Abstract
Data providers holding sensitive medical data often need to exchange data pertaining to patients for whom they hold particular data. This involves requesting information from other providers to augment the data they hold. However, revealing the superset of identifiers for which a provider requires information can, in itself, leak sensitive private data. Data linkage services exist to facilitate the exchange of anonymized identifiers between data providers. Reliance on third parties to provide these services still raises issues around the trust, privacy and security of such implementations. The rise and use of blockchain and distributed ledger technologies over the last decade has, alongside innovation and disruption in the financial sphere, also brought to the fore and refined the use of associated privacy-preserving cryptographic protocols and techniques. These techniques are now being adopted and used in fields removed from the original financial use cases. In this paper we present a combination of a blockchain-native auditing and trust-enabling environment alongside a query exchange protocol. This allows the exchange of sets of patient identifiers between data providers in such a way that only identifiers lying in the intersection of sets of identifiers are revealed and shared, allowing further secure and privacy-preserving exchange of medical information to be carried out between the two parties. We present the design and implementation of a system demonstrating the effectiveness of these exchange protocols giving a reference architecture for the implementation of such a system.
Highlights
The increasing prevalence of electronic health record (EHR) data and its use for both administrative and research purposes has generated the ability for data consumers to derive novel and unexpected results from an increased breadth of available data
We found that utilizing the core features and underlying principals of blockchain technology would meet this key requirement
We have presented a reference architecture for a data linkage model that replaces the need for a centralized trusted third party with a blockchain mediated trust-less system
Summary
The increasing prevalence of electronic health record (EHR) data and its use for both administrative and research purposes has generated the ability for data consumers to derive novel and unexpected results from an increased breadth of available data. Through linking data sets in such a way data consumers, that is the data scientists or administrative analysts, can access richer sources of data and derive otherwise inaccessible results. Data linkage systems often rely on a trusted third party to link data to mitigate against the privacy risks inherent in linking data between individually sensitive sources. These trusted third parties act as a firewall between individual data sources and act to preserve the privacy of the records being linked and to provide guarantees regarding data integrity
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