Department of Systems Engineering, University of the North, Barranquilla 081007, Colombia.
CNCA Research Group, The National Training Service (Servicio Nacional de Aprendizaje-SENA), Barranquilla 080005, Colombia.
Int J Environ Res Public Health. 2020 Sep 29;17(19):7132. doi: 10.3390/ijerph17197132.
The current information systems for the registration and control of electronic medical records (EMR) present a series of problems in terms of the fragmentation, security, and privacy of medical information, since each health institution, laboratory, doctor, etc. has its own database and manages its own information, without the intervention of patients. This situation does not favor effective treatment and prevention of diseases for the population, due to potential information loss, misinformation, or data leaks related to a patient, which in turn may imply a direct risk for the individual and high public health costs for governments. One of the proposed solutions to this problem has been the creation of electronic medical record (EMR) systems using blockchain networks; however, most of them do not take into account the occurrence of connectivity failures, such as those found in various developing countries, which can lead to failures in the integrity of the system data. To address these problems, HealthyBlock is presented in this paper as an architecture based on blockchain networks, which proposes a unified electronic medical record system that considers different clinical providers, with resilience in data integrity during connectivity failure and with usability, security, and privacy characteristics. On the basis of the HealthyBlock architecture, a prototype was implemented for the care of patients in a network of hospitals. The results of the evaluation showed high efficiency in keeping the EMRs of patients unified, updated, and secure, regardless of the network clinical provider they consult.
目前的电子病历（EMR）注册和控制系统在医疗信息的碎片化、安全性和隐私性方面存在一系列问题，因为每个医疗机构、实验室、医生等都有自己的数据库，并管理自己的信息，而患者则无法干预。这种情况不利于有效治疗和预防人群疾病，因为可能会导致潜在的信息丢失、错误信息或与患者相关的数据泄露，这反过来可能对个人构成直接风险，并给政府带来高昂的公共卫生成本。针对这个问题，已经提出了使用区块链网络创建电子病历（EMR）系统的解决方案；然而，其中大多数都没有考虑到连接失败的情况，例如在各种发展中国家经常发生的连接失败情况，这可能导致系统数据完整性出现故障。为了解决这些问题，本文提出了 HealthyBlock，它是一种基于区块链网络的架构，提出了一种统一的电子病历系统，该系统考虑了不同的临床提供者，在连接失败时具有数据完整性的弹性，并且具有可用性、安全性和隐私性的特点。在 HealthyBlock 架构的基础上，为医院网络中的患者护理实现了一个原型。评估结果表明，无论患者咨询的是网络临床提供者，该原型都能高效地保持患者的 EMR 统一、更新和安全。
