Self-sovereign identity empowered non-fungible patient tokenization for health information exchange using blockchain technology

Abstract

Background: Patient tokenization is a novel approach that allows anonymous patient-level linkage across healthcare facilities, minimizing the risk of breaching protected health information in health information exchange (HIE). Most patient tokenization is the centralized approach that is unable to address data security concerns fundamentally. Non-Fungible Tokens (NFT), which are non-transferable cryptographic assets on the blockchain, have the potential to provide secure, decentralized, and trustworthy patient tokenization. Self-Sovereign Identity (SSI) is a user-centric approach to verify the ownership of NFTs in a decentralized manner.

Methods: We have developed a blockchain architecture that contains four modules: (1) Creation module for NFTs creation, (2) Linkage module to link the local patients' accounts to their NFTs, (3) Authentication module that allows patients to permit healthcare providers to access their token, and (4) Exchange module, which involves the HIE process and the validation of the legitimacy of the token through SSI.

Results: A case study has been conducted on the proposed architecture. Over 3 million transactions have been completed successfully with a blockchain validation and written time of 1.17 s on average. A stability test has also been conducted with a higher throughput of 200 transactions per second running for an hour with an average transaction processing time of 1.42 s.

Conclusions: This study proposed a blockchain architecture that achieves SSI-enabled NFT-based patient tokenization. Our architecture design, implementation, and case studies have demonstrated the feasibility and potential of NFT with SSI to establish a secure, transparent, and patient-centric identity management and HIE.

Keywords: Blockchain; Health information exchange; Non-fungible token; Patient tokenization; Self-sovereign identity; Smart contract.