Zhang Peng, White Jules, Schmidt Douglas C, Lenz Gunther, Rosenbloom S Trent
Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA.
Varian Medical Systems, Palo Alto, California, USA.
Comput Struct Biotechnol J. 2018 Jul 29;16:267-278. doi: 10.1016/j.csbj.2018.07.004. eCollection 2018.
Secure and scalable data sharing is essential for collaborative clinical decision making. Conventional clinical data efforts are often siloed, however, which creates barriers to efficient information exchange and impedes effective treatment decision made for patients. This paper provides four contributions to the study of applying blockchain technology to clinical data sharing in the context of technical requirements defined in the "Shared Nationwide Interoperability Roadmap" from the (ONC). First, we analyze the ONC requirements and their implications for blockchain-based systems. Second, we present FHIRChain, which is a blockchain-based architecture designed to meet ONC requirements by encapsulating the HL7 (FHIR) standard for shared clinical data. Third, we demonstrate a FHIRChain-based decentralized app using digital health identities to authenticate participants in a case study of collaborative decision making for remote cancer care. Fourth, we highlight key lessons learned from our case study.
安全且可扩展的数据共享对于协作式临床决策至关重要。然而，传统的临床数据工作往往相互孤立，这为高效的信息交换设置了障碍，并阻碍了为患者做出有效的治疗决策。本文在（美国）国家卫生信息技术协调办公室（ONC）发布的《全国共享互操作性路线图》所定义的技术要求背景下，对将区块链技术应用于临床数据共享的研究做出了四点贡献。第一，我们分析了ONC的要求及其对基于区块链的系统的影响。第二，我们提出了FHIRChain，这是一种基于区块链的架构，旨在通过封装用于共享临床数据的HL7（快速医疗互操作性资源，FHIR）标准来满足ONC的要求。第三，在一个远程癌症护理协作决策的案例研究中，我们展示了一个基于FHIRChain的去中心化应用程序，该程序使用数字健康身份来认证参与者。第四，我们强调了从案例研究中学到的关键经验教训。
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