Kanagi Karamo, Ku Cooper Cheng-Yuan, Lin Li-Kai, Hsieh Wen-Huai
Institute of Information Management, National Chiao Tung University, Hsin-Chu City, Taiwan.
Division of Information Technology, Data Communications Branch, Chunghwa Telecom Inc., Taipei City, Taiwan.
Methods Inf Med. 2020 Dec;59(6):193-204. doi: 10.1055/s-0041-1727193. Epub 2021 May 12.
While electronic health records have been collected for many years in Taiwan, their interoperability across different health care providers has not been entirely achieved yet. The exchange of clinical data is still inefficient and time consuming.
This study proposes an efficient patient-centric framework based on the blockchain technology that makes clinical data accessible to patients and enable transparent, traceable, secure, and effective data sharing between physicians and other health care providers.
Health care experts were interviewed for the study, and medical data were collected in collaboration with Ministry of Health and Welfare (MOHW) Chang-Hua hospital. The proposed framework was designed based on the detailed analysis of this information. The framework includes smart contracts in an Ethereum-based permissioned blockchain to secure and facilitate clinical data exchange among different parties such as hospitals, clinics, patients, and other stakeholders. In addition, the framework employs the Logical Observation Identifiers Names and Codes (LOINC) standard to ensure the interoperability and reuse of clinical data.
The prototype of the proposed framework was deployed in Chang-Hua hospital to demonstrate the sharing of health examination reports with many other clinics in suburban areas. The framework was found to reduce the average access time to patient health reports from the existing next-day service to a few seconds.
The proposed framework can be adopted to achieve health record sharing among health care providers with higher efficiency and protected privacy compared to the system currently used in Taiwan based on the client-server architecture.
虽然台湾地区已收集电子健康记录多年,但不同医疗服务提供者之间的互操作性尚未完全实现。临床数据的交换仍然效率低下且耗时。
本研究提出了一种基于区块链技术的高效以患者为中心的框架,该框架使患者能够访问临床数据,并实现医生与其他医疗服务提供者之间透明、可追溯、安全且有效的数据共享。
本研究对医疗保健专家进行了访谈,并与卫生福利部彰化医院合作收集了医疗数据。基于对这些信息的详细分析设计了所提出的框架。该框架包括基于以太坊的许可区块链中的智能合约,以确保并促进医院、诊所、患者及其他利益相关者等不同方之间的临床数据交换。此外,该框架采用逻辑观察标识符名称和代码(LOINC)标准来确保临床数据的互操作性和重用性。
所提出框架的原型已在彰化医院部署,以展示与郊区许多其他诊所共享健康检查报告。结果发现,该框架将患者健康报告的平均获取时间从现有的次日服务缩短至几秒。
与台湾目前基于客户端 - 服务器架构使用的系统相比,所提出的框架可用于在医疗服务提供者之间实现更高效率且隐私得到保护的健康记录共享。