Electronic Health Record Management Research Articles

Aguhyper: a hyperledger-based electronic health record management framework

The increasing importance of healthcare records, particularly given the emergence of new diseases, emphasizes the need for secure electronic storage and dissemination. With these records dispersed across diverse healthcare entities, their physical maintenance proves to be excessively time-consuming. The prevalent management of electronic healthcare records (EHRs) presents inherent security vulnerabilities, including susceptibility to attacks and potential breaches orchestrated by malicious actors. To tackle these challenges, this article introduces AguHyper, a secure storage and sharing solution for EHRs built on a permissioned blockchain framework. AguHyper utilizes Hyperledger Fabric and the InterPlanetary Distributed File System (IPFS). Hyperledger Fabric establishes the blockchain network, while IPFS manages the off-chain storage of encrypted data, with hash values securely stored within the blockchain. Focusing on security, privacy, scalability, and data integrity, AguHyper’s decentralized architecture eliminates single points of failure and ensures transparency for all network participants. The study develops a prototype to address gaps identified in prior research, providing insights into blockchain technology applications in healthcare. Detailed analyses of system architecture, AguHyper’s implementation configurations, and performance assessments with diverse datasets are provided. The experimental setup incorporates CouchDB and the Raft consensus mechanism, enabling a thorough comparison of system performance against existing studies in terms of throughput and latency. This contributes significantly to a comprehensive evaluation of the proposed solution and offers a unique perspective on existing literature in the field.

Performance Evaluation of Genetic Algorithm-Driven Blockchain Encryption for EHR Management and Validation

In the realm of electronic health record (EHR) management, ensuring robust security and validation mechanisms is paramount due to the sensitive nature of healthcare data. This research focuses on the performance evaluation of a genetic algorithm-driven blockchain encryption approach for enhancing EHR security and validation. The proposed method leverages genetic algorithms to optimize encryption parameters within a blockchain framework, aiming to safeguard patient privacy and prevent unauthorized access. By integrating advanced cryptographic techniques like Elliptic Curve Cryptography (ECC) and Keyed-Hash Message Authentication Code (HMAC)-based authentication, along with machine learning for data classification. The evaluation of the approach holds significant promise in advancing secure EHR management practices, addressing critical challenges in data privacy and integrity within healthcare environments. Finally, as a result, this study presents a comparative analysis of cryptographic systems genetic algorithm-driven blockchain encryption (GADBE)+ECC and GADBE+ Advanced Encryption Standard (AES), focusing on the scaling of encryption and decryption times relative to key sizes and data volumes. Results show that both systems exhibit increasing times with larger key sizes and data sizes. ECC consistently demonstrates superior speed over AES, with decryption times ranging from 0.4 to 3.5 seconds for key sizes from 128 to 512 bits, indicating potential performance advantages of ECC in cryptographic applications.

Management of Electronic Health Records in Virtual Health Environments

Management of Electronic Health Records in Virtual Health Environments

E2EE enhanced patient-centric blockchain-based system for EHR management.

To secure sensitive medical records in the healthcare clouds, this paper proposes an End-to-End Encryption (E2EE) to enhance a patient-centric blockchain-based system for electronic health record (EHR) management. The suggested system with a focus on the patient enables individuals to oversee their medical records within various involved parties by authorizing or withdrawing permission for access to their records. Utilizing the inter-planetary file system (IPFS) for record storage is chosen due to its decentralized nature and its ability to guarantee the unchangeability of records. Then an E2EE enhancement maintains the medical data integrity using dual level-Hybrid encryption: symmetric Advanced Encryption Standard (AES) and asymmetric Elliptic Curve Cryptography (ECC) cryptographic techniques. The proposed system is implemented using the Ethereum blockchain system for EHR data sharing and integration utilizing a web-based interface for the patient and all users to initiate the EHR sharing transactions over the IPFS cloud. The proposed system performance is evaluated in a working system prototype. For different file sizes between 512 KB to 100 MB, the performance metrics used to evaluate the proposed system were the time consumed for generating key, encryption, and decryption. The results demonstrate the proposed system's superiority over other cutting-edge systems and its practical ability to share secure health data in cloud environments.

Exploring the Impact of Artificial Intelligence in Healthcare

The integration of artificial intelligence (AI) applications has revolutionized healthcare. This study conducts a comprehensive literature review to elucidate the multifaceted role of AI in healthcare, focusing on key aspects including medical imaging and diagnostics, virtual patient care, medical research and drug discovery, patient engagement and compliance, rehabilitation, and administrative applications. AI's impact is observed across various domains, including detecting clinical conditions in medical imaging, early diagnosis of coronavirus disease 2019 (COVID-19), virtual patient care utilizing AI-powered tools, electronic health record management, enhancing patient engagement and treatment compliance, reducing administrative burdens for healthcare professionals (HCPs), drug and vaccine discovery, identification of medical prescription errors, extensive data storage and analysis, and technology-assisted rehabilitation. However, the integration of AI in healthcare encounters several technical, ethical, and social challenges, such as privacy concerns, safety issues, autonomy and consent, cost considerations, information transparency, access disparities, and efficacy uncertainties. Effective governance of AI applications is imperative to ensure patient safety, accountability, and to bolster HCPs' confidence, thus fostering acceptance and yielding significant health benefits. Precise governance is essential to address regulatory, ethical, and trust concerns while advancing the adoption and implementation of AI in healthcare. With the onset of the COVID-19 pandemic, AI has sparked a healthcare revolution, signaling a promising leap forward to meet future healthcare demands.

Exploring the Impact of Artificial Intelligence in Healthcare

The integration of artificial intelligence (AI) applications has revolutionized healthcare. This study conducts a comprehensive literature review to elucidate the multifaceted role of AI in healthcare, focusing on key aspects including medical imaging and diagnostics, virtual patient care, medical research and drug discovery, patient engagement and compliance, rehabilitation, and administrative applications. AI's impact is observed across various domains, including detecting clinical conditions in medical imaging, early diagnosis of coronavirus disease 2019 (COVID-19), virtual patient care utilizing AI-powered tools, electronic health record management, enhancing patient engagement and treatment compliance, reducing administrative burdens for healthcare professionals (HCPs), drug and vaccine discovery, identification of medical prescription errors, extensive data storage and analysis, and technology-assisted rehabilitation. However, the integration of AI in healthcare encounters several technical, ethical, and social challenges, such as privacy concerns, safety issues, autonomy and consent, cost considerations, information transparency, access disparities, and efficacy uncertainties. Effective governance of AI applications is imperative to ensure patient safety, accountability, and to bolster HCPs' confidence, thus fostering acceptance and yielding significant health benefits. Precise governance is essential to address regulatory, ethical, and trust concerns while advancing the adoption and implementation of AI in healthcare. With the onset of the COVID-19 pandemic, AI has sparked a healthcare revolution, signaling a promising leap forward to meet future healthcare demands.

A Review on State-of-Art Blockchain Schemes for Electronic Health Records Management

Abstract In today’s world, Electronic Health Records (EHR) are highly segregated and available only within the organization with which the patient is associated. If a patient has to visit another hospital there is no secure way for hospitals to communicate and share medical records. Hence, people are always asked to redo tests that have been done earlier in different hospitals. This leads to monetary, time, and resource loss. Even if the organizations are ready to share data, there are no secure methods for sharing without disturbing data privacy, integrity, and confidentiality. When health data are stored or transferred via unsecured means there are always possibilities for adversaries to initiate an attack and modify them. To overcome these hurdles and secure the storage and sharing of health records, blockchain, a very disruptive technology can be integrated with the healthcare system for EHR management. This paper surveys recent works on the distributed, decentralized systems for EHR storage in healthcare organizations.

A systematic study on integrating blockchain in healthcare for electronic health record management and tracking medical supplies

In the current landscape of swiftly evolving technology, security remains a paramount concern. Motivated by the challenges presented during pandemics such as COVID-19, this article aims to enhance healthcare transparency and expedite treatment processes. The existing centralized medical data management system scatters patient records across disparate hospitals and pharmacies, prompting the necessity for a patient-centric data repository. The integration of blockchain emerges as a viable solution, giving patients control over their information and facilitating seamless sharing with relevant institutions—be it hospitals, pharmacies, or insurance firms. This article outlines a strategic framework for securing medical data based on comprehensive literature review and proposes measures derived from previous studies. Furthermore, the study explores blockchain's application in tracing medicinal supplies, crucial for detecting counterfeit medications within the supply chain. Detailed elucidation of IBM Research's proposed model highlights the potential of blockchain in this domain. Additionally, an extensive comparative analysis of existing models underscores their strengths and limitations in these healthcare applications. Challenges persist in deploying blockchain in developing countries, primarily due to resource limitations, signalling the need for tailored solutions conducive to such environments. This study serves as an exploration, emphasising the need for continued research and innovation in harnessing blockchain's potential for healthcare transformation.

Machine learning for effective EHR management in blockchain-cloud integration

<p>Machine learning (ML) techniques have gained prominence in effectively managing Electronic Health Record (EHR) systems within the context of blockchain-cloud integration. This study presents a hybrid Machine Learning approach that combines logistic regression (LR) and random forest (RF) techniques for EHR management, leveraging the data stored in a blockchain-cloud integrated system. The tamper-resistant nature of blockchain ensures the authenticity and security of the stored patient information, serving as a reliable source for learning. The proposed LR+RF model is evaluated against other algorithms, considering various performance metrics. The analysis reveals that the LR+RF model achieves an impressive accuracy rate of 98.37%, indicating its efficacy in accurately classifying EHR data and facilitating effective management. Furthermore, the study compares the performance of blockchain-cloud-based decentralized storage with blockchain-based storage and peer-to-peer storage in terms of latency and throughput. The results demonstrate that the blockchain-cloud integrated decentralized storage surpasses other storage methods, achieving an average throughput of 6.8 units and a latency of 4.7 units. These findings highlight the potential of the proposed LR+RF model for EHR management within a blockchain-cloud integrated environment. The use of blockchain as a secure storage environment ensures the integrity of patient information, while Machine Learning techniques enhance the accuracy of classification.</p>

Parallel-Based Corpus Annotation for Malay Health Documents

Named entity recognition (NER) is a crucial component of various natural language processing (NLP) applications, particularly in healthcare. It involves accurately identifying and extracting named entities such as medical terms, diseases, and drug names, and healthcare professionals are essential for tasks like clinical text analysis, electronic health record management, and medical research. However, healthcare NER faces challenges, especially in Malay, in which specialized corpora are limited, and no general corpus is available yet. To address this, the paper proposes a method for constructing an annotated corpus of Malay health documents. The researchers leverage a parallel source that contains annotated entities in English due to the limited tools available for the Malay language, and it is very language-dependent. Additional credible Malay documents are incorporated as sources to enhance the development. The targeted health entities in this research include penyakit (diseases), simptom (symptoms), and rawatan (treatments). The primary objective is to facilitate the development of NER algorithms specifically tailored to the healthcare domain in the Malay language. The methodology encompasses data collection, preprocessing, annotation of text in both English and Malay, and corpus creation. The outcome of this research is the establishment of the Malay Health Document Annotated Corpus, which serves as a valuable resource for training and evaluating NLP models in the Malay language. Future research directions may focus on developing domain-specific NER models, exploring alternative algorithms, and enhancing performance. Overall, this research aims to address the challenges of healthcare NER in the Malay language by constructing an annotated corpus and facilitating the development of tailored NER algorithms for the healthcare domain.

A hackathon as a tool to enhance research and practice on electronic health record systems' interoperability for chronic disease management and prevention.

The development of a standardized technical framework for exchanging electronic health records is widely recognized as a challenging endeavor that necessitates appropriate technological, semantic, organizational, and legal interventions to support the continuity of health and care. In this context, this study delineates a pan-European hackathon aimed at evaluating the efforts undertaken by member states of the European Union to develop a European electronic health record exchange format. This format is intended to facilitate secure cross-border healthcare and optimize service delivery to citizens, paving the way toward a unified European health data space. The hackathon was conducted within the scope of the X-eHealth project. Interested parties were initially presented with a representative clinical scenario and a set of specifications pertaining to the European electronic health record exchange format, encompassing Laboratory Results Reports, Medical Imaging and Reports, and Hospital Discharge Reports. In addition, five onboarding webinars and two professional training events were organized to support the participating entities. To ensure a minimum acceptable quality threshold, a set of inclusion criteria for participants was outlined for the interested teams. Eight teams participated in the hackathon, showcasing state-of-the-art applications. These teams utilized technologies such as Health Level Seven-Fast Healthcare Interoperability Resources (HL7 FHIR) and Clinical Document Architecture (CDA), alongside pertinent IHE integration profiles. They demonstrated a range of complementary uses and practices, contributing substantial inputs toward the development of future-proof electronic health record management systems. The execution of the hackathon demonstrated the efficacy of such approaches in uniting teams from diverse backgrounds to develop state-of-the-art applications. The outcomes produced by the event serve as proof-of-concept demonstrators for managing and preventing chronic diseases, delivering value to citizens, companies, and the research community.

Highly secured EHR management system based on blockchain technology with digitally signed authentication using data sanitization and polynomial interpolation

With the increased specifications of healthcare services, diagnosis become very common in most of the healthcare sector to provide better treatment for patients. Here, the person’s medical information can be tracked with the help of an Electronic Health Record (EHR). The EHR system maintains the digital medical records of medical organizations. Enterprise-wide data systems, along with other networking activities, are used to exchange medical documents in the current environment where the patient seeks rapid access to their medical records. Moreover, the EHR system faces many problems regarding integrity, management and security. Still, there are some concerns regarding the security and privacy of patient medical records. However, it suffers from managing the large volume of electronically generated healthcare data. Thus, this work adapts blockchain technology, which effectively stores healthcare data. Therefore, decentralized technology was just recently introduced in order to offer an innovative viewpoint on data security and system effectiveness. In this work, a blockchain-related system is developed to secure patients’ health data with high verifiability. A total of two mechanisms are carried out in the developed model to encrypt the privacy of the health data that is Data Sanitization and Polynomial Interpolation-based Cryptography (DSPIC). In the data sanitization mechanism, the optimal key is generated through the Modernized Position-based Coot and Penguins Search Optimization Algorithm (MP-CPeSOA). The polynomial interpolation method is carried out through the estimation of values between two data points to handle the heterogeneity. The objective function is considered for securing the patient's health data with Euclidian distance, hiding ratio, preservation ratio and correlation among the original data and the restored data. In this developed model, the generated key is digitally signed to provide high security for the patient’s health data. At last, the effectiveness of the suggested blockchain-adopted EHR preservation system is enhanced by conducting experiments on different EHR management schemes.

Secure And Efficient Access Control Over Blockchain PHR Cloud Storage System

A novel architecture of blockchain-based secured electronic health record (EHR) management system is presented in this paper. Electronic health data record-keeping in cloud-based storage systems always pose a threat to information security. Intruders can delete EHR of patients, giving benefits to insurance companies or hiding medical malpractices. A secured EHR management system is required that would essentially solve such issues. The blockchain is an emerging technology that can be adapted to develop a secured and an efficient data management system. Storing and sharing health records through electronic systems pose security risks. However, establishing a new blockchain based system replacing the existing system is expensive. In our proposed architecture, we introduced an integration mechanism, named as the blockchain handshaker, between the existing cloud based EHR management system and public blockchain network to develop a secured health record management system. A blockchain-based protocol that secures health records, addressing all of the main security and complementary properties defined in current regulations. A prototype to provide evidence on the feasibility of the proposed concept is presented in this paper. The performance assessments demonstrate the efficiency of our proposed solution in terms of computation, communication, and storage.

Blockchain-based Electronic Health Record Management System

The Blockchain-based Electronic Health Record (B-EHR) system represents a significant advancement in healthcare data management. Concerns over data confidentiality and security have become increasingly critical in the healthcare sector, given the need for immediate data accessibility. Traditional centralized systems face accessibility issues, necessitating a transformative solution, and blockchain technology emerges as a promising candidate. This research introduces a patient-controlled, blockchain-based system that efficiently manages and safeguards individuals' health-related data. By harnessing the Ethereum network and utilizing tools such as Ganache, Solidity, and web3.js, this system takes a systematic approach to overcome the limitations of centralized systems. Smart contracts, the basis of blockchain technology, serve as the backbone for storing and processing patients' data in a decentralized manner. Transactions are conducted securely through these smart contracts, ensuring patient privacy and data security. Notably, any modifications to transactions can be verified and propagated across the entire distributed network, enhancing data integrity. Complementing this system is a cryptocurrency wallet like MetaMask, providing a centrally controlled repository where records can be swiftly accessed and secured by authorized individuals, including doctors and patients. This integration significantly improves data accessibility and security within the healthcare domain. Ultimately, this research aims to leverage blockchain technology for simultaneous data retrieval, enhancing efficiency, credibility, and accessibility. It offers a robust framework for securely storing data with tailored access permissions and facilitates the safe transfer of patient medical records. In essence, it introduces a swift and secure health record system and an innovative protocol, promoting greater transparency and ownership of sensitive data in the healthcare sector through blockchain integration.

Electronic Health Record Management System using RFID: Improving Efficiency and Accuracy in Healthcare

This research presents the development and implementation of an Electronic Health Record Management System (EHRMS) using Radio Frequency Identification (RFID) technology. The study discusses the limitations of traditional paper-based health record systems and highlights the benefits of integrating RFID technology in healthcare settings. The EHRMS streamlines patient identification and data capture processes, enhances data accuracy, and improves overall healthcare delivery. Real-time synchronization ensures up-to-date and easily accessible patient records, empowering healthcare providers to make informed decisions and provide timely interventions. The paper concludes with the potential impact of the RFID-based EHRMS in transforming healthcare record management and improving patient outcomes.

A Hybrid Blockchain-Edge Architecture for Electronic Health Record Management With Attribute-Based Cryptographic Mechanisms

This paper presents a hybrid blockchain-edge architecture for managing Electronic Health Records (EHRs) with attribute-based cryptographic mechanisms. The architecture introduces a novel attribute-based signature aggregation (ABSA) scheme and multi-authority attribute-based encryption (MA-ABE) integrated with Paillier homomorphic encryption (HE) to protect patients’ anonymity and safeguard their EHRs. All the EHR activities and access control events are recorded permanently as blockchain transactions. We develop the ABSA module on Hyperledger Ursa cryptography library, MA-ABE module on OpenABE toolset, and blockchain network on Hyperledger Fabric. We measure the execution time of ABSA’s signing and verification functions, MA-ABE with different access policies and homomorphic encryption schemes, and compare the results with other existing blockchain-based EHR systems. We validate the access activities and authentication events recorded in blockchain transactions and evaluate the transaction throughput and latency using Hyperledger Caliper. The results show that the performance meets real-world scenarios’ requirements while safeguarding EHR and is robust against unauthorized retrievals.

Level of Professional Awareness among Health Record Officers in Bayelsa State and Their Implications for Patient Care, Health Systems, and Health Policy

As Electronic health records (EHRs) become more commonplace, and are expected to play a key role in improving the quality of Nigeria health care. Thus, EHRs can improve quality of care delivery in numerous ways such as providing accurate and up-to-date patient information and medical knowledge, rapid retrieval of health information, ability to exchange health information to all authorized participants within or across organizations, automated clinical reminders, improved adherence to treatment guidelines, and accumulation of data for quality monitoring and improvement. Based on regulatory and governmental recommendations, the EHR is being adapted in an increasing number of academic institutions (NDUTH), government hospitals (FMC) and private practice settings. It is incumbent upon HIM leadership to ensure students are skillful users of the technologies that will be in place as they care for patients. The study aimed to explore, identify and understand critical awareness of electronic health records management level to ensure confidentiality in public health care sector (FMC & NDUTH) in Bayelsa State, Nigeria. The cross-sectional descriptive design was used and a total of 159 health professionals who represented a variety of user groups across different specialties within the hospital completed the questionnaire. The collected data were analyzed. both descriptively and inferentially. Frequency and percentages were used to analyse the data and the result presented in tables. Data analysis was facilitated using the Statistical Package for Social Sciences (SPSS version 20.0). Majority of the respondents (90.6%) were aware of the electronic health record management among health record officers. To ensure continuity of care, it is necessary to develop educational and manageable program to improve EHR awareness. The findings may inform other hospitals and healthcare systems on actions that can be taken prior to EHR implementation to reduce concerns for quality, confidentiality, safety of patient care and improve the chance of successful implementation.

PbDinEHR: A Novel Privacy by Design Developed Framework Using Distributed Data Storage and Sharing for Secure and Scalable Electronic Health Records Management

Privacy in Electronic Health Records (EHR) has become a significant concern in today’s rapidly changing world, particularly for personal and sensitive user data. The sheer volume and sensitive nature of patient records require healthcare providers to exercise an intense quantity of caution during EHR implementation. In recent years, various healthcare providers have been hit by ransomware and distributed denial of service attacks, halting many emergency services during COVID-19. Personal data breaches are becoming more common day by day, and privacy concerns are often raised when sharing data across a network, mainly due to transparency and security issues. To tackle this problem, various researchers have proposed privacy-preserving solutions for EHR. However, most solutions do not extensively use Privacy by Design (PbD) mechanisms, distributed data storage and sharing when designing their frameworks, which is the emphasis of this study. To design a framework for Privacy by Design in Electronic Health Records (PbDinEHR) that can preserve the privacy of patients during data collection, storage, access and sharing, we have analysed the fundamental principles of privacy by design and privacy design strategies, and the compatibility of our proposed healthcare principles with Privacy Impact Assessment (PIA), Australian Privacy Principles (APPs) and General Data Protection Regulation (GDPR). To demonstrate the proposed framework, ‘PbDinEHR’, we have implemented a Patient Record Management System (PRMS) to create interfaces for patients and healthcare providers. In addition, to provide transparency and security for sharing patients’ medical files with various healthcare providers, we have implemented a distributed file system and two permission blockchain networks using the InterPlanetary File System (IPFS) and Ethereum blockchain. This allows us to expand the proposed privacy by design mechanisms in the future to enable healthcare providers, patients, imaging labs and others to share patient-centric data in a transparent manner. The developed framework has been tested and evaluated to ensure user performance, effectiveness, and security. The complete solution is expected to provide progressive resistance in the face of continuous data breaches in the patient information domain.

An Approach for Implementing of Electronic Health Records Management using Blockchain Technology

Abstract: Data accessibility refers to making sure that users have unrestricted access to information, whereas data privacy refers to making sure that users have control over access to information. Data accessibility and privacy conflicts are common, and the healthcare industry is one where they are particularly crucial. In this post, we talk about how blockchain technology and smart contracts could be useful in various common situations involving data access, data management, and data Interoperability for the particular healthcare area. We then suggest developing a sizable information architecture based on smart contracts as information intermediaries to access electronic health records (EHRs). Our key contribution is how we frame the problems of data accessibility and privacy in healthcare and how we suggest a blockchain-based integrated architecture.

Electronic Health Record Management through Blockchain and Cloud Computing

Electronic Health Record Management through Blockchain and Cloud Computing