Ethereum and medical records

Personal Health Systems View all 5 Articles. Personal Health Records PHRs have the potential to give patients fine-grained, personalized and secure access to their own medical data and to enable self-management of care. Emergent trends around the use of Blockchain, or Distributed Ledger Technology, seem to offer solutions to some of the problems faced in enabling these technologies, especially to support issues consent, data exchange, and data access. Our intention is to enable patient use of the data in order to support their care and to provide a strong consent mechanisms for sharing of data between different organizations and apps. Ledger of Me is based on around the principle that this combination of event-driven smart contracts, medical record data, and patient control is important for the adoption of blockchain-based solutions for the PHR.

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By 2020, 1-in-5 healthcare orgs will adopt blockchain; here’s why

Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. Annual Symposium proceedings. Free to read. Electronic medical records EMRs are critical, highly sensitive private information in healthcare, and need to be frequently shared among peers.

Blockchain provides a shared, immutable and transparent history of all the transactions to build applications with trust, accountability and transparency.

This provides a unique opportunity to develop a secure and trustable EMR data management and sharing system using blockchain. In this paper, we present our perspectives on blockchain based healthcare data management, in particular, for EMR data sharing between healthcare providers and for research studies.

We propose a framework on managing and sharing EMR data for cancer patient care. In collaboration with Stony Brook University Hospital, we implemented our framework in a prototype that ensures privacy, security, availability, and fine-grained access control over EMR data. The proposed work can significantly reduce the turnaround time for EMR sharing, improve decision making for medical care, and reduce the overall cost. Electronic medical records EMRs are critical but highly sensitive private information for diagnosis and treatment in healthcare, which need to be frequently distributed and shared among peers such as healthcare providers, insurance companies, pharmacies, researchers, patients families, among others.

A patient, suffering from a serious medical condition such as cancer, or HIV, has to maintain the long history of the treatment process and post-treatment rehabilitation and monitoring. Having access to a complete history may be crucial for his treatment: for instance, knowing the delivered radiation doses or laboratory results is necessary for continuing the treatment.

A patient may visit multiple medical institutions for a consultation, or may be transferred from one hospital to another. According to the legislation 1 — 4 , a patient is given a right over his health information and may set rules and limits on who can look at and receive his health information. If a patient needs to share his clinical data for the research purposes, or transfer them from one hospital to another, he may be required to sign a consent that specifies what type of data will be shared, the information about the recipient, and the period during which the data can be accessed by the recipient.

This may be extremely difficult to coordinate, especially when a patient is moving to another city, region, or country and may not know in advance the caregiver or hospital where he will be receiving care later on. Even if the consent is provided, the process of transferring the data is time consuming, especially if sending them by post.

Ecosystems for health information exchange HIE such as CommonWell Health Alliance aim to ensure that the data form patient electronic health record are securely, efficiently and accurately shared nationwide in US.

Moreover, such ecosystems do not address the requirements in case of transferring data from one country to another. Data aggregation for research purposes also requires the consent unless the data are anonymized. However, it has been shown that independent release of locally anonymized medical data corresponding to the same patient and originated from different sources e.

It also requires either conducting all the operations such as search, or anonymization over encrypted data, or choosing a fully trusted entity that will have access to sensitive information about the patients. The former still requires management of large amounts of memory 33 and is not suitable for hospital environment.

The latter was proven to be very difficult to put in practice. An example of GoogleHealth wallet 5 has shown that patients are concerned about their privacy and aware of the potential risk that their sensitive data might be misused. Having access to a ledger - shared, immutable, and transparent history of all the actions that have happened to all the participants of the network such as a patient modifying permissions, a doctor, accessing or uploading new data, or sharing them for research overcome the issues presented above.

By providing the tool to achieve consensus among distributed entities without relying on a single trusted party, blockchain technology will guarantee data security, control over sensitive data, and will facilitate healthcare data management for the patient and different actors in medical domain.

In the healthcare settings we can define a transaction as a process of creating, uploading or transferring EMR data that is performed within the connected peers. A set of transactions grouped at certain time is added to the ledger that records all the transaction and therefore represents the state of the network.

The key benefits of applying the blockchain technology in healthcare are the following: verifiable and immutable transactions; tamper resistance, transparency, and integrity of distributed sensitive medical data. This is mainly achieved by employing consensus protocol and cryptographic primitives such as hashing and digital signatures.

The possibility of using blockchain for healthcare data management has recently raised a lot of attention in both industry and academia 7 , 21 , 27 , However, only one functioning prototype of a system that uses blockchain for medical data management has been proposed 7. In our work, we focus on a practical implementation of a system that uses blockchain technology and can be integrated in clinical practice.

Combining these technologies allows us to guarantee data security and privacy as well as availability with respect to the access control policy defined by the patient. The contribution of the paper is twofold. First, we propose multiple scenarios of blockchain applications in healthcare and analyze existing technology implementations that could be used to put the scenarios in practice. Second, we present a framework for blockchain based data sharing for primary care of oncology patients under cancer treatment.

We developed a prototype in collaboration with the Department of Radiation Oncology in a major US hospital. Therefore, the functionality of the prototype is expected to meet the requirements from medical practice perspective. Blockchain is a peer-to-peer distributed ledger technology that was initially used in the financial industry. Based on how the identity of a user is defined within a network, one could distinguish between permissioned and permissionless blockchain systems. A permissionless system is one in which the identities of participants are either pseudonymous or even anonymous 20 and every user may append a new block to the ledger.

In contrast, in case of a permissioned blockchain, the identity of a user is controlled by an identity provider. Next we introduce two most well-known implementations of the blockchain technology: Ethereum 8 and Hyperledger Ethereum 8 is an implementation of a permissionless programmable blockchain that allows any user to create and execute the code of arbitrary algorithmic complexity on the Ethereum platform: Ethereum Virtual Machine EVM.

Externally owned account EOA is an account controlled by a private key of a user. Contract account is the second type of accounts that can be seen as an autonomous agent that lives in the Ethereum execution environment and is controlled by its contract code: smart contract.

Smart contract is used to encode arbitrary state transition functions, allowing users to create systems with different functionalities by transforming the logic of the system into the code. Code execution in Ethereum must be paid.

The transaction price limits the number of computational steps for the code execution in order to prevent infinite loops or other computational wastage. Users could participate in a consensus process to obtain the tokens to be paid for transaction execution. In Ethereum, the consensus is achieved by using a proof-of-work PoW mechanism.

These requirements set the difficulty threshold for the process of finding the nonce The difficulty threshold impacts the amount of energy to be spent to find such nonce. For example, the amount of energy used by Bitcoin mining is comparable to the Irish national energy consumption These two findings show that PoW can negatively impact the system scalability and overall throughput Instead of having participants mine by exchanging their wealth for computational resources which are then exchanged for mining rewards , in virtual mining, participants could exchange their wealth directly for the ability to append a new block to the ledger However, providing a rigorous argument for or against the stability of virtual mining remains an open problem In the case of a permissionned system, users do not have an incentive to cheat as their identity is revealed to the identity server.

Moreover, participation in consensus management is restricted to a predefined set of users. This opens a possibility to use a state machine replication algorithm such as PBFT 19 as a consensus mechanism.

Hyperledger 11 — an implementation of a permissioned blockchaian — is an open source blockchain initiative hosted by the Linux Foundation. Hyperledger has a modular architecture that allows plugging in different consensus mechanisms, including PBFT. Hyperledger services could be logically grouped in three categories: Membership services, Blockchain services, and Chaincode services Membership services manage identity, privacy, and confidentiality on the network.

A user is assigned a username and a password that will be used to issue the Enrollment certificate ECert to identify every registered user. It is possible to use different Transaction certificates TCert associated with the same ECert for every transaction to ensure their unlinkability a mapping between TCert and Ecert are only known to the membership service. In Hyperledger, smart contracts are implemented by the chaincode. Chaincode services provide a secure way to execute smart contracts on validating nodes.

In Hyperledger, smart contracts are implemented by chaincode that consist of Logic and associated World State State. Logic of the chaincode is a set of rules that define how transactions will be executed and how State will change.

State is a database that stores the information in a form of keys and values that are arbitrary byte arrays. The State also contains the block number to which it corresponds. Ledger manages blockchain by including an efficiently cryptographic hash of the State when appending a block. This allows efficient synchronization if a node was temporary off-line, minimizing the amount of stored data at the node Blockchain provides a unique opportunity to support healthcare.

In this section, we propose three scenarios: primary patient care, medical research, and connected health.

Figure 1 shows a graphical representation of the combination of the aforementioned scenarios. Scenarios of using blockchain in different healthcare settings: Scenario 1: Primary patient care; Scenario 2: Data aggregation for the research purposes; Scenario 3: Connecting different healthcare players for better patient care. Scenario 1: Primary Patient Care. Using blockchain technology for primary patient care can help to address the following problems of the current healthcare systems:.

A patient often visits multiple disconnected hospitals. He has to keep the history of all his data and maintain the updates. This leads to the situation when required information may not be available. Due to the unavailability of the data, patient may have to repeat some tests for laboratory results. This is common when the results are stored in another hospital and can not be immediately accessed. The healthcare data are sensitive and their management is cumbersome.

Yet, there is no privacy-preserving system in clinical practice that allows patients to maintain access control policy in an efficient manner. Sharing data between different healthcare providers may require major effort and could be time consuming.

Next, we propose two approaches that can be implemented separately or combined to improve patient care. Institution-based: The network would be formed by the trusted peers: healthcare institutions or general practitioners caregivers. The peers will run consensus protocol and maintain a distributed ledger. The patient or his relatives will be able to access and manage his data through an application at any node where his information is stored.

If a peer is off-line, a patient could access the data through any other online node. The network would connect doctors, nurses, and family to achieve efficiency and transparency of the treatment. This will help to eliminate human-made mistakes, to ensure consensus in case of a debate about certain stage of the treatment.

Jurnal Riset Kesehatan

Metrics details. Clinical Trials CTs help in testing and validating the safety and efficacy of newly discovered drugs on specific patient population cohorts. However, these trials usually experience many challenges, such as extensive time frames, high financial cost, regulatory and administrative barriers, and insufficient workforce. In addition, CTs face several data management challenges pertaining to protocol compliance, patient enrollment, transparency, traceability, data integrity, and selective reporting. Blockchain can potentially address such challenges because of its intrinsic features and properties. Although existing literature broadly discusses the applicability of blockchain-based solutions for CTs, only a few studies present their working proof-of-concept. We propose a blockchain-based framework for CT data management, using Ethereum smart contracts, which employs IPFS as the file storage system to automate processes and information exchange among CT stakeholders.

integrates distributed health records using blockchain technology 3 Platforms used in the solution, where E: Ethereum and H: Hyperledger.

Blockchain-Based Medical Record Management with Biofeedback Information

John D. Halamka, M. We're feeling less confused now, and hope you will, too. Let's look at banks, which we are forced to trust because there hasn't been an alternative. But a bank is one corporation. A corporation can come and go. A corporation can falsify a corrupt record. The whole blockchain concept came out of the idea, as an alternative, of a decentralized public ledger: A network of thousands of independent server farms. And then, add to that, an algorithm that says once something is written to this chain, it can never be erased or altered. And, by the way, let's put in cryptography that ensures integrity.

Ether and Chloroform

ethereum and medical records

Jacob A. This post has been paid for in order to allow third-party generated content to be published. It has been written for educational purposes. The healthcare industry is ready for change. Unfortunately, the innovation that does exist in healthcare is fragmented; startups form to take on chunks of inefficiency in the system, but we are a far cry from our dream of true interoperability.

Sathyanarayanan M.

Secure and Trustable Electronic Medical Records Sharing using Blockchain.

Published on 7. Authors of this article:. Background: The Health Avatar Platform provides a mobile health environment with interconnected patient Avatars, physician apps, and intelligent agents termed IoA 3 for data privacy and participatory medicine; however, its fully decentralized architecture has come at the expense of decentralized data management and data provenance. Objective: The introduction of blockchain and smart contract technologies to the legacy Health Avatar Platform with a clinical metadata registry remarkably strengthens decentralized health data integrity and immutable transaction traceability at the corresponding data-element level in a privacy-preserving fashion. A crypto-economy ecosystem was built to facilitate secure and traceable exchanges of sensitive health data. We implemented an Ethereum-based hash chain for all transactions and smart contract—based processes to guarantee decentralized data integrity and to generate block data containing transaction metadata on-chain.

Blockchain in Healthcare: How Blockchain Can Revolutionize The Medical Industry

Emerging technologies, as described by Industry 4. Blockchain technology is a peer network for transferring digital assets and data without any hassle intermediate technologies and supports the popular crypto currency bitcoin. Bitcoin was first announced in and implemented by Nakamoto in Rayome, The chain will continue to grow when new blocks are added. All transactions occur in a decentralized manner, eliminating the need for any intermediaries to verify transactions Tsai et al. Blockchain has some key features, such as decentralization, transparency, variability and adaptability. Blockchain operates in a decentralized environment and employs digital signatures, cryptographic hash and distributed core technologies, consensus mechanisms.

In a medical record management system, a complete database is used to store and obtain patient medical information. The electronic medical.


Takes privacy and security concerns to the next level, and increases trust in the system and the records. In many cases, digitized or even printed copies of medical records must be obtained when multiple healthcare companies or doctors are involved. Blockchain removes this by using Smart Contracts that govern the way information is to be added into the chain in a common format to all parties. The communication of healthcare records is neither secure nor efficient enough to serve its purpose, with frequent breaches data threatening the sanctity of the entire system.

Electronic Medical Record System Using Ethereum Blockchain and Role-Based Access Control

Through a lifespan, a person patient can change several medical providers individual doctors, hospitals. This knowledge, medical information, about the patient, stays within the premises of each institution and cannot be shared in an easy way with another provider. The patient has no knowledge who and why has access to their data. The main benefit of this project is that it gives patients control over the distribution of their own data.

Separate from its work with Mayo Clinic, Medicalchain is preparing to pilot a telemedicine application based on Hyperledger blockchain in four clinics in London.

The Short Case for Blockchain in Healthcare

A Medical Record System smart contract for hospitals and patients. Built with Truffle and zeppelin-solidity. If you don't have a private key, you can use one provided by Ganache for development only! A Medical Record System contract deployer keeps records of patient stays, including admission date, discharge date, and visit reason code:. As an incentive to share their name, patients get paid in tokens when they share their name:.

Singapore touts blockchain use in COVID-19 data management

Blockchain, a distributed peer-to-peer ledger technology, has been leveraged by a number of industries in the interest of decentralizing and reducing costs. The most famous implementation of blockchain would be its use in cryptocurrency, the most widely known of which being Bitcoin and Ethereum. The blockchain platform uses unique, immutable, and time-stamped blocks of records or sets of data, which are linked in chains through cryptography to allow for more reliable and transparent data storage and transfers. Though the technology is still young and its use cases are growing, its use in health care spaces to date has remained limited.

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