JMIR Publications

ABSTRACT

Background:

While living in the era of transparency, the medical documents are not accessible so transparently. The blockchain which allow records to be immutable, and transparent. Using these characters of blockchain, we developed the medical document monitoring system to notify the changes of them with blockchain technology.

Objective:

The purpose of this study is to examine whether patients can verify forgery and alteration of their medical records based on blockchain technology.

Methods:

We enrolled participants who come to two primary clinics in Korea. Three sub-studies were done: (1) survey of recognition of a blockchain and medical records changes and digital literacy of the participants (2) an observational study on using the mobile alert application using a blockchain, (3) a usability survey study. The participants’ medical documents were profiled with FHIR, hashed, and transacted to the blockchain. The application checked the changes of the document with querying the blockchain.

Results:

There are totally 70 patients are enrolled in this study. In terms of the recognition of the medical record changes, the participant tends not to allow to change medical record. Subsequently, the participants tend to need for medical record monitoring system. In digital literacy, most of questions were answered as “good” digital literacy. Only 44 participants, who login to the application more than once and use the application more than 28 days, were analyzed about using pattern and the second survey. The app was accessed 5.1 ± 2.6 times for 33.6 ± 10.0 days. The mean SUS score is 63.21 ± 25.06, which indicated okay usability.

Conclusions:

The system monitoring changes of medical documents was desired, interested by patients. The blockchain helps the application to inform patients of changes in their documents without uploading the medical record itself on the network, ensuring transparency of the medical record, and patient empowerment.