Blockchain-based Electronic Patient Records for Regulated Circular Healthcare Jurisdictions

Alexaki, Sofia; Alexandris, George; Katos, Vasilios; Petroulakis, Nikolaos E.

doi:10.1109/camad.2018.8514954

Cited by 34 publications

(22 citation statements)

References 14 publications

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“…Alexaki et al describe a solution for regulated circular healthcare jurisdictions using the blockchain and smart contract technologies. Such a solution has the potential to contribute to more modular and interoperable healthcare services as well as to enable circularity by providing the necessary collaborating mechanism [86].…”

Section: Data Management and Storagementioning

confidence: 99%

Information and Communication Technology Solutions for the Circular Economy

2020

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The concept of circular economy (CE) is becoming progressively popular with academia, industry, and policymakers, as a potential path towards a more sustainable economic system. Information and communication technology (ICT) systems have influenced every aspect of modern life and the CE is no exception. Cutting-edge technologies, such as big data, cloud computing, cyber-physical systems, internet of things, virtual and augmented reality, and blockchain, can play an integral role in the embracing of CE concepts and the rollout of CE programs by governments, organizations, and society as a whole. The current paper conducts an extensive academic literature review on prominent ICT solutions paving the way towards a CE. For the categorization of the solutions, a novel two-fold approach is introduced, focusing on both the technological aspect of the solutions (e.g., communications, computing, data analysis, etc.), and the main CE concept(s) employed (i.e., reduce, reuse, recycle and restore) that each solution is the most relevant to. The role of each solution in the transition to CE is highlighted. Results suggest that ICT solutions related to data collection and data analysis, and in particular to the internet of things, blockchain, digital platforms, artificial intelligence algorithms, and software tools, are amongst the most popular solutions proposed by academic researchers. Results also suggest that greater emphasis is placed on the “reduce” component of the CE, although ICT solutions for the other “R” components, as well as holistic ICT-based solutions, do exist as well. Specific important challenges impeding the adoption of ICT solutions for the CE are also identified and reviewed, with consumer and business attitude, economic costs, possible environmental impacts, lack of education around the CE, and lack of familiarization with modern technologies being found among the most prominent ones.

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Section: Data Management and Storagementioning

confidence: 99%

Information and Communication Technology Solutions for the Circular Economy

2020

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“…Most of the research reviewed focused on blockchain’s use to strengthen HIT security or patients’ privacy during health data exchange or access; 53% (37/70) papers focused on addressing patients’ lack of control over the privacy and security of their data [ 10 - 46 ], and 40% (28/70) papers addressed blockchain’s ability to prevent data tampering [ 10 , 12 , 21 , 25 , 33 , 34 , 37 , 38 , 40 - 44 , 46 - 60 ]. Data breaches were addressed in 37% (26/70) papers [ 15 , 18 , 19 , 22 , 24 , 29 , 31 , 32 , 34 , 36 - 38 , 43 , 44 , 54 , 56 - 66 ], 9% (6/70) papers mentioned malicious attacks (eg, impersonation) that blockchain could potentially resolve [ 17 , 34 , 44 , 56 , 60 , 67 ], and 4% (3/70) papers focused on how blockchain can preserve patients’ anonymity while third parties accessed their health and medical records for activities such as medical research [ 41 , 42 , 68 ].…”

Section: Resultsmentioning

confidence: 99%

“…It is challenging to keep track of all data and ensure its immutability in the context of complex medical cases that require multiple diverse activities, patients’ visits, and providers’ treatments [ 17 ]. Blockchain-based MIMS facilitate the creation of immutable records with traceable transactions that cannot be changed over time.…”

Section: Resultsmentioning

confidence: 99%

The Current State of Research, Challenges, and Future Research Directions of Blockchain Technology in Patient Care: Systematic Review

Durneva¹,

Cousins²,

Chen³

2020

J Med Internet Res

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Background Blockchain offers a promising new distributed technology to address the challenges of data standardization, system interoperability, security, privacy, and accessibility of medical records. Objective The purpose of this review is to assess the research on the use of blockchain technology for patient care and the associated challenges and to provide a research agenda for future research. Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Excerpta Medica dataBASE (EMBASE), and Web of Science databases for peer-reviewed research articles published up to December 2019 that examined the implementation of blockchain technology in health care settings. We identified 800 articles from which we selected 70 empirical research articles for a detailed review. Results Blockchain-based patient care applications include medical information systems, personal health records, mobile health and telemedicine, data preservation systems and social networks, health information exchanges and remote monitoring systems, and medical research systems. These blockchain-based health care applications may improve patient engagement and empowerment, improve health care provider access to information, and enhance the use of health care information for medical research. Conclusions Blockchain health information technology (HIT) provides benefits such as ensuring data privacy and security of health data, facilitating interoperability of heterogeneous HIT systems, and improving the quality of health care outcomes. However, barriers to using blockchain technology to build HIT include security and privacy vulnerabilities, user resistance, high computing power requirements and implementation costs, inefficient consensus algorithms, and challenges of integrating blockchain with existing HIT. With 51% of the research focused on medical information systems such as electronic health record and electronic medical record, and 53% of the research focused on data security and privacy issues, this review shows that HIT research is primarily focused on the use of blockchain technologies to address the current challenges HIT faces. Although Blockchain presents significant potential for disrupting health care, most ideas are in their infancy.

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“…The project achieved this using FHIR profiles as a computational conformance scheme. Figure 15 shows the details of this distribution and others like older versions of HL7 [63], [65], [69], [75], [77], [80], [95], [123], Logical Observations Identifiers Names and Codes (LOINC) [30], [53], [65], [95], [165], World Health Organisation's (WHO's) International Classification of Diseases (ICD) [53], [65], [95], [130], International Organization for Standards (ISO) [95], Systematised Nomenclature of Medicine -Clinical Terms (SNOMED-CT) [59], [95], Digital Imaging and Communication in Medicine (DICOM) [65], [95], [114], Open Electronic Health Records (OpenEHR) [95], [106], [115]. OmniPHR [95] for instance uses a translator hosted as a super-peer (blockchain node) in the blockchain network.…”

Section: ) Standards or Ontologies Analysismentioning

confidence: 99%

“…Others mentioned once in reviewed papers are Integrating Healthcare Enterprise (IHE) [95], [114], [123], Institute of Electrical Electronics Engineers (IEEE) [65], XML Document Transform (xDT), CDMA [28], International Classification of Primary Care (ICPC) [53], CARRE [70], International Organization for Standards (ISO) Technical Committee 251 (TC251) [65], ISO13606 [106], European Committee for Standards (CEN) [95], Human Phenotype Ontology (HPO) [59], Online Mendelian Inheritance of Man (OMIM) [59], Kyoto Encyclopaedia of Genes and Genomes (KEGG) [59], Clinical Document Architecture (CDA) [95], Systematised Nomenclature of Dentistry (SNODENT) [135].…”

Section: ) Standards or Ontologies Analysismentioning

confidence: 99%

A Systematic Review of Blockchain in Healthcare: Frameworks, Prototypes, and Implementations

2020

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Blockchain, a form of distributed ledger technology has attracted the interests of stakeholders across several sectors including healthcare. Its' potential in the multi-stakeholder operated sector like health has been responsible for several investments, studies, and implementations. Electronic Health Records (EHR) systems traditionally used for the exchange of health information amongst healthcare stakeholders have been criticised for centralising power, failures and attack-points with exchange data custodians. EHRs have struggled in the face of multi-stakeholder and system requirements while adhering to security, privacy, ethical and other regulatory constraints. Blockchain is promising amongst others to address the many EHR challenges, primarily trustless and secure exchange of health information amongst stakeholders. Many blockchain-in-healthcare frameworks have been proposed; some prototyped and/or implemented. This study leveraged the PRISMA framework to systematically search and evaluate the different models proposed; prototyped and/or implemented. The bibliometric and functional distribution of all 143 articles from this study were presented. This study evaluated 61 articles that discussed either prototypes or pilot or implementations. The technical and architectural analysis of these 61 articles for privacy, security, cost, and performance were detailed. Blockchain was found to solve the trust, security and privacy constraints of traditional EHRs often at significant performance, storage and cost trade-offs. INDEX TERMS Bioinformatics, blockchain, DLT, distributed ledger technology, distributed computing, distributed databases, health information management, health information exchange, hospitals, pharmaceutical technology, telemedicine, digital health, eHealth, mHealth.

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Blockchain-based Electronic Patient Records for Regulated Circular Healthcare Jurisdictions

Cited by 34 publications

References 14 publications

Information and Communication Technology Solutions for the Circular Economy

Information and Communication Technology Solutions for the Circular Economy

The Current State of Research, Challenges, and Future Research Directions of Blockchain Technology in Patient Care: Systematic Review

A Systematic Review of Blockchain in Healthcare: Frameworks, Prototypes, and Implementations

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