A framework for secure and decentralized sharing of medical imaging data via blockchain consensus

TLDR

Electronic sharing of medical imaging data is vital, yet current systems rely on trusted third‑party intermediaries, and the proposed blockchain approach faces privacy‑security complexity, regulatory uncertainty, and unproven large‑scale feasibility. The study examines blockchain as a means to achieve consensus without a central authority for decentralized medical imaging data sharing. They propose a framework that stores radiological studies on a blockchain ledger and enforces patient‑defined access permissions across domains. The framework eliminates third‑party access to protected health information, satisfies key interoperability criteria, and can be extended to other domains.

Abstract

The electronic sharing of medical imaging data is an important element of modern healthcare systems, but current infrastructure for cross-site image transfer depends on trust in third-party intermediaries. In this work, we examine the blockchain concept, which enables parties to establish consensus without relying on a central authority. We develop a framework for cross-domain image sharing that uses a blockchain as a distributed data store to establish a ledger of radiological studies and patient-defined access permissions. The blockchain framework is shown to eliminate third-party access to protected health information, satisfy many criteria of an interoperable health system, and readily generalize to domains beyond medical imaging. Relative drawbacks of the framework include the complexity of the privacy and security models and an unclear regulatory environment. Ultimately, the large-scale feasibility of such an approach remains to be demonstrated and will depend on a number of factors which we discuss in detail.