Page 203 - ITU KALEIDOSCOPE, ATLANTA 2019

DESIGN OF A CREDIBLE BLOCKCHAIN-BASED E-HEALTH RECORDS (CB-EHRS)
PLATFORM

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Lingyu Xu ; Antoine Bagula ; Omowunmi Isafiade ; Kun Ma ; Tapiwa Chiwewe 2
1 University of the Western Cape
2
IBM Research Africa

ABSTRACT

With the rapid development of electronic health care, the
era of medical big data has already emerged. However,
in the global electronic health industry environment, one
of the significant challenges is that the various medical
institutions are independent of one another. Patients,
doctors and medical researchers have significant barriers
in accessing medical data. As an intervention strategy using
blockchain principle, this paper explores the characteristics
of blockchain which are applicable to the management
of electronic health records (EHRs), and presents
a credible blockchain-based electronic health records
(CB-EHRs) management platform. A CB-EHRs platform
is characterized by decentralization, data tamper-proof, Figure 1 – An assessment of the use of EHRs between 2012
collective maintenance mechanisms, security and credibility. and 2016 [5]
This platform cannot only realize data sharing between
medical institutions, but also ensures the privacy of users. inevitable for most, if not all, medical practitioners [4]. In a
This paper introduces the components of the CB-EHRs EHRs study conducted in 2016 [5], researchers examined
platform model and the implementation principle of its related 15,285 physicians in 28 different departments. Figure 1
functions. In addition, this paper also reviews and selects present an overview of the result of their study. The goal of
the delegated Byzantine Fault Tolerance (dBFT) consensus the research was to know the extent to which the EHRs system
mechanism as a viable option for the CB-EHRs platform. is utilized, score of EHRs system, satisfaction levels, impacts
Finally, by comparing with the Practical Byzantine Fault on doctors’ daily routines and doctor-patient communication.
Tolerance (PBFT) consensus mechanism and our research, Overall, the acceptance and use of the EHRs system have
we highlight the potential advantages of our proposed dramatically changed since 2012 as seen in Figure 1. More
CB-EHRs platform in the medical domain. than 91% respondents indicated that they are using EHRs,
compared with a 74% rate observed in 2012. In addition, 2%
Keywords - Blockchain, CB-EHRs, data sharing, electronic of the respondents said that they are in the process of installing
health records, privacy protection EHRs, and 3% plan to buy or use EHRs in the coming year.
This means that almost every medical practitioner will use
1. INTRODUCTION EHRs in the near future. Considering the outcome of this
study, it is clear that the shift from a paper-based structure to
In recent years, various electronic information technologies electronic-based records is rapidly evolving. In the current
have penetrated daily human life, such as cloud computing, age, only a few doctors can operate effectively and efficiently
Internet of things and internet technologies. Hence, the era without EHRs.
of globalized big data has emerged [1]. Furthermore, with
the rapid development of medical and health services, a large While it is widely recognized that an EHRs platform is an
amount of medical data is generated on a daily basis, which inevitable technology platform in the medical domain, there
confirms a necessity for electronic health records (EHRs) are still a number of challenges that need to be tackled
technology. EHRs is an electronic version of a patients in this domain, in order to promote its use in the near
medical history. So far, most EHRs are managed by an EHRs future. Such challenges include, but are not limited to:
platform belonging to an independent medical institution. (i) difficulty in data sharing; (ii) trust and (iii) privacy
Moreover, an EHRs platform also promotes data-driven concerns. Hence, as a way of intervention and by leveraging
decision support in healthcare, for example, through data the principles of blockchain technology, this paper presents
mining [2,3]. While the spread and use of EHRs across the a credible blockchain-based electronic health records (CB-
globe have not been fully realized, EHRs is now becoming EHRs) management platform. CB-EHRs platforms are

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