Description:FIELD OF INVENTION
The field of invention involves designing a Healthcare Support Management System utilizing IoT-based blockchain technology. This system integrates IoT devices for real-time health monitoring and blockchain for secure, immutable data storage and sharing, enhancing patient care, data integrity, and interoperability among healthcare providers, while ensuring privacy and security of sensitive health information.
BACKGROUND OF INVENTION
The design of a Healthcare Support Management System using an IoT-based blockchain platform emerges from the growing need for efficient, secure, and real-time health monitoring and data management. Traditional healthcare systems often face challenges such as data breaches, lack of interoperability, and delayed patient care due to fragmented and insecure data storage methods. With the advent of IoT technology, real-time health monitoring through wearable devices and sensors has become possible, providing continuous tracking of vital parameters like heart rate, blood pressure, and glucose levels. However, the sheer volume of data generated by IoT devices necessitates a secure and reliable method of storage and sharing. Blockchain technology offers a solution by providing a decentralized, immutable ledger that ensures the integrity, security, and privacy of health data. By integrating IoT with blockchain, this healthcare support management system can facilitate seamless data sharing among healthcare providers, enhance patient care through timely interventions, and maintain stringent data security protocols. This combination also addresses issues of data interoperability, allowing for a unified view of patient health records across different healthcare systems. Furthermore, the system supports patient-centric care models by giving patients control over their health data, fostering trust and transparency in healthcare services. This innovative approach aims to revolutionize healthcare delivery by leveraging cutting-edge technologies to meet contemporary healthcare needs.
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SUMMARY
The invention involves designing a Healthcare Support Management System that integrates IoT-based health monitoring devices with blockchain technology to create a secure, efficient, and real-time health data management platform. The system leverages IoT devices to continuously monitor patients' vital signs, such as heart rate, blood pressure, and glucose levels, and transmits this data to a blockchain network. The blockchain ensures the data's security, integrity, and immutability, providing a decentralized ledger that healthcare providers can access in real time. This integration facilitates seamless data sharing among medical professionals, enhances patient care through timely interventions, and maintains stringent data privacy standards. Patients retain control over their health information, promoting transparency and trust in the healthcare system. The system also supports interoperability across different healthcare providers, offering a unified view of patient health records. This innovative approach aims to revolutionize healthcare delivery by combining real-time health monitoring with the security and reliability of blockchain technology, addressing the challenges of data breaches, fragmented records, and delayed care in traditional healthcare systems.
DETAILED DESCRIPTION OF INVENTION
Blockchain technology is recognized as a transformative advancement poised to revolutionize human activities and relationships. Its potential has captured the interest of academics, developers, and practitioners, leading to the creation of numerous platforms, systems, and prototypes. Notable platforms include Bitcoin, Ethereum, and Hyperledger, each significantly influencing blockchain applications. Bitcoin introduced blockchain as the foundation for cryptocurrencies. Ethereum redefined blockchain usage through smart contracts, leading to various applications such as crowdfunding and smart property. This evolution extended blockchain's application across industries, healthcare, and supply chains, known as blockchain 3.0. These advancements are driven by progress in computer science and economics, encompassing peer-to-peer networks, asymmetric cryptography, consensus protocols, decentralized storage, decentralized computing, smart contracts, and incentive systems. This review explores blockchain's application in healthcare and its integration with IoT, focusing on smart cities and drug supply chains. The integration of blockchain with IoT varies based on its role in the system, its involvement in data exchanges, and its emphasis on service provision. The integration mechanisms discussed are broadly classified based on existing literature. Blockchain provides significant security benefits for healthcare and IoT, protecting data, systems, and networks. Effective data management in both sectors involves acquisition, processing, dissemination, retrieval, security, and storage. Challenges include the lack of unique patient identities, messaging interoperability, and data encoding standards in healthcare, and the complexity of managing heterogeneous data in IoT. Blockchain-based systems are proposed as solutions. Smart cities and drug supply chain management face technical and economic challenges, such as big data management and financial losses from counterfeiting. Figure 1 illustrates the issues and solutions before blockchain's advent.

Figure 1: Challenges and Solutions in Smart City and Drug Supply Chain Management.
Recently, blockchain has been applied alone or in combination with existing solutions in both smart city initiatives and the drug supply chain to address various issues. Its use is driven by blockchain's qualitative characteristics, such as reliability, robustness, and fault tolerance. However, designing blockchain-based systems for healthcare and IoT domains presents several challenges, including ensuring confidentiality, increasing throughput and scalability, limited storage capacity, and the lack of regulatory guidance. Despite these challenges, various systems and prototypes are being developed in healthcare and IoT. This review highlights the benefits blockchain brings to these domains and explores its application in diverse contexts. The review is organized as follows: After this introduction, background information on blockchain technology, the Internet of Things, and Health Information Technology (HIT) is provided. Next, the methodology used to prepare this review is described. This is followed by the presentation of the review's results, including a comprehensive summary of the findings. The succeeding sections discuss the review's findings, open issues, conclusions, and limitations.
Although blockchain is a relatively recent area of study, numerous literature reviews have been conducted on the topic overall and on specific application areas. Furthermore, research has delved into specific issues within particular application domains.
Despite the wealth of existing reviews, several key issues remain unaddressed. These reviews tend to avoid acknowledging the shortcomings of research efforts, leading to what refers to as a "construct identity fallacy." This can hinder knowledge development, as it results in accumulating knowledge rather than actively building upon it.
Furthermore, these reviews often fail to highlight emerging patterns in the development of artifacts within specific application domains, neglect to evaluate the relative performance of prototypes or systems across different areas, and overlook opportunities to extend solutions from one application domain to another. This phenomenon, termed "exaptation" by and labeled "knowledge brokering" by, involves using analogical reasoning to transfer knowledge from familiar to unfamiliar domains.
Additionally, existing reviews do not comprehensively cover the integration of blockchain and IoT, nor do they thoroughly address data management activities, particularly regarding data security, access control, and privacy preservation. While some publications touch on these topics to some extent, they do not delve deeply into blockchain-based IoT security solutions or adequately cover data integrity concerns.
Therefore, conducting a thorough review is crucial to addressing these gaps and achieving several objectives:
1. Describing evolving trends in artifact development.
2. Explaining how blockchain is utilized for data management, including security, access control, and privacy.
3. Illustrating methods for integrating blockchain and IoT.
4. Providing a basis for future research in selected application areas.
This review makes notable contributions to the existing literature by addressing specific gaps, such as the lack of comprehensive reviews on access control and data integrity in blockchain-based systems, as well as the scarcity of thorough reviews on blockchain-IoT integration. Additionally, it enhances understanding of privacy-preserving techniques in blockchain systems. The following key contributions can be highlighted:
1. Emphasizing the primary focus of blockchain research on data management, this review extensively covers major data management activities and the techniques employed to enhance them.
2. Highlighting the criticality of data security in data management, the review categorizes existing literature into three main subjects: data integrity, access control, and privacy preservation, presenting a taxonomy of methods used in these areas.
3. Identifying smart city and drug supply chain management as prominently featured areas in IoT and healthcare, respectively, the review addresses these topics as special issues.
4. Exploring various factors influencing the design of blockchain-based systems throughout the review, specific attention is given to detailing these influential factors.
Exploring Blockchain and Peer-to-Peer Networks
The definition of blockchain technology lacks consensus among scholars, leading to varied interpretations. Some view blockchain as a distributed digital ledger, while others see it as a data structure or transaction management technology. These differing perspectives stem from authors' viewpoints and the ongoing evolution of blockchain, making it a dynamic and evolving concept.
Blockchain technology has transitioned from its early stages (blockchain 1.0) to more advanced iterations (blockchain 3.0). This evolution is built upon foundational aspects outlined in references such as, where key concepts like peer-to-peer networks, distributed ledgers, consensus mechanisms, smart contracts, and application domains are identified as fundamental.
Peer-to-peer (P2P) networks form the backbone of blockchain technology. These networks come in various topologies, communication patterns, and node types. The primary network topologies include centralized, decentralized structured, and decentralized unstructured systems.
In centralized P2P networks, a central directory server manages network resources and addresses. In contrast, decentralized structured networks rely on selected nodes maintaining a Distributed Hash Table (DHT) to store resource information. Decentralized unstructured networks have no central server or data placement rules, allowing nodes to join and leave freely.
P2P network topologies influence node communication. Centralized networks enable direct interactions based on directory server information. Decentralized structured networks use keys and values in DHT to access data, while decentralized unstructured networks employ techniques like flooding and random walks for communication.
P2P networks can be homogeneous or heterogeneous, based on the similarity or variation in node capabilities. Blockchain inherits P2P characteristics, including permission requirements for centralized networks and open entry for decentralized systems.
Blockchain systems are classified based on permission (permissioned or permissionless) and governance (public or private). Permissioned blockchains require authorization, while permissionless blockchains allow free participation. Governance models further categorize blockchains into public and private variants.

Exploring Consensus Mechanisms
Consensus mechanisms are pivotal in blockchain to ensure agreement among nodes regarding block validity. These methods vary from purely computational, like proof of work, to communication-based protocols such as Practical Byzantine Fault Tolerance (PBFT). Between these extremes lie diverse mechanisms like Proof of Stake (PoS), Threshold Relay, and Proof of Burn, each offering unique benefits and trade-offs. Additionally, there are advanced variants of these popular mechanisms discussed in reputable reviews for further insights.

Smart Contracts: Automating Transactions
Smart contracts are autonomous procedures triggered by transaction execution on a blockchain. While all blockchain systems support smart contracts, they differ in supported languages and execution environments. Common smart contract languages include Solidity, Golang, Serpent, Java, Python, and LLL, with execution environments like the Ethereum Virtual Machine (EVM), Java Virtual Machine (JVM), Docker Image, and Haskell environment providing versatile execution platforms.
Application Areas and Blockchain Utilization
Blockchain's evolution is evident in its expanding application areas and diverse use cases. Specific sectors like healthcare, financial systems, and digital rights management often require either a centralized peer-to-peer network or a permissioned private blockchain. Centralized networks use a single ledger on a central server, while decentralized structured topologies, recommended for banking applications, employ Distributed Hash Tables (DHTs) to manage data references accessible through blockchain. Decentralized unstructured topologies are prevalent in cryptocurrency and certain IoT scenarios, employing clustering techniques and communication methods like gossiping for efficient data distribution among nodes.
These variations underscore the adaptability of blockchain to different sectors, emphasizing the need to select appropriate consensus mechanisms, smart contract languages, and network topologies based on specific application requirements.

Figure 2: Key Elements of a Blockchain
"Internet of Things (IoT) Security Challenges and Architectural Variability"
In the context of IoT security challenges and architectural variability, it's widely recognized that IoT devices face fundamental constraints such as limited memory space, processing power, and battery life. These devices are often dispersed across various geographical locations and are relatively new in the technology landscape. Consequently, they are susceptible to security threats, necessitating robust security measures. Communication among IoT devices is typically based on ad hoc IP protocols such as Near Field Communication (NFC), Bluetooth, IEEE 802.15.4, Wi-Fi, ZigBee, and 6LoWPAN. However, these communication channels can expose information systems to risks like intrusion and data tampering.
Moreover, the absence of a standardized layering scheme for IoT leads to architectural variations. While some publications describe IoT devices as comprising three layers (application, network, and perception layers), others introduce additional layers such as business, service management, or middleware layers. This diversity in layering adds complexity and security challenges to IoT systems, hindering secure communication and integration.
Unlike traditional devices with dominant operating systems, IoT lacks a unified operating system, making interoperability a significant challenge. Additionally, the absence of specific data formats complicates data integration between IoT devices. Middleware solutions have been proposed to address integration challenges but come with inherent security risks.
Considering the healthcare domain, Health Information Technology (HIT) encompasses various systems like Electronic Health Records (EHR), Computerized Provider Order Entry (CPOE), and Electronic Medical Records (EMR). The emergence of Health IoT (HIoT) within HIT introduces new capabilities through wearable and implantable sensors, enabling real-time patient monitoring and disease modeling. However, integration challenges persist due to fragmented utilization of HIT systems, leading to duplicate information and integration complexities.
Efforts to integrate HIT systems face technological and non-technical challenges, including workflow design issues, security complexities, and data encoding standards. Stakeholders in healthcare, including providers, patients, insurers, and technology vendors, have varying interests that must be addressed for effective HIT integration.
Blockchain technology is increasingly seen as a potential solution to address these challenges by providing secure and interoperable data exchange, managing access rules, enhancing data liquidity, and ensuring unique patient identities. This integration of blockchain with IoT and HIT domains offers promising avenues for improving system security, data integrity, and interoperability.

Figure 3: Review Process Workflow
Exploring Integration Strategies for Blockchain and IoT:
A Comparative Analysis of Architectural Approaches:
Considering the nascent stage of blockchain applications within the Internet of Things (IoT), most initiatives have yet to progress beyond proof-of-concept or technology readiness levels (TRL). Nevertheless, within the spectrum of blockchain 3.0 applications, IoT integration stands out as the most prominent domain. Articles in this sphere delve into a wide array of topics, encompassing the integration mechanics of blockchain with IoT, strategies for managing IoT data, enhancing IoT security, and addressing challenges related to smart cities.
Another transformative domain for blockchain is healthcare, where its primary utility lies in data management. In the context of IoT, discussions often revolve around elucidating the significant benefits of incorporating blockchain, especially in bolstering IoT data security. Moreover, several scholarly works highlight successful instances of blockchain integration with IoT, alongside exploring its implications in smart city initiatives.
Conversely, certain authors delve into the potential advantages of blockchain in healthcare. These benefits span from establishing a dependable, secure, and immutable data provenance system to enhancing drug supply chains, facilitating medical research and clinical trials, streamlining payment systems, and securely managing medical records. However, despite these advantages, the adoption of blockchain in healthcare presents challenges such as ensuring confidentiality, scaling blockchain systems, managing security concerns, addressing limited storage capacities for large data like images, and optimizing cost-effectiveness.
Evaluating Blockchain-IoT Integration Strategies
Authors navigating the integration of blockchain with IoT strive to leverage the synergies between these technologies to maximize their combined benefits. This strategic decision-making hinges on several factors, including the targeted application domain, requisite latency and throughput, regulatory landscape, and the manageability of blockchain participants.
Within this framework, two notable studies categorize blockchain-IoT integration methods into three distinct models. One study categorizes integration solutions based on the volume of data traversing the blockchain during IoT device interactions. In contrast, another study compares blockchain with cloud services for provisioning. These approaches are not mutually exclusive; instead, they complement each other. For instance, while emphasizes the direct relationship between blockchain and IoT devices, broadens this association to encompass cloud services.
In the first integration model, blockchain primarily serves as a storage medium for certain IoT data or metadata, termed as off-chain usage. Extending this model to the cloud, blockchain plays a supportive role rather than being the primary service provider, termed as Cloud over Blockchain (CoB). The second model involves significant blockchain involvement, where all data from IoT interactions flows through blockchain, establishing it as the central service channel, while availing analytical and virtualization services from the cloud, termed as Blockchain over Cloud (BoC). The third model facilitates simultaneous data exchanges between blockchain and IoT devices, allowing for direct utilization of both technologies' strengths, termed as Mixed Blockchain-Cloud (MBC). This model offers a balanced perspective regarding the dominance of cloud versus blockchain services.
Enhancing Data Management Through Blockchain: A Comprehensive Analysis
The realm of security within the Internet of Things (IoT) has garnered substantial attention in literature, especially concerning data security. Blockchain technology, however, offers a myriad of solutions beyond data security. This section explores the advantages of leveraging blockchain to address a wide array of security concerns, with a subsequent focus on data management and its intricacies.
In, the discourse revolves around the security challenges inherent in IoT and how blockchain technology can effectively surmount these challenges. Similarly, presents a literature review on the application of blockchain for security purposes, particularly emphasizing IoT security. Several other studies, including, underscore the potential security enhancements facilitated by blockchain technology in the realm of IoT security. The resultant benefits in this domain include:
• The immutability of transactions on the blockchain facilitates the registration, tracing, and management of the Identity of Things (IDoT) throughout their lifecycle.
• Leveraging cryptography and distributed ledger technology endows IoT devices with fault tolerance.
• Smart contracts play a pivotal role in user authorization, maintaining software integrity, enhancing software synchronization, and ensuring privacy.
• Lightweight blockchain-based security protocols simplify the establishment of secure communication channels between IoT devices.
• The distributed nature of blockchain mitigates the risks associated with a single point of failure.
• Blockchain's expansive address space, surpassing that of IPv6, proves instrumental in evading collusion and providing Global Unique Identity (GUI) for IoT devices.
While these benefits are significant, much of the literature tends to focus on data security, a subset of data management that will be elaborated upon in the subsequent section.
Augmenting Data Management with Blockchain Technology
Data management encompasses a spectrum of operations including acquisition, processing, securing, dissemination, retrieval, and storage of data in a structured manner. These operations are influenced by various factors such as application requirements, system architecture, and intended usage. Numerous blockchain-based data management solutions have been proposed, tailored to the unique characteristics of healthcare and IoT applications.
The proliferation of IoT, including Healthcare IoT (HIoT), has led to an exponential increase in sensor deployments, necessitating sophisticated data management systems. These systems must contend with heterogeneous real-time data streams, ushering in the era of big data 3.0. Traditional data management approaches struggle with scalability, prompting the need for robust data management systems capable of handling vast data volumes.
Furthermore, traditional client/server-based data management systems are prone to single points of failure, inadequately addressing evolving service requirements. In contrast, blockchain-based systems offer encrypted data storage mechanisms, ensuring data security and integrity. Moreover, blockchain's decentralized nature and tamper-proof features make it a compelling choice for data management across various domains.

Streamlining Data Acquisition
Blockchain technology streamlines data acquisition by securely assigning unique identifiers to things, entities, and users during the authentication process. This ensures data is sourced from legitimate and authenticated entities. Various authentication designs and methodologies are employed, ranging from private key assignments to pseudonymous naming capabilities offered by blockchain.
Optimizing Data Processing
Smart contracts have become integral to blockchain systems, autonomously processing data. Architectural solutions vary, from node assignments based on processing capabilities to the integration of fog and edge computing with blockchain for data processing. These architectural choices impact system latency and consensus mechanisms.
Fortifying Data Security
Blockchain-based systems primarily focus on enhancing data integrity, access control, and privacy preservation. Strategies such as journaling, encryption, and checksumming are employed to ensure data integrity. Access control mechanisms and privacy-preserving techniques further bolster data security.
In summary, blockchain's attributes, including data ownership security, data assurance, resilience, credibility, decentralization, and tamper-proof features, make it a compelling choice for addressing data management challenges across various domains.
Enhancing Security Through Access Control Mechanisms
Access control, which involves managing resource rights, stands as a pivotal element in security frameworks. Literature delves into this aspect from various perspectives. For instance, employs the Objective, Model, Architecture, and Mechanism (OMAM) reference model to categorize access control mechanisms in IoT. This categorization encompasses models like Role-Based Access Control (RBAC), Attribute-Based Access Control (ABAC), Usage Control (UCON), and Capability-Based Access Control (CapBAC). In parallel, architectural frameworks such as Extensible Access Control Markup Language (XACML), Open Authorization (OAuth), and User Managed Access (UMA) are explored. These models and architectures align with objectives like ISO/IEC 27002/27,005 standards, employing mechanisms such as Access Control Lists (ACLs) to achieve security goals. Conversely, offers a review and classification of access control approaches, highlighting their diverse variants and implementations.
Enhancing Privacy Through Innovative Techniques
In addressing privacy concerns, the literature identifies two primary categories: data privacy and context privacy, as outlined. Data privacy encompasses challenges related to maintaining privacy during data aggregation and querying, while context privacy deals with preserving location and temporal privacy.
In contexts where blockchain plays a role within a system, conducted a literature survey and classified privacy-preserving techniques into four key categories. These include
(a) smart contract or key management derivation using secure multiparty computation (SMPC), (b) identity anonymization techniques such as mixing, ring signatures, and zero-knowledge proofs to secure user identities in transactions,
(c) transaction data anonymization methods like mixing, differential privacy, zero-knowledge proofs, and homomorphic hiding to protect transaction contents, and
(d) on-chain data protection utilizing encryption techniques like asymmetric encryption and attribute-based encryption to secure data stored on the blockchain.
Integration of Blockchain and IoT
Blockchain and IoT integration is a significant focus, particularly in sectors like healthcare. This integration is categorized into three main methods: IoT-IoT or CoB, IoT-blockchain or BoC, and hybrid integration. CoB involves using blockchain as metadata storage for actual files, often seen in healthcare applications dealing with radiology data due to bandwidth considerations. BoC heavily utilizes blockchain for data storage, while hybrid models combine edge or fog networks with blockchain, suitable for latency-sensitive systems with many sensors.
Data Management in IoT and Healthcare
Data management encompasses various tasks across the data lifecycle, including acquisition, processing, security, dissemination, retrieval, and storage. Blockchain plays a crucial role in ensuring data integrity, access control, and privacy preservation. For data acquisition, authentication methods like public keys and pseudonyms are common, with emerging techniques such as voice recognition. Data processing benefits from smart contracts and architecture designed for efficient processing. Security measures often involve encryption and third-party systems for unique identifiers and digital signatures. Access control and privacy preservation vary, with established blockchain platforms and encryption techniques being utilized for these purposes. Architecture also plays a role, with strategies like sidechains and hierarchical blockchains used to enhance privacy and security in data management.

Figure 4: Categorization of Key Data Security Approaches in Blockchain Systems
Exploration of the literature highlights several ongoing challenges that warrant further investigation. The publications indicate that integration methods and data management practices are influenced by various factors in the application domains. These factors encompass legal regulations specific to each domain, the intended functionalities of the systems, the scale of IoT device deployment, chosen architectural frameworks, the nature of the application domain, data sensitivity considerations, and the desired throughput and latency requirements. These complexities underscore the need for continued research and innovation to address these multifaceted issues effectively.

Figure 5: The correlations between the application domains and their influencing factors.
The examined studies provide implementations based on these influential criteria. While these works offer notable solutions, there remain some unaddressed concerns and inconsistencies across certain themes.
Firstly, these instantiations often aim to demonstrate the superiority of their prototypes over similar solutions, which they believe are relevant to solving specific problems. However, during this review, inconsistencies were noted between these works; what one publication considers a strength may be viewed as a flaw in another. Therefore, a comparative review focusing on the performance of these various instantiations would be beneficial.
Secondly, data processing, a critical data management operation, is facilitated by smart contracts in blockchain-based systems. However, the usage of smart contracts varies across these systems, potentially impacting system performance. Research examining the optimal number of smart contracts for system use could provide insights for future studies.
Thirdly, many articles lack clear guidance on data retrieval methods. Given the complexity of data retrieval in blockchain systems, which can occur on or off-chain, especially concerning encrypted image files in healthcare, further research in this area is necessary.
Fourthly, the disintegrated use of Health Information Technology (HIT) is attributed to factors like the absence of reliable methods for assigning unique IDs. Blockchain offers potential solutions to such problems, yet there is limited literature on integrating disparate healthcare systems using blockchain, despite its potential benefits.
Lastly, additional challenges such as leveraging blockchain for patient monitoring, triage, evaluating providers' operational and financial performance, and disease spread surveillance have received little attention in publications but warrant further investigation.

DETAILED DESCRIPTION OF DIAGRAM
Figure 1: Challenges and Solutions in Smart City and Drug Supply Chain Management.
Figure 2: Key Elements of a Blockchain
Figure 3: Review Process Workflow
Figure 4: Categorization of Key Data Security Approaches in Blockchain Systems
Figure 5: The correlations between the application domains and their influencing factors. , Claims:1. Design of Healthcare Support Management System Using the Iot Based Blockchain Platform claims that blockchain technology is utilized in optimizing data management activities and its integration with IoT systems.
2. It explores emerging trends in developing implementations and showcases the advantages of blockchain adoption in specific domains like smart cities and drug supply chains.
3. Blockchain has shown significant potential in enhancing various aspects of smart cities, including energy management, real-time data exchange, and traffic optimization.
4. In drug supply chains, blockchain aids in improving transparency, combating counterfeiting, and ensuring product authenticity.
5. Data security emerges as a primary focus, encompassing data integrity, access control, and privacy preservation, with blockchain offering solutions through encryption, third-party systems, architectural designs, hardware solutions, and smart contracts.
6. Authentication processes benefit from blockchain's capabilities, enabling decentralized and autonomous authentication procedures across different applications.
7. Blockchain's revival of smart contracts enhances data processing capabilities, allowing for autonomous data processing activities.
8. Dissemination mechanisms are well-defined in many instantiations, primarily using publish-subscribe, hierarchical structures, and trigger-based procedures.
9. However, data retrieval methods in blockchain-based systems remain understudied and require further exploration.
10. Data storage solutions in blockchain systems address legal concerns and diverse data management challenges, including file management strategies and compliance with legal standards.