Department of Information Engineering, Jiangxi University of Science and Technology, Jiangxi, 341000, China.
Department of Software Engineering, Harbin Institute of Technology, ShengZhen, 518000, GuangDong, China.
J Med Syst. 2024 Nov 18;48(1):106. doi: 10.1007/s10916-024-02120-9.
In recent years, Electronic health records (EHR) has gradually become the mainstream in the healthcare field. However, due to the fact that EHR systems are provided by different vendors, data is dispersed and stored, which leads to the phenomenon of data silos, making medical information too fragmented and bringing some challenges to current medical services. Therefore, in view of the difficulties in sharing EHR between medical institutions, the risk of privacy leakage, and the lack of EHR usage control by patients, an EHR sharing model based on consortium blockchain is proposed in this paper. Firstly, the Interplanetary File System is combined with consortium blockchain, which forms a hybrid storage scheme of EHR, this technology effectively improves data security, privacy protection, and operational efficiency. Secondly, the model combines unidirectional multi-hop conditional proxy re-encryption based on type and identity with distributed key generation technology to achieve secure EHR sharing with fine grained control. At the same time, users are required to link the operation records of EHR, so as to realize the traceability of EHR usage. A dynamic Byzantine fault-tolerant algorithm based on reputation and clustering is then proposed to solve the problems of arbitrary master node selection, high latency and low throughput of PBFT, enabling the nodes to reach consensus more efficiently. Finally, the model is analyzed in terms of security and user control, showing that the model is less energy intensive in terms of communication overhead and time consumption, and can effectively achieve secure sharing between medical data.
近年来，电子健康记录（EHR）逐渐成为医疗保健领域的主流。然而，由于 EHR 系统由不同的供应商提供，数据分散存储，导致出现数据孤岛现象，使医疗信息过于碎片化，给当前的医疗服务带来了一些挑战。因此，针对医疗机构间 EHR 共享的困难、隐私泄露的风险以及患者对 EHR 使用的缺乏控制，本文提出了一种基于联盟区块链的 EHR 共享模型。首先，将星际文件系统与联盟区块链相结合，形成 EHR 的混合存储方案，该技术有效提高了数据安全性、隐私保护和操作效率。其次，该模型结合了基于类型和身份的单向多跳条件代理重加密和分布式密钥生成技术，实现了具有细粒度控制的安全 EHR 共享。同时，要求用户链接 EHR 的操作记录，以实现 EHR 使用的可追溯性。然后提出了一种基于声誉和聚类的动态拜占庭容错算法，以解决任意主节点选择、PBFT 延迟高和吞吐量低的问题，使节点能够更有效地达成共识。最后，从安全性和用户控制两个方面对模型进行了分析，结果表明，该模型在通信开销和时间消耗方面的能量消耗较低，能够有效地实现医疗数据的安全共享。
