Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun 9;22(6):e16748.
doi: 10.2196/16748.

An Architecture and Management Platform for Blockchain-Based Personal Health Record Exchange: Development and Usability Study

Hsiu-An Lee  1   2   3   4   5 , Hsin-Hua Kung  2   3   4   5 , Jai Ganesh Udayasankaran  3   4   6 , Boonchai Kijsanayotin  3   4   7 , Alvin B Marcelo  3   4   8 , Louis R Chao  1 , Chien-Yeh Hsu  2   3   4   5   9
Affiliations

An Architecture and Management Platform for Blockchain-Based Personal Health Record Exchange: Development and Usability Study

Hsiu-An Lee et al. J Med Internet Res. .

Abstract

Background: Personal health record (PHR) security, correctness, and protection are essential for health and medical services. Blockchain architecture can provide efficient data retrieval and security requirements. Exchangeable PHRs and the self-management of patient health can offer many benefits to traditional medical services by allowing people to manage their own health records for disease prevention, prediction, and control while reducing resource burdens on the health care infrastructure and improving population health and quality of life.

Objective: This study aimed to build a blockchain-based architecture for an international health record exchange platform to ensure health record confidentiality, integrity, and availability for health management and used Health Level 7 Fast Healthcare Interoperability Resource international standards as the data format that could allow international, cross-institutional, and patient/doctor exchanges of PHRs.

Methods: The PHR architecture in this study comprised 2 main components. The first component was the PHR management platform, on which users could upload PHRs, view their record content, authorize PHR exchanges with doctors or other medical health care providers, and check their block information. When a PHR was uploaded, the hash value of the PHR would be calculated by the SHA-256 algorithm and the PHR would be encrypted by the Rivest-Shamir-Adleman encryption mechanism before being transferred to a secure database. The second component was the blockchain exchange architecture, which was based on Ethereum to create a private chain. Proof of authority, which delivers transactions through a consensus mechanism based on identity, was used for consensus. The hash value was calculated based on the previous hash value, block content, and timestamp by a hash function.

Results: The PHR blockchain architecture constructed in this study is an effective method for the management and utilization of PHRs. The platform has been deployed in Southeast Asian countries via the Asia eHealth Information Network (AeHIN) and has become the first PHR management platform for cross-region medical data exchange.

Conclusions: Some systems have shown that blockchain technology has great potential for electronic health record applications. This study combined different types of data storage modes to effectively solve the problems of PHR data security, storage, and transmission and proposed a hybrid blockchain and data security approach to enable effective international PHR exchange. By partnering with the AeHIN and making use of the network's regional reach and expert pool, the platform could be deployed and promoted successfully. In the future, the PHR platform could be utilized for the purpose of precision and individual medicine in a cross-country manner because of the platform's provision of a secure and efficient PHR sharing and management architecture, making it a reasonable base for future data collection sources and the data analytics needed for precision medicine.

Keywords: blockchain; health information interoperability; health information management; personal health records; precision health care.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Personal health record management platform and blockchain architecture. PHR: personal health record.
Figure 2
Figure 2
Personal health record creation, uploading, and verification procedure. DB: database; PHR: personal health record.
Figure 3
Figure 3
Block creation process. PHR: personal health record.
Figure 4
Figure 4
Block content on the blockchain architecture. PHR: personal health record.
Figure 5
Figure 5
Workflow of a user uploading their personal health record. PHR: personal health record.
Figure 6
Figure 6
Workflow of a user sharing their personal health record with a doctor. PHR: personal health record; RSA: Rivest-Shamir-Adleman.
Figure 7
Figure 7
Workflow of a user viewing their own personal health record. PHR: personal health record; RSA: Rivest-Shamir-Adleman.
Figure 8
Figure 8
The user interface of a personal health record viewer.
Figure 9
Figure 9
Block content.
Figure 10
Figure 10
Authority control user interface.
Figure 11
Figure 11
Blockchain connection diagram.
See this image and copyright information in PMC

References

    1. Farmer C, Fenu E, O'Flynn N, Guthrie B. Clinical assessment and management of multimorbidity: summary of NICE guidance. Br Med J. 2016 Sep 21;354:i4843. doi: 10.1136/bmj.i4843. - DOI - PubMed
    1. Ford EW, Hesse BW, Huerta TR. Personal health record use in the United States: forecasting future adoption levels. J Med Internet Res. 2016 Mar 30;18(3):e73. doi: 10.2196/jmir.4973. https://www.jmir.org/2016/3/e73/ - DOI - PMC - PubMed
    1. Kaelber DC, Jha AK, Johnston D, Middleton B, Bates DW. A research agenda for personal health records (PHRs) J Am Med Inform Assoc. 2008;15(6):729–36. doi: 10.1197/jamia.M2547. http://europepmc.org/abstract/MED/18756002 - DOI - PMC - PubMed
    1. AHIMA e-HIM Personal Health Record Work Group American Health Information Management Association. 2005. [2020-03-18]. Role of the Personal Health Record in the EHR (2010 update) - Retired https://library.ahima.org/doc?oid=103209#.XnGsmagzaM8.
    1. American Health Information Management Association. New York: Markle Foundation; 2003. [2020-03-18]. Connecting for Health: A Public-Private Collaborative(Report) http://bok.ahima.org/PdfView?oid=76138.

Publication types

MeSH terms