Blockchain Technology for Integrating Electronic Records of Digital Healthcare System

Md. Halimuzzaman ¹, Dr. Jaideep Sharma ², Tapan Bhattacharjee ³, Bilash Mallik ⁴, Rashadur Rahman ⁵, Mohammad Rezaul Karim ⁶, Mostafa Masrur Ikram ⁷, Md Fokhrul Islam ⁸

This study determined the multifaceted benefits of blockchain in enhancing the overall efficiency, effectiveness, and integrity of digital healthcare systems.

Abstract

Background: In most healthcare facilities, the shift from paper-based medical records to electronic health records (EHRs) has taken place. However, there are issues with credibility, management, and secure data storage with the existing EHR systems. In the healthcare industry, interoperability and user control over personal data are also major challenges. Block chain technology has become a potent tool that can provide immutability, security, and user control over records that are saved; yet, its potential usage in EHR systems is still not well understood. Objectives: This research attempts to close this knowledge gap by developing an EHR framework that is built on blockchain technology and is compatible with many national and international EHR standards, including HL7 and HIPAA. Methods: In order to investigate the state of the art in the field of EHRs, including blockchain-based EHR implementations, a systematic literature review is the study approach used. Results: The report analyzes numerous national and international EHR standards, identifies the interoperability needs based on these standards, and outlines the interoperability challenges in the current blockchain-based EHR frameworks. Without the requirement for centralized systems, the suggested framework can give the healthcare industry safer ways to exchange health information while also offering the features of immutability, security, and user control over stored records. Conclusion:  This work contributes to the understanding of Blockchain technology's potential application in EHR frameworks and offers an interoperable Blockchain-based EHR framework that can meet the requirements outlined in multiple national and international EHR standards.

Keywords: Blockchain; Healthcare; Security; Electronic Health Records (EHRs); Health information management (HIM)

References

Aaron M. Gamino, A. M. G. (2021, September 30). The impact of the consolidated omnibus reconciliation act of 1985 on young adult health insurance coverage: Applied Economics: Vol 54 , No 17—Get Access. https://www.tandfonline.com/doi/full/10.1080/00036846.2021.1983142

Adane, K., Gizachew, M., & Kendie, S. (2019). The role of medical data in efficient patient care delivery: A review. Risk Management and Healthcare Policy, Volume 12, 67–73. https://doi.org/10.2147/RMHP.S179259

Adel, E., El-Sappagh, S., Barakat, S., & Elmogy, M. (2019). Chapter 14—A unified fuzzy ontology for distributed electronic health record semantic interoperability. In N. Dey, A. S. Ashour, S. J. Fong, & S. Borra (Eds.), U-Healthcare Monitoring Systems (pp. 353–395). Academic Press. https://doi.org/10.1016/B978-0-12-815370-3.00014-1

Adel, E., Sappagh, S. E., Barakat, S., & Elmogy, M. (2020). A semantic interoperability framework for distributed electronic health record based on fuzzy ontology. International Journal of Medical Engineering and Informatics, 12(3), 207. https://doi.org/10.1504/IJMEI.2020.107081

Adesh Mukati, A. M. (2023, May 30). D40900412423. Indian Journal of Cryptography and Network Security (IJCNS). https://www.ijcns.latticescipub.com/portfolio-item/d40900412423/

Amit Doegar, S. R. M. S. (2021, May 21). Data Collection and Processing in Health Care | SpringerLink. https://link.springer.com/chapter/10.1007/978-981-16-0415-7_4

Angelika Haendel, M. A. (2022, July 26). The View of Health Information Managers (HIM): Strategic Insights Through Data Analytics | SpringerLink. https://link.springer.com/chapter/10.1007/978-3-030-91237-6_10

Bigini, G., Zichichi, M., Lattanzi, E., Ferretti, S., & D’Angelo, G. (2023). On the Decentralization of Health Systems for Data Availability: A DLT-based Architecture. 2023 IEEE 20th Consumer Communications & Networking Conference (CCNC), 372–377. https://doi.org/10.1109/CCNC51644.2023.10059701

Capuzzo, M., Zanella, A., Zuccotto, M., Cunico, F., Cristani, M., Castellini, A., Farinelli, A., & Gamberini, L. (2022). IoT Systems for Healthy and Safe Life Environments. 2022 IEEE 7th Forum on Research and Technologies for Society and Industry Innovation (RTSI), 31–37. https://doi.org/10.1109/RTSI55261.2022.9905193

Daniel J. Solove, D. J. S. (2020). HIPAA Mighty and Flawed: Regulation has Wide-Reaching Impact on the Healthcare Industry. Journal of AHIMA, 84(4), 30–31.

Erdogdu, M., & Ünüsan, Ç. (2022). The Importance and Use of Blockchain Technology in International Payment Methods. International Journal on Engineering, Science and Technology, 4(3), Article 3. https://doi.org/10.46328/ijonest.146

Fabacher, T., Sauleau, E.-A., & Leclerc Du Sablon, N. (2023). Evaluating the Portability of Rheumatoid Arthritis Phenotyping Algorithms: A Case Study on French EHRs. In Caring is Sharing – Exploiting the Value in Data for Health and Innovation (pp. 768–772). IOS Press. https://doi.org/10.3233/SHTI230263

Fatima, S., Aun, M., Hussain, S., Din, B. ul, Sajjad, W., Shahzadi, N., & Jameel, R. (2022). A Secure BlockChain Framework for IoT Healthcare. 2022 International Conference on Emerging Trends in Electrical, Control, and Telecommunication Engineering (ETECTE), 1–6. https://doi.org/10.1109/ETECTE55893.2022.10007122

Gandhi, J., & Walker, I. A. (2022). Patient monitoring techniques. Surgery - Oxford International Edition, 40(6), 370–377. https://doi.org/10.1016/j.mpsur.2022.03.018

Ganta, T., Appel, J. M., & Genes, N. (2023). Patient portal access for caregivers of adult and geriatric patients: Reframing the ethics of digital patient communication. Journal of Medical Ethics, 49(3), 156–159. https://doi.org/10.1136/medethics-2021-107759

George Karway, M. A. G. (2022, December 1). My Data Choices: Pilot evaluation of patient-controlled medical record sharing technology—George Karway, Julia Ivanova, Tina Kaing, Michael Todd, Darwyn Chern, Anita Murcko, Kazi Syed, Mirtha Garcia, Michael Franczak, Mary J Whitfield, Maria Adela Grando, 2022. https://journals.sagepub.com/doi/10.1177/14604582221143893

Govindaraj, V., & Murugan, S. D. A. (2023). An Early Warning Smart Healthcare Kit to Avoid Road Accidents. 2023 7th International Conference on Intelligent Computing and Control Systems (ICICCS), 1–5. https://doi.org/10.1109/ICICCS56967.2023.10142341

Hoang, H. D., Duy, P. T., Tien, N. T., Thu Hien, D. T., & Pham, V.-H. (2022). A Blockchain-based approach and Attribute-based Encryption for Healthcare Record Data Exchange. 2022 RIVF International Conference on Computing and Communication Technologies (RIVF), 65–70. https://doi.org/10.1109/RIVF55975.2022.10013886

Khan, F., Khan, S., Tahir, S., Ahmad, J., Tahir, H., & Shah, S. A. (2021). Granular Data Access Control with a Patient-Centric Policy Update for Healthcare. Sensors, 21(10), Article 10. https://doi.org/10.3390/s21103556

Kulüke, M., Kindermann, S., & Kölling, T. (2023). IPFS Pinning Service for Open Climate Research Data (EGU23-6311). EGU23. Copernicus Meetings. https://doi.org/10.5194/egusphere-egu23-6311

Kumar, A., Kumar Sah, B., Mehrotra, T., & Rajput, G. K. (2023). A Review on Double Spending Problem in Blockchain. 2023 International Conference on Computational Intelligence and Sustainable Engineering Solutions (CISES), 881–889. https://doi.org/10.1109/CISES58720.2023.10183579

Mahendra Pratap Singh, M. P. S. (2023, April 17). Role of Access Control in Information Security: A Security Analysis Approach | IntechOpen. https://www.intechopen.com/chapters/86916

Maryam Farhadi, H. S. (2022). Assessing HIPAA Compliance of Open Source Electronic Health Record Applications | IGI Global. https://www.igi-global.com/gateway/chapter/309039

Micelle J. Haydel, P. F. E. (Director). (2021, February 4). Health Insurance Portability and Accountability Act. StatPearls Publishing. https://typeset.io/papers/health-insurance-portability-and-accountability-act-zlzig9kezk

Nobari, A. H., Srivastava, A., Gutfreund, D., & Ahmed, F. (2022). LINKS: A dataset of a hundred million planar linkage mechanisms for data-driven kinematic design (arXiv:2208.14567). arXiv. https://doi.org/10.48550/arXiv.2208.14567

Pandey, P., & Litoriya, R. (2020). Implementing healthcare services on a large scale: Challenges and remedies based on blockchain technology. Health Policy and Technology, 9(1), 69–78. https://doi.org/10.1016/j.hlpt.2020.01.004

Patel, P., & Barton, J. (2023). Administrative Inefficiency and The United States Healthcare System. Journal of Student Research, 11(3). https://doi.org/10.47611/jsr.v11i3.1674

Priya, J., & Palanisamy, C. (2022). Novel Block Chain Technique for Data Privacy and Access Anonymity in Smart Healthcare. Intelligent Automation & Soft Computing, 35(1), 243–259. https://doi.org/10.32604/iasc.2023.025719

Quasim, M. T., Mobarak, M. M., Nisa, K. U., Meraj, M., & Khan, M. Z. (2023). Blockchain-based Secure Health Records in the Healthcare Industry. 2023 7th International Conference on Trends in Electronics and Informatics (ICOEI), 545–549. https://doi.org/10.1109/ICOEI56765.2023.10125802

Rudzidatul Akmam Dziyauddin, F. A. R. (2023, April 7). Sustainability | Free Full-Text | Blockchain-Based Framework for Interoperable Electronic Health Records for an Improved Healthcare System. https://www.mdpi.com/2071-1050/15/8/6337

S. Farjana Farvin, R. Nithyashree, R. Sivanandhini, & D. R. Subasri. (2023). U-MEDCHAINA Blockchain Based System for Medical Records Access and Permissions Management. International Journal of Advanced Research in Science, Communication and Technology, 297–303. https://doi.org/10.48175/IJARSCT-9133

Singh, S., Gupta, S., & Indu. (2023). MedEHR-Electronic health Record using Blockchain. 2023 International Conference on Computational Intelligence, Communication Technology and Networking (CICTN), 58–62. https://doi.org/10.1109/CICTN57981.2023.10141053

Sosu, R. N. A., Quist-Aphetsi, K., & Nana, L. (2019). A Decentralized Cryptographic Blockchain Approach for Health Information System. 2019 International Conference on Computing, Computational Modelling and Applications (ICCMA), 120–1204. https://doi.org/10.1109/ICCMA.2019.00027

Suljanovic, N., Souvent, A., Taylor, G., Radi, M., Cantenot, J., Lambert, E., & Morais, H. (2019). Design of Interoperable Communication Architecture for TSO-DSO Data Exchange. 2019 IEEE Milan PowerTech, 1–6. https://doi.org/10.1109/PTC.2019.8810941

Sundvall, E., Terner, A., Broberg, H., & Gillespie, C. (2019). Configuration of Input Forms in EHR Systems Using Spreadsheets, openEHR Archetypes and Templates. In MEDINFO 2019: Health and Wellbeing e-Networks for All (pp. 1781–1782). IOS Press. https://doi.org/10.3233/SHTI190645

Swapnil Singh, D. K. (2022). Medical IoT: Opportunities, Issues in Security and Privacy—A Compreh. https://www.taylorfrancis.com/chapters/edit/10.1201/9781003239895-6/medical-iot-opportunities-issues-security-privacy-comprehensive-review-deepa-krishnan-swapnil-singh

Taherdoost, H. (2023). The Role of Blockchain in Medical Data Sharing. Cryptography, 7(3), Article 3. https://doi.org/10.3390/cryptography7030036

Vishal Patel, V. P. (2019). A framework for secure and decentralized sharing of medical imaging data via blockchain consensus—Vishal Patel, 2019. https://journals.sagepub.com/doi/10.1177/1460458218769699

Walid, R., Joshi, K. P., & Geol Choi, S. (2023). Semantically Rich Differential Access to Secure Cloud EHR. 2023 IEEE 9th Intl Conference on Big Data Security on Cloud (BigDataSecurity), IEEE Intl Conference on High Performance and Smart Computing, (HPSC) and IEEE Intl Conference on Intelligent Data and Security (IDS), 1–9. https://doi.org/10.1109/BigDataSecurity-HPSC-IDS58521.2023.00012

Xue, L., Liu, D., Huang, C., Shen, X., Zhuang, W., Sun, R., & Ying, B. (2022). Blockchain-Based Data Sharing With Key Update for Future Networks. IEEE Journal on Selected Areas in Communications, 40(12), 3437–3451. https://doi.org/10.1109/JSAC.2022.3213312

Zandvakili, I., & Pulaski, M. (2023). A phenotypic approach to obesity treatment. Nutrition in Clinical Practice, 38(5), 959–975. https://doi.org/10.1002/ncp.11013