Sreejith R, Senthil S
School of Computer Science and Engineering, REVA University, Bangalore, India.
Department of Business Administration, Rajagiri College of Social Sciences (Autonomous), Kochi, India.
Heliyon. 2023 Apr 3;9(4):e15180. doi: 10.1016/j.heliyon.2023.e15180. eCollection 2023 Apr.
The exponential growth in the global population and significant advancements in healthcare broadened the scope of intervention for e-Healthcare through decentralized data access and information exchange, making complex clinical decisions. e-Healthcare can perform several functionalities, including EHR communication, telemedicine, and complex clinical decision systems (CCDS), but large-scale users still find it challenging to maintain interoperability, stability, and scalability. Accommodating an extensive array of stakeholders, which includes patients, doctors, hospitals, and laboratories, demands interoperability to serve scalable services. FHIR frameworks have played a vital role in e-Healthcare designs. Most of the existing HL7-FHIR frameworks have used REST-API using HTTP-query for CRUD tasks that impose numerous rules and constraints, making the process more complex and time-consuming, violating the quality-of-service (QoS) standards on different levels. This paper develops a novel, robust Smart-Contract Authentication Assisted HL7-FHIR framework toward an interoperable e-Healthcare solution. Unlike classical REST API-based FHIR, our proposed method applies a Graph-mapping concept that transforms each resource variable into an equivalent Graph-Mapped Data Structure (GMS), which is subsequently stored in the NoSQL MongoDB database, reducing computational costs and time to meet QoS demands. The proposed model employs three key components, GMS-driven HL7 FHIR Gateway Model, Smart Contract Authentication and Client Model. The Smart Contract function helped verify and authenticate users to ensure privacy and secure EHR exchange. The assessment of the performance of the proposed model reveals a significant reduction in computational time with optimal resource utilization making it a significant and viable option to better the real-world e-Healthcare mechanisms.
全球人口的指数增长以及医疗保健领域的重大进步，通过分散的数据访问和信息交换拓宽了电子医疗保健的干预范围，从而做出复杂的临床决策。电子医疗保健可以执行多种功能，包括电子健康记录通信、远程医疗和复杂临床决策系统（CCDS），但大规模用户仍然发现维持互操作性、稳定性和可扩展性具有挑战性。容纳包括患者、医生、医院和实验室在内的广泛利益相关者，需要互操作性来提供可扩展的服务。FHIR框架在电子医疗保健设计中发挥了至关重要的作用。现有的大多数HL7-FHIR框架都使用基于HTTP查询的REST-API来执行CRUD任务，这些任务施加了许多规则和约束，使过程更加复杂和耗时，在不同层面上违反了服务质量（QoS）标准。本文针对可互操作的电子医疗保健解决方案，开发了一种新颖、强大的智能合约认证辅助HL7-FHIR框架。与基于经典REST API的FHIR不同，我们提出的方法应用了一种图形映射概念，将每个资源变量转换为等效的图形映射数据结构（GMS），随后将其存储在NoSQL MongoDB数据库中，降低计算成本和时间以满足QoS要求。所提出的模型采用了三个关键组件，即GMS驱动的HL7 FHIR网关模型、智能合约认证和客户端模型。智能合约功能有助于验证和认证用户，以确保电子健康记录交换的隐私和安全。对所提出模型的性能评估表明，计算时间显著减少，资源得到优化利用，使其成为改善现实世界电子医疗保健机制的重要且可行的选择。
