 systems, scalability is defined by the number of transactions per second. Scalability is governed by the speed of consensus and the block size. Currently used consensus mechanisms require verification from more than one node. A limit is placed on the block size to speed up the exchange of transactions for verification. Even with a limit placed on the transaction, a consensus is considered slow compared to speeds required in Healthcare 4.0 applications. Waiting for con- sensus before propagating alerts and timely information destroys this information's purpose and may lead to failing in the QoS of the required task. Methods to increase transaction speed should be explored to benefit from the integration between blockchain and edge fully. Due to the limited transaction size, storing large files, such as electronic health records (EHR), is challenging on a blockchain. To secure these files off the blockchain, MedRec [12] uses a blockchain for permission management of the patient's medical history. A smart contract for each authorized person is present to record data entered by this person in the EHR database. A hash of the data is saved in the blockchain to allow database auditing. The problem with the MedRec approach is that the data is stored in a centralized location which puts the cloud in control of the data rather than the patient. To overcome centralization, authors in [29] used IPFS for storage while keeping the blockchain as a source for permission management. 7.5.3.2 Identity Management in a Mobile Scenario In remote control and autonomous applications, such as remote surgery and self- driving ambulances, verifying the source of control is important. A local blockchain connecting the access point and end devices can enhance the data source authenti- cation [30]. Local blockchains might be a good solution for static or low mobility devices, as surgery robots, that don't change their access points often. Mobile devices, 5G Wireless Communication System in Healthcare Informatics such as ambulances, need to e