School of Economics and Management, Beijing Jiaotong University, Beijing 100000, China.
Health Service Center, Beijing Jiaotong University, Beijing 100000, China.
Biomed Res Int. 2021 Feb 1;2021:6676171. doi: 10.1155/2021/6676171. eCollection 2021.
The maintenance and sharing of electronic medical records are one of the essential tasks in the medical treatment combination. Traditional cloud-based electronic medical record storage system is difficult to realize data security sharing. The tamper resistance and traceability of blockchain technology provide the possibility for the sharing of highly sensitive medical data. This paper proposes a safe sharing scheme of stroke electronic medical records based on the consortium blockchain. The scheme adopts the storage method of ciphertext of medical records stored in the cloud and index of medical records stored on the blockchain. The privacy protection mechanism proposed in this paper innovatively combines proxy reencryption and searchable encryption which supports patient pseudoidentity search. The mechanism could achieve controllable sharing of medical records and precise search. According to the organizational characteristics of the stroke medical treatment combination, this paper proposes an improved Practical Byzantine Fault Tolerance mechanism to reach a consensus between consensus nodes. Then, the proposed scheme is analyzed and evaluated from three aspects of medical record integrity, user privacy, and data security. The results show that the scheme can not only ensure the privacy of patient identity information and private key data but also resist the tampering and deletion attacks of internal and external malicious nodes on the medical record data. Therefore, the proposed scheme is conducive to the improvement of the timeliness of stroke treatment and the safe sharing of electronic medical records in stroke medical treatment combination.
电子病历的维护和共享是医联体中的重要任务之一。传统的基于云的电子病历存储系统难以实现数据安全共享。区块链技术的抗篡改和可追溯性为高度敏感医疗数据的共享提供了可能性。本文提出了一种基于联盟区块链的脑卒中电子病历安全共享方案。该方案采用密文存储在云端的病历和索引存储在区块链上的病历的存储方法。本文提出的隐私保护机制创新性地结合了代理重加密和支持患者伪身份搜索的可搜索加密。该机制可以实现病历的可控共享和精确搜索。根据脑卒中医联体的组织特点，本文提出了一种改进的实用拜占庭容错机制，以在共识节点之间达成共识。然后，从病历完整性、用户隐私和数据安全性三个方面对所提出的方案进行了分析和评估。结果表明，该方案不仅可以确保患者身份信息和私钥数据的隐私性，还可以抵抗病历数据的内部和外部恶意节点的篡改和删除攻击。因此，该方案有利于提高脑卒中治疗的及时性和脑卒中医联体中电子病历的安全共享。
