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实施区块链以实现高效医疗保健:系统评价。

Implementing Blockchains for Efficient Health Care: Systematic Review.

作者信息

Vazirani Anuraag A, O'Donoghue Odhran, Brindley David, Meinert Edward

机构信息

Healthcare Translation Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.

Global Digital Health Unit, Department of Primary Care and Public Health, Imperial College London, London, United Kingdom.

出版信息

J Med Internet Res. 2019 Feb 12;21(2):e12439. doi: 10.2196/12439.

Abstract

BACKGROUND

The decentralized nature of sensitive health information can bring about situations where timely information is unavailable, worsening health outcomes. Furthermore, as patient involvement in health care increases, there is a growing need for patients to access and control their data. Blockchain is a secure, decentralized online ledger that could be used to manage electronic health records (EHRs) efficiently, therefore with the potential to improve health outcomes by creating a conduit for interoperability.

OBJECTIVE

This study aimed to perform a systematic review to assess the feasibility of blockchain as a method of managing health care records efficiently.

METHODS

Reviewers identified studies via systematic searches of databases including PubMed, MEDLINE, Scopus, EMBASE, ProQuest, and Cochrane Library. Suitability for inclusion of each was assessed independently.

RESULTS

Of the 71 included studies, the majority discuss potential benefits and limitations without evaluation of their effectiveness, although some systems were tested on live data.

CONCLUSIONS

Blockchain could create a mechanism to manage access to EHRs stored on the cloud. Using a blockchain can increase interoperability while maintaining privacy and security of data. It contains inherent integrity and conforms to strict legal regulations. Increased interoperability would be beneficial for health outcomes. Although this technology is currently unfamiliar to most, investments into creating a sufficiently user-friendly interface and educating users on how best to take advantage of it would lead to improved health outcomes.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/10994.

摘要

背景

敏感健康信息的分散性可能导致无法及时获取信息的情况,从而使健康结果恶化。此外,随着患者在医疗保健中的参与度增加,患者对获取和控制其数据的需求也日益增长。区块链是一种安全的、去中心化的在线账本,可用于高效管理电子健康记录(EHR),因此有可能通过创建互操作性渠道来改善健康结果。

目的

本研究旨在进行系统评价,以评估区块链作为一种有效管理医疗保健记录方法的可行性。

方法

评审人员通过对包括PubMed、MEDLINE、Scopus、EMBASE、ProQuest和Cochrane图书馆在内的数据库进行系统检索来识别研究。对每项研究纳入的适用性进行独立评估。

结果

在纳入的71项研究中,大多数讨论了潜在的益处和局限性,但未评估其有效性,尽管一些系统在实时数据上进行了测试。

结论

区块链可以创建一种机制来管理对存储在云端的电子健康记录的访问。使用区块链可以提高互操作性,同时保持数据的隐私和安全性。它具有内在的完整性,并符合严格的法律法规。增强的互操作性将有利于健康结果。尽管目前大多数人对这项技术并不熟悉,但投资创建一个足够用户友好的界面并教育用户如何最好地利用它将有助于改善健康结果。

国际注册报告识别码(IRRID):RR2-10.2196/10994。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4c4/6390185/1f43f89fe497/jmir_v21i2e12439_fig1.jpg

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