The HealthChain Blockchain for Electronic Health Records: Development Study

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: The maintenance of accurate health records of patients is a requirement of health care professionals. Furthermore, these records should be shared across different health care organizations in order 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 accomplishment of these jobs and delivery of quality care. However, there are technical and legal hurdles that prevent the adoption of these systems, such as the concern about performance and privacy issues. Objective: The aim of this paper is to build and evaluate an experimental blockchain for EHRs, named HealthChain, which addresses the disadvantages of traditional EHR systems. Methods: HealthChain is built based on consortium blockchain technology. Specifically, three stakeholders, 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. Peer nodes host instance of the distributed ledger consisting of EHRs, and instance of chaincode regulating the permissions of participants; designated orderers establish consensus on the order of EHRs and then disseminate blocks to peers. Results: HealthChain achieves the functional and non-functional requirements. While it can store EHRs in distributed ledger and share them among different participants, it demonstrates superior features, such as privacy preserving, security, and high throughout. These are the main reasons why HealthChain is proposed. Conclusions: Consortium blockchain technology can help build EHR system and solve the problems that prevent the adoption of traditional ones.