Abstract:
There is hardly any human activity which has not been positively affected by digital technologies impacting the access and exchange of information. Specifically, within the healthcare sector major improvements could be achieved. Nowadays nearly all medical records are kept in electronic healthcare record (EHR) systems improving the access to clinical data intending to streamline costs. Electronic Health Records (EHRs) are however largely non-portable and kept on the systems where they have been created mainly due to interoperability, security, and liability reasons. This is resulting in a lack of medical quality for the patient and an increase of healthcare costs since the information transfer among different healthcare providers, spread over different locations, is highly dependent on the patient who is not considered as data owner and may not be aware of certain treatments received. Moreover, medical data is strictly personal and the consequences of unintentional disclosure of this sensitive data are severe. Recordkeeping systems embedded in the various healthcare systems must therefore adhere to the highest standards of security and privacy.
The objective of this thesis was to investigate how data security, privacy and scalability challenges within the context of Electronic Health Record systems can be overcome considering the patient as the owner of his patient data by taking advantage of the Blockchain technology. Blockchains allow for immutable recordkeeping, which means that data stored on the blockchain cannot be changed or tampered with. Each block on the blockchain stores the computed hash of the contents of the previous block, which makes each new block dependent on the previous block. Nodes store their own copies of the blockchain and keep them synchronized by using mechanisms for distributed consensus. Distributed consensus mechanisms for blockchains facilitate methods to decide which block is to be added to the blockchain next and essentially decide which version of the blockchain is the correct one.
In this research a blockchain-based EHR framework has been proposed to overcome above mentioned challenges. We have implemented a prototype of Electronic Health Records System using permissioned blockchain platform “Hyperledger”. This system ensures better data security, data privacy, scalability and easy accessibility and availability of medical records. A thorough description has been provided as to which modules are needed to assure a proper data extraction, mapping, monitoring, user access management and intervention with the Blockchain. In conclusion, it is possible to overcome security and privacy and scalability (in recently proposed blockchain-based EHR systems) issues by using the Blockchain technology for a variety of use-cases, such as secure storage and sharing of medical data. Although the presented implementation is intended for use in EHR systems, it should also be applicable to other types of recordkeeping systems.