A private decentralized e-health environment, empowered by blockchain technology, grants authorized healthcare entities to legitimately access the patient's medical data without relying on a centralized node. Every activity from authorized entities is recorded immutably in the blockchain transactions. In terms of privacy, the e-health system preserves a default privacy option as an initial state for every patient since the patients may frequently customize their medical data over time for several purposes. Moreover, adjustments in the patient's privacy contexts are often solely from the patient's initiative without any doctor or stakeholders' recommendation. Therefore, we design, implement, and evaluate user-defined data privacy utilizing nudge theory for decentralized e-health systems named PDPM to tackle these issues. Patients can determine the privacy of their medical records to be closed to certain parties. Data privacy management is dynamic, which can be executed on the blockchain via the smart contract feature. Tamper-proof user-defined data privacy can resolve the dispute between the e-health entities related to privacy management and adjustments. In short, the authorized entities cannot deny any changes since every activity is recorded in the ledgers. Meanwhile, the nudge theory technique supports providing the best patient privacy recommendations based on their behaviour activities even though the final decision rests on the patient. Finally, we demonstrate how to use PDPM to realize user-defined data privacy management in decentralized e-health environments.

This study looks at how an e-Health System can reduce morbidity (poor health) in unreached communities. The e-Health system combines affordable sensors and Body Area Networking technology with mobile health concepts and is called a Portable Health Clinic. The health clinic is portable because all the medical devices fit inside a briefcase and are carried to unreached communities by a healthcare assistants. Patient morbidity is diagnosed using software stratification algorithm and categorized according to triage color-coding scheme within the briefcase. Morbid patients are connected to remote doctor in a telemedicine call center using the mobile network coverage. Electronic Health Records (EHR) are used for the medical consultancy and e-Prescription is generated. The effectiveness of the portable health clinic system to target morbidity was tested on 8690 patients in rural and urban areas of Bangladesh during September 2012 to January 2013. There were two phases to the experiment: the first phase identified the intensity of morbidity and the second phase re-examined the morbid patients, two months later. The experiment results show a decrease in patients to identify as morbid among those who participated in telemedicine process.

Faced with social problems such as rapidly aging society, the solutions have been expected in sports medicine. Humans became widely distributed on the earth from their birth by acquiring abilities to walk in an upright position and to adapt themselves to various natural environments. However, seeking a ‘comfortable environment’ in modern civilization has deteriorated these genetic characteristics of humans, and the consumption of resources and energy to acquire such a ‘comfortable environment’ has induced global warming-associated natural disasters and the destruction of social order. To halt this vicious cycle, we may reactivate the genetic characteristics in humans by doing exercise. To do this, we have developed a health promotion program for middle aged and older people, Jukunen Taiikudaigaku Program, in cooperation with the Japanese government, developed high-intensity interval walking training (IWT), and examined the physical and mental effects on 5,400 people for these 10 years. We found that IWT for 4 months increased physical fitness by 10-20%, decreased the indices of life-style related diseases by 10-20%. Since a prescription of IWT can be conducted by using an IT network system called e-Health Promotion System, the participants in the program were able to receive the prescription even if they lived remote from trainers, enabling them to perform IWT at their favored places and times, and also at low cost. Moreover, we found some single nucleotide polymorphisms closely related to inter-individual differences in the responses to IWT. Further, the system enables us to assess the inactivation/activation of genes for inflammatory responses which has been suggested to be involved in life-style related diseases. Also, the system enables us to search foods to promote health when they are consumed during exercise training. Thus, the system would have strong potential to promote health of middle-aged and older people in advanced aging society.

Recently, many studies reported various advanced e-Health service systems in patient care monitoring utilizing sensor networks and questionnaire systems. We propose an informant driven e-Health service system for the identification of heart rate related mental stress factors with a simple operation of informant-client model. Through performance analysis, we show that the proposed system is a cost-effective stress identification system applicable to mobile wireless networks.