JMIR Publications

ABSTRACT

Background:

PHR security, correctness and protection is essential to health and medical services. Blockchain architecture can provide efficiency of data retrieval and security requirements. Exchangeable PHR and self-management of health by patient can offer many benefits to the traditional medical service, allowing people to manage their own health records for disease prevention, prediction and control, while reducing resource burdens on health care infrastructure, and improving population health and quality of life.

Objective:

This study builds a blockchain-based architecture for an international health record exchange platform, using blockchain to ensure the health record confidentiality, integrity, and availability for health management and using HL7 FHIR international standards as the data format, allowing international, cross-institution, and patient/doctor exchange of personal health records.

Methods:

The PHR architecture in this study consists of two main components. The first component is the PHR management platform, from which users can upload PHRs, view their record content, authorize PHR exchange with doctors or other medical health care providers, and check their block information. When a PHR is uploaded, the hash value of the PHR is calculated by the SHA-256 algorithm, and the PHR is encrypted by an RSA encryption mechanism before being transferred to the secure database. The second component of the architecture is the blockchain exchange architecture, which is based on Ethereum to create a private chain. Proof of Authority (PoA), which delivers transactions through a consensus mechanism based on identity, which is used for consensus. The hash value is calculated based on the previous hash value, block content and timestamp by hash function.

Results:

A blockchain architecture of PHR is constructed. It is an effective method for the management and utilization of personal health records. The platform has been applied in Southeast Asian countries via the association of Asia eHealth Information Network, and has become the first PHR management platform for cross-region medical data exchange.

Conclusions:

Some of the systems have shown that Blockchain has great potential for electronic health records applications. This study combines different types of data storage modes to effectively solve the problems of PHR data security, storage and transmission, proposing a hybrid blockchain and data security approach, enabling effective international PHR exchange. By using AeHIN's cross-international network, the PHR platform can be deployed and promoted successfully. We expect, in the future, the PHR platform can be utilized for the purpose of precision and individual medicine in a cross-country manner since the platform provides a secure and efficient PHR sharing and management architecture, and thus it can be a reasonable base for the future data collection sources of data analytics for precision medicine.