Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Oct 07, 2020)
Date Submitted: Aug 10, 2020
Open Peer Review Period: Aug 9, 2020 - Oct 4, 2020
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BlockMed: Blockchain-based Electronic Consent Management for Secure and Privacy-Protected Healthcare Interoperability
ABSTRACT
Background:
An electronic consent management system can improve the care service significantly by balancing the risks to patient privacy with the benefits of health information exchange and interoperability. Patients leave their health information on multiple providers’ silo. A holistic report and privacy-preserved analysis can help to expedite several medical services including both personal- and community-care. Furthermore, access to consent-based, anonymous health records can accelerate innovation in health services and researches.
Objective:
We propose BlockMed, a proof-of-concept (POC) for a novel, cost-effective e-consent management system. Given proper consent, BlockMed can query the patient’s information fractured over multiple healthcare-providers’ silo make it available to the patient. At the same time, BlockMed also enables privacy-preserved data analysis by third-party service providers in the same system. Leveraging the unique and anonymous Ethereum id, BlockMed masks out the patient’s original identification in the provider’s secured local silo and abstract away any complication caused by changes in the identification information on multiple silos.
Methods:
The core functionalities of BlockMed are developed with a set of smart contracts on Ethereum blockchain. To develop those smart contracts, we have divided the potential users into three different groups such as, patient, provider, and third-party analyzer. Users are identified by their anonymous Ethereum id and need to sign the consent to access healthcare data. After signing, BlockMed can automatically initiate the queries to fetch data from providers’ data warehouse, enables analysis on any third-party service provider’s infrastructure if required, and finally, presents a report to the intended users including the patient. The signed consents stay on Ethereum forever leaving a permanent audit trail to uphold the integrity of the system.
Results:
We evaluated our system in terms of its functionality and cost. Our decentralized application (DApp) can not only query the data from multiple providers' silo but also enable third-party report generation with proper consent and privacy. Masking out the actual patient identification information under anonymous Ethereum ID our DApp can operate irrespective of geographical boundaries. Our cost analysis shows that the adoption of decentralized blockchain-based technology can avoid huge amount of capital investment required for similar services using centralized infrastructure such as AWS cloud.
Conclusions:
Many prior studies have already confirmed that blockchain can improve and expedite data sharing among different providers. Our POC, BlockMed takes it to one step ahead where the data analysis is also integrated. We prove the efficacy of BlockMed by evaluating its functionalities qualitatively as well as its comparing its cost with an alternative cloud-based architecture.
Citation
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