Abstract
Electronic health records (EHRs) are important assets of the healthcare system and should be shared among medical practitioners to improve the accuracy and efficiency of diagnosis. Blockchain technology has been investigated and adopted in healthcare as a solution for EHR sharing while preserving privacy and security. Blockchain can revolutionize the healthcare system by providing a decentralized, distributed, immutable, and secure architecture. However, scalability has always been a bottleneck in blockchain networks due to the consensus mechanism and ledger replication to all network participants. Sharding helps address this issue by artificially partitioning the network into small groups termed shards and processing transactions parallelly while running consensus within each shard with a subset of blockchain nodes. Although this technique helps resolve issues related to scalability, cross-shard communication overhead can degrade network performance. This study proposes a transaction-based sharding technique wherein shards are formed on the basis of a patient’s previously visited health entities. Simulation results show that the proposed technique outperforms standard-based healthcare blockchain techniques in terms of the number of appointments processed, consensus latency, and throughput. The proposed technique eliminates cross-shard communication by forming complete shards based on “the need to participate” nodes per patient.
Highlights
Technology has revolutionized and improved healthcare systems in the last few years.Sharing electronic health records (EHRs) is a key aspect of the healthcare ecosystem, which drives the interoperability of patients’ data across multiple entities in healthcare for better treatment and diagnosis
When patients visit other healthcare providers, they are unable to provide a detailed record of their medical history as it is stored in a private database
To summarize the obtained results from the various simulated scenarios, we examine the impact of our proposed sharding technique on the performance of a healthcare blockchain and compared the results against the unsharded model
Summary
Technology has revolutionized and improved healthcare systems in the last few years. Sharing electronic health records (EHRs) is a key aspect of the healthcare ecosystem, which drives the interoperability of patients’ data across multiple entities in healthcare for better treatment and diagnosis. Blockchain can distinctively transform the healthcare ecosystem in a smart and safe manner by allowing a secure, private, and decentralized network among peers to collaborate without a third party through consensus. It is founded on a shared, distributed, and immutable digital ledger of transactions, which appends blocks to the ledger in chronological order once the transactions within the block are verified by most network participants. The proposed transaction-based sharding for healthcare blockchain eliminates cross-shard communication by forming complete shards for each patient appointment or request for a service to be provided by a participating entity
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