Application of Blockchain Technology in Healthcare
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3.1 Electronic Medical Records
To transform healthcare, the focus should be attributed to the management of
health data that could be improved from the potential to connect heterogeneous
systems and increase Electronic Health Records (EHRs) accuracy. While Electronic medical records (EMRs) and EHRs are used interchangeably, there is a
difference between the two terms. EMRs term came along first, which is a digital
version of the paper charts in the clinician’s office. An EMR contains the medical
and treatment history of the patients in one practice. However, EHRs focus on
the total health of the patient-going beyond standard clinical data collected in
the provider’s office and inclusive of a broader view on a patient’s care [1].
From the mapping study, blockchain technology supports the management
of EHRs. In this context, Ekblaw et al. present [7] MedRec, an EHR-related
implementation that proposes a decentralized approach to manage authorization,
permissions, and data sharing between healthcare stakeholders. MedRec uses
ethereum platform to enable patients to have knowledge and information on
who can get to their healthcare information.
A second application that integrates EHR, is FHIRChain (Fast Health Interoperability Records + Blockchain) [25]. It’s a blockchain-based application
implemented using ethereum for sharing clinical data that focuses on healthcare record management. FHIRChain provides solutions for patients that meet
the requirements from the ONC.
Similarly, Xia et al. present Medshare [24] an ethereum application for systems that struggle with a lack of collaboration for sharing data between cloud
services due to the adverse risks towards displaying the contents of private data.
Medshare provides data provenance, auditing, and control between big data entities for sharing medical data in cloud repositories.
Other blockchain-based EMR applications include MedBlock [8] and BlockHIE [16]. MedBlock [8] provides a mechanism for a record search. The proposed system maintains the address of blocks containing the records of a patient,
grouped by a healthcare provider or department. Each patient inventory contains a reference to the corresponding record on the blockchain. BlocHIE [16]
proposed by Jiang et al. where they present a healthcare platform based on
blockchain technology.
To keep exploiting existing databases, BlocHIE combines both off-chain storage, where data is stored in external hospitals’ databases, and on-chain verification. The blockchain system stores a hashed value of external records. Authors
improve fairness and throughput by proposing FAIR-FIRST and TP&FAIR, two
fairness-based transaction packing algorithms. There is also another healthcare
blockchain-based framework, Ancile [6] which uses ethereum smart contracts to
achieve data privacy, security, access control and interoperability of EMRs.
Roehrs et al. [22] present omniPHR, a distributed model that maintain an
interoperable single-view of Personal Health Records (PHR). The proposed solution is based on an elastic, interoperable and scalable architecture of PHR data.
Furthermore, omniPHR evaluation could ensure the division of PHR into data
blocks and its distribution in a routing overlay network.
271
3.1 Electronic Medical Records
To transform healthcare, the focus should be attributed to the management of
health data that could be improved from the potential to connect heterogeneous
systems and increase Electronic Health Records (EHRs) accuracy. While Electronic medical records (EMRs) and EHRs are used interchangeably, there is a
difference between the two terms. EMRs term came along first, which is a digital
version of the paper charts in the clinician’s office. An EMR contains the medical
and treatment history of the patients in one practice. However, EHRs focus on
the total health of the patient-going beyond standard clinical data collected in
the provider’s office and inclusive of a broader view on a patient’s care [1].
From the mapping study, blockchain technology supports the management
of EHRs. In this context, Ekblaw et al. present [7] MedRec, an EHR-related
implementation that proposes a decentralized approach to manage authorization,
permissions, and data sharing between healthcare stakeholders. MedRec uses
ethereum platform to enable patients to have knowledge and information on
who can get to their healthcare information.
A second application that integrates EHR, is FHIRChain (Fast Health Interoperability Records + Blockchain) [25]. It’s a blockchain-based application
implemented using ethereum for sharing clinical data that focuses on healthcare record management. FHIRChain provides solutions for patients that meet
the requirements from the ONC.
Similarly, Xia et al. present Medshare [24] an ethereum application for systems that struggle with a lack of collaboration for sharing data between cloud
services due to the adverse risks towards displaying the contents of private data.
Medshare provides data provenance, auditing, and control between big data entities for sharing medical data in cloud repositories.
Other blockchain-based EMR applications include MedBlock [8] and BlockHIE [16]. MedBlock [8] provides a mechanism for a record search. The proposed system maintains the address of blocks containing the records of a patient,
grouped by a healthcare provider or department. Each patient inventory contains a reference to the corresponding record on the blockchain. BlocHIE [16]
proposed by Jiang et al. where they present a healthcare platform based on
blockchain technology.
To keep exploiting existing databases, BlocHIE combines both off-chain storage, where data is stored in external hospitals’ databases, and on-chain verification. The blockchain system stores a hashed value of external records. Authors
improve fairness and throughput by proposing FAIR-FIRST and TP&FAIR, two
fairness-based transaction packing algorithms. There is also another healthcare
blockchain-based framework, Ancile [6] which uses ethereum smart contracts to
achieve data privacy, security, access control and interoperability of EMRs.
Roehrs et al. [22] present omniPHR, a distributed model that maintain an
interoperable single-view of Personal Health Records (PHR). The proposed solution is based on an elastic, interoperable and scalable architecture of PHR data.
Furthermore, omniPHR evaluation could ensure the division of PHR into data
blocks and its distribution in a routing overlay network.