A Ledger of Me: Personalizing Healthcare Using Blockchain Technology

Abstract

Personal Health Records (PHRs) have the potential to give patients fine-grained, personalized and secure access to their own medical data and to enable self-management of care. Emergent trends around the use of Blockchain, or Distributed Ledger Technology, seem to offer solutions to some of the problems faced in enabling these technologies, especially to support issues consent, data exchange, and data access. We present an analysis of existing blockchain-based health record solutions and a reference architecture for a “Ledger of Me” system that extends PHR to create a new platform combining the collection and access of medical data and digital interventions with smart contracts. Our intention is to enable patient use of the data in order to support their care and to provide a strong consent mechanisms for sharing of data between different organizations and apps. Ledger of Me is based on around the principle that this combination of event-driven smart contracts, medical record data, and patient control is important for the adoption of blockchain-based solutions for the PHR. The reference architecture we present can serve as the basis of a range of future blockchain-based medical application architectures.

Generating design knowledge for blockchain-based access control to personal health records

“…Further research focused on the use of blockchain technology to secure PHRs, such as studies by Roehrs et al (2017), da Conceicao et al (2018), Dagher et al (2018) and Beinke et al (2019). Leeming et al (2019) identified 11 solutions for blockchain PHRs, five of which-Guard Time, Carechain, Dovetail, MedRec and Medical Chain-are published in Whitepapers. So far, only a few approaches have been implemented and evaluated, such as OmniPHR by Roehrs et al (2017), MedRec by Ekblaw et al (2016) and FHIRChain by Zhang et al (2018).…”

Mapping Research Trends of Blockchain Technology in Healthcare

“…Several BcT based architecture formats should utilize the unique advantages of the technology. Blockchain-based medical data sharing projects such as GuardTime, MedRec, Carechain, MedicalChain and Dovetail have already been tested using prototypes [10]. It can be concluded that qualitative studies are progressing accordingly, and further studies can look for potential solutions to implementation cost [22], scalability and security issues of BcT [9] from the technical or technological perspective.…”

“…Moreover, BcT makes the decision-making process seamless through allowing concurrent assessment by each stakeholder involved, which accordingly increases trust [8]. These features of BcT are believed to have the capability of solving the current issues facing the healthcare industry [10]. Therefore, research trend analysis of BcT in healthcare is needed to understand the state of the art [6].…”

Evaluation of data usability generated by wearables & IoT-enabled home use medical devices via Telehealth to identify if blockchain can solve potential challenges

“…"Management of consent and access to healthcare data has attracted the greatest attention as a potential target for blockchain-based applications" states Leeming (2019) as he analyses a Personalized Health Record (PHR) blockchain that aids in overcoming the current challenges of accessing personal health data, exchanging health data with other stakeholders as well as providing consent to this data. To better understand its value, Lemming reviewed common features and traits of blockchain-based PHR applications, such as "health data is not stored in the chain" or "enabling telehealth" (Leeming, 2019). He discusses the fact that it would not make sense to store a full set of health data on the blockchain due to high cost incurred by cryptographically encrypting the data or covering the token costs for decentralized data storage (deepening on the consensus algorithm used).…”

“…A common concept for blockchain application in healthcare is its ability to provide consent and access rights to providers, insurers or other stakeholders by the patient, who should be the owner of his/her own health record. Leeming (2019) describes efforts to utilize a Personalized Health Record (PHR) blockchain to manage patient consent and access to healthcare data, but blockchain interoperability problems and high cost to pay miners are identified downsides.…”