Abstract
BackgroundHealth care professionals are required to maintain accurate health records of patients. Furthermore, these records should be shared across different health care organizations for professionals to have a complete review of medical history and avoid missing important information. Nowadays, health care providers use electronic health records (EHRs) as a key to the implementation of these goals and delivery of quality care. However, there are technical and legal hurdles that prevent the adoption of these systems, such as concerns about performance and privacy issues.ObjectiveThis study aimed to build and evaluate an experimental blockchain for EHRs, named HealthChain, which overcomes the disadvantages of traditional EHR systems.MethodsHealthChain is built based on consortium blockchain technology. Specifically, three organizations, namely hospitals, insurance providers, and governmental agencies, form a consortium that operates under a governance model, which enforces the business logic agreed by all participants. Every peer node hosts an instance of the distributed ledger consisting of EHRs and an instance of chaincode regulating the permissions of participants. Designated orderers establish consensus on the order of EHRs and then disseminate blocks to peers.ResultsHealthChain achieves functional and nonfunctional requirements. It can store EHRs in a distributed ledger and share them among different participants. Moreover, it demonstrates superior features, such as privacy preservation, security, and high throughput. These are the main reasons why HealthChain is proposed.ConclusionsConsortium blockchain technology can help to build new EHR systems and solve the problems that prevent the adoption of traditional systems.
Highlights
It has long been believed that electronic health records (EHRs) should be maintained across time and space, and could be accessed at any time and any place within the law [1]
Every peer node hosts an instance of the distributed ledger consisting of EHRs and an instance of chaincode regulating the permissions of participants
The prototype of HealthChain is implemented with Hyperledger Fabric v1.4.1, an enterprise-grade permissioned distributed ledger platform [16]
Summary
It has long been believed that electronic health records (EHRs) should be maintained across time and space, and could be accessed at any time and any place within the law [1]. In the first stage of digitization, we store a patient’s medical history within the jurisdiction of a health care provider irrespective whether electronic medical records (EMRs) are on a local server [2] or in the cloud [3]. Such EMR systems have no essential difference with old-fashioned paper-based ones, since information technology just takes the management of medical records from paper folders to hard drives. There are technical and legal hurdles that prevent the adoption of these systems, such as concerns about performance and privacy issues
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