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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.

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Purpose -With the popularity of e-commerce, information security is vital to most organizations. For managers, building and implementing an information security policy (ISP) has long been assumed to be an effective managerial measure to elevate an organization's security level. This paper attempts to investigate the dominant factors for an organization to build an ISP, and whether an ISP may elevate an organization's security level? Design/methodology/approach -A survey was designed and the data were collected from 165 chief information officers in Taiwan. Findings -The empirical results show that some organizational characteristics (business type and MIS/IS department size) might be good predictors for the ISP adoption and that the functions, contents, implementation and procedures of an ISP may significantly contribute to managers' perceived elevation of information security. Practical implications -Building or adopting an ISP is examined empirically to be an effective managerial measure to elevate its security level in Taiwan, and that the building of an information security should focus on the comprehensiveness of its contents, procedures and implementation items, rather than on the documents only. Originality/value -Few empirical studies have been conducted so far to examine the effectiveness of an ISP, thus the value of this paper is high.

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