Meinert Edward, Alturkistani Abrar, Foley Kimberley A, Osama Tasnime, Car Josip, Majeed Azeem, Van Velthoven Michelle, Wells Glenn, Brindley David
Global Digital Health Unit, Department of Primary Care and Public Health, Imperial College London, London, United Kingdom.
Healthcare Translation Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.
JMIR Res Protoc. 2019 Feb 8;8(2):e10994. doi: 10.2196/10994.
A blockchain is a digitized, decentralized, distributed public ledger that acts as a shared and synchronized database that records cryptocurrency transactions. Despite the shift toward digital platforms enabled by electronic medical records, demonstrating a will to reform the health care sector, health systems face issues including security, interoperability, data fragmentation, timely access to patient data, and silos. The application of health care blockchains could enable data interoperability, enhancement of precision medicine, and reduction in prescription frauds through implementing novel methods in access and patient consent.
To summarize the evidence on the strategies and frameworks utilized to implement blockchains for patient data in health care to ensure privacy and improve interoperability and scalability. It is anticipated this review will assist in the development of recommendations that will assist key stakeholders in health care blockchain implementation, and we predict that the evidence generated will challenge the health care status quo, moving away from more traditional approaches and facilitating decision making of patients, health care providers, and researchers.
A systematic search of MEDLINE/PubMed, Embase, Scopus, ProQuest Technology Collection and Engineering Index will be conducted. Two experienced independent reviewers will conduct titles and abstract screening followed by full-text reading to determine study eligibility. Data will then be extracted onto data extraction forms before using the Cochrane Collaboration Risk of Bias Tool to appraise the quality of included randomized studies and the Risk of Bias in nonrandomized studies of Interventions to assess the quality of nonrandomized studies. Data will then be analyzed and synthesized.
Database searches will be initiated in September 2018. We expect to complete the review in January 2019.
This review will summarize the strategies and frameworks used to implement blockchains in health care to increase data privacy, interoperability, and scalability. This review will also help clarify if the strategies and frameworks required for the operationalization of blockchains in health care ensure the privacy of patient data while enabling efficiency, interoperability, and scalability.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/10994.
区块链是一种数字化、去中心化、分布式的公共账本，它作为一个共享且同步的数据库，记录加密货币交易。尽管电子病历推动了向数字平台的转变，显示出医疗保健行业改革的意愿，但卫生系统仍面临安全、互操作性、数据碎片化、患者数据的及时获取以及数据孤岛等问题。医疗保健区块链的应用可以通过在访问和患者同意方面实施新方法，实现数据互操作性、提升精准医疗水平并减少处方欺诈。
总结在医疗保健领域将区块链应用于患者数据以确保隐私、提高互操作性和可扩展性所采用的策略和框架的证据。预计本综述将有助于制定相关建议，以协助医疗保健区块链实施中的关键利益相关者，并且我们预测所产生的证据将挑战医疗保健现状，摆脱更传统的方法，促进患者、医疗保健提供者和研究人员的决策。
将对MEDLINE/PubMed、Embase、Scopus、ProQuest技术文集和工程索引进行系统检索。两名经验丰富的独立评审人员将进行标题和摘要筛选，随后进行全文阅读以确定研究的合格性。然后将数据提取到数据提取表格上，之后使用Cochrane协作偏倚风险工具评估纳入的随机研究的质量，并使用干预性非随机研究中的偏倚风险工具评估非随机研究的质量。然后对数据进行分析和综合。
数据库检索将于2018年9月启动。我们预计在2019年1月完成综述。
本综述将总结在医疗保健领域实施区块链以增加数据隐私、互操作性和可扩展性所使用的策略和框架。本综述还将有助于阐明医疗保健区块链运营所需的策略和框架是否在确保患者数据隐私的同时实现了效率、互操作性和可扩展性。
国际注册报告识别号（IRRID）：PRR1-10.2196/10994
