Digital identity systems have been around for almost as long as computers and have evolved with the increased usage of online services. Digital identities have traditionally been used as a way of authenticating to the computer systems at work, or a personal online service, such as an email. Today, our physical existence has a digital counterpart that became an integral part of everyday life. Self-Sovereign Identity (SSI) is the next step in the evolution of the digital identity management systems. The blockchain technology and distributed ledgers have provided necessary building blocks and facilities, that bring us closer to the realisation of an ideal Self-Sovereign Identity. But what exactly is an ideal Self-Sovereign Identity? What are the characteristics? Trade-offs? Here, we propose the framework and methodology that can be used to evaluate, describe, and compare SSI systems. Based on our comparison criteria and the evaluation framework, we present a systematic analytical study of existing SSI systems: uPort, Sovrin, ShoCard, Civic, and Blockstack.

Background Clinical decision support (CDS) is a tool that helps clinicians in decision making by generating clinical alerts to supplement their previous knowledge and experience. However, CDS generates a high volume of irrelevant alerts, resulting in alert fatigue among clinicians. Alert fatigue is the mental state of alerts consuming too much time and mental energy, which often results in relevant alerts being overridden unjustifiably, along with clinically irrelevant ones. Consequently, clinicians become less responsive to important alerts, which opens the door to medication errors. Objective This study aims to explore how a blockchain-based solution can reduce alert fatigue through collaborative alert sharing in the health sector, thus improving overall health care quality for both patients and clinicians. Methods We have designed a 4-step approach to answer this research question. First, we identified five potential challenges based on the published literature through a scoping review. Second, a framework is designed to reduce alert fatigue by addressing the identified challenges with different digital components. Third, an evaluation is made by comparing MedAlert with other proposed solutions. Finally, the limitations and future work are also discussed. Results Of the 341 academic papers collected, 8 were selected and analyzed. MedAlert securely distributes low-level (nonlife-threatening) clinical alerts to patients, enabling a collaborative clinical decision. Among the solutions in our framework, Hyperledger (private permissioned blockchain) and BankID (federated digital identity management) have been selected to overcome challenges such as data integrity, user identity, and privacy issues. Conclusions MedAlert can reduce alert fatigue by attracting the attention of patients and clinicians, instead of solely reducing the total number of alerts. MedAlert offers other advantages, such as ensuring a higher degree of patient privacy and faster transaction times compared with other frameworks. This framework may not be suitable for elderly patients who are not technology savvy or in-patients. Future work in validating this framework based on real health care scenarios is needed to provide the performance evaluations of MedAlert and thus gain support for the better development of this idea.

Privacy plays a central role in many application domains that utilize blockchain technology. It is central in Personal Data Management, Electronic Health records, or systems that interact with any public institution. However, blockchains are subject to potential privacy issues such as transaction linkability, compliance with data protection regulations, on-chain data privacy, and malicious smart contracts. To deal with these challenges, novel privacy-preserving solutions based on crypto-privacy techniques are emerging. The goal of this survey is to provide insights into the privacy-preserving techniques associated with blockchain. We analyse the existing privacypreserving mechanisms for blockchain and propose a framework that categorizes the main techniques examined. Furthermore, we summarize some typical applications of blockchain where the privacy protection is the main requirement. CCS CONCEPTS • General and reference → Surveys and overviews; Evaluation; • Security and privacy → Cryptography; Privacy-preserving protocols; Cryptanalysis and other attacks; • Software and its engineering → Peer-to-peer architectures; • Social and professional topics → Identity theft.

As the world is gradually moving towards digitization, forgery of vital digital documents has become relatively easy. Therefore, the need for efficient and secure verification and authentication practices of digital documents is also increasing. Self-sovereign identity (SSI) is a set of technologies that build on core concepts in identity management, blockchain technology, and cryptography. SSI enables entities to create fraud-proof verifiable credentials and instantly verify the authenticity of a digital credential. The online document verification solutions must deal with a myriad of issues in regard to privacy and security. Moreover, various challenging and tedious processes have made document verification overly complex and time-consuming which motivated us to conduct this research. This work presents a novel framework for online document verification based on SSI technology. The solution address the complexity and interoperability issues that are present in the current digital document verification systems. We look at a particular use case, i.e., document verification in online loan processing and evaluate how this proposed approach can make an impact on the existing system. Our solution based on SSI standards replaces the intermediary and enables trust between players in the ecosystem. The technology also holds the potential to make the system more efficient, interoperable, and privacy-preserving.

Background: The increasing usage of various online services requires an efficient digital identity management approach. Unfortunately, the original Internet protocols were not designed with built-in identity management, which creates challenges related to privacy, security, and usability. Thereis an increasing concern regarding the management of these sensitive data in the society, who have access to it and where it is stored. Blockchain technology can, potentially offer a secure solution to address this problem, in a decentralized manner without any centralized authority. This is of importance for e-health services where the patient and the healthcare provider often are required toprove their identity. Blockchain technology can be utilized for creating digital identities and make themanagement of those identities easier, giving a higher degree of control to the user than what current solutions offer. It can be used for creating a digital identity on the blockchain, making it easier to manage for individuals and entities, giving them greater control over who has their personal in-formation and how they handle it, and it could be utilized to create a higher degree of trust andsecurity to e-health applications. Objective The aim of this research work is to review the state-of-the- art regarding blockchain-based decentralized identity management for healthcare applications. Based on this summary, we provide a viewpoint on how blockchain-based decentralized identity frameworks couldbe utilized for virtualized healthcare applications. Method This research has applied a scoping, semi-systematic review approach to summarize thestate-of-the-art. Included identity management systems were evaluated based on seven criteria:Autonomy, Authority, Availability, Approval, Confidentiality, Tenacity and Interoperability ResultsSeven blockchain-based identity management systems were included and evaluated in this work:These include solutions built with Ethereum, Hyperledger Indy, Hyperledger Fabric, Hedera andSovrin  blockchains. Conclusion Digital identity management is crucial for virtual healthcare. Decentralized identity management for healthcare purposes is currently being explored, both in academia and the private sector. More work is needed with the aim to improve the efficiency of current DIM solutions and to fully understand what technical frameworks are best suited for e-health applications.