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is
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ap
er
en
h
an
ce
s
h
ea
lth
ca
r
e
d
ata
s
ec
u
r
ity
an
d
e
n
s
u
r
es
co
n
tin
u
ity
o
f
ac
ce
s
s
an
d
d
ep
en
d
ab
ilit
y
o
f
th
e
d
ata.
Op
tim
ally
m
a
n
ag
i
n
g
t
h
e
ev
er
-
g
r
o
win
g
v
o
lu
m
e
o
f
h
ea
lth
ca
r
e
d
ata
u
s
in
g
b
lo
ck
ch
ain
to
p
r
o
v
id
e
im
m
u
ta
b
ilit
y
o
f
d
ata
an
d
cl
o
u
d
co
m
p
u
tin
g
f
o
r
d
y
n
am
ic
s
ca
lab
ilit
y
.
C
o
n
s
eq
u
en
tly
,
th
e
r
e
wo
u
ld
b
e
im
p
r
o
v
ed
p
atien
t c
a
r
e,
ex
p
ed
ited
tr
ea
tm
en
t,
a
n
d
s
e
am
less
h
ea
lth
m
an
ag
em
en
t.
2.
L
I
T
E
R
AT
U
R
E
R
E
VI
E
W
T
h
e
liter
atu
r
e
ex
p
o
s
es
th
e
n
ec
ess
ity
f
o
r
a
n
ew
s
o
lu
tio
n
th
at
was
to
b
e
at
th
e
ce
n
ter
o
f
an
e
x
p
o
n
e
n
t
i
a
l
l
y
g
r
o
w
i
n
g
n
u
m
b
e
r
o
f
I
o
T
d
e
v
i
c
e
s
a
n
d
d
at
a
[
1
2
]
,
th
u
s
o
p
e
n
i
n
g
w
a
y
s
t
o
m
o
r
e
a
d
v
a
n
c
e
d
,
s
e
c
u
r
e
[
1
3
]
,
an
d
ef
f
icien
t
h
ea
lt
h
ca
r
e
s
y
s
te
m
s
[
1
4
]
.
I
o
T
tec
h
n
o
lo
g
y
,
as
a
p
p
lied
in
d
if
f
er
en
t
asp
ec
ts
o
f
h
ea
lth
ca
r
e
[
1
5
]
,
h
as
ch
an
g
ed
th
e
d
im
en
s
io
n
s
o
f
p
atien
t
m
o
n
ito
r
in
g
,
elec
tr
o
n
ic
h
ea
lth
r
ec
o
r
d
s
(
E
HR
)
m
an
ag
em
en
t
[
1
6
]
,
an
d
d
is
ea
s
e
p
r
ed
ictio
n
.
Sev
er
al
liter
atu
r
es
h
av
e
d
is
cu
s
s
ed
m
an
y
m
o
d
els
o
f
I
o
T
with
AI
an
d
m
ac
h
in
e
lear
n
in
g
in
teg
r
atio
n
s
th
at
s
h
o
u
l
d
im
p
r
o
v
e
m
ed
ical
s
er
v
ices
[
1
7
]
.
Fo
r
in
s
tan
ce
,
th
e
ea
r
ly
d
etec
tio
n
o
f
ch
r
o
n
ic
d
is
ea
s
es
b
y
u
s
in
g
I
o
T
d
ev
ices a
lo
n
g
with
th
e
em
p
lo
y
m
en
t
o
f
AI
m
o
d
els ten
d
s
to
s
h
o
w
p
r
o
m
is
in
g
r
e
s
u
lts
[
1
8
]
.
T
h
e
m
ain
o
b
jectiv
e,
h
o
wev
er
,
r
em
ain
s
t
h
e
m
er
g
in
g
o
f
I
o
T
with
b
lo
ck
ch
ain
tech
n
o
lo
g
y
s
o
as
to
ad
d
r
ess
is
s
u
es
o
f
s
ec
u
r
ity
,
p
r
iv
ac
y
ch
allen
g
es,
an
d
in
ter
o
p
er
ab
ilit
y
[
1
9
]
.
So
m
e
r
esear
ch
er
s
h
av
e
p
r
o
p
o
s
ed
f
r
am
ewo
r
k
s
b
ased
o
n
b
lo
ck
c
h
ain
f
o
r
s
ec
u
r
e
r
e
m
o
te
p
atien
t
m
o
n
ito
r
in
g
,
E
HR
m
an
ag
em
en
t,
an
d
C
OVI
D
-
1
9
p
atien
t
tr
ac
k
in
g
.
T
h
ese
ar
c
h
itectu
r
es
f
ac
ilit
ate
d
ata
s
ec
u
r
ity
an
d
i
n
teg
r
ity
,
p
atien
t
p
r
iv
ac
y
,
an
d
s
y
s
tem
in
ter
o
p
er
a
b
ilit
y
[
2
0
]
.
W
h
er
ea
s
a
lo
t
h
as
b
ee
n
ac
h
iev
ed
,
is
s
u
es
r
elate
d
to
s
ca
lab
ilit
y
,
co
n
s
t
r
ain
ts
o
n
r
eso
u
r
ce
s
,
an
d
d
if
f
icu
lties
in
in
teg
r
atio
n
r
em
ain
am
o
n
g
o
th
er
s
th
at
ar
e
y
et
to
b
e
r
eso
lv
ed
an
d
r
eq
u
i
r
e
f
u
r
th
er
r
esear
ch
a
n
d
d
ev
elo
p
m
e
n
t.
L
iter
atu
r
e
r
e
v
i
ew
p
r
esen
ts
s
ev
er
al
s
m
ar
t
h
ea
lth
ca
r
e
tech
n
o
lo
g
ies
b
ased
o
n
I
o
T
an
d
clo
u
d
co
m
p
u
tin
g
.
I
o
T
was
also
s
h
o
wn
in
s
tu
d
ies
to
h
av
e
th
e
p
o
te
n
tial
to
allev
iate
th
e
b
u
r
d
en
o
n
h
ea
lth
ca
r
e
s
y
s
tem
s
b
y
ad
o
p
tin
g
ef
f
icien
t
s
o
lu
tio
n
s
f
o
r
r
em
o
te
p
atien
t
m
o
n
ito
r
in
g
[
2
1
]
.
T
h
e
m
ain
ap
p
licat
io
n
s
in
clu
d
e
r
ap
id
d
is
ea
s
e
d
iag
n
o
s
is
,
p
r
ev
en
tio
n
,
an
d
e
n
h
an
ce
d
m
e
d
ical
d
ec
i
s
i
on
-
m
ak
in
g
.
Ho
wev
er
,
is
s
u
es
o
f
d
ata
s
ec
u
r
ity
,
m
o
b
ilit
y
,
h
eter
o
g
e
n
eity
,
le
g
alities
,
an
d
b
ig
d
ata
m
a
n
ag
em
en
t
r
em
ain
.
Sectio
n
C
:
d
escr
ib
e
v
ar
io
u
s
f
r
a
m
ewo
r
k
s
an
d
m
o
d
els,
in
clu
d
in
g
f
o
g
c
o
m
p
u
tin
g
a
n
d
b
lo
c
k
ch
ain
-
b
ase
d
ap
p
r
o
ac
h
es
in
f
in
d
in
g
way
s
to
r
esp
o
n
d
t
o
th
e
a
f
o
r
em
en
tio
n
ed
ch
allen
g
es
b
y
in
cr
ea
s
in
g
th
e
e
f
f
icien
c
y
o
f
h
ea
lth
ca
r
e
d
eliv
er
y
s
y
s
tem
s
.
Fo
g
-
b
ased
f
r
am
ewo
r
k
s
en
s
u
r
e
d
ata
p
r
o
ce
s
s
in
g
ef
f
icien
cy
,
wh
ile
b
lo
ck
ch
ain
o
f
f
er
s
s
ec
u
r
e
d
,
d
ec
en
tr
alize
d
d
ata
m
an
ag
em
en
t
[
2
2
]
.
Ov
er
all,
in
teg
r
atin
g
I
o
T
a
n
d
clo
u
d
tech
n
o
lo
g
ies
in
h
ea
lth
c
ar
e
p
r
o
m
is
es
s
ig
n
if
ican
t
im
p
r
o
v
em
en
ts
,
b
u
t
ad
d
r
ess
in
g
th
ese
ch
allen
g
es
is
cr
u
cial
f
o
r
s
u
cc
ess
f
u
l
im
p
lem
en
tatio
n
.
T
h
e
ap
p
lic
atio
n
o
f
b
lo
c
k
ch
ai
n
tech
n
o
lo
g
y
in
clo
u
d
-
b
ased
s
y
s
tem
s
,
p
ar
ticu
lar
ly
in
h
ea
lth
c
ar
e
to
m
an
ag
e
E
HR
s
,
h
as
attr
ac
ted
m
u
ch
in
te
r
est
b
ec
au
s
e
o
f
its
ca
p
a
b
ilit
y
to
e
n
h
an
ce
s
ec
u
r
ity
a
n
d
p
r
iv
ac
y
[
2
3
]
.
T
h
e
in
teg
r
atio
n
o
f
b
lo
c
k
ch
ain
with
clo
u
d
co
m
p
u
tin
g
is
th
e
f
o
cu
s
o
f
s
c
h
o
lar
s
lik
e
T
aşcı,
Me
n
ts
iev
,
C
ac
h
in
,
Ag
g
ar
wal,
an
d
T
h
ak
k
ar
,
wh
o
id
en
tifie
d
d
ec
en
tr
alize
d
s
to
r
a
g
e
s
o
lu
tio
n
s
as
a
way
o
f
r
ed
u
cin
g
s
ec
u
r
ity
r
is
k
s
co
m
m
o
n
with
ce
n
tr
al
ized
s
y
s
tem
s
.
T
h
e
u
n
ch
an
g
ea
b
le
n
atu
r
e
o
f
b
lo
ck
c
h
ain
,
in
clu
d
in
g
led
g
e
r
in
g
a
n
d
cr
y
p
to
g
r
ap
h
ic
lay
er
s
,
d
ir
ec
tly
ad
d
r
ess
es
co
n
ce
r
n
s
r
eg
ar
d
in
g
d
ata
tam
p
e
r
in
g
an
d
u
n
au
th
o
r
ized
ac
ce
s
s
.
T
h
e
m
ed
ical
in
f
o
r
m
atio
n
o
n
t
h
e
b
l
o
ck
ch
ain
p
r
o
v
id
es
a
r
eliab
le
way
o
f
m
ain
tain
i
n
g
p
r
iv
ac
y
an
d
t
r
u
s
t
u
s
in
g
o
p
e
n
-
s
o
u
r
ce
tech
n
o
lo
g
ies,
en
s
u
r
i
n
g
th
e
s
af
e
s
h
ar
in
g
o
f
E
HR
s
am
o
n
g
m
u
ltip
le
h
o
s
p
itals
.
Dec
en
tr
alize
d
ap
p
licatio
n
s
(
d
Ap
p
s
)
an
d
en
ter
p
r
is
e
s
o
lu
t
io
n
s
ar
e
b
u
ilt
u
s
in
g
eth
er
eu
m
,
h
y
p
er
led
g
e
r
,
h
y
p
er
l
ed
g
er
f
ab
r
ic,
an
d
p
er
m
is
s
io
n
e
d
n
etwo
r
k
s
.
Mo
r
e
o
v
er
,
b
lo
c
k
c
h
ain
ca
n
b
e
u
tili
ze
d
f
o
r
id
e
n
tity
m
an
a
g
em
en
t,
d
is
tr
ib
u
ted
s
to
r
ag
e
s
y
s
tem
s
,
I
o
T
,
an
d
s
ec
u
r
e
f
ile
s
y
s
tem
s
,
wh
ich
m
ak
es
it
an
ex
ce
p
tio
n
al
d
ata
m
an
ag
em
e
n
t
an
d
co
llab
o
r
atio
n
e
n
h
an
ce
r
ac
r
o
s
s
s
ev
er
al
d
o
m
ain
s
ap
ar
t
f
r
o
m
h
ea
lth
ca
r
e
[
2
4
]
.
C
lo
u
d
s
to
r
ag
e
b
ec
o
m
es
m
o
r
e
s
ec
u
r
e
with
t
h
e
in
teg
r
atio
n
o
f
b
lo
c
k
ch
ain
tech
n
o
l
o
g
y
,
wh
ic
h
g
u
ar
an
tees
d
ata
in
teg
r
ity
th
r
o
u
g
h
d
ec
e
n
tr
alize
d
v
er
if
icatio
n
an
d
im
m
u
tab
le
r
ec
o
r
d
s
,
g
o
in
g
b
ey
o
n
d
tr
ad
itio
n
a
l
au
d
it
m
eth
o
d
s
.
Ho
wev
er
,
it
is
wo
r
th
n
o
tin
g
th
at
s
ca
lab
ilit
y
co
n
tin
u
es
to
b
e
a
c
h
allen
g
e,
an
d
en
er
g
y
co
n
s
u
m
p
tio
n
also
s
er
v
es a
s
an
o
th
er
o
b
s
tacle
to
f
u
lly
r
ea
lizin
g
b
lo
ck
ch
ai
n
-
b
ased
s
ec
u
r
ity
f
o
r
d
ata
m
an
ag
em
e
n
t
an
d
s
h
ar
in
g
.
No
n
eth
eless
,
d
e
s
p
ite
th
ese
lim
itatio
n
s
,
b
lo
ck
ch
ai
n
r
em
ai
n
s
a
cr
itical
tech
n
o
lo
g
y
th
at
o
f
f
er
s
co
n
tem
p
o
r
ar
y
tr
a
n
s
p
ar
en
t
an
d
d
is
tr
ib
u
ted
p
latf
o
r
m
s
f
o
r
m
a
n
ag
in
g
d
ata.
Ultim
ately
,
co
m
in
g
to
th
e
to
p
ic
o
f
s
ec
u
r
ity
an
d
au
d
itin
g
,
let
u
s
co
n
s
id
er
a
s
y
s
tem
th
at
k
ee
p
s
th
e
d
ata
s
af
e
a
n
d
s
ec
u
r
e
in
th
e
clo
u
d
wh
ile
also
en
s
u
r
in
g
n
o
o
n
e
ca
n
tam
p
er
with
it.
T
h
is
s
y
s
tem
is
ca
lled
a
b
lo
ck
c
h
ain
-
b
ased
d
ec
en
tr
ali
ze
d
p
u
b
lic
au
d
itin
g
s
ch
em
e
.
I
t
h
as
two
m
ain
p
h
a
s
es.
First,
th
e
s
etu
p
p
h
ase
p
r
ep
ar
es
ev
er
y
th
in
g
b
y
p
ass
in
g
o
n
s
ec
r
et
k
ey
s
f
o
r
s
ec
u
r
e
class
if
icatio
n
an
d
s
to
r
a
g
e
o
f
th
e
d
a
ta.
Seco
n
d
is
th
e
au
d
it
p
h
ase,
wh
ich
en
s
u
r
es
th
e
d
ata
is
in
tact
b
y
u
s
in
g
a
s
m
ar
t c
o
n
t
r
ac
t o
n
t
h
e
b
lo
ck
ch
ain
to
d
o
u
b
le
-
ch
ec
k
th
a
t e
v
er
y
th
in
g
is
in
o
r
d
er
[
2
5
]
.
T
h
er
ef
o
r
e,
we
s
u
g
g
est
a
n
a
p
p
r
o
ac
h
we
ca
ll
d
is
tr
ib
u
ted
,
b
y
co
m
b
in
in
g
clo
u
d
s
er
v
er
s
with
s
tan
d
ar
d
o
n
es
u
s
in
g
b
lo
c
k
ch
ain
tech
n
i
q
u
es
to
f
o
cu
s
o
n
clo
u
d
task
s
ch
ed
u
lin
g
an
d
ad
d
r
ess
th
e
p
er
f
o
r
m
an
ce
o
v
er
h
ea
d
p
o
s
ed
b
y
b
l
o
ck
ch
ai
n
.
T
h
is
wh
o
le
p
r
o
ce
s
s
in
v
o
lv
es
a
f
ew
k
e
y
p
lay
er
s
:
th
e
k
ey
g
en
er
atio
n
ce
n
tr
e
(
KGC),
clo
u
d
s
er
v
er
(
C
S),
d
ata
u
s
er
(
U)
,
an
d
th
ir
d
-
p
a
r
ty
au
d
ito
r
(
T
PA)
.
T
h
ey
f
u
n
ctio
n
to
g
et
h
er
to
e
n
s
u
r
e
d
ata
s
tay
s
s
af
e
an
d
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
5
0
2
-
4
7
52
In
d
o
n
esian
J
E
lec
E
n
g
&
C
o
m
p
Sci
,
Vo
l.
3
7
,
No
.
2
,
Feb
r
u
a
r
y
20
2
5
:
9
2
8
-
9
3
6
930
n
o
b
o
d
y
ca
n
m
ess
with
it.
No
w,
th
er
e’
s
a
n
o
th
er
s
y
s
tem
ca
l
led
d
ec
en
tr
alize
d
an
d
p
r
iv
ac
y
-
p
r
eser
v
in
g
p
u
b
lic
au
d
itin
g
(
DB
PA)
.
T
h
is
s
tr
u
ctu
r
e
u
s
es
alg
o
r
ith
m
s
s
u
ch
as
GUI
,
s
ettin
g
,
s
to
r
ag
e,
g
en
l
o
g
f
ile
,
an
d
ch
ec
k
i
n
g
lo
g
f
ile
to
k
ee
p
y
o
u
r
d
ata
s
af
e
an
d
p
r
iv
ate.
I
t
ev
en
u
s
es
b
lo
ck
c
h
ain
to
m
ak
e
s
u
r
e
ev
er
y
th
i
n
g
is
tr
an
s
p
ar
en
t
an
d
d
ep
en
d
a
b
le.
3.
M
E
T
H
O
D
Dec
en
tr
alize
d
au
to
n
o
m
o
u
s
h
e
alth
ca
r
e
s
y
s
tem
(
DAHS)
is
d
e
s
ig
n
ed
o
n
a
m
u
ltil
ay
er
ap
p
r
o
a
ch
b
u
ilt
o
n
b
lo
ck
ch
ain
,
clo
u
d
co
m
p
u
tin
g
,
an
d
I
o
T
f
o
r
f
lawless
d
ata
f
lo
w,
au
t
o
n
o
m
o
u
s
h
ea
lt
h
ca
r
e
m
an
ag
e
m
en
t,
an
d
r
ea
l
-
tim
e
d
ec
is
io
n
-
m
ak
i
n
g
.
3.
1
.
I
o
T
da
t
a
co
llect
io
n a
nd
prepro
ce
s
s
i
ng
T
h
e
ar
ch
itectu
r
e
c
o
m
p
r
is
es
I
o
T
-
en
ab
le
d
d
ev
ices
attac
h
ed
to
a
p
atien
t,
wh
ich
ca
n
m
o
n
i
to
r
h
ea
lth
p
ar
am
eter
s
o
f
h
ea
r
t
b
its
,
b
lo
o
d
p
r
ess
u
r
e
lev
el,
s
u
g
ar
lev
el,
a
n
d
p
h
y
s
ical
ac
tiv
ity
.
T
h
ese
ab
o
v
e
-
m
en
tio
n
ed
I
o
T
s
en
s
o
r
s
ar
e
o
p
er
atio
n
al
i
n
co
n
tin
u
o
u
s
m
o
d
es
b
y
m
o
n
ito
r
in
g
v
ital
h
ea
lth
d
ata.
Pre
p
r
o
ce
s
s
in
g
o
f
d
ata
is
d
o
n
e
d
u
r
in
g
t
h
e
f
o
g
c
o
m
p
u
ti
n
g
lay
er
to
f
ilter
o
u
t
n
o
n
-
ess
en
tial
o
r
r
ed
u
n
d
an
t
d
ata
th
at
r
ed
u
ce
s
th
e
co
m
p
u
tatio
n
al
lo
ad
o
n
th
e
clo
u
d
an
d
in
cr
ea
s
e
s
r
ea
l
-
tim
e
r
esp
o
n
s
iv
en
ess
.
3.
2
.
B
lo
c
k
cha
in
-
ena
bled da
t
a
inte
g
rit
y
T
h
e
f
ilter
ed
,
cr
u
cial
h
e
alth
d
ata
is
s
en
t
to
a
p
er
m
is
s
io
n
ed
b
lo
ck
c
h
ain
n
etwo
r
k
,
wh
er
e
it
will
b
e
im
m
u
tab
ly
lo
g
g
ed
.
I
o
T
d
e
v
ice
s
an
d
h
ea
lth
ca
r
e
p
r
o
v
i
d
er
s
ar
e
n
o
d
es
i
n
th
e
n
etwo
r
k
th
at
ca
n
s
to
r
e
th
e
d
ata
in
a
d
ec
en
tr
alize
d
way
.
B
lo
ck
ch
a
in
en
s
u
r
es
th
at
th
e
r
ec
o
r
d
s
o
f
a
p
atien
t
ar
e
ta
m
p
er
-
p
r
o
o
f
,
tr
an
s
p
ar
en
t,
an
d
tr
ac
ea
b
le.
T
r
ig
g
er
i
n
g
h
ea
lth
ca
r
e
wo
r
k
f
lo
ws
au
to
n
o
m
o
u
s
ly
d
u
e
to
p
r
ed
e
f
in
ed
h
ea
lth
c
o
n
d
itio
n
s
is
f
ac
ilit
ated
b
y
s
m
ar
t
co
n
tr
ac
ts
em
b
ed
d
e
d
with
in
th
e
b
lo
ck
ch
ain
.
T
h
is
m
ay
au
to
m
atica
lly
tr
ig
g
er
an
ale
r
t
to
th
e
p
r
o
v
id
e
r
if
a
p
atien
t
’
s
h
ea
r
t r
ate
is
h
ig
h
,
f
o
r
ex
am
p
le,
at
wh
ich
p
o
in
t a
ct
io
n
ca
n
b
e
tak
en
.
3
.
3
.
Clo
ud
co
m
pu
t
ing
f
o
r
da
t
a
s
t
o
ra
g
e
a
nd
a
na
ly
s
is
E
last
ic
s
to
r
ag
e
o
f
th
e
p
r
o
c
ess
ed
h
ea
lth
ca
r
e
d
ata
in
th
e
clo
u
d
lay
er
allo
ws
lar
g
e
-
s
ca
le
d
ata
m
an
ag
em
en
t.
Su
p
p
o
r
t
f
o
r
r
ea
l
-
tim
e
h
ea
lth
an
aly
tics
is
also
p
r
o
v
id
e
d
,
wh
ich
ca
n
lev
er
ag
e
m
ac
h
in
e
lear
n
in
g
alg
o
r
ith
m
s
to
lear
n
h
ea
lth
tr
e
n
d
s
f
r
o
m
p
atien
ts
an
d
p
r
ed
ict
f
u
tu
r
e
h
ea
lth
in
s
ig
h
ts
.
I
n
ca
s
es
o
f
lo
n
g
-
ter
m
d
at
a
s
to
r
ag
e,
s
ca
lab
ilit
y
,
an
d
ac
ce
s
s
ar
e
p
r
o
v
id
ed
b
y
th
e
cl
o
u
d
;
h
en
ce
,
h
ea
lth
ca
r
e
p
r
o
v
id
e
r
s
an
d
p
atien
ts
ca
n
r
etr
iev
e
h
ea
lth
r
ec
o
r
d
s
at
a
n
y
t
im
e
an
d
f
r
o
m
a
n
y
wh
er
e.
3.
4
.
S
m
a
rt
c
o
ntr
a
ct
s
f
o
r
a
ut
o
m
a
t
i
o
n o
f
hea
lt
hca
re
a
ct
io
n
s
Au
to
n
o
m
o
u
s
h
ea
lth
wo
r
k
f
lo
w
s
r
ely
o
n
s
m
ar
t
co
n
tr
ac
ts
th
at
h
av
e
r
u
les
an
d
r
eg
u
latio
n
s
p
r
e
d
ef
in
ed
f
o
r
th
e
co
n
d
u
ct
o
f
a
s
y
s
tem
with
o
u
t
th
e
n
ee
d
f
o
r
h
u
m
an
in
ter
v
en
tio
n
.
T
h
ese
m
a
y
b
e
in
b
u
il
t
r
u
les
th
at
c
o
n
tr
o
l
ac
ce
s
s
to
d
ata,
aler
t
p
atien
ts
in
ca
s
e
o
f
ce
r
tain
an
o
m
alies,
o
r
ev
en
h
ea
lth
r
esp
o
n
s
es.
Fo
r
in
s
tan
ce
,
th
ey
m
ay
s
et
tim
es
f
o
r
f
o
llo
w
-
u
p
ap
p
o
in
tm
en
ts
in
d
ep
en
d
en
tly
,
in
itia
te
p
r
escr
ip
tio
n
s
,
o
r
s
en
d
o
f
f
em
er
g
en
cy
aler
ts
o
n
th
eir
o
wn
b
ased
o
n
p
atien
t
d
ata.
3
.
5
.
Dec
ent
ra
lized
a
cc
ess
a
n
d g
o
v
er
na
nce
Dy
n
am
ic
b
lo
ck
c
h
ain
g
o
v
er
n
a
n
ce
m
ak
es
th
e
d
ec
is
io
n
-
m
ak
i
n
g
o
f
p
r
o
to
c
o
l
ch
an
g
es,
d
ata
ac
ce
s
s
,
an
d
s
y
s
tem
u
p
d
ates
d
ec
en
tr
alize
d
.
T
h
is
m
eth
o
d
o
lo
g
y
ca
n
b
e
s
h
ar
ed
b
etwe
en
h
ea
lth
en
titi
es
an
d
ca
n
m
ain
tain
d
ata
p
r
iv
ac
y
a
n
d
s
ec
u
r
ity
f
o
r
t
h
e
p
a
tien
t.
4.
P
RO
P
O
SE
D
ARCH
I
T
E
CT
URE
Owin
g
to
th
e
i
n
teg
r
atio
n
o
f
b
lo
ck
ch
ain
,
clo
u
d
c
o
m
p
u
tin
g
,
an
d
I
o
T
,
DAHS
ar
ch
itectu
r
e
i
s
d
esig
n
ed
as
an
in
teg
r
ated
,
d
ec
e
n
tr
alize
d
,
an
d
a
u
to
n
o
m
o
u
s
p
ar
ad
ig
m
in
th
e
asp
ec
t
o
f
lay
er
s
.
Var
io
u
s
lay
er
s
o
f
th
e
ar
ch
itectu
r
e
p
er
f
o
r
m
v
ar
io
u
s
o
p
er
atio
n
s
lead
in
g
th
e
p
atien
ts
to
co
n
n
ec
t
with
th
e
f
ir
m
i
n
r
ea
l
-
tim
e,
au
to
m
atin
g
d
ata
an
d
s
ec
u
r
ity
m
an
ag
em
e
n
t
,
an
d
m
ak
in
g
d
ec
is
io
n
s
au
to
n
o
m
o
u
s
ly
.
As
s
h
o
wn
in
Fig
u
r
e
1
DAHS
lay
er
s
an
d
o
p
er
atio
n
s
ar
e
g
i
v
en
as
f
o
llo
ws.
T
h
e
lay
er
wis
e
b
r
ea
k
d
o
wn
o
f
s
y
s
tem
ar
ch
itectu
r
e
f
o
r
Fig
u
r
e
1
is
s
h
o
wn
i
n
T
ab
le
1
an
d
s
y
s
tem
r
eq
u
ir
e
m
e
n
ts
in
T
ab
le
2
f
o
r
th
e
s
am
e.
4.
1
.
I
o
T
la
y
er
I
o
T
l
a
y
er
:
s
m
ar
t
s
en
s
o
r
s
ar
e
im
p
lan
ted
in
p
atien
ts
to
g
ath
er
d
ata
s
u
ch
as
h
ea
r
t
b
it
,
b
lo
o
d
p
r
ess
u
r
e
lev
el
co
o
lin
g
s
y
s
tem
s
o
f
s
u
g
ar
lev
els,
an
d
p
h
y
s
ical
p
e
n
d
u
lu
m
ac
tiv
ity
.
T
h
ese
s
en
s
o
r
s
ar
e
u
s
ed
to
m
o
n
ito
r
p
atien
t
d
ata,
an
d
th
e
ca
p
tu
r
e
d
d
ata
is
p
r
e
-
p
r
o
ce
s
s
ed
o
n
ed
g
e
b
ef
o
r
e
f
o
r
war
d
i
n
g
it
f
o
r
an
aly
s
is
in
th
e
clo
u
d
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
d
o
n
esian
J
E
lec
E
n
g
&
C
o
m
p
Sci
I
SS
N:
2
5
0
2
-
4
7
52
I
n
teg
r
a
tin
g
b
lo
ck
ch
a
i
n
,
in
tern
et
o
f th
in
g
s
,
a
n
d
clo
u
d
fo
r
s
ec
u
r
e
h
ea
lth
ca
r
e
(
K
S
en
t
h
u
r
K
u
ma
r
a
n
)
931
Her
e,
wh
at
th
is
p
r
o
ce
s
s
d
o
es
i
s
s
to
r
e
th
e
d
ata
in
its
o
r
ig
in
al
f
o
r
m
an
d
s
en
d
o
v
er
ess
en
tial
h
ea
lth
in
f
o
r
m
atio
n
o
n
ly
.
T
h
is
lay
er
is
illu
s
tr
ated
in
th
e
d
iag
r
am
as I
o
T
p
atien
t sen
s
o
r
d
ata
an
d
v
ital sig
n
m
o
n
i
to
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in
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.
Fig
u
r
e
1
.
Dec
en
t
r
alize
d
au
to
m
ated
h
ea
lth
ca
r
e
s
y
s
tem
ar
ch
ite
ctu
r
e
T
ab
le
1
.
L
a
y
er
-
wis
e
b
r
ea
k
d
o
w
n
o
f
th
e
s
y
s
tem
ar
ch
itectu
r
e
La
y
e
r
F
u
n
c
t
i
o
n
Te
c
h
n
o
l
o
g
i
e
s
u
se
d
1
.
I
o
T
G
a
t
h
e
r
s
p
a
t
i
e
n
t
se
n
s
o
r
d
a
t
a
f
r
o
m
b
e
a
c
o
n
s
.
W
e
a
r
a
b
l
e
se
n
s
o
r
s,
I
o
T
d
e
v
i
c
e
s
2
.
F
o
g
C
o
m
p
u
t
i
n
g
Pre
-
p
r
o
c
e
sses
d
a
t
a
a
t
t
h
e
e
d
g
e
f
i
l
t
e
r
s
e
ssen
t
i
a
l
d
a
t
a
a
n
d
se
n
d
s t
o
t
h
e
c
l
o
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d
b
e
n
e
f
i
t
F
o
g
n
o
d
e
s,
e
d
g
e
c
o
m
p
u
t
i
n
g
3
.
B
l
o
c
k
c
h
a
i
n
S
e
c
u
r
i
t
y
a
n
d
i
mm
u
t
a
b
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l
i
t
y
o
f
d
a
t
a
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s
w
e
l
l
a
s w
o
r
k
f
l
o
w
a
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t
o
ma
t
i
o
n
t
h
r
o
u
g
h
smar
t
c
o
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t
r
a
c
t
s
P
e
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mi
ssi
o
n
e
d
b
l
o
c
k
c
h
a
i
n
,
sm
a
r
t
c
o
n
t
r
a
c
t
s
4
.
C
l
o
u
d
C
o
m
p
u
t
i
n
g
O
f
f
e
r
s sc
a
l
a
b
l
e
st
o
r
a
g
e
a
n
d
r
e
a
l
-
t
i
me
a
n
a
l
y
t
i
c
s
o
f
h
e
a
l
t
h
d
a
t
a
,
p
r
o
v
i
d
i
n
g
a
so
l
u
t
i
o
n
f
o
r
l
o
n
g
-
t
e
r
m
d
a
t
a
ma
n
a
g
e
me
n
t
.
C
l
o
u
d
s
t
o
r
a
g
e
,
d
i
st
r
i
b
u
t
e
d
d
a
t
a
b
a
se
s,
A
I
5
.
A
p
p
l
i
c
a
t
i
o
n
La
y
e
r
P
r
o
v
i
d
e
s
b
u
i
l
t
-
i
n
u
ser
i
n
t
e
r
a
c
t
i
o
n
f
o
r
p
a
t
i
e
n
t
s
a
n
d
h
e
a
l
t
h
c
a
r
e
p
r
o
v
i
d
e
r
s
t
o
r
e
t
r
i
e
v
e
d
a
t
a
.
W
e
b
a
n
d
mo
b
i
l
e
a
p
p
l
i
c
a
t
i
o
n
s
T
ab
le
2
.
Sy
s
tem
r
eq
u
ir
em
en
ts
La
y
e
r
R
e
c
o
mm
e
n
d
e
d
s
p
e
c
i
f
i
c
a
t
i
o
n
D
e
scri
p
t
i
o
n
1.
I
o
T
sen
s
o
r
s
Lo
w
-
p
o
w
e
r
,
h
i
g
h
-
a
c
c
u
r
a
c
y
s
e
n
so
r
s f
o
r
r
e
a
l
-
t
i
m
e
mo
n
i
t
o
r
i
n
g
C
o
l
l
e
c
t
s
v
i
t
a
l
si
g
n
s s
u
c
h
a
s
h
e
a
r
t
r
a
t
e
,
g
l
u
c
o
se
,
a
n
d
b
l
o
o
d
p
r
e
ss
u
r
e
.
2.
F
o
g
n
o
d
e
s
D
e
c
e
n
t
r
a
l
i
z
e
d
p
r
o
c
e
ss
i
n
g
u
n
i
t
s wi
t
h
l
o
w
l
a
t
e
n
c
y
P
r
e
p
r
o
c
e
ss
e
s i
n
f
o
r
mat
i
o
n
t
o
r
e
d
u
c
e
t
h
e
l
o
a
d
o
f
c
l
o
u
d
s
t
o
r
a
g
e
.
3.
B
l
o
c
k
c
h
a
i
n
n
o
d
e
s
H
i
g
h
-
p
e
r
f
o
r
ma
n
c
e
n
o
d
e
s
w
i
t
h
sec
u
r
e
d
a
t
a
t
r
a
n
s
mi
ss
i
o
n
P
e
r
mi
t
i
mm
u
t
a
b
l
e
a
n
d
d
e
c
e
n
t
r
a
l
i
z
e
d
c
o
n
t
r
o
l
o
f
h
e
a
l
t
h
c
a
r
e
d
a
t
a
.
4.
C
l
o
u
d
s
t
o
r
a
g
e
S
c
a
l
a
b
l
e
c
l
o
u
d
i
n
f
r
a
st
r
u
c
t
u
r
e
w
i
t
h
r
e
a
l
-
t
i
me
a
n
a
l
y
t
i
c
s
S
t
o
r
e
s
p
r
o
c
e
sse
d
h
e
a
l
t
h
d
a
t
a
a
n
d
s
u
p
p
o
r
t
s
p
r
e
d
i
c
t
i
v
e
a
n
a
l
y
t
i
c
s.
5.
A
p
p
l
i
c
a
t
i
o
n
p
l
a
t
f
o
r
m
M
o
b
i
l
e
o
r
w
e
b
-
b
a
s
e
d
i
n
t
e
r
f
a
c
e
f
o
r
e
n
d
-
u
s
e
r
s
P
r
o
v
i
d
e
s a
c
c
e
ss
t
o
d
a
t
a
b
y
p
a
t
i
e
n
t
s
a
n
d
h
e
a
l
t
h
c
a
r
e
p
r
o
v
i
d
e
r
s
.
4.
2
.
F
o
g
c
o
m
pu
t
ing
la
y
er
T
h
e
f
o
g
c
o
m
p
u
tin
g
la
y
er
:
th
i
s
is
a
d
is
tr
ib
u
ted
p
r
o
ce
s
s
in
g
u
n
it
clo
s
e
to
th
e
n
etwo
r
k
ed
g
e
f
o
r
p
r
e
-
p
r
o
ce
s
s
in
g
d
ata
f
aster
b
ef
o
r
e
it
is
s
h
if
ted
to
th
e
clo
u
d
.
B
y
elim
in
atin
g
u
n
n
ec
ess
ar
y
d
ata,
it r
ed
u
ce
s
th
e
am
o
u
n
t
o
f
in
f
o
r
m
atio
n
s
en
t
t
o
th
e
clo
u
d
an
d
in
tu
r
n
o
p
tim
izes
r
ea
l
-
tim
e
h
ea
lth
m
o
n
ito
r
in
g
.
T
h
is
lay
er
allo
ws
o
n
ly
s
ig
n
if
ican
t
h
ea
lth
m
o
n
ito
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s
to
b
e
s
en
t,
lim
itin
g
t
h
e
p
r
o
ce
s
s
in
g
tim
e
o
f
ir
r
elev
a
n
t
d
ata.
I
t
im
p
r
o
v
ed
s
y
s
tem
ef
f
icien
cy
an
d
th
e
a
b
ilit
y
to
r
e
s
p
o
n
d
to
h
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lth
cr
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es b
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tak
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g
o
n
p
r
ep
r
o
ce
s
s
in
g
at
o
n
e
o
f
t
h
e
ed
g
es.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
5
0
2
-
4
7
52
In
d
o
n
esian
J
E
lec
E
n
g
&
C
o
m
p
Sci
,
Vo
l.
3
7
,
No
.
2
,
Feb
r
u
a
r
y
20
2
5
:
9
2
8
-
9
3
6
932
4.
3
.
B
lo
c
k
cha
in
la
y
er
All
th
e
3
la
y
er
s
ar
e
tr
an
s
p
ar
e
n
t.
T
h
e
b
lo
c
k
ch
ain
lay
er
en
s
u
r
es
th
at
p
atie
n
t
r
ec
o
r
d
s
ar
e
s
to
r
ed
in
a
d
ec
en
tr
alize
d
an
d
im
m
u
tab
le
m
an
n
er
.
T
am
p
er
-
p
r
o
o
f
h
ea
lth
tr
an
s
ac
tio
n
s
:
all
p
atien
t
d
ata
f
l
o
win
g
b
etwe
en
th
e
clo
u
d
,
h
ea
lth
ca
r
e
p
r
o
v
id
er
s
,
a
n
d
p
atien
ts
th
em
s
elv
es
will
b
e
s
to
r
ed
as
h
ea
lth
tr
an
s
ac
tio
n
s
in
a
b
lo
ck
ch
ain
led
g
er
.
T
h
is
lay
er
u
s
es
s
m
ar
t
c
o
n
tr
ac
ts
to
au
to
m
atica
lly
k
ick
o
f
f
h
ea
lth
wo
r
k
f
lo
ws
wh
en
p
ar
ticu
lar
h
ea
lth
co
n
d
itio
n
s
ar
e
id
en
tifie
d
,
th
er
eb
y
en
s
u
r
in
g
tim
ely
lo
g
ic.
T
h
e
b
lo
ck
ch
ain
lay
e
r
is
eq
u
ip
p
e
d
with
an
ellip
tical
cu
r
v
e
in
teg
r
ated
en
c
r
y
p
tio
n
s
y
s
tem
(
E
C
I
E
S).
W
ith
a
p
e
r
m
i
s
s
io
n
ed
b
lo
ck
c
h
ain
o
n
ly
au
t
h
o
r
ized
e
n
titi
es
e.
g
.
,
h
ea
lth
ca
r
e
p
r
o
v
id
er
s
a
n
d
p
a
tien
ts
ar
e
allo
wed
to
ac
ce
s
s
th
e
d
ata,
AE
S
-
e
n
cr
y
p
te
d
at
r
est
an
d
in
tr
an
s
it
en
s
u
r
in
g
tr
a
n
s
p
ar
en
cy
,
an
d
tr
a
ce
ab
ilit
y
as we
ll a
ch
iev
es p
atien
t p
r
iv
ac
y
ac
r
o
s
s
th
e
s
y
s
tem
.
4.
4
.
Underly
ing
clo
ud
c
o
m
p
uting
la
y
er
(
s
t
o
ra
g
e
a
nd
a
na
l
y
t
ics
)
C
lo
u
d
co
m
p
u
tin
g
lay
er
:
t
h
e
i
n
f
o
r
m
atio
n
co
llected
f
r
o
m
I
o
T
d
ev
ices
is
ag
g
r
eg
ated
o
v
er
th
e
clo
u
d
co
m
p
u
tin
g
lay
er
th
at
w
o
u
ld
in
tu
r
n
p
r
o
v
id
e
s
ca
lab
le
s
to
r
a
g
e
an
d
r
ea
l
-
tim
e
an
aly
tics
.
L
ev
er
ag
in
g
AI
-
d
r
iv
e
n
alg
o
r
ith
m
s
,
th
is
lay
er
p
r
o
ce
s
s
es
m
ass
iv
e
am
o
u
n
ts
o
f
h
ea
lth
d
ata
to
m
ak
e
s
en
s
e
o
f
tr
e
n
d
s
an
d
p
r
e
d
ict
th
e
r
is
k
f
o
r
f
u
tu
r
e
illn
ess
es.
T
h
e
g
o
o
d
th
in
g
is
th
at
th
e
clo
u
d
o
f
f
er
s
a
lo
t
in
ter
m
s
o
f
i
n
ter
o
p
e
r
ab
ilit
y
,
s
o
h
ea
lth
ca
r
e
p
r
o
v
id
e
r
s
an
d
p
atien
ts
ca
n
ac
c
ess
h
ea
lth
r
ec
o
r
d
s
wh
en
ev
e
r
t
h
ey
wan
t
to
.
W
ith
s
ec
u
r
e
d
ata
s
to
r
ag
e,
t
h
e
clo
u
d
also
s
u
p
p
o
r
ts
p
r
e
d
ictiv
e
an
aly
t
ics wh
ich
ca
n
f
u
r
t
h
er
ass
is
t in
h
ea
lth
ca
r
e
m
an
a
g
em
en
t.
4.
5
.
Aut
hentic
a
t
io
n
a
nd
a
ut
ho
riza
t
io
n la
y
er
T
h
e
th
ir
d
lay
er
a
d
d
s
th
e
d
y
n
am
ic
b
lo
ck
ch
ain
g
o
v
er
n
an
ce
,
m
ea
n
in
g
th
a
t
h
o
s
p
itals
,
r
eg
u
lato
r
s
,
an
d
in
s
u
r
er
s
ca
n
p
ar
ticip
ate
in
allo
wan
ce
d
ec
is
io
n
s
o
n
s
ec
u
r
ity
u
p
d
ates
o
r
p
r
o
t
o
co
l
ch
an
g
es
as
well
as
p
atien
t
d
ata
ac
ce
s
s
.
Ma
n
y
h
ea
lth
ca
r
e
b
lo
ck
ch
ain
s
ar
e
p
e
r
m
is
s
io
n
-
b
as
ed
,
u
s
in
g
c
o
n
s
o
r
tiu
m
ch
ain
s
f
o
r
d
ec
en
tr
alize
d
g
o
v
er
n
an
ce
with
n
o
s
in
g
le
co
n
tr
o
l
p
o
in
t
to
en
f
o
r
ce
th
e
n
et
wo
r
k
an
d
k
ee
p
d
ata
s
ets
d
is
tr
i
b
u
ted
.
T
h
is
lay
er
is
ess
en
tial
to
co
n
tr
o
l
ac
ce
s
s
an
d
m
ak
e
th
e
s
y
s
tem
r
eg
u
latio
n
-
c
o
m
p
lian
t,
n
o
t
o
n
ly
p
r
o
tectin
g
p
atien
t
p
r
iv
ac
y
b
u
t
also
g
u
ar
an
teein
g
th
at
ev
e
r
y
th
in
g
in
s
id
e
it is
in
tac
t.
4.
6
.
Appl
ica
t
io
n
la
y
er
User
s
-
p
atien
ts
an
d
h
ea
lth
ca
r
e
p
r
o
v
id
er
s
u
s
e
m
o
b
ile
o
r
web
ap
p
s
to
in
te
r
ac
t
with
th
e
s
y
s
tem
.
User
in
ter
ac
tio
n
lay
er
th
ey
will
b
e
ab
le
to
tr
ac
k
th
eir
h
ea
lth
s
tatu
s
in
r
ea
l
-
tim
e,
ch
ec
k
o
u
t
th
e
d
etails
o
f
v
is
it
s
,
an
d
s
h
ar
e
th
em
o
n
l
y
with
th
o
s
e
th
ey
tr
u
s
t.
On
th
e
o
th
er
h
a
n
d
,
f
o
r
h
ea
lt
h
ca
r
e
p
r
o
v
id
er
s
,
t
h
i
s
lay
er
s
er
v
es
as
a
m
ed
iu
m
to
av
ail
ac
ce
s
s
o
f
p
ati
en
t
d
ata
th
r
o
u
g
h
aler
tin
g
an
d
r
ep
o
r
tin
g
m
ec
h
a
n
is
m
s
s
o
th
at
t
h
ey
tak
e
n
ec
ess
ar
y
ac
tio
n
b
ased
o
n
d
ec
is
io
n
s
.
Su
ch
a
l
ay
er
p
r
o
v
id
es
a
s
m
o
o
th
co
m
m
u
n
icatio
n
m
ec
h
an
is
m
b
e
twee
n
th
e
u
s
er
s
an
d
th
e
h
ea
lth
ca
r
e
s
y
s
tem
b
elo
w
it
r
esu
ltin
g
in
h
ea
lth
ier
life
s
ty
le
m
an
ag
em
en
t,
an
d
r
ea
l
-
tim
e
d
e
cisi
o
n
-
m
ak
in
g
.
5.
P
E
RF
O
RM
A
NCE
M
E
T
R
I
C
S AN
D
RE
SUL
T
S
T
h
e
u
s
e
o
f
th
e
p
r
o
p
o
s
ed
h
y
b
r
i
d
o
f
b
lo
c
k
ch
ain
,
I
o
T
,
an
d
clo
u
d
co
m
p
u
tin
g
was
an
im
p
r
o
v
in
g
f
ac
to
r
in
th
e
asp
ec
t
o
f
s
ec
u
r
ity
wh
ile
en
h
an
cin
g
th
e
ef
f
icien
c
y
an
d
s
ca
lab
ilit
y
f
o
r
ev
er
y
d
a
y
u
s
e
in
th
e
h
ea
lth
ca
r
e
s
y
s
tem
.
T
h
e
en
v
is
io
n
ed
s
y
s
tem
an
d
its
ar
ch
itectu
r
e,
wh
i
ch
em
p
lo
y
s
th
e
d
y
n
am
ic
p
r
o
x
y
n
o
d
e
s
elec
tio
n
alg
o
r
ith
m
o
r
DPNS,
also
u
s
ed
s
o
p
h
is
ticated
cr
y
p
to
g
r
ap
h
ic
m
ec
h
an
is
m
s
an
d
elim
in
ated
k
ey
s
h
o
r
tco
m
in
g
s
o
f
ex
is
tin
g
h
ea
lth
s
y
s
tem
s
.
T
h
e
u
s
e
o
f
th
e
p
r
o
p
o
s
ed
h
y
b
r
i
d
o
f
b
lo
c
k
ch
ain
,
I
o
T
,
an
d
clo
u
d
co
m
p
u
tin
g
was
an
im
p
r
o
v
in
g
f
ac
to
r
in
th
e
asp
ec
t
o
f
s
ec
u
r
ity
wh
ile
e
n
h
an
cin
g
th
e
ef
f
icien
c
y
an
d
s
ca
lab
ilit
y
f
o
r
ev
er
y
d
a
y
u
s
e
in
th
e
h
ea
lth
ca
r
e
s
y
s
tem
.
T
h
e
en
v
is
io
n
ed
s
y
s
tem
an
d
its
ar
ch
itectu
r
e,
wh
i
ch
em
p
lo
y
s
th
e
d
y
n
am
ic
p
r
o
x
y
n
o
d
e
s
elec
tio
n
alg
o
r
ith
m
o
r
DPNS,
also
u
s
ed
s
o
p
h
is
ticated
cr
y
p
to
g
r
ap
h
ic
m
ec
h
an
is
m
s
an
d
elim
in
ated
k
ey
s
h
o
r
tco
m
in
g
s
o
f
ex
is
tin
g
h
ea
lth
s
y
s
tem
s
.
T
h
e
Fig
u
r
e
2
s
h
o
ws
th
at
w
h
en
it
c
o
m
es
to
I
o
T
d
ev
ices,
as
th
e
n
u
m
b
er
o
f
co
n
n
ec
ted
d
ev
ices
g
r
ew
f
r
o
m
1
0
0
to
1
,
0
0
0
;
th
e
s
y
s
tem
s
h
o
wed
s
tab
le
p
er
f
o
r
m
a
n
ce
.
Fin
ally
,
o
u
r
a
v
er
a
g
e
p
r
o
ce
s
s
in
g
tim
e
s
tay
ed
at
ar
o
u
n
d
1
.
2
s
ec
o
n
d
s
with
th
e
o
n
ly
s
p
ik
e
to
alm
o
s
t
1
.
3
s
ec
o
n
d
s
wh
en
we
wer
e
lo
ad
ed
o
n
m
a
x
im
u
m
ca
p
ac
ity
.
I
t
s
h
o
ws
th
at
th
e
s
y
s
tem
s
ca
les
ef
f
icien
tly
,
s
u
p
p
o
r
t
in
g
m
a
n
y
d
ev
ices
with
o
u
t
m
ajo
r
d
elay
s
.
Fig
u
r
e
3
s
h
o
ws
th
e
cu
m
u
lativ
e
h
ea
lth
a
ler
ts
g
en
er
ated
b
y
s
m
ar
t
co
n
tr
ac
ts
in
th
e
p
ast
3
0
d
a
y
s
T
h
e
m
ec
h
an
is
m
p
r
o
v
id
ed
a
n
ea
r
r
ea
l
-
tim
e
aler
tin
g
ca
p
a
b
ilit
y
u
s
in
g
p
atien
t
h
em
o
d
y
n
a
m
ics
an
d
id
en
tifie
d
ev
e
n
ts
th
at
f
all
o
u
ts
id
e
o
f
th
e
n
o
r
m
al
r
a
n
g
e,
s
en
d
in
g
1
5
0
a
ler
ts
o
v
er
th
is
tim
e
p
er
i
o
d
.
T
h
is
g
r
ap
h
s
h
o
ws
th
e
ab
ilit
y
o
f
th
e
s
y
s
tem
to
co
n
tin
u
o
u
s
ly
m
o
n
ito
r
p
atien
t
d
ata,
an
d
a
u
to
m
atica
lly
in
itiat
e
alar
m
s
in
r
esp
o
n
s
e
to
h
ea
lth
an
o
m
alies.
Fo
r
m
u
las:
f
o
r
m
u
las
m
en
tio
n
e
d
h
er
ein
y
ield
q
u
a
n
tific
atio
n
o
f
s
y
s
tem
ef
f
icien
cy
in
ter
m
s
o
f
laten
cy
,
d
ata
r
ed
u
ctio
n
,
an
d
cl
o
u
d
s
ca
l
ab
ilit
y
-
im
p
o
r
tan
t
f
o
r
p
e
r
f
o
r
m
a
n
ce
m
etr
ics
ev
alu
atio
n
s
u
ch
a
s
p
r
o
ce
s
s
in
g
s
p
ee
d
,
s
to
r
ag
e
g
r
o
wth
,
an
d
ef
f
icien
cy
in
h
an
d
lin
g
d
ata.
T
o
tal
l
aten
cy
in
th
e
s
y
s
tem
is
an
im
p
o
r
tan
t
f
ac
to
r
i
n
d
eter
m
in
in
g
th
e
s
p
ee
d
o
f
g
at
h
er
in
g
p
atien
ts
’
d
ata,
p
r
o
ce
s
s
in
g
it,
an
d
ac
tin
g
o
n
it.
T
h
e
to
tal
laten
cy
in
o
u
r
p
r
o
p
o
s
ed
d
ec
en
tr
alize
d
h
ea
lth
ca
r
e
s
y
s
tem
is
th
e
ag
g
r
eg
atio
n
o
f
d
elay
s
f
r
o
m
th
e
I
o
T
lay
er
,
f
o
g
co
m
p
u
tin
g
s
tag
e,
b
lo
ck
ch
ain
,
an
d
clo
u
d
c
o
m
p
u
tin
g
as sh
o
wn
in
(
1
)
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
d
o
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n
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r
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i
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tern
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clo
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r
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r
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r
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W
h
er
e,
r
ep
r
esen
ts
th
e
tim
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it
t
ak
es
f
o
r
I
o
T
d
ev
ices
to
co
llect
r
ea
l
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tim
e
h
ea
lth
d
ata.
ac
co
u
n
ts
f
o
r
th
e
tim
e
s
p
en
t
p
r
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p
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ce
s
s
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d
at
a
at
th
e
f
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g
lay
e
r
.
ℎ
is
th
e
tim
e
r
eq
u
ir
ed
f
o
r
b
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ch
ai
n
v
er
if
icatio
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d
r
ec
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r
d
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r
ef
lects
th
e
tim
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n
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d
ed
f
o
r
clo
u
d
s
to
r
a
g
e
an
d
d
ata
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al
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s
is
.
W
h
ile
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ilter
in
g
o
u
t
u
n
n
ec
ess
ar
y
d
ata
in
th
e
clo
u
d
,
m
o
s
t
o
f
th
e
w
o
r
k
is
d
o
n
e
b
y
th
e
Fo
g
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m
p
u
tin
g
lay
er
.
T
h
e
ef
f
e
ctiv
en
ess
o
f
f
ilter
in
g
ca
n
b
e
esti
m
ated
b
y
th
e
d
ata
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ed
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ctio
n
r
atio
(
R
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,
r
e
p
r
e
s
en
tin
g
th
e
r
atio
o
f
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ata
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ilter
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o
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t
v
er
s
u
s
th
e
to
tal
d
ata
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llected
b
y
I
o
T
d
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ices
as sh
o
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in
(
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.
=
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100
(
2
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D
input
r
ep
r
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ts
th
e
o
r
ig
in
al
am
o
u
n
t
o
f
d
ata
co
llected
b
y
I
o
T
d
ev
ices.
D
filtered
is
th
e
am
o
u
n
t
o
f
d
ata
th
at
h
as
b
ee
n
r
em
o
v
e
d
b
y
th
e
f
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g
lay
er
.
R
is
th
e
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ata
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ed
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ctio
n
p
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ce
n
tag
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o
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n
t
o
f
p
atien
t
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ata
is
in
cr
ea
s
in
g
,
it
also
m
ea
n
s
th
at
th
e
s
ca
lin
g
f
o
r
clo
u
d
s
to
r
ag
e
s
h
o
u
ld
in
c
r
ea
s
e.
T
h
e
f
o
r
m
u
la
i
n
s
to
r
ag
e
g
r
o
wth
at
tim
e
t,
wh
ich
is
r
e
p
r
esen
ted
a
s
S(t)
,
d
e
p
icts
h
o
w
th
e
e
v
o
lu
ti
o
n
o
f
s
to
r
a
g
e
v
ar
ies
as
th
e
d
at
a
f
r
o
m
I
o
T
d
ev
ices
g
r
o
ws
as sh
o
wn
in
(
3
)
.
(
)
=
0
+
∗
(
3
)
S(t)
is
th
e
to
tal
s
to
r
ag
e
r
eq
u
ir
e
d
at
tim
e
ttt.
S
0
r
e
p
r
esen
ts
th
e
in
itial
s
to
r
ag
e
ca
p
ac
ity
.
r
is
th
e
r
ate
at
wh
ich
d
ata
is
g
en
er
ated
(
e.
g
.
,
p
e
r
d
a
y
)
.
t
i
s
tim
e
in
d
ay
s
.
F
i
g
u
r
e
2
.
D
a
t
a
p
r
o
c
ess
i
n
g
t
i
m
e
v
s
.
n
u
m
b
e
r
o
f
I
o
T
d
e
v
i
c
e
s
Fig
u
r
e
3.
Hea
lth
aler
ts
g
e
n
er
at
ed
b
y
s
m
ar
t
5
.
1
.
Securit
y
enha
ncem
ent
T
h
ese
h
elp
ed
to
in
te
g
r
ate
b
lo
c
k
ch
ain
tech
n
o
lo
g
y
to
p
r
o
v
id
e
d
ata
s
ec
u
r
ity
an
d
p
r
iv
ac
y
t
o
p
r
ev
en
t
an
y
th
ir
d
-
p
ar
t
y
m
a
n
ip
u
latio
n
.
T
h
e
en
cr
y
p
tio
n
o
f
d
ata
u
s
in
g
th
e
E
C
I
E
S
in
th
e
p
r
o
ce
s
s
o
f
th
e
clo
u
d
s
to
r
ag
e
o
f
h
ea
lth
ca
r
e
in
f
o
r
m
atio
n
o
f
f
er
e
d
th
e
ess
en
tial
asp
ec
ts
o
f
d
ata
s
ec
u
r
ity
,
n
am
ely
,
co
n
f
id
en
tial
ity
an
d
in
teg
r
ity
.
I
n
th
e
lig
h
t
o
f
th
e
c
o
n
s
id
er
ati
o
n
s
p
r
o
v
i
d
ed
ab
o
v
e
th
e
p
e
cu
liar
r
elian
ce
o
n
t
h
e
f
r
am
ewo
r
k
p
r
o
v
id
e
d
a
d
ec
en
tr
alize
d
d
esig
n
th
at
allo
wed
f
o
r
th
e
r
em
o
v
al
o
f
a
s
in
g
le
p
o
in
t
f
o
r
a
DDo
S
attac
k
o
r
an
y
o
th
er
v
a
r
iety
o
f
s
ec
u
r
ity
th
r
ea
ts
wh
ich
is
co
m
p
lian
t w
ith
th
e
h
ig
h
le
v
el
o
f
s
ec
u
r
ity
r
eq
u
ir
ed
in
th
e
h
ea
lth
ca
r
e
d
o
m
ain
.
5
.
2
.
E
f
f
iciency
i
m
pro
v
em
ent
s
T
h
e
s
elec
tio
n
o
f
a
liv
e
p
r
o
x
y
n
o
d
e
r
ed
u
c
ed
laten
c
y
as
it
h
el
p
ed
in
m
an
ag
in
g
th
e
in
ter
n
al
t
r
an
s
f
er
o
f
d
ata
b
etwe
en
th
e
I
o
T
d
e
v
ice
s
an
d
th
e
b
lo
ck
c
h
ain
.
Sm
ar
t
co
n
tr
ac
ts
co
n
tr
o
l
t
h
e
lo
a
d
s
w
ith
in
th
em
an
d
th
e
d
y
n
am
ic
s
elec
tio
n
o
f
GPUs
with
o
u
t
th
e
f
o
r
m
atio
n
o
f
b
o
t
tlen
ec
k
s
.
Als
o
,
th
e
ef
f
icien
c
y
o
f
ac
ce
s
s
co
n
tr
o
l
au
to
m
atio
n
en
h
an
ce
d
t
h
e
f
lo
w
o
f
d
ata
with
in
th
e
s
y
s
tem
,
m
ad
e
it
m
o
r
e
s
en
s
itiv
e,
an
d
c
u
t
o
u
t
u
n
n
ec
ess
ar
y
tim
e
d
em
an
d
s
o
n
th
e
ad
m
in
is
tr
ativ
e
s
id
e.
5
.
3
.
Securit
y
enha
ncem
ent
s
T
h
e
u
s
e
o
f
th
e
b
lo
ck
ch
ain
h
el
p
ed
to
p
r
o
v
i
d
e
d
ata
s
ec
u
r
ity
s
o
th
at
n
o
o
n
e
ca
n
m
o
d
if
y
o
r
g
ain
ac
ce
s
s
to
th
e
d
ata
in
a
n
y
n
eg
ativ
e
m
a
n
n
er
.
E
C
I
E
S
was
ap
p
lied
i
n
e
n
cr
y
p
tin
g
h
ea
lth
ca
r
e
d
ata
b
e
f
o
r
e
its
s
to
r
ag
e
in
th
e
clo
u
d
af
f
o
r
d
in
g
s
tr
o
n
g
co
n
f
id
e
n
tiality
o
v
er
th
e
s
to
r
ed
d
ata
as we
ll a
s
th
e
s
to
r
ed
d
ata’
s
in
teg
r
ity
.
T
h
is
m
ad
e
th
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
5
0
2
-
4
7
52
In
d
o
n
esian
J
E
lec
E
n
g
&
C
o
m
p
Sci
,
Vo
l.
3
7
,
No
.
2
,
Feb
r
u
a
r
y
20
2
5
:
9
2
8
-
9
3
6
934
f
r
am
ewo
r
k
elim
in
ate
s
in
g
le
p
o
in
ts
o
f
f
ailu
r
e
a
n
d
m
in
im
ize
DDo
S
attac
k
s
an
d
o
th
er
cr
az
y
s
ec
u
r
ity
r
is
k
s
th
at
wer
e
ac
ce
p
tab
le
with
in
th
e
h
ig
h
-
s
ec
u
r
ity
r
e
q
u
ir
em
en
ts
o
f
th
e
h
ea
lth
ca
r
e
d
o
m
ain
.
5
.
4
.
Sca
la
bil
it
y
T
h
e
co
n
ce
p
t
o
f
clu
s
ter
ed
I
o
T
n
etwo
r
k
s
an
d
o
f
f
-
ch
ai
n
s
to
r
ag
e
to
ad
d
r
ess
s
ca
lab
ilit
y
is
s
u
es
was
f
o
u
n
d
to
h
av
e
im
p
r
o
v
e
d
th
e
f
r
am
ew
o
r
k
’
s
s
ca
lab
ilit
y
,
a
g
ain
,
b
y
a
h
u
g
e
m
a
r
g
in
.
T
h
u
s
,
b
y
ag
g
r
eg
at
in
g
th
e
d
ev
ices
i
n
to
clu
s
ter
s
,
it
was
p
o
s
s
ib
le
to
ex
ten
d
th
e
ca
p
ac
it
y
o
f
th
e
s
y
s
tem
th
at
was
r
eq
u
ir
ed
f
o
r
m
an
ag
i
n
g
ad
d
itio
n
al
f
lo
ws
o
f
in
f
o
r
m
atio
n
.
Oth
er
m
eth
o
d
s
o
f
d
ata
s
to
r
ag
e,
n
am
el
y
o
f
f
-
c
h
ain
s
to
r
ag
e,
m
ad
e
it
p
o
s
s
ib
le
to
wo
r
k
ef
f
ec
tiv
ely
,
with
o
u
t
t
h
r
ea
ten
i
n
g
th
e
s
y
s
tem
’
s
r
eliab
ilit
y
a
n
d
f
u
r
th
er
ex
p
a
n
s
io
n
wh
en
m
o
r
e
p
ati
en
ts
a
n
d
d
ata
r
elate
d
to
th
eir
h
ea
lth
s
tatu
s
wo
u
ld
b
e
in
v
o
l
v
ed
.
5
.
5
.
Rea
l
-
t
im
e
m
o
nito
ring
a
nd
da
t
a
m
a
na
g
e
m
ent
Sin
ce
th
r
o
u
g
h
I
o
T
p
r
o
d
u
cts,
i
t
is
p
o
s
s
ib
le
to
m
o
n
ito
r
p
atie
n
ts
co
n
s
tan
tly
an
d
im
p
r
o
v
e
c
o
n
tr
o
l
o
v
er
th
eir
h
ea
lth
s
tate,
tim
ely
ac
tio
n
s
ca
n
b
e
ta
k
en
to
p
r
ev
e
n
t ser
io
u
s
is
s
u
es.
Au
to
m
ated
r
ea
l
-
tim
e
d
ata
an
aly
s
is
an
d
r
ea
l
-
tim
e
aler
tin
g
m
ec
h
an
is
m
s
b
y
s
m
ar
t
co
n
tr
ac
ts
g
r
ea
tly
im
p
r
o
v
e
d
th
e
v
alu
e
o
f
p
atien
t
ca
r
e
b
y
p
r
o
v
id
in
g
im
m
ed
iate
ac
tio
n
s
o
n
ad
v
e
r
s
e
h
ea
lth
s
tatu
s
.
T
h
e
in
c
o
r
p
o
r
atio
n
o
f
clo
u
d
co
m
p
u
tin
g
w
as
m
o
r
e
d
y
n
am
ic
s
to
r
in
g
an
d
p
r
o
ce
s
s
in
g
d
em
an
d
s
f
r
o
m
th
e
n
u
m
b
er
s
o
f
d
ata
s
ets as g
en
er
ated
b
y
I
o
T
d
ev
ices.
5.
6
.
E
f
f
iciency
i
m
pro
v
em
ent
s
T
h
is
h
as
en
s
u
r
ed
th
at
th
r
o
u
g
h
d
y
n
a
m
ic
p
r
o
x
y
n
o
d
e
s
elec
tio
n
,
th
er
e
is
a
lo
w
laten
cy
in
th
e
tr
an
s
m
is
s
io
n
o
f
d
ata
b
etwe
en
a
d
e
v
ice
with
in
th
e
in
ter
n
et
o
f
th
in
g
s
an
d
th
e
b
l
o
ck
ch
ain
.
Su
ch
d
y
n
am
i
c
s
elec
tio
n
m
ad
e
th
r
o
u
g
h
s
m
ar
t
co
n
tr
ac
ts
also
h
elp
ed
in
ac
h
ie
v
in
g
a
p
r
o
p
e
r
lo
a
d
d
is
tr
ib
u
tio
n
wh
er
e
th
er
e
wer
e
no
b
o
ttlen
ec
k
s
.
Als
o
,
th
e
au
to
m
ated
ac
ce
s
s
co
n
tr
o
l c
r
ea
ted
a
m
o
r
e
ef
f
icien
t
m
ea
n
s
o
f
s
h
ar
i
n
g
d
ata
as it d
id
n
o
t
h
in
d
er
f
u
n
ctio
n
ality
,
an
d
ea
s
e
an
d
cu
t
d
o
wn
o
n
tim
e
an
d
u
n
n
ec
ess
ar
y
p
ap
er
wo
r
k
.
6.
CO
NCLU
SI
O
N
I
n
co
n
cl
u
s
io
n
,
th
is
r
esear
ch
s
h
o
wed
th
at
th
e
i
n
teg
r
atio
n
o
f
I
o
T
with
b
lo
ck
c
h
ain
an
d
clo
u
d
c
o
m
p
u
tin
g
in
d
ec
en
tr
alize
d
h
ea
lth
ca
r
e
s
y
s
tem
s
s
ig
n
if
ican
tly
im
p
r
o
v
e
d
h
o
w
h
ea
lth
ca
r
e
c
h
allen
g
es
co
u
ld
b
e
ad
d
r
ess
ed
.
T
h
is
f
r
am
ewo
r
k
g
r
ea
tly
im
p
r
o
v
es
th
e
p
r
iv
ac
y
,
s
ec
u
r
ity
ef
f
ici
en
cy
,
a
n
d
s
ca
lab
ilit
y
o
f
th
e
s
y
s
tem
b
y
u
s
in
g
I
o
T
f
o
r
r
ea
l
-
tim
e
m
o
n
ito
r
in
g
o
f
p
atien
ts
,
b
lo
ck
ch
ain
f
o
r
s
ec
u
r
e
im
m
u
tab
le
d
ata
s
to
r
a
g
e,
a
n
d
clo
u
d
c
o
m
p
u
tin
g
t
o
o
b
tain
s
ca
lab
le
s
to
r
ag
e
o
r
p
r
o
ce
s
s
in
g
.
Sm
ar
t
c
o
n
tr
ac
ts
wi
ll
en
s
u
r
e
t
h
at
h
ea
lth
ca
r
e
w
o
r
k
f
lo
ws
ar
e
m
o
s
tly
au
to
m
ated
,
a
n
d
less
m
an
u
al
i
n
ter
ac
tio
n
is
r
eq
u
ir
e
d
wh
ich
ca
n
im
p
r
o
v
e
th
e
p
r
ec
is
en
ess
an
d
s
p
ee
d
o
f
ca
r
e.
T
h
is
s
y
s
tem
m
ak
es
s
u
r
e
th
at
p
atien
t
d
ata
is
s
ec
u
r
e
an
d
o
n
ly
av
ai
lab
le
to
th
o
s
e
au
th
o
r
ized
wh
ile
allo
win
g
d
o
cto
r
s
an
d
p
atien
ts
to
in
ter
ac
t
m
o
r
e
ef
f
icien
t
ly
.
T
h
is
en
ab
les
b
et
ter
-
p
ac
ed
r
esp
o
n
s
e
f
r
o
m
a
s
ec
u
r
e,
u
r
g
en
t,
a
n
d
p
atien
t
-
ce
n
ter
ed
a
r
ch
itectu
r
e
u
p
o
n
wh
ic
h
f
u
tu
r
e
ap
p
licatio
n
s
s
u
ch
as
AI
-
d
r
iv
en
p
r
ed
icti
v
e
ca
r
e
f
o
r
g
lo
b
al
h
ea
lth
m
o
n
ito
r
in
g
,
a
n
d
cr
o
s
s
-
b
o
r
d
er
h
ea
lth
ca
r
e
co
llab
o
r
atio
n
ca
n
b
e
b
u
ilt.
I
n
s
u
m
,
t
h
is
d
ec
en
tr
alize
d
p
ar
ad
i
g
m
h
as
o
p
en
ed
th
e
f
lo
o
d
g
ates
b
y
r
ev
o
lu
tio
n
izin
g
g
lo
b
al
h
ea
lth
ca
r
e
d
eliv
er
y
in
a
wa
y
th
at
tr
an
s
lates
to
b
etter
p
atien
t o
u
tco
m
es wo
r
ld
wid
e.
RE
F
E
R
E
NC
E
S
[
1
]
P
.
P
a
n
d
e
y
a
n
d
R
.
Li
t
o
r
i
y
a
,
“
S
e
c
u
r
i
n
g
e
-
h
e
a
l
t
h
n
e
t
w
o
r
k
s
f
r
o
m
c
o
u
n
t
e
r
f
e
i
t
me
d
i
c
i
n
e
p
e
n
e
t
r
a
t
i
o
n
u
si
n
g
b
l
o
c
k
c
h
a
i
n
,”
Wi
r
e
l
e
ss
Pe
rso
n
a
l
C
o
m
m
u
n
i
c
a
t
i
o
n
s
,
v
o
l
.
1
1
7
,
n
o
.
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,
p
p
.
7
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o
i
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s
1
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7
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1
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7.
[
2
]
J.
G
r
o
v
e
r
,
“
S
e
c
u
r
i
t
y
o
f
v
e
h
i
c
u
l
a
r
A
d
H
o
c
n
e
t
w
o
r
k
s
u
s
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n
g
b
l
o
c
k
c
h
a
i
n
:
A
c
o
mp
r
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h
e
n
si
v
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v
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w
,
”
V
e
h
i
c
u
l
a
r
C
o
m
m
u
n
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c
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t
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o
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s
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v
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.
3
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v
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.
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0
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1
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8
.
[
3
]
M
.
Ji
a
n
g
a
n
d
X
.
Q
i
n
,
“
D
i
s
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i
b
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p
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li
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ACM,
IS
TE
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IEE
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M
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m
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a
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d
IEI
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c
a
n
b
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c
o
n
tac
ted
a
t
e
m
a
il
:
k
h
e
k
a
re
.
1
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3
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g
m
a
il
.
c
o
m
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
5
0
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7
52
In
d
o
n
esian
J
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n
g
&
C
o
m
p
Sci
,
Vo
l.
3
7
,
No
.
2
,
Feb
r
u
a
r
y
20
2
5
:
9
2
8
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3
6
936
Th
a
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Athi
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c
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c
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n
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c
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tac
ted
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il
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wt
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.
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c
a
n
b
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c
o
n
tac
ted
a
t
e
m
a
il
:
h
iri
t
ish
@g
m
a
il
.
c
o
m
.
Evaluation Warning : The document was created with Spire.PDF for Python.