Abstract
BackgroundData security issues still constitute the main reason for the sluggish dissemination of electronic health records (EHRs). Given that blockchain technology offers the possibility to verify transactions through a decentralized network, it may serve as a solution to secure health-related data. Therefore, we have identified stakeholder-specific requirements and propose a blockchain-based architecture for EHRs, while referring to the already existing scientific discussions on the potential of blockchain for use in EHRs.ObjectiveThis study aimed to introduce blockchain technology for EHRs, based on identifying stakeholders and systematically eliciting their requirements, and to discuss the key benefits (KBs) and key challenges (KCs) of blockchain technology in the context of EHRs.MethodsThe blockchain-based architecture was developed in the framework of the design science research paradigm. The requirements were identified using a structured literature review and interviews with nine health care experts. Subsequently, the proposed architecture was evaluated using 4 workshops with 15 participants.ResultsWe identified three major EHR stakeholder groups and 34 respective requirements. On this basis, we developed a five-layer architecture. The subsequent evaluation of the artifact was followed by the discussion of 12 KBs and 12 KCs of a blockchain-based architecture for EHRs. To address the KCs, we derived five recommendations for action for science and practice.ConclusionsOur findings indicate that blockchain technology offers considerable potential to advance EHRs. Improvements to currently available EHR solutions are expected, for instance, in the areas of data security, traceability, and automation by smart contracts. Future research could examine the patient’s acceptance of blockchain-based EHRs and cost-benefit analyses.
Highlights
In the course of digitization, electronic health records (EHRs) have become one of the most important topics within the health care sector, as they are expected to significantly improve intersectoral collaboration and reduce health care expenses [1]
The subsequent evaluation of the artifact was followed by the discussion of 12 key benefits (KBs) and 12 key challenge research questions (RQs) (KC) of a blockchain-based architecture for EHRs
Our findings indicate that blockchain technology offers considerable potential to advance EHRs
Summary
In the course of digitization, electronic health records (EHRs) have become one of the most important topics within the health care sector, as they are expected to significantly improve intersectoral collaboration and reduce health care expenses [1]. For privacy and security concerns, many patients refrain from using an EHR because they fear that the private provider may sell their health data to make profit [2]. Similar to the health care industry, the financial sector exchanges highly sensitive customer data. In this context, blockchain technology has recently gained attention as a possible solution to secure sensitive transactions. Blockchain technology offers potential, for instance, in the areas of disintermediation, decentralization, the reduction of necessary trust between https://www.jmir.org/2019/10/e13585. Data security issues still constitute the main reason for the sluggish dissemination of electronic health records (EHRs). Given that blockchain technology offers the possibility to verify transactions through a decentralized network, it may serve as a solution to secure health-related data. We have identified stakeholder-specific requirements and propose a blockchain-based architecture for EHRs, while referring to the already existing scientific discussions on the potential of blockchain for use in EHRs
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