A Patient-Centric Health Information Exchange Framework Using Blockchain Technology

TLDR

Health Information Exchange improves patient care, yet current systems face security, privacy, data inconsistency, and access barriers that the Office of the National Coordinator seeks to overcome by shifting data ownership to patients. This study proposes a patient‑centric HIE solution that leverages blockchain’s perceived invulnerability to address these challenges. The authors design a blockchain model using smart contracts, personalized data segmentation, and clinician‑allowed lists to secure data, ensure provenance, and grant patients full control over their records. Large‑scale simulation demonstrates the model’s feasibility, stability, security, and robustness.

Abstract

Health Information Exchange (HIE) exhibits remarkable benefits for patient care such as improving healthcare quality and expediting coordinated care. The Office of the National Coordinator (ONC) for Health Information Technology is seeking patient-centric HIE designs that shift data ownership from providers to patients. There are multiple barriers to patient-centric HIE in the current system, such as security and privacy concerns, data inconsistency, timely access to the right records across multiple healthcare facilities. After investigating the current workflow of HIE, this paper provides a feasible solution to these challenges by utilizing the unique features of blockchain, a distributed ledger technology which is considered "unhackable". Utilizing the smart contract feature, which is a programmable self-executing protocol running on a blockchain, we developed a blockchain model to protect data security and patients' privacy, ensure data provenance, and provide patients full control of their health records. By personalizing data segmentation and an "allowed list" for clinicians to access their data, this design achieves patient-centric HIE. We conducted a large-scale simulation of this patient-centric HIE process and quantitatively evaluated the model's feasibility, stability, security, and robustness.