PACEX: PAtient-Centric EMR eXchange in Healthcare Systems using Blockchain

Toshniwal, Bhavesh; Podili, Prashanth; Reddy, Ravula Jaysimha; Kataoka, Kotaro

doi:10.1109/iemcon.2019.8936258

Cited by 14 publications

(8 citation statements)

References 16 publications

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“…Most of the current limitations can be grouped into 1 of the following 3 main categories: (1) scalability, (2) privacy, and (3) usability. Scalability issues pertained to the inability of blockchain PHR to store large file sizes such as medical images [ 44 , 53 , 54 ] or to the slowness in confirming transactions, especially with the incorporation of streaming data from internet of things devices [ 45 , 76 ].…”

Section: Resultsmentioning

confidence: 99%

Blockchain Personal Health Records: Systematic Review

Fang¹,

Tan²,

Tan³

et al. 2021

J Med Internet Res

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Background Blockchain technology has the potential to enable more secure, transparent, and equitable data management. In the health care domain, it has been applied most frequently to electronic health records. In addition to securely managing data, blockchain has significant advantages in distributing data access, control, and ownership to end users. Due to this attribute, among others, the use of blockchain to power personal health records (PHRs) is especially appealing. Objective This review aims to examine the current landscape, design choices, limitations, and future directions of blockchain-based PHRs. Methods Adopting the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, a cross-disciplinary systematic review was performed in July 2020 on all eligible articles, including gray literature, from the following 8 databases: ACM, IEEE Xplore, MEDLINE, ScienceDirect, Scopus, SpringerLink, Web of Science, and Google Scholar. Three reviewers independently performed a full-text review and data abstraction using a standardized data collection form. Results A total of 58 articles met the inclusion criteria. In the review, we found that the blockchain PHR space has matured over the past 5 years, from purely conceptual ideas initially to an increasing trend of publications describing prototypes and even implementations. Although the eventual application of blockchain in PHRs is intended for the health care industry, the majority of the articles were found in engineering or computer science publications. Among the blockchain PHRs described, permissioned blockchains and off-chain storage were the most common design choices. Although 18 articles described a tethered blockchain PHR, all of them were at the conceptual stage. Conclusions This review revealed that although research interest in blockchain PHRs is increasing and that the space is maturing, this technology is still largely in the conceptual stage. Being the first systematic review on blockchain PHRs, this review should serve as a basis for future reviews to track the development of the space.

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Section: Resultsmentioning

confidence: 99%

Blockchain Personal Health Records: Systematic Review

Fang¹,

Tan²,

Tan³

et al. 2021

J Med Internet Res

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“…Most selected studies (19) recommend using the on-chain transactions to store metadata about the health records, the hash value of the original record, and a pointer to an off-chain storage mechanism where the actual record is kept [5,8,10,25,29,30,37,40,41,[44][45][46][47][53][54][55][56]. Two studies [3,15] only keep a link to the off-chain record file.…”

Section: Resultsmentioning

confidence: 99%

“…Figure 5 displays the range of technologies that they used. Blockchain-based frameworks underpinned most of the solution designs, particularly those that provided smart contracts support: Ethereum and Ethereum-based platforms were selected as core elements of 15 studies [56], [8], [3], [41], [51], [55], [15], [32], [30], [5], [45], [44], [25], [54], [40] while Hyperledger frameworks featured as the central component in 3 studies [53], [21], [29]. Specific blockchain technologies were used for prototype-based studies like Corda [4], OPNET [37] and other customized implementations [47].…”

Section: Rq1: What Is the Present Research And Implementations Approa...mentioning

confidence: 99%

“…This feature supports use cases like the use of Internet of Medical Things (IoMT) devices for patient health monitoring or wearable devices for wellness information like those recommended by Azbeg et al [3], Uddin et al [47], Griggs et al [15], Mubarakali [32], and Tripathi et al [46] Blockchains arrange their information in connected blocks of data and, as each node in the network has a copy of all blocks, the Blockchain is also auditable. Studies like that of Toshniwal et al [45] take advantage of this feature through a medical records exchange system that keeps track of the movement of electronic medical records between the healthcare providers.…”

Section: Rq1: What Is the Present Research And Implementations Approa...mentioning

confidence: 99%

See 1 more Smart Citation

Blockchains and Self-Sovereign Identities Applied to Healthcare Solutions: A Systematic Review

Siqueira¹,

Conceição²,

Rocha³

2021

Preprint

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Self-Sovereign Identity (SSI), a Blockchain-based technology for digital identity management, is a promising concept for handling health data. It could represent a step forward in empowering users, granting them control over their data. This work conducts a systematic literature review to investigate state-of-the-art measures based on SSI and Blockchain technologies for dealing with electronic health records (EHRs), identifying gaps, and determining the key questions for future research. As a result, this review shows a growing interest in Blockchain methods to handle EHRs, but few works consider using the self-sovereign identity approaches. The results obtained in this work also suggest that: Blockchain technologies provide a viable alternative to deliver EHR solutions such as patient monitoring, healthcare data trading, and prescription control; consolidated Blockchain technologies are the preferred core components of most effective strategies; keeping raw health data off-chain helps to create scalable solutions; health data standards make searching medical records in Blockchain structures feasible; Smart Contracts are essential components of Blockchain-based EHR solutions; the concepts of data ownership and Self-Sovereign Identity have been neither adequately defined nor employed in the health context. CCS Concepts: • Applied computing → Health care information systems; • Security and privacy → Privacy protections; • Computer systems organization → Peer-to-peer architectures; • General and reference → Surveys and overviews.

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“…(3) usability. Scalability issues pertained to the inability of blockchain PHR to store large file sizes such as medical images [44,53,54] or to the slowness in confirming transactions, especially with the incorporation of streaming data from internet of things devices [45,76].…”

Section: Current Limitationsmentioning

confidence: 99%

Blockchain Personal Health Records: Systematic Review (Preprint)

Fang¹,

Tan²,

Tan³

et al. 2020

Preprint

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BACKGROUND Blockchain technology has the potential to enable more secure, transparent and equitable data management. In the healthcare domain, it has been most frequently applied to electronic health records (EHRs). Apart from securely managing data, blockchain also has a significant advantage of distributing data access, control and ownership to the end-users. This attribute, among others, makes it especially appealing when used to power personal health records (PHRs). OBJECTIVE In this review, we aim to examine the current landscape, design choices and limitations of blockchain-based PHRs. METHODS Adopting the PRISMA guidelines, a cross-discipline systematic review was performed in July 2020 on all eligible articles, including grey literature, from the following eight databases: ACM, IEEE Xplore, MEDLINE, ScienceDirect, Scopus, SpringerLink, Web of Science and Google Scholar. Three reviewers independently performed a full-text review and data abstraction using a standardized data collection form. RESULTS 58 articles fulfilled the inclusion criteria. The review found that the blockchain PHR space has been maturing over the past five years, from purely conceptual ideas initially to an increasing trend of publications describing prototypes and even implementations. Although the eventual PHR application is purposed for the healthcare industry, majority of the articles came from Engineering or Computer Science publications. Among the blockchain PHRs described, permissioned blockchains and off-chain storage were the more common design choices. While eighteen articles described a tethered blockchain PHR, all of these were at the conceptual stage. CONCLUSIONS This review revealed that research interest in using blockchain for PHRs is increasing and that the space is maturing. With further experimentation, this trend will very likely lead to breakthroughs to address existing limitations which could ultimately accelerate the adoption of blockchain PHRs.

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PACEX: PAtient-Centric EMR eXchange in Healthcare Systems using Blockchain

Cited by 14 publications

References 16 publications

Blockchain Personal Health Records: Systematic Review

Blockchain Personal Health Records: Systematic Review

Blockchains and Self-Sovereign Identities Applied to Healthcare Solutions: A Systematic Review

Blockchain Personal Health Records: Systematic Review (Preprint)

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