizations like: Care-
Health, Practo, and Doctor 24x7, etc. These have freshly saw a rapid surge in pe-
tition for tele-health and medicine-facilities for combating the feast of the corona-
virus. Telehealth and distant sessions permit well-organized health care admittance
and suggestion a healthier attention management and dealing-treatment results [].
Telehealth and medicine services allows health-care specialists to virtually screen,
analyze, and evaluate patients by providing cost-effective facilities, thus minimal-
izing patient admittance and workforce limitations, expanding technology capabil-
ities, and mitigating the risk of exposure of doctors, nursing-staff, or patients in the
pandemic time. Also, telehealth increases employments opportunities in the IT dig-
ital data platform and communication knowledges technologies. This is also help
patients for managing their disease complete better-quality selfcare and admittance
to education and care structures. The chief profits of the telehealth and medicine
systems are that disclose computer-generated healthcare structures have the possi-
ble to positively alleviate.
In current time these telehealth services and system are based on ‘Centralization
Systems’. This current system existing in applications and systems is increases the
danger of solo fact of letdown. As well as the information in existing applications
are disposed to a diversity of outside and interior information cracks. This central-
ization system makes users for negotiating the dependability and obtainability of
applications. In the centralized system there is high involvement of third parties
and large risk of malicious attacks for stealing the patient and other transaction
information. The decentralized-ledger technology ‘Blockchain’ can helps for ad-
dressing and improving these such critical difficulties.
The evolving decentralized-blockchain tech trails a distributed-manner for manag-
ing a public record of health-care data amongst various applicants. In blockchain
tech, entirely every ledger facsimile is saved, proved and tamper-proof with each
data-node. Lots of current challenges like trailing the places visited by patients,
defending distant doctor-patient discussion information, tracking medicines and
health-medical instruments & apparatus across the supply-chain management, au-
thenticating the identifications of doctors, and verifying the source of productions
health-medical instruments & apparatus, etc. are amongst various issues are dis-
course and improving thru the blockchain-technology [1].
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1.1 Introduction to Blockchain

Blockchain is one of the most powerful distributed-ledger expertise which comprises

entirely information in the form of ledger on a distributed network. These information’s
are kept in the node-blocks which links to an exclusive unique-hash value. Individually
every node-block state to the previous data-block and composed in the form of chain
manner. Therefore, the whole data-chain is formed which is called ‘Blockchain’. Block-
chain expertise is the speediest and most protected tech for sharing the information &
material over the web. Respectively, every data-block might comprise a transaction-
record or any additional information created on the system-application. These decen-
tralized applications on Blockchain platform are known as DApps (Decentralized ap-
plications). Blockchain is a public distributed-ledger tech that allows user to save and
transmission of information in a tamper-proof, provable, and unchallengeable mode.
On a blockchain, the transaction-record of every data-node is existing on completely
data-nodes, which are linked on a Peer-to-Peer (P2P) net which upsurges the accessi-
bility of data rapidly [1]. Blockchain supports several features along with transparency
and security (see Fig. 1).

Fig. 1. Features of Blockchain

Thus, the information is tamper-proof and transparent so, it can be simply proved by
all the applicants. The perception of cryptography safeguards that all the information
on Blockchain is unchallengeable i.e., Tamper-proof. Blockchain is divided into four
categories, and each has unique features (see Fig. 2).
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Fig. 2. Categorization of Blockchain and features

1.2 Overview of Ethereum and Smart Contract

Ethereum is one of the greatest open-source public-blockchain framework. Ethereum

holds one of the most powerful application in smart-digitalized ledger-agreements
called as Smart Contracts. Smart Contract comprises completely transaction infor-
mation in encrypted-procedure on the blockchain-net. Many developers and creators
comparable for developing and design the decentralized applications (DApps) on this
blockchain framework. Ethereum is a permission-less & open-free system blockchain
which previously uses Proof-of-work (PoW) consensus-procedure for proofing all data-
block nodes. But now this framework uses the Proof-of-Stack (PoS) algorithm. This
framework easily compatible with Python, Go, Node, JavaScript, and Solidity, etc. pro-
gramming-languages for designing apps [2].
Solidity is contract-oriented high-level contract design-language. Solidity is particu-
larly planned for scripting and managing the hi-tech smart-distributed-ledgers called
smart-contracts. This linguistic compatible easily with both blockchain that is: private
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as well as public. This open-free framework is extremely supporting this contract-lan-

guage for designing and implementing the smart-contracts in the decentralized-appli-
cations (Dapps).
A smart-contract in the Solidity-linguistic is an assembly of program-code and it illus-
trates that exist this is present on definite-address on the Ethereum-blockchain frame-
work. In this paper, we write four smart-contract of this model where we allocated the
information such as Medicine data, Transaction-hash, addresses of producer, addresses
of supplier, addresses of patient, addresses of doctor, disease-information, and prescrip-
tion-information, etc.
For writing and deploying the contracts we use the most popular IDE called as Remix-
IDE. The remix is a collection of gears to relate with the Ethereum-blockchain for de-
bugging the full program-code and kept it in the Git-repository. GitHub is an open stage
for coders and program-designers uses Git-repository. On this entirely every program-
codes of apps and software-codes are kept at the cloud-stage. The Remix-IDE is an IDE
for Solidity-DApp developers. The Remix-IDE is an open-online platform which is ac-
cessible by using the link: https://remix.ethereum.org. The remix is a web-browser
built-compiler and IDE that allows workers for building Ethereum-Smart-Contracts
thru Solidity-language also for debugging contacts. We have castoff this IDE for im-
plementing our Solidity-language-code through ‘extension .sol’ which deploys entirely
four contracts for transmission [2]. Smart contract has several benefits and use-cases in
real life application (see Fig. 3).

Fig. 3. Smart Contract working, Benefits and Use Cases

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1.3 Consensus Algorithm

In the current time the Ethereum framework uses the Proof-of-Stake (PoS) consensus
method which arises after Proof-of-Work (PoW). Equally PoW and PoS procedures
have the similar effort for validating every data-block of the blockchain but PoS quite
modest than PoW. This algorithm uses the staked procedure for securing each data-
block of information on the net. PoS used fewer calculation hash-power than the PoW.
PoS practices broadly for Ethereum System communications and transaction-infor-
mation which direct from the sending person to the acknowledger on the blockchain
net. PoS primary differs the verification and formerly authenticate the chunk of nodes
of the chain. This shows proof of authenticating and confirming the PoS blockchain-
consensus procedure [2-5].
This paper covers the possible prospects that blockchain-tech can powers the telehealth
and medicine systems by improving their main drawbacks in terms of dependability,
immutableness, transparency-of-data, faith, and safety. In this paper we design a model
using smart contract on blockchain that illustrates case studies of providing peer-to-
peer and most secure transmission connection in telehealth and medicine system.
The remainder of the paper is organized as follows. Section 2 presents potential oppor-
tunities for blockchain technology in telehealth and telemedicine Section 3 illustrates
the role of smart in the designed model. Section 4 deliberates the conclusions and future
enhancement.

2. Opportunities/Areas in Telehealth and Medicine System by using

Blockchain Technology

This section deliberates the vital areas and opportunities in the telehealth and medicine
system by using the most powerful decentralized blockchain technology. Main oppor-
tunities and areas given below:

2.1 Role of blockchain application smart contracts in patient agreement manage-

ment

The efficacy of tele-care and health-nursing be contingent on the honesty of the elec-
tronic-health-records (eHRs). This eHRs contain whole affected people health antiq-
uity, treatment information, and medicine details, etc. The eHRs contains extremely
confidential and private information, which desires for transmitting the information in
the P2P connection mode. The P2P (Peer-to-Peer) is securely setup helps for maintain-
ing up to date the medical information between authorized parties like patient-to-hos-
pitals, doctor-to-pharmacies, and patient-to-pharmacies, and between the high authori-
ties, etc. Current traditional system is totally dependent on the intermediate service pro-
viders and third parties.
Blockchain-tech leads for enforcing faith as no mediators are intricate. Blockchain has
a feature of computerized ledgers called smart contracts. Smart contracts provide the
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proof-of-work of eHRs records. Blockchain provides best managing power and estab-
lish the most secure P2P mode between the authorized users without involvement of
third parties.

2.2 Tracking of distant treatment records

The telehealth and medicine system needs an automated head-on meeting system be-
tween the patients and Doctors. This automated system used for providing the operative
wellbeing examination to the distant patient. In current telehealth structures, health-
administrations are incapable for managing the patient health information. All admin-
istrations are dependent on third party services which holds the data and records of
patient. These parties also provide less storage for saving all patients information’s.
Blockchain-tech delivers a solitary and intelligible decentralization approach. Through
this decentralization, all eHRs of patients are hold securely and in bulk quality without
involvement of third parties on the network. This increases the faith, perceptibility, and
transparency of patient-records. Smart-contracts empower the proof-of-work ledger for
tracing the medical past-history of the remote-patients.

2.3 Tracking of medicines, medical-apparatus, and instruments:

Current centralized telehealth and medical structures has deficiency of transparency,

perceptibility, and temper-proof information. Current systems fail for tracking supply
chain information about the medicines, medical-apparatus, and instruments. Block-
chain-tech provides transparency and clearly tacking information of supply-chain.
Blockchain linked the whole information of the supply-chain from the raw material
supplier to final product and final product from shopkeeper to patient securely in the
ledger. Smart-contract ledgers are design for recording and managing the whole infor-
mation securely [6-8].

2.4 Fast and Secure Payment System:

The existing telehealth structures regularly hire central third-party facilities for trans-
mitting transactions between patients, hospitals, doctors, and other functions for using
facilities. Still, the central transaction payment procedures are sluggish, possibly de-
fenseless for hacking, and non-transparent. In central system, lots of transactions are
occurs which are hard to detect and recover. Blockchain-tech stand provides crypto-
currency tokens-based transaction system. This system is highly secure by using many
cryptographic algorithms. Blockchain provides the straight transmission of transaction
form wallet in P2P mode. This P2P provides a rapid, safe, transparent, and tamper-
proof network structure that does not requirement a central third-party service for re-
solving the transmission of transactions [9-10].
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3. Role of smart contract

Smart Contract is the one of major player in this Telehealth and medicine service sys-
tem which resolve all the entire issues of current centralized system. In this model four
contracts are design which shows the transmitting of the information of medicine and
medical apparatus from beginning stage to ending stage i.e., from Raw Material Sup-
plier to final medicine information receiver (the Patient). In this smart contract whole
data and information is present in encrypted form and only the authorized users seem
the actual data. In the smart contract all the transmission information is immutable and
tamper-proof on the blockchain network. This section deals with smart contract codes
and their final representation.

3.1 Supplier to Producer Contract

This is the first smart contract which illustrate whole transaction information between
the ‘Raw Material Supplier’ and the Production company of medicine and apparatus
(Producer). This smart contract stores the information like Supplier Name, address of
Supplier, address of Producer, Producer Name, Medicine salt information and appa-
ratus, additional material information, quantity of the material and total transaction
amount information. This contract provides the detail tracking and validating infor-
mation transmitting between both users. In this the ‘Supplier’ has only authority to
change the information in the contract. The code of smart contract from supplier to
producer is depicted (see Fig. 4).

Fig. 4. Code for supplier to producer smart contract

3.2 Final Contract: Supplier to Producer

After the execution of the final smart contracts is generated, in which entirely whole
information are existing in encrypted manner. The original information is only seen by
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the ‘Supplier’ and the ‘Producer’. This contract is view by everyone, but the transmis-
sion input-data is only clear by the authorized-party. The final contract from supplier
to producer is depicted (see Fig. 5).

Fig. 5. Final smart contract from supplier to producer

3.3 Producer to Wholesaler Contract

This is the second smart contract which illustrate whole transaction information
between the ‘Producer’ and the ‘Wholesaler’. This smart contract stores the infor-
mation like Producer Name, address of Producer, address of Wholesaler, Whole-
saler Name, Medicine API compound information, Medicine Exception infor-
mation and expiry date information of medicine and kit, and price of medicine etc.
Medicine API compound is the most important information which conveys the in-
formation of efficacy of the medicine as well as the salt composition of the medi-
cine. This API compound also conveys the information the color of medicine. The
second most important information is ‘Exception information’ which conveys the
all the data of effect of medicine like allergies, and side effects etc. This contract
provides the detail tracking and validating information of the medicine which sends
to sales end. In this the ‘Producer’ has only authority to change the information in
the contract. The code of smart contract from producer to wholesaler is depicted
(see Fig. 6).
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Fig. 6. Code for producer to wholesaler smart contract

3.4 Final Contract: Producer to Wholesaler

After the execution of the final smart contracts is generated, in which entirely
whole information are existing in encrypted manner. The original information is
only seen by the ‘Producer’ and the ‘Wholesaler’. This contract is view by every-
one, but the transmission input-data is only clear by the authorized-party. The final
contract from producer to wholesaler is depicted (see Fig. 7).

Fig. 7. Final smart contract from producer to wholesaler

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3.5 Wholesaler to Retailer Contract

In this smart contract illustrate whole transaction information between the ‘Whole-
saler’ and the retail shopkeeper of medicine and apparatus (Retailer). This smart
contract stores the information like Producer Name, address of Wholesaler, Whole-
saler Name, address of Retailer, Retailer Name, Medicine information & appa-
ratus, additional defect information of medicine, efficacy, and expiry date infor-
mation as well as the price of medicine. This contract provides the detail tracking
and validating information transmitting between both users. In this the ‘Whole-
saler’ has only authority to change the information in the contract. The code of
smart contract from wholesaler to retailer is depicted (see Fig. 8).

Fig. 8. Code for wholesaler to retailer smart contract

3.6 Final Contract: Wholesaler to Retailer

After the execution of the final smart contracts is generated, in which entirely
whole information are existing in encrypted manner. The original information is
only seen by the ‘Retailer’ and the ‘Wholesaler’. This contract is view by everyone,
but the transmission input data is only clear by the authorized party. The final con-
tract from wholesaler to retailer is depicted (see Fig. 9).
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Fig. 9. Final smart contract from wholesaler to retailer

3.7 Doctor to Patient Contract

This is the most important smart contract which illustrate whole discussion infor-
mation between the ‘Doctor’ and the ‘Patient’. This smart contract stores the in-
formation like Doctor Name, address of Doctor, address of Patient’, Patient Name,
Problem and disease information, Prescription information, and consultant fee in-
formation. This contract provides the detail tracking and validating information
transmitting between both. In this the ‘Doctor’ has only authority to change the
information in the contract. The code of smart contract from doctor to patient is
depicted (see Fig. 10).
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Fig. 10. Code for doctor to patient smart contract

3.8 Final Contract: Doctor to Patient

After the execution of the final smart contracts is generated, in which entirely
whole information are existing in encrypted manner. The original information is
only seen by the ‘Doctor’ and the ‘Patient’. This contract is view by everyone, but
the transmission input data is only clear by the authorized party. The final contract
from doctor to patient is depicted (see Fig. 11).
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Fig. 11. Final smart contract from doctor to patient

3.9 Retailer to Patient Contract

This is the final smart contract which illustrate whole transaction information be-
tween the ‘Retailer’, the final seller of the medicine & apparatus and the Patient.
This smart contract stores the information like Retailer Name, address of Retailer,
address of Patient, Doctor Name, Medicine & apparatus billing information, date of
bill, and amount information. This contract provides the detail tracking and validat-
ing information transmitting between both. In this the ‘Retailer’ has only authority
to change the information in the contract. The code of smart contract from retailer
to patient is depicted (see Fig. 12).

Fig. 12. Code for retailer to patient smart contract

3.10 Final Contract: Retailer to Patient

After the execution of the final smart contracts is generated, in which entirely whole
information are existing in encrypted manner. The original information is only seen
by the ‘Retailer’ and the ‘Patient’. This contract is view by everyone, but the trans-
mission input-data is only clear by the authorized-party. The final contract from
retailer to patient is depicted (see Fig. 13).
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Fig. 13. Final smart contract from retailer to patient

4 Conclusion and Future Enhancement

This paper illustrates the overview of blockchain-tech in telehealth and medicine sys-
tems. Paper explains the important structures for providing distant healthcare facilities
in easy and secure manner. Blockchain technology has an ability to provide this decen-
tralization, tamper-proof, observable, absolute, and security to this system. In this, the
detail exploration and discussion of the possible area & prospects presented by block-
chain-tech is telehealth and medicine system are provided. In this, the detail discussion
of the most popular application Smart Contract on Ethereum framework of blockchain-
technology is given. The four smart contracts are deployed which show the speedy,
tamper-proof, and most secure transmission of medicine data and telehealth record over
the network. Main areas and opportunities trailed by closing explanations are given
below:
• Blockchain-tech can provide an important part for effectively transmitting the
health-information between the users. By implementing smart contracts, the data
transmits securely, speedily, and tamper-proof manner.
• Second main area is to provides the faster and secure claim payment to distant
patient over the network in the P2P connection. The smart contract leads to provide
proper proof-of-work leader contract which speedily helps the patient. Thus, excit-
ing revolution in the current blockchain-tech is used for minimizing the payment
execution time and highly upsurge its correctness for the health-care area.
• The hereditary derivation characteristic of blockchain-tech can allow health spe-
cialists for tacking properly detect authentication details, medicines and medical-
apparatus commonly used for distant treatment.
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• Blockchain provide the very powerful information safety and confidentiality. By

these main characteristics, designers and health originations develops a very ap-
propriate system for digitization & computerization service system.
Finally, in the future we implement and demonstrates the supply chain management
and procedures of tracking and monitoring the medicine and medical apparatus in tele-
health and medicine system.

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