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Real-time tracking and surveillance of patients' health has become ubiquitous in the healthcare sector as a result of the development of fog, cloud computing, and Internet of Things (IoT) technologies. Medical IoT (MIoT) equipment often transfers health data to a pharmaceutical data center, where it is saved, evaluated, and made available to relevant stakeholders or users. Fog layers have been utilized to increase the scalability and flexibility of IoT-based healthcare services, by providing quick response times and low latency. Our proposed solution focuses on an electronic healthcare system that manages both critical and non-critical patients simultaneously. Fog layer is distributed into two halves: critical fog cluster and non-critical fog cluster. Critical patients are handled at critical fog clusters for quick response, while non-critical patients are handled using blockchain technology at non-critical fog cluster, which protects the privacy of patient health records. The suggested solution requires little modification to the current IoT ecosystem while decrease the response time for critical messages and offloading the cloud infrastructure. Reduced storage requirements for cloud data centers benefit users in addition to saving money on construction and operating expenses. In addition, we examined the proposed work for recall, accuracy, precision, and F-score. The results show that the suggested approach is successful in protecting privacy while retaining standard network settings. Moreover, suggested system and benchmark are evaluated in terms of system response time, drop rate, throughput, fog, and cloud utilization. Evaluated results clearly indicate the performance of proposed system is better than benchmark.

IoT-fog-based healthcare 4.0 system using blockchain technology