Addressing the Challenges of Electronic Health Records Using Blockchain and IPFS

Abstract

Electronic Health Records (EHR) are the healthcare sector’s core digital strategy meant to improve the quality of care provided to patients. Despite the benefits afforded by this digital transformation initiative, adoption among healthcare organizations has been slower than desired. The sheer volume and sensitive nature of patient records compel these organizations to exercise a healthy amount of caution in implementing EHR. Cyberattacks have also increased the risks associated with non-optimal EHR implementations. An influx of high-profile data breaches has plagued the sector during the COVID-19 pandemic, which put the spotlight on EHR cybersecurity. One objective of this research project is to aid the acceleration of EHR adoption. Another objective is to ensure the robustness of the system to resist malicious attacks. For the former, a systematic review was used to unearth all the possible causes why the adoption of EHR has been anemic. In this paper, sixty-five existing proposed EHR solutions were analyzed and it was found that there are fourteen major challenges that need to be addressed to reduce friction and risk for health organizations. These were privacy, security, confidentiality, interoperability, access control, scalability, authentication, accessibility, availability, data storage, data ownership, data validity, data integrity, and ease of use. We propose EHRChain, a new framework that tackles all the listed challenges simultaneously to address the first objective while also being designed to achieve the second objective. It is enabled by dual-blockchains based on Hyperledger Sawtooth to allow patient data decentralization via a consortium blockchain and IPFS for distributed data storage.

A survey of healthcare sector digitization strategies: Vulnerabilities, countermeasures and opportunities

“…As such, there has been slower adoption of this digital transformation among healthcare organizations. Owing to the high volume and sensitive nature of patient records, the healthcare sector is cautious in the implementation of HER [19]. In addition, there have been reported cases of disrupted services, compromised health records, expensive payments to ransomware attackers, unavailability of essential health care services, and the stealing and selling of patient health records in the black market [20], [21].…”

Survey on Security and Interoperability of Electronic Health Record Sharing Using Blockchain Technology

“…To tackle these issues, many related examinations and applications have embraced a cross-breed storage design. This is an off-chain storage system where only the reference information stored in a blockchain, and the actual copy of the information may be stored using an Interplanetary File System (IPFS) by Pilares et al (2022).…”

“…Some probable solutions to the above limitations to utilization of blockchain in healthcare applications have been proposed. For instance, as a corrective measure to the scalability issue, it is feasible to use an "off-chain," storage technique, where only the link/reference to the information is stored in the blockchain, whereas the actual data in encrypted form are stored using the IPFS (Pilares et al, 2022). This method of storage also resolves the GDPRs "right to be forgotten" issue, since in the off-chain approach, the original data are stored in IPFS, and can thus be erased forever.…”

Survey on Electronic Health Record Management Using Amalgamation of Artificial Intelligence and Blockchain Technologies

“…PHRs are useful for remote assistance and reduce response time in the event of a disaster. Healthcare experts make recommendations to patients based on information available in both EHR and PHR (Fang et al, 2021;Pilares et al, 2022). Figure 1 shows the cycle of EHR data storage.…”