A Unified Health Information System Framework for Connecting Data, People, Devices, and Systems

The COVID-19 pandemic has heightened the necessity for pervasive data and system interoperability to manage healthcare information and knowledge. There is an urgent need to better understand the role of interoperability in improving the societal responses to the pandemic. This paper explores data and system interoperability, a very specific area that could contribute to fighting COVID-19. Specifically, the authors propose a unified health information system framework to connect data, systems, and devices to increase interoperability and manage healthcare information and knowledge. A blockchain-based solution is also provided as a recommendation for improving the data and system interoperability in healthcare

Interoperability Benefits and Challenges in Smart City Services: Blockchain as a Solution

The widespread usage of smart devices with various city-centric services speeds up and improves civic life, in contrast to growing privacy and security concerns. Security issues are exacerbated when e-government service providers trade their services within a centralised framework. Due to security concerns, city-centric centralised services are being converted to blockchain-based systems, which is a very time-consuming and challenging process. The interoperability of these blockchain-based systems is also more challenging due to protocol variances, an excessive amount of local transactions that raise scalability and rapidly occupy memory. In this paper, we have proposed a framework for interoperability across various blockchain-based smart city services. It also summarises how independent service providers might continue self-service choices (i.e., local transactions) without overloading the blockchain network and other organisations. A simulated interoperability network is used to show the network’s effectiveness. The experimental outcomes show the scalability and memory optimization of the blockchain network

Blockchain vehicles for efficient Medical Record management

The lack of interoperability in Britain’s medical records systems precludes the realisation of benefits generated by increased spending elsewhere in healthcare. Growing concerns regarding the security of online medical data following breaches, and regarding regulations governing data ownership, mandate strict parameters in the development of efficient methods to administrate medical records. Furthermore, consideration must be placed on the rise of connected devices, which vastly increase the amount of data that can be collected in order to improve a patient’s long-term health outcomes. Increasing numbers of healthcare systems are developing Blockchain-based systems to manage medical data. A Blockchain is a decentralised, continuously growing online ledger of records, validated by members of the network. Traditionally used to manage cryptocurrency records, distributed ledger technology can be applied to various aspects of healthcare. In this manuscript, we focus on how Electronic Medical Records in particular can be managed by Blockchain, and how the introduction of this novel technology can create a more efficient and interoperable infrastructure to manage records that leads to improved healthcare outcomes, while maintaining patient data ownership and without compromising privacy or security of sensitive data

Balancing patient control and practical access policy for electronic health records via blockchain technology

Electronic health records (EHRs) have revolutionized the health information technology domain, as patient data can be easily stored and accessed within and among medical institutions. However, in working towards nationwide patient engagement and interoperability goals, recent literature adopts a very patient-centric model---patients own their universal, holistic medical records and control exactly who can access their health data. I contend that this approach is largely impractical for healthcare workflows, where many separate providers require access to health records for care delivery. My work investigates the potential of a blockchain network to balance patient control and provider accessibility with a two-fold approach. First, I conduct a survey investigation to identify patient concerns and determine the level of control patients would like over their health information. Second, I implement a blockchain network prototype to address the spectrum of patient control preferences and automate practical access policy. There are conflicting demands amongst patients and providers for EHR access---privacy versus flexibility. Yet, I find blockchain technology, when manipulated to model access states, automate an organizational role-based access scheme, and provide an immutable history of behavior in the network, to be a very plausible solution for balancing patient desires and provider needs. My approach is, to my knowledge, the first example of blockchain\u27s use for less patient-centric, nudge theory-based EHR access control, an idea that could align access control interests as academics, the government, and the healthcare industry make strides towards interoperable, universal patient records

Towards Secure Interoperability of EHR among Healthcare Organizations in Palestine

Technological development in the e-health field helps to facilitate and enhance healthcare, and improve treatment quality. Different public and private healthcare facilities in Palestine employ different health information systems; consequently, sharing health information has become more challenging and complex. In this paper, the researchers firstly investigate the current status of Electronic Health Records (EHR) in Palestine and the readiness of the various healthcare centers to foster the interoperability of EHRs. Secondly, the researchers propose a secure framework that might be used to deploy interoperability among healthcare centers. The mixed method approach was used to achieve the objectives of the research. Interviews were conducted with IT managers, and questionnaires were distributed to 331 out of 2350 personnel employed in five Palestinian hospitals. The findings of quantitative and qualitative studies show that there is no electronic exchange of EHRs between private and public healthcare facilities, and they highlight the necessity of putting interoperability into practice to enhance the quality of healthcare in Palestine and keep up with global advancements in health technology. Based on these findings, the researchers propose a technical framework for interoperability in Palestine using UXP/ X-Road, to securely and effectively share EHRs among healthcare centers

Towards a Blockchain Assisted Patient Owned System for Electronic Health Records

Security and privacy of patients’ data is a major concern in the healthcare industry. In this paper, we propose a system that activates robust security and privacy of patients’ medical records as well as enables interoperability and data exchange between the different healthcare providers. The work proposes the shift from patient’s electronic health records being managed and controlled by the healthcare industry to a patient-centric application where patients are in control of their data. The aim of this research is to build an Electronic Healthcare Record (EHR) system that is layered on the Ethereum blockchain platform and smart contract in order to eliminate the need for third-party systems. With this system, the healthcare provider can search for patient’s data and request the patients’ consent to access it. Patients manage their data which enables an expedited data exchange across EHR systems. Each patient’s data are stored on the peer-to-peer node ledger. The proposed patient-centric EHR platform is cross-platform compliant, as it can be accessed via personal computers and mobile devices and facilitates interoperability across healthcare providers as patients’ medical records are gathered from different healthcare providers and stored in a unified format. The proposed framework is tested on a private Ethereum network using Ganache. The results show the effectiveness of the system with respect to security, privacy, performance and interoperability

Securing, Standardizing, and Simplifying Electronic Health Record Audit Logs Through Permissioned Blockchain Technology

Audit logs perform critical functions in electronic health record (EHR) systems. They provide a chronological record of all operations performed in an EHR, allowing health care organizations to track EHR usage, hold system users accountable for their interactions with patient records, detect anomalous and potentially malicious behavior in the system, protect patient privacy, and develop insight into workflows and interactions among system users. However, several problems exist with the way that current state-of-the-art EHR technology handles audit data. Specifically, current systems complicate the collection and analysis of audit logs because they lack an interoperable audit log structure, spread audit log data from different EHR applications across multiple data repositories, and often fail to record all useful information about events in the EHR. Permissioned blockchain technology offers two opportunities to mitigate these issues. First, smart contracts running on the blockchain can impose an interoperable structure on audit log data, both within single health care organizations and across all organizations participating in the network. Second, the blockchain ledger constitutes a consolidated repository for all audit log data at each organization, simplifying the collection of data for analysis. AuditChain, the prototype system I present in this thesis, leverages Hyperleger Fabric\u27s permissioned blockchain technology to address these issues of audit log interoperability, content, structure, and consolidation. Specifically, AuditChain uses the blockchain ledger and smart contracts to standardize audit log content, simplify access to audit log data, and ensure that audit logs contain all necessary and useful information