{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:09:07Z","timestamp":1768313347286,"version":"3.49.0"},"reference-count":28,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,5,2]],"date-time":"2020-05-02T00:00:00Z","timestamp":1588377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["GR-2016-02361306"],"award-info":[{"award-number":["GR-2016-02361306"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>In a pandemic situation such as that we are living at the time of writing of this paper due to the Covid-19 virus, the need of tele-healthcare service becomes dramatically fundamental to reduce the movement of patients, thence reducing the risk of infection. Leveraging the recent Cloud computing and Internet of Things (IoT) technologies, this paper aims at proposing a tele-medical laboratory service where clinical exams are performed on patients directly in a hospital by technicians through IoT medical devices and results are automatically sent via the hospital Cloud to doctors of federated hospitals for validation and\/or consultation. In particular, we discuss a distributed scenario where nurses, technicians and medical doctors belonging to different hospitals cooperate through their federated hospital Clouds to form a virtual health team able to carry out a healthcare workflow in secure fashion leveraging the intrinsic security features of the Blockchain technology. In particular, both public and hybrid Blockchain scenarios are discussed and assessed using the Ethereum platform.<\/jats:p>","DOI":"10.3390\/s20092590","type":"journal-article","created":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T14:00:43Z","timestamp":1588600843000},"page":"2590","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":104,"title":["Blockchain-Based Healthcare Workflow for Tele-Medical Laboratory in Federated Hospital IoT Clouds"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9003-6194","authenticated-orcid":false,"given":"Antonio","family":"Celesti","sequence":"first","affiliation":[{"name":"Department of MIFT, University of Messina, 98122 Messina, Italy"},{"name":"INdAM-GNCS, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9300-2731","authenticated-orcid":false,"given":"Armando","family":"Ruggeri","sequence":"additional","affiliation":[{"name":"Department of MIFT, University of Messina, 98122 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3574-1848","authenticated-orcid":false,"given":"Maria","family":"Fazio","sequence":"additional","affiliation":[{"name":"Department of MIFT, University of Messina, 98122 Messina, Italy"},{"name":"IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4688-0894","authenticated-orcid":false,"given":"Antonino","family":"Galletta","sequence":"additional","affiliation":[{"name":"Department of MIFT, University of Messina, 98122 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Villari","sequence":"additional","affiliation":[{"name":"Department of MIFT, University of Messina, 98122 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Romano","sequence":"additional","affiliation":[{"name":"ASP Messina, 98123 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hassenteufel, P., Schweyer, F.X., Gerlinger, T., Henkel, R., L\u00fcckenbach, C., and Reiter, R. (2019). The role of professional groups in policy change: Physician\u2019s organizations and the issue of local medical provision shortages in France and Germany. Eur. Policy Anal.","DOI":"10.1002\/epa2.1073"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/hpm.2612","article-title":"Impact of the doctor deficit on hospital management in Poland: A mixed-method study","volume":"34","author":"Mikos","year":"2019","journal-title":"Int. J. Health Plan. Manag."},{"key":"ref_3","first-page":"325","article-title":"BEACON: A cloud network federation framework","volume":"567","author":"Huedo","year":"2016","journal-title":"Commun. Comput. Inf. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Celesti, A., Fazio, M., Giacobbe, M., Puliafito, A., and Villari, M. (2016, January 23\u201325). Characterizing cloud federation in IoT. Proceedings of the 2016 30th International Conference on Advanced Information Networking and Applications Workshops (WAINA), Crans-Montana, Switzerland.","DOI":"10.1109\/WAINA.2016.152"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Mulfari, D., Celesti, A., Villari, M., and Puliafito, A. (2013, January 13\u201315). How cloud computing can support on-demand assistive services. Proceedings of the 10th International Cross-Disciplinary Conference on Web Accessibility (ACM), Rio de Janeiro, Brazil.","DOI":"10.1145\/2461121.2461140"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.ijinfomgt.2013.09.004","article-title":"An exploratory study to understand the critical factors affecting the decision to adopt cloud computing in Taiwan hospital","volume":"34","author":"Lian","year":"2014","journal-title":"Int. J. Inf. Manag."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Griggs, K., Ossipova, O., Kohlios, C., Baccarini, A., Howson, E., and Hayajneh, T. (2018). Healthcare Blockchain System Using Smart Contracts for Secure Automated Remote Patient Monitoring. J. Med. Syst., 42.","DOI":"10.1007\/s10916-018-0982-x"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Zubaydi, H.D., Chong, Y.W., Ko, K., Hanshi, S.M., and Karuppayah, S. (2019). A Review on the Role of Blockchain Technology in the Healthcare Domain. Electronics, 8.","DOI":"10.3390\/electronics8060679"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Agbo, C.C., Mahmoud, Q.H., and Eklund, J.M. (2019). Blockchain Technology in Healthcare: A Systematic Review. Healthcare, 7.","DOI":"10.3390\/healthcare7020056"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"H\u00f6lbl, M., Kompara, M., Kami\u0161ali\u0107, A., and Nemec Zlatolas, L. (2018). A Systematic Review of the Use of Blockchain in Healthcare. Symmetry, 10.","DOI":"10.20944\/preprints201809.0136.v1"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Qadri, Y.A., Nauman, A., Zikria, Y.B., Vasilakos, A.V., and Kim, S.W. (2020). The Future of Healthcare Internet of Things: A Survey of Emerging Technologies. IEEE Commun. Surv. Tutor., 1\u201353.","DOI":"10.1109\/COMST.2020.2973314"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Chakraborty, S., Aich, S., and Kim, H. (2019, January 17\u201320). A Secure Healthcare System Design Framework using Blockchain Technology. Proceedings of the 2019 21st International Conference on Advanced Communication Technology (ICACT), PyeongChang, Korea.","DOI":"10.23919\/ICACT.2019.8701983"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Dasaklis, T.K., Casino, F., and Patsakis, C. (2018, January 23\u201325). Blockchain Meets Smart Health: Towards Next Generation Healthcare Services. Proceedings of the 2018 9th International Conference on Information, Intelligence, Systems and Applications (IISA), Zakynthos, Greece.","DOI":"10.1109\/IISA.2018.8633601"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Srivastava, G., Crichigno, J., and Dhar, S. (2019, January 5\u20138). A Light and Secure Healthcare Blockchain for IoT Medical Devices. Proceedings of the 2019 IEEE Canadian Conference of Electrical and Computer Engineering (CCECE), Edmonton, AB, Canada.","DOI":"10.1109\/CCECE.2019.8861593"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Hossein, K.M., Esmaeili, M.E., Dargahi, T., and khonsari, A. (2019, January 5\u20138). Blockchain-Based Privacy-Preserving Healthcare Architecture. Proceedings of the 2019 IEEE Canadian Conference of Electrical and Computer Engineering (CCECE), Edmonton, AB, Canada.","DOI":"10.1109\/CCECE.2019.8861857"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Zhang, P., White, J., Schmidt, D., Lenz, G., and Rosenbloom, S. (2018). FHIRChain: Applying Blockchain to Securely and Scalably Share Clinical Data. Comput. Struct. Biotechnol. J., 16.","DOI":"10.1016\/j.csbj.2018.07.004"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ramani, V., Kumar, T., Bracken, A., Liyanage, M., and Ylianttila, M. (2018, January 9\u201313). Secure and Efficient Data Accessibility in Blockchain Based Healthcare Systems. Proceedings of the 2018 IEEE Global Communications Conference (GLOBECOM), Abu Dhabi, UAE.","DOI":"10.1109\/GLOCOM.2018.8647221"},{"key":"ref_18","unstructured":"Biggs, J., Hinish, S.R., Natale, M.A., and Patronick, M. (2017). Blockchain: Revolutionizing the Global Supply Chain by Building Trust and Transparency, Rutgers University."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Shen, B., Guo, J., and Yang, Y. (2019). MedChain: Efficient Healthcare Data Sharing via Blockchain. Appl. Sci., 9.","DOI":"10.3390\/app9061207"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Khatoon, A. (2020). A Blockchain-Based Smart Contract System for Healthcare Management. Electronics, 9.","DOI":"10.3390\/electronics9010094"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Satamraju, K.P. (2020). Proof of Concept of Scalable Integration of Internet of Things and Blockchain in Healthcare. Sensors, 20.","DOI":"10.3390\/s20051389"},{"key":"ref_22","unstructured":"(2020, March 20). Telemedcare Clinical Monitoring Unit (CMU). Available online: https:\/\/www.telemedcare.com\/."},{"key":"ref_23","unstructured":"(2020, March 20). Enverse Continous Glucose Monitoring. Available online: https:\/\/www.eversensediabetes.com\/."},{"key":"ref_24","unstructured":"(2020, March 20). Med-Care. Available online: Http:\/\/www.t4all.it\/portfolio-articoli\/med-care\/."},{"key":"ref_25","unstructured":"(2020, March 20). HomoScreen. Available online: https:\/\/www.pixcell-medical.com\/products\/hemoscreen."},{"key":"ref_26","unstructured":"(2020, March 20). Samsung Labgeo PT10S. Available online: https:\/\/samsunghealthcare.com\/en\/products\/InVitroDiagnostics\/Samsung%20LABGEO%20PT10\/Point-of-Care\/benefit."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Galletta, A., Bonanno, L., Celesti, A., Marino, S., Bramanti, P., and Villari, M. (2017, January 3\u20136). An approach to share MRI data over the Cloud preserving patients\u2019 privacy. Proceedings of the 2017 IEEE Symposium on Computers and Communications (ISCC), Heraklion, Greece.","DOI":"10.1109\/ISCC.2017.8024511"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Galletta, A., Celesti, A., Tusa, F., Fazio, M., Bramanti, P., and Villari, M. (2017, January 2\u20135). Big MRI Data Dissemination and Retrieval in a Multi-Cloud Hospital Storage System. Proceedings of the 2017 International Conference on Digital Health, London, UK.","DOI":"10.1145\/3079452.3079507"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/9\/2590\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:32:28Z","timestamp":1760362348000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/9\/2590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,2]]},"references-count":28,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["s20092590"],"URL":"https:\/\/doi.org\/10.3390\/s20092590","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,2]]}}}