Application of Blockchain to Maintaining Patient Records in Electronic Health Record for Enhanced Privacy, Scalability, and Availability
Open accessAbstract
OBJECTIVES: Electronic Health Record (EHR) systems are increasingly used as an effective method to share patients' records among different hospitals. However, it is still a challenge to access scattered patient data through multiple EHRs. Our goal is to build a system to access patient records easily among EHRs without relying on a centralized supervisory system. METHODS: We apply consortium blockchain to compose a distributed system using Hyperledger Fabric incorporating existent EHRs. Peer nodes hold the same ledger on which the address of a patient record in an EHR is written. Individual patients are identified by unique certificates issued by a local certificate authorities that collaborate with each other in a channel of the network. To protect a patient's privacy, we use a proxy re-encryption scheme when the data are transferred. We designed and implemented various chaincodes to handle business logic agreed by member organizations of the network. RESULTS: We developed a prototype system to implement our concept and tested its performance including chaincode logic. The results demonstrated that our system can be used by doctors to find patient's records and verify patient's consent on access to the data. Patients also can seamlessly receive their past records from other hospitals. The access log is stored transparently and immutably in the ledger that is used for auditing purpose. CONCLUSIONS: Our system is feasible and flexible with scalability and availability in adapting to existing EHRs for strengthening security and privacy in managing patient records. Our research is expected to provide an effective method to integrate dispersed patient records among medical institutions.
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The proposed solution is superior to two existing cloud-based PHR management solutions [36], [37] as shown in Table 2.
“The table shows the superiority of the proposed solution as it employs blockchain technology, Ethereum smart contracts, distributed trusted oracles, distributed decentralized database storage, and proxy re-encryption technology.”
From Blockchain for Giving Patients Control Over Their Medical Records (2020) · cites this paper as [36]
The Introduction and Methods describe a blockchain system for sharing patient records across existing EHRs, so the citation identifies a relevant comparison system. But the Results describe a prototype tested on a local network, and the Discussion says it *could* run in the cloud; the paper does not establish that it is an existing cloud-based PHR management solution. It also does not substantiate the citing paper’s claim of superiority. (LLM, conf=0.86)
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Cites
Dagher, G. G., Mohler, J., Milojkovic, M., & Marella, P. B. (2018) · Sustainable Cities and Society · doi:10.1016/j.scs.2018.02.014 · Cited by 854 · see citing works
Performance Benchmarking and Optimizing Hyperledger Fabric Blockchain Platform
Thakkar, P., Nathan, S., & Viswanathan, B. (2018) · 2018 IEEE 26th International Symposium on Modeling, Analysis, and Simulation of Computer and Telecommunication Systems (MASCOTS) · doi:10.1109/mascots.2018.00034 · Cited by 632 · see citing works
Greenhalgh, T., Hinder, S., Stramer, K., Bratan, T., & Russell, J. (2010) · BMJ · doi:10.1136/bmj.c5814 · Cited by 343 · see citing works
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Blockchain for Giving Patients Control Over Their Medical Records
Madine, M. M., Battah, A. A., Yaqoob, I., Salah, K., Jayaraman, R., Al-Hammadi, Y., Pesic, S., & Ellahham, S. (2020) · IEEE Access · doi:10.1109/access.2020.3032553 · Cited by 194 · see citing works
“The authors of [26] have employed blockchain technology”
Method
- Authors
- Tith, D., Lee, J.-S., Suzuki, H., Wijesundara, W. M. A. B., Taira, N., Obi, T., & Ohyama, N.
- Affiliations
- Tokyo Institute of Technology (JP)
- Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Japan.
- Corresponding author
- Lee, Joong-Sun
- ORCID
- Venue
- Healthcare Informatics Research
- Published
- 2020
- Volume
- 26
- Issue
- 1
- Pages
- 3
- ISSN
- 2093-3681 (ISSN-L)
- 2093-369X
- PMC
- PMC7010942
- OpenAlex
- W3005995123
- Cited by
- 101
- References
- 3
- Citations by year
- 2026: 10 · 2025: 19 · 2024: 17 · 2023: 23 · 2022: 13 · 2021: 13 · 2020: 6
- FWCI
- 12.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Healthcare Informatics Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Institutional Repositories DataBase (IRDB) (submittedVersion)
- Funders
- Japan Society for the Promotion of Science (18K12099)
- Topics
- Physical Sciences › Computer Science › Information Systems › Blockchain Technology Applications and Security
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Physical Sciences › Computer Science › Information Systems › Blockchain Technology in Education and Learning
- Keywords
- blockchain, electronic health records, Hyperledger Fabric, consortium blockchain, proxy re-encryption, data privacy, distributed ledger technology, chaincode, certificate authority, audit logging, scalability, availability
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