Table 2.

Limitations of health data management systems.

Health data management system	Limitation
Paper charts	Illegible handwriting resulting in incorrect treatments [33] and deaths [34,35]. Requires physical storage and are susceptible to unplanned destruction such as flood, fire, rodents, and degradation. Physically cumbersome to read, understand, and search for specific information. The cost and time required for paper charts to be requested for duplication and then delivered are unacceptably high.
Computer-based	Medical records are managed by the physicians and cannot be accessed by the patients. Physicians visiting a patient have to note down or memorize the patient’s medical data to return to the hospital and record it digitally, which may lead to error.
Client-server-based	A patient has no traceability on how his or her data are used. The issues of security, privacy, and single point of failure. In addition, a cohesive view of a patient’s medical data from multiple hospitals is difficult. Requires repeating medical tests at times, which results in more time, cost, and effect on health conditions.
Cloud-based	Single point of failure, loss of data control and stewardship, a requirement of steady internet connection, and data reliability [36,37].
IoTa-based	Data security and patient privacy are a major concern.
Big-data–based	The process of data aggregation from different storage sites is time consuming, complex, and expensive. The data are stored using different formats and requires preprocessing. In addition, preserving the security of the data and privacy of the patient identity while maintaining the usefulness of data for analysis and studies is quite challenging.
Blockchain-based	The process of ledger update on multiple nodes is energy consuming [38] and suffers from the issue of low throughput [39].

^aIoT: Internet of Things.