Dataset Information

A blockchain-based framework for electronic medical records sharing with fine-grained access control.

ABSTRACT: In the medical system, the verification, preservation and synchronization of electronic medical records has always been a difficult problem, and the random dissemination of patient records will bring various risks to patient privacy. Therefore, how to achieve secure data sharing on the basis of ensuring users' personal privacy becomes the key. In recent years, blockchain has been proposed to be a promising solution to achieve data sharing with security and privacy preservation due to its advantages of immutability. So, a distributed electronic medical records searchable scheme was proposed by leveraging blockchain and smart contract technology. Firstly, we perform a hash calculation on the electronic medical data and store the corresponding value on the blockchain to ensure its integrity and authenticity. Then, we encrypt the electronic medical data and store it in the interplanetary file system which is a distributed storage protocol. These operations not only can solve centralized data store of servers of several medical institutions, but also be good at lowering stress from data store and high-frequency access to blockchain. Secondly, the encrypted keyword index information of electronic medical records was stored on the Ethereum blockchain, meanwhile a smart contract deployed in the Ethereum blockchain is used to realize keyword search instead of depending on a centralized third party. Furthermore, we use attribute-based encryption scheme to ensure that only the attributes meeting the access policy can decrypt the encrypted electronic medical records. Finally, our performance analysis and security analysis show that the scheme is secure and efficient.

SUBMITTER: Sun J

PROVIDER: S-EPMC7537906 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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A blockchain-based framework for electronic medical records sharing with fine-grained access control.

Sun Jin J Ren Lili L Wang Shangping S Yao Xiaomin X

PloS one 20201006 10

In the medical system, the verification, preservation and synchronization of electronic medical records has always been a difficult problem, and the random dissemination of patient records will bring various risks to patient privacy. Therefore, how to achieve secure data sharing on the basis of ensuring users' personal privacy becomes the key. In recent years, blockchain has been proposed to be a promising solution to achieve data sharing with security and privacy preservation due to its advanta ...[more]

PMID: 33022027

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Project description:BackgroundLongitudinal personal health record (PHR) provides a foundation for managing patients' health care, but we do not have such a system in the U.S. except for the patients in the Department of Veterans Affairs. Such a gap exists mainly in the rest of the U.S. by the fact that patients' electronic health records are scattered across multiple health care facilities and often not shared due to privacy, security, and business interests concerns from both patients and health care organizations. In addition, patients have ethical concerns related to consent. To patients, data security, privacy, and consent are based on trustfulness, rather than patients' engagement in ensuring only authorized people can view their PHRs with patient-managed granularity. Resolving these challenges is an important step in making longitudinal PHR useful for patient care.ObjectiveThis research aims to design and implement a blockchain-enabled sharing platform prototype for PHR with desired patient-controlled data security, privacy, and consent granularity.MethodsBuilt upon our prior work of a blockchain-enabled access control (BAC) model, we design a blockchain-enabled sharing platform for PHR with patient-controlled security, privacy, and consent granularity. We further implement the construct by building a prototypical platform among a patient and two typical health care organizations. Health organizations that hold the patient's electronic health records can join the platform with trust based on the validation from the patient. The mutual trust can be established through a rigorous validation process by both the patient and the built-in Hyperledger Fabric blockchain consensus mechanism.ResultsWe proposed a system trusted by patients and health care providers and constructed a Web-based PHR sharing platform with patient-controlled security, privacy, and consent granularity. We analyzed the system scalability in three aspects and showed millisecond range of performance when simultaneously changing access permissions on hundreds of PHRs. Consent, security and privacy of the model are ensured by the merits of the BAC model. We discovered the current blockchain model limits the system scalability due to using a non-graphical database. A new graphical database is suggested for future improvements.ConclusionsIn this research, we report a solution to electronically sharing and managing patients' electronic health records originating from multiple organizations, focusing on privacy, security, and granularity control of consent in the U.S. Specifically, the system protects data security and privacy, and provides auditability, scalability, distributedness, patient consent autonomy, and zero-trust capabilities. The prototypical instantiation of the designed model suggested the feasibility of combining emerging blockchain technology with next generation access control model to tackle a longstanding longitudinal PHR problem.

Project description:BackgroundAlthough researchers are giving increased attention to blockchain-based personal health records (PHRs) and data sharing, the majority of research focuses on technical design. Very little is known about health care consumers' intentions to adopt the applications.ObjectiveThis study aims to explore the intentions and concerns of health care consumers regarding the adoption of blockchain-based personal health records and data sharing.MethodsThree focus groups were conducted, in which 26 participants were shown a prototype of a user interface for a self-sovereign blockchain-based PHR system (ie, a system in which the individual owns, has custody of, and controls access to their personal health information) to be used for privacy and secure health data sharing. A microinterlocutor analysis of focus group transcriptions was performed to show a descriptive overview of participant responses. NVivo 12.0 was used to code the categories of the responses.ResultsParticipants did not exhibit a substantial increase in their willingness to become owners of health data and share the data with third parties after the blockchain solution was introduced. Participants were concerned about the risks of losing private keys, the resulting difficulty in accessing care, and the irrevocability of data access on blockchain. They did, however, favor a blockchain-based PHR that incorporates a private key recovery system and offers a health wallet hosted by government or other positively perceived organizations. They were more inclined to share data via blockchain if the third party used the data for collective good and offered participants nonmonetary forms of compensation and if the access could be revoked from the third party.ConclusionsHealth care consumers were not strongly inclined to adopt blockchain-based PHRs and health data sharing. However, their intentions may increase when the concerns and recommendations demonstrated in this study are considered in application design.

Dataset Information

A blockchain-based framework for electronic medical records sharing with fine-grained access control.

Publications

A blockchain-based framework for electronic medical records sharing with fine-grained access control.

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