Creating and utilizing digital identities are fundamental steps towards accessing online services. In order to facilitate the management of user identities, the concept of identity management has been introduced. Various systems and protocols have been developed to manage online identities. However, these systems are provider-centric, focusing on aiding providers in managing their user bases. As a result, users often have limited control over their identity data and remain unaware of how centralized identity providers use or potentially misuse their data. Self-Sovereign Identity (SSI) has emerged as a new paradigm in the digital identity management landscape, aiming to empower users by allowing them greater control over their identity data. Although SSI is a relatively new domain, there have been numerous efforts, primarily from the industry, to introduce SSI standards, protocols, and systems, with multiple options in each category. Researchers eager to contribute to the SSI domain might find it challenging to understand the interconnections among these components. Notably, the SSI domain faces several challenges, as highlighted in various research works. These challenges must be addressed before SSI can achieve widespread adoption. This article presents a comprehensive systematic literature review of SSI, offers a detailed taxonomy, and identifies and analyzes the open challenges in SSI.

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: 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.

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.