BTP-Report Rough
Blockchain Based System for Secure Storage of
Electronic Health Records
Introduction:
Electronic Health Record is a digital version of a patient file which contains
their medical, personal information, their past medical visits, past ailments
and past medical test [Link] records also have patient’s previous
medical prescriptions and diagnostic data. This data is confidential and
should be kept private. The access of this information should also be
regulated using strict access control policies. A storage system which
stores these electronic records should be made in a way that the records
are available to other hospitals and clients in the same hospital to ensure
usage of this data wherever the patient consults.
Blockchain Technology provides a decentralized ledger or storage method,
where data can be stored and shared easily among participants in a
blockchain network. A blockchain consists of a growing list of records,
called blocks, which are linked using cryptography and can record
transactions between two parties efficiently and in a verifiable and
permanent way [1].
Blockchain Technology can be adopted in healthcare systems, where
successful implementations would ensure preservation of medical history of
patients and would also allow hospitals and doctors to easily share
important medical data with each other even in a cross-hospital setting
[2].Generally Blockchain implementations use a public blockchain network
to store data and implement the business logic but in the case of electronic
health records storing these on a public blockchain would be problematic.
The data would no longer remain private as anyone can access data on a
public blockchain [Link] access control would also be very
difficult and costly to all [Link] records also contain test reports
(e.g X-rays and CT scan etc) these are multimedia files and if they are
stored on the blockchain it would make the storage process
computationally extremely costly and make the complete system difficult to
scale. Storing these multimedia files on a blockchain would mean
disseminating all these bulky files on every peer in the blockchain network ,
this would put heavy strain on the participant’s bandwidth as well as their
memory and storage space.
In this project , I introduce a private blockchain network which only contains
peers from participating hospitals and authorized client peers;this
blockchain allows the storage of electronic health records . This is a private
blockchain network so only the hospitals and peers which are present in
the network can access the health records this ensures that the confidential
data remains secure. The test reports which are multimedia files and are
too big to be efficiently stored on the blockchain are stored using an off-
chain storage approach , these reports and other multimedia resources are
referenced in the blockchain network so that they can be easily accessed
without using excess resources to store them directly in the blockchain
network. The only left problem with using a blockchain to store electronic
health records was an access control policy , which is also implemented in
this project as I am creating channels within the network to create
transactions which are only between the hospitals or organizations present
in the channel and access control policies are defined when the channel
was defined. The access control is ensured using public and private key
[Link] the approach mentioned above I am able to create a
system which can store electronic health records securely while creating an
efficient storage scheme which makes the system easy to scale and also
easy to implement further policies,functions.
Literature Review:
The blockchain technology is one of the present-day innovations that have
been gaining popularity in many applications including secure storage of
electronic health records. The Healthcare domain has a growing
requirement for an efficient framework to store and share electronic health
records with hospitals and clients connected on a network. Oliveira et al.
proposed a blockchain-based approach to storing and sharing electronic
medical records [3]. In their approach, medical records are encrypted
before they are stored in the blockchain and the keys are shared between
the patients and their trusted healthcare workers. Alexaki et al. described a
similar approach to using the blockchain to enable the sharing of medical
data between healthcare providers, while respecting the patient's privacy
and preserving the data’s integrity [4].They presented a conceptual medical
record access and sharing mechanism and showed that their approach
was suitable for regulated healthcare jurisdictions. Zhao et al. proposed a
key management scheme using a body sensor network to secure data in a
health blockchain[5].They utilized biosensor nodes to collect physiological
data for generating and recovering the keys used to encrypt and decrypt
medical data stored in the blockchain. Rui and Xu introduced a novel
blockchain framework to publish time sensitive healthcare information such
as COVID-19 cases and testing records [6]. They used temporary blocks to
facilitate timely publication of new medical records, and then combined
them into a permanently published block. Although the above methods
addressed the security concern through encryption it is not efficient enough
to scale the system for a consortium of hospitals , and these methods have
not addressed the problem of storing multimedia files on the blockchain.
For example, the work presented in [3] mentioned storing only the hash
values of large medical records into the blockchain without detailing on
how to effectively store the data themselves. It should be understood that
storing big multimedia files on the blockchain directly would cause
maintenance and scalability issues due to the storage of numerous large
medical records. In the approach that is used in this project a private
blockchain is created to avoid all these privacy and security concerns . The
use of an off-chain database to store large multimedia removes the
problem of storing multimedia files on the blockchain.
There are studies that implement role based access control policies in a
blockchain framework to restrict access of sensitive information to
authorized clients only. Guo et al. proposed a hybrid architecture of using
both blockchain and edge nodes to facilitate attribute-based access control
of electronic health records [7]. They used smart contracts to enforce
access control of electronic health record data. In contrast, in my approach
the access control is defined in the network channel properties itself which
is created using hyperledger fabric . This creates secure and efficient
access control policies which define the functionality that a particular client
of a particular hospital can use on the electronic health record data.
References
[1] Nakamoto, Satoshi. “A Peer-to-Peer Electronic Cash
System.” [Link], [Link] Accessed
18 July 2022.
[2] T. Kumar, V. Ramani, I. Ahmad, A. Braeken, E. Harjula
and M. Ylianttila, "Blockchain Utilization in Healthcare: Key
Requirements and Challenges," 2018 IEEE 20th
International Conference on e-Health Networking,
Applications and Services (Healthcom), 2018, pp. 1-7, doi:
10.1109/HealthCom.2018.8531136.
[3] M. T. de Oliveira et al., "Towards a Blockchain-Based Secure
Electronic Medical Record for Healthcare Applications," ICC
2019 - 2019 IEEE International Conference on
Communications (ICC), 2019, pp. 1-6, doi:
10.1109/ICC.2019.8761307.
[4] S. Alexaki, G. Alexandris, V. Katos and N. E. Petroulakis,
"Blockchain-based Electronic Patient Records for Regulated
Circular Healthcare Jurisdictions," 2018 IEEE 23rd
International Workshop on Computer Aided Modeling and
Design of Communication Links and Networks (CAMAD),
2018, pp. 1-6, doi: 10.1109/CAMAD.2018.8514954.
[5] H. Zhao, Y. Zhang, Y. Peng and R. Xu, "Lightweight Backup
and Efficient Recovery Scheme for Health Blockchain Keys,"
2017 IEEE 13th International Symposium on Autonomous
Decentralized System (ISADS), 2017, pp. 229-234, doi:
10.1109/ISADS.2017.22.
[6] R. Ming and H. Xu, "Timely Publication of Transaction
Records in a Private Blockchain," 2020 IEEE 20th
International Conference on Software Quality, Reliability and
Security Companion (QRS-C), 2020, pp. 116-123, doi:
10.1109/QRS-C51114.2020.00030.
[7] H. Guo, W. Li, M. Nejad and C. -C. Shen, "Access Control for
Electronic Health Records with Hybrid Blockchain-Edge
Architecture," 2019 IEEE International Conference on
Blockchain (Blockchain), 2019, pp. 44-51, doi:
10.1109/Blockchain.2019.00015.