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. 2018 Jul 29:16:267-278.
doi: 10.1016/j.csbj.2018.07.004. eCollection 2018.

FHIRChain: Applying Blockchain to Securely and Scalably Share Clinical Data

Peng Zhang  1 , Jules White  1 , Douglas C Schmidt  1 , Gunther Lenz  2 , S Trent Rosenbloom  3
Affiliations

FHIRChain: Applying Blockchain to Securely and Scalably Share Clinical Data

Peng Zhang et al. Comput Struct Biotechnol J. .

Abstract

Secure and scalable data sharing is essential for collaborative clinical decision making. Conventional clinical data efforts are often siloed, however, which creates barriers to efficient information exchange and impedes effective treatment decision made for patients. This paper provides four contributions to the study of applying blockchain technology to clinical data sharing in the context of technical requirements defined in the "Shared Nationwide Interoperability Roadmap" from the Office of the National Coordinator for Health Information Technology (ONC). First, we analyze the ONC requirements and their implications for blockchain-based systems. Second, we present FHIRChain, which is a blockchain-based architecture designed to meet ONC requirements by encapsulating the HL7 Fast Healthcare Interoperability Resources (FHIR) standard for shared clinical data. Third, we demonstrate a FHIRChain-based decentralized app using digital health identities to authenticate participants in a case study of collaborative decision making for remote cancer care. Fourth, we highlight key lessons learned from our case study.

Keywords: Blockchain; Cancer care; Clinical data sharing; Decentralized app; Digital health identity; Interoperability; Smart contracts.

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Figures

Fig. 1
Fig. 1
The Blockchain Structure: a Continuously Growing and Immutable List of Ordered and Validated Transactions.
Fig. 2
Fig. 2
Architectural Components in FHIRChain.
Fig. 3
Fig. 3
Example of the Creation and Retrieval of an Access Token Using FHIRChain.
Fig. 4
Fig. 4
Composition and Structure of the FHIRChain Architecture with Modular Components.
Fig. 5
Fig. 5
Workflow of the User Registration and Authentication Process in the FHIRChain DApp.
Fig. 6
Fig. 6
Workflow of Access Authorization in the FHIRChain DApp.
Fig. 7
Fig. 7
Screenshot of Our FHIRChain-based DApp User Interface.
See this image and copyright information in PMC

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