Faculty of Engineering, Information and Systems, University of Tsukuba, Ibaraki, Japan.
Graduate School of Science and Technology, University of Tsukuba, Ibaraki, Japan.
J Med Syst. 2024 Sep 19;48(1):90. doi: 10.1007/s10916-024-02102-x.
IT has made significant progress in various fields over the past few years, with many industries transitioning from paper-based to electronic media. However, sharing electronic medical records remains a long-term challenge, particularly when patients are in emergency situations, making it difficult to access and control their medical information. Previous studies have proposed permissioned blockchains with limited participants or mechanisms that allow emergency medical information sharing to pre-designated participants. However, permissioned blockchains require prior participation by medical institutions, and limiting sharing entities restricts the number of potential partners. This means that sharing medical information with local emergency doctors becomes impossible if a patient is unconscious and far away from home, such as when traveling abroad. To tackle this challenge, we propose an emergency access control system for a global electronic medical information system that can be shared using a public blockchain, allowing anyone to participate. Our proposed system assumes that the patient wears a pendant with tamper-proof and biometric authentication capabilities. In the event of unconsciousness, emergency doctors can perform biometrics on behalf of the patient, allowing the family doctor to share health records with the emergency doctor through a secure channel that uses the Diffie-Hellman (DH) key exchange protocol. The pendant's biometric authentication function prevents unauthorized use if it is stolen, and we have tested the blockchain's fee for using the public blockchain, demonstrating that the proposed system is practical.
在过去的几年中，信息技术在各个领域都取得了重大进展，许多行业已经从纸质媒体向电子媒体转变。然而，电子病历的共享仍然是一个长期的挑战，特别是当患者处于紧急情况下时，难以访问和控制他们的医疗信息。以前的研究提出了许可区块链，其参与者数量有限，或者允许向预先指定的参与者共享紧急医疗信息的机制。然而，许可区块链需要医疗机构事先参与，并且限制共享实体限制了潜在合作伙伴的数量。这意味着，如果患者昏迷不醒且远离家乡，例如在国外旅行时，与当地急诊医生共享医疗信息变得不可能。为了解决这个挑战，我们提出了一个全球电子医疗信息系统的紧急访问控制系统，该系统可以使用公共区块链进行共享，允许任何人参与。我们提出的系统假设患者佩戴带有防篡改和生物识别认证功能的吊坠。在无意识的情况下，急诊医生可以代表患者进行生物特征识别，允许家庭医生通过使用 Diffie-Hellman (DH) 密钥交换协议的安全通道与急诊医生共享健康记录。吊坠的生物特征识别功能可防止在被盗时被未经授权使用，我们已经测试了使用公共区块链的区块链费用，证明了所提出的系统是实用的。
