In Healthcare 4.0, Remote patient monitoring (RPM) becomes a more powerful and flexible patient observation through wearable sensors at any time and anywhere. The most focused application area of RPM which allows doctors to get real-time information of their patient remotely with the help of wireless communication system. Thus, RPM reduces the time and cost of the patient. It also provides the quality care to the patient. To enhance the security and privacy of the patient data, in this paper, we have presented a Permissioned blockchain-based healthcare architecture. We have also discussed the challenges and their solutions. We have described the applications of blockchain. We also have given the usage of Machine learning with blockchain technology which can impact the healthcare industry.