A Blockchain Solution for Electronic Medical Records

Problem
Electronic Medical Record (EMR) is a digitalized patient medical information system used by healthcare providers. Current system was never designed to manage the complexities of globalized multi-­institutional, lifetime medical records. As globalization increases, patients often move between providers in different regions. Their data becomes scattered across various organizations, and the access to earlier records often get lost. As the providers are the primary keeper of EMRs, patients face significant impediments in viewing their reports, correcting erroneous data, and distributing the information. The situation is much like consumer finance, where an individual may have several bank accounts, credit cards, loans, and assets but no unified way to access and control them. In the case of finance, however, there is an infrastructure in place that greases the wheels: currency. With the medical information, we are still in the age of barter.

Solution
By its sensitive nature, EHRs can effectively take advantage of a distributed ledger of permissioned Blockchain. It would allow multiple providers or stakeholders like doctors, hospitals, labs, and insurers request permission to access and update patients medical record from the blockchain. And allow patients to share their personal health data from their wearable devices. Moreover, patients have the power to control and monitor who access their data. With our platform providers can provide better patient care based on more accurate and up-to-date information in a consensus-based efficient manner.

The solution is developed using the Hyperledger Fabric, which is the most mature permissioned blockchain in the market today. Fabric leverages container technology to host smart contracts called “chaincode” that comprise the application logic of the system. In addition, the primary difference between the Fabric and other blockchains such as Ethereum is that the Fabric nodes have an access control layer built in, which allow appointing a group of participants in the network who are given the express authority to provide the validation of blocks of transactions. Or, to participate in the consensus mechanism. The Fabric provides far better security, performance, and speed of innovation for an enterprise blockchain.

Our solution does not seek to build directly on a public blockchain, instead constructing a private blockchain. It is the Fabric Access Control Layer that ensures only the registered providers are permitted to append blocks to the blockchain. We believe this level of centralized trust in healthcare providers is reasonable, as patients already place a high degree of trust in their healthcare.

System Design
The user can share data with healthcare providers to seek healthcare services, and with insurance companies to get a quote for the insurance policy and to be insured. When data sharing is detected in the system, there will be an event generated to record the data access request.

This record is then submitted to the blockchain network which is followed by several steps to transform a list of records into a transaction. A list of transactions will be used to form a block, and validator nodes in the blockchain network will validate the block. After a series of processes, the integrity of the record can be preserved, and future validation on the block and the transaction related to this record is available. Each time there is an operation on the medical data, a record will be reflected to the blockchain. This ensures that every action on medical record is accountable.

We implement an access control layer by utilizing the Hyperledger Fabric membership service component and the channel scheme. The access control layer is responsible for Fabric client and validator enrollment by issuing enrollment certificates and transaction certificates.