PatientDataChain: A Blockchain-Based Approach to Integrate Personal Health Records

Abstract

Currently there is not a single trusted infrastructure used for the exchange and storage of medical data along the healthcare value chain and, thus, there is no platform used for monitoring patients’ traceability within the entire healthcare chain. This situation leads to difficult communication and increased procedural costs, and thus it limits healthcare players from developing a better understanding and know-how of patients’ traceability that could further boost innovation and development of the best-fitted health services. PatientDataChain blockchain-based technology is a novel approach, based on a decentralized healthcare infrastructure that incorporates a trust layer in the healthcare value chain. Our aim was to provide an integrated vision based on interoperability principles, that relies on the usage of specific sensors from various wearable devices, allowing us to collect specific data from patients’ medical records. Interconnecting different healthcare providers, the collected data is integrated into a unitary personal health records (PHR) system, where the patient is the owner of his/her data. The decentralized nature of PatientDataChain, based on blockchain technology, leveraged the proper context to create a novel and improved data-sharing and exchange system, which is secure, flexible, and reliable. This approach brings increased benefits to data confidentiality and privacy, while providing secure access to patient medical records. This paper presents the design, implementation, and experimental validation of our proposed system, called PatientDataChain. The original contributions of our paper include the definition of the concept of unifying the entire healthcare value chain, the design of the architectural model of the system, the development of the system components, as well as the validation through a proof of concept (PoC) conducted with a medical clinic from Bucharest, using a dataset of 100 patients and over 1000 transactions. The proof of concept demonstrated the feasibility of the model in integrating the personal health records from heterogeneous sources (healthcare systems and sensors) in a unified, decentralized PHR system, with enhanced data exchange among healthcare players.

Functionalities and Issues in the Implementation of Personal Health Records: Systematic Review

“…The health record function provides patients options to view clinical documents that can be retrieved from health providers’ EHR [ 22 , 23 , 34 ]. This information can include problem lists [ 22 , 24 - 29 , 45 , 56 , 67 - 71 ], allergies [ 22 , 25 - 28 , 30 - 33 , 35 - 39 , 56 , 67 - 70 ], immunization [ 22 , 26 - 28 , 30 , 32 - 35 , 40 - 42 , 56 , 68 - 71 ], laboratory and test results [ 22 , 24 , 26 - 30 , 33 , 36 , 37 , 40 , 42 - 61 , 67 - 71 ], diagnostic information [ 32 , 37 , 44 , 45 , 62 ], discharge information [ 31 , 34 , 63 ], and clinical notes [ 24 , 30 , 33 , 42 , 50 , 61 , 64 , 67 , 69 ]. Figure 3 shows an example of test results in PittPHR [ 33 ].…”

“…This function can also include information about medical history [ 22 , 24 , 30 , 33 , 35 , 37 , 39 , 45 , 51 , 57 , 64 , 65 , 67 , 68 ], family history [ 28 , 30 , 32 , 33 , 35 , 37 , 66 ], genetic history [ 45 ], surgical history [ 26 , 28 , 33 , 35 , 45 , 66 , 68 ], social history [ 32 , 33 , 35 , 37 , 45 , 68 ]. Some studies suggested that this function also supports patients’ ability to print the record [ 24 , 36 ] and add comments or notes in health records [ 28 , 61 ].…”

“…Health record [22,25,26,30,31,34,39,42,[44][45][46]55,59,66,68,70,[72][73][74][75][76][77][78] Allows patients to manage personal information and view information related to health providers and insurance.…”

“…PHRs should also add information about the purpose or class of medications to give patients an understanding of the medication type [74] and allow pharmacists to explore the data according to their common questions [80]. This function also allows patients to view list of prescribed medications [26,30,39,54,79,82,83], prescribing physician [79], refill prescription [24,27,[29][30][31]33,34,36,39,48,53,55,57,60,61,84], order medications [29,39,71], deliver purchased medication [79], as well as track the delivery of medication [36,39,42]. Some PHRs also provide medication schedulers and reminders of when to take medicines [28,70,83,85], drug or medicine reconciliation [42,51,63,83], and warning alerts of potential adverse interactions based on the medication and allergy list [38,68,73].…”

“…Patients can also monitor other self-health data such as sleep [33,66,95,100,101], period [33,100], moods [98,100,101], and stress [66,70,100]. These clinical measures enable calculation such as BMI [39,66,70,85,100], body fat percentage [70], waist-to-height ratio [70], calorie [70], cholesterol level [66,86], and glycemia [86]. This information can also calculate disease risks such as cardiovascular disease risk and metabolic syndrome risk [85].…”