JMIR Publications

ABSTRACT

Background:

Data security issues still constitute the main reason for the sluggish dissemination of electronic health records (EHR). Given the fact that blockchain technology offers the possibility to verify transactions via a decentralized network it may serve as a solution to secure health related data. While referring to the already existing scientific discussions on the potentials of blockchain for the use in EHR, we identify stakeholder-specific requirements and propose a blockchain-based architecture for EHR.

Objective:

Introduction of blockchain technology for EHR, based on a systematically elicitation of stakeholders and respective requirements. Discussion of key benefits and key challenges of blockchain technology in the context of EHR.

Methods:

The blockchain-based architecture is developed in the framework of the design science research paradigm. The requirements are identified by means of a structured literature review and interviews with nine healthcare experts. Subsequently, we evaluate the proposed architecture, via four workshops with 15 participants.

Results:

We identified three major EHR stakeholder groups and 34 respective requirements. On this basis we developed a five-layer architecture. The subsequent evaluation of the artefact is followed by the discussion of twelve key benefits and twelve key challenges of a blockchain-based architecture for EHR. To address the key challenges, we derived five recommendations for action for science and practice.

Conclusions:

Our findings indicate that blockchain technology offers considerable potential to advance EHR. Improvements to currently available EHR solutions are expected for instance in the areas of data security, traceability and automation by smart contracts. Future research could examine the patient’s acceptance of blockchain-based EHR as well as cost-benefit analyses.