scholarly journals Towards a Stakeholder-Oriented Blockchain-Based Architecture for Electronic Health Records: Design Science Research Study

10.2196/13585 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e13585 ◽  
Author(s):  
Jan Heinrich Beinke ◽  
Christian Fitte ◽  
Frank Teuteberg
Keyword(s):  
Electronic Health Records ◽  
Data Security ◽  
Design Science ◽  
Science Research ◽  
Design Science Research ◽  
Future Research ◽  
Health Records ◽  
Blockchain Technology ◽  
Recommendations For Action ◽  
Electronic Health

Background Data security issues still constitute the main reason for the sluggish dissemination of electronic health records (EHRs). Given that blockchain technology offers the possibility to verify transactions through a decentralized network, it may serve as a solution to secure health-related data. Therefore, we have identified stakeholder-specific requirements and propose a blockchain-based architecture for EHRs, while referring to the already existing scientific discussions on the potential of blockchain for use in EHRs. Objective This study aimed to introduce blockchain technology for EHRs, based on identifying stakeholders and systematically eliciting their requirements, and to discuss the key benefits (KBs) and key challenges (KCs) of blockchain technology in the context of EHRs. Methods The blockchain-based architecture was developed in the framework of the design science research paradigm. The requirements were identified using a structured literature review and interviews with nine health care experts. Subsequently, the proposed architecture was evaluated using 4 workshops with 15 participants. Results We identified three major EHR stakeholder groups and 34 respective requirements. On this basis, we developed a five-layer architecture. The subsequent evaluation of the artifact was followed by the discussion of 12 KBs and 12 KCs of a blockchain-based architecture for EHRs. To address the KCs, we derived five recommendations for action for science and practice. Conclusions Our findings indicate that blockchain technology offers considerable potential to advance EHRs. Improvements to currently available EHR solutions are expected, for instance, in the areas of data security, traceability, and automation by smart contracts. Future research could examine the patient’s acceptance of blockchain-based EHRs and cost-benefit analyses.

scholarly journals Towards a Stakeholder-Oriented Blockchain-Based Architecture for Electronic Health Records: Design Science Research Study (Preprint)

2019 ◽  
Author(s):  
Jan Heinrich Beinke ◽  
Christian Fitte ◽  
Frank Teuteberg
Keyword(s):  
Electronic Health Records ◽  
Data Security ◽  
Design Science ◽  
Science Research ◽  
Design Science Research ◽  
Future Research ◽  
Health Records ◽  
Blockchain Technology ◽  
Recommendations For Action ◽  
Electronic Health

BACKGROUND Data security issues still constitute the main reason for the sluggish dissemination of electronic health records (EHRs). Given that blockchain technology offers the possibility to verify transactions through a decentralized network, it may serve as a solution to secure health-related data. Therefore, we have identified stakeholder-specific requirements and propose a blockchain-based architecture for EHRs, while referring to the already existing scientific discussions on the potential of blockchain for use in EHRs. OBJECTIVE This study aimed to introduce blockchain technology for EHRs, based on identifying stakeholders and systematically eliciting their requirements, and to discuss the key benefits (KBs) and key challenges (KCs) of blockchain technology in the context of EHRs. METHODS The blockchain-based architecture was developed in the framework of the design science research paradigm. The requirements were identified using a structured literature review and interviews with nine health care experts. Subsequently, the proposed architecture was evaluated using 4 workshops with 15 participants. RESULTS We identified three major EHR stakeholder groups and 34 respective requirements. On this basis, we developed a five-layer architecture. The subsequent evaluation of the artifact was followed by the discussion of 12 KBs and 12 KCs of a blockchain-based architecture for EHRs. To address the KCs, we derived five recommendations for action for science and practice. CONCLUSIONS Our findings indicate that blockchain technology offers considerable potential to advance EHRs. Improvements to currently available EHR solutions are expected, for instance, in the areas of data security, traceability, and automation by smart contracts. Future research could examine the patient’s acceptance of blockchain-based EHRs and cost-benefit analyses.

scholarly journals Healthchain: A novel framework on privacy preservation of electronic health records using blockchain technology

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243043
Author(s):  
Shekha Chenthara ◽  
Khandakar Ahmed ◽  
Hua Wang ◽  
Frank Whittaker ◽  
Zhenxiang Chen
Keyword(s):  
Electronic Health Records ◽  
Data Security ◽  
Data Privacy ◽  
Health Data ◽  
Cyber Attacks ◽  
Security Risk ◽  
Patient Privacy ◽  
Health Records ◽  
Blockchain Technology ◽  
Electronic Health

The privacy of Electronic Health Records (EHRs) is facing a major hurdle with outsourcing private health data in the cloud as there exists danger of leaking health information to unauthorized parties. In fact, EHRs are stored on centralized databases that increases the security risk footprint and requires trust in a single authority which cannot effectively protect data from internal attacks. This research focuses on ensuring the patient privacy and data security while sharing the sensitive data across same or different organisations as well as healthcare providers in a distributed environment. This research develops a privacy-preserving framework viz Healthchain based on Blockchain technology that maintains security, privacy, scalability and integrity of the e-health data. The Blockchain is built on Hyperledger fabric, a permissioned distributed ledger solutions by using Hyperledger composer and stores EHRs by utilizing InterPlanetary File System (IPFS) to build this healthchain framework. Moreover, the data stored in the IPFS is encrypted by using a unique cryptographic public key encryption algorithm to create a robust blockchain solution for electronic health data. The objective of the research is to provide a foundation for developing security solutions against cyber-attacks by exploiting the inherent features of the blockchain, and thus contribute to the robustness of healthcare information sharing environments. Through the results, the proposed model shows that the healthcare records are not traceable to unauthorized access as the model stores only the encrypted hash of the records that proves effectiveness in terms of data security, enhanced data privacy, improved data scalability, interoperability and data integrity while sharing and accessing medical records among stakeholders across the healthchain network.

Research and application of artificial intelligence based on electronic health record data from patients with cancer: a systematic review (Preprint)

2021 ◽  
Author(s):  
Xinyu Yang ◽  
Dongmei Mu ◽  
Hao Peng ◽  
Hua Li ◽  
Ying Wang ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Electronic Health Records ◽  
Ensemble Methods ◽  
Future Research ◽  
Electronic Health Record Data ◽  
Health Records ◽  
Patients With Cancer ◽  
Cancer Management ◽  
Treatment And Prevention ◽  
Electronic Health

BACKGROUND With the accumulation of electronic health records data and the development of artificial intelligence, patients with cancer urgently need new evidence of more personalized clinical and demographic characteristics and more sophisticated treatment and prevention strategies. However, no research has systematically analyzed the application and significance of electronic health records and artificial intelligence in cancer care. OBJECTIVE In this study, we reviewed the literature on the application of AI based on EHR data from patients with cancer, hoping to provide reference for subsequent researchers, and help accelerate the application of EHR data and AI technology in the field of cancer, so as to help patients get more scientific and accurate treatment. METHODS Three databases were systematically searched to retrieve potentially relevant articles published from January 2009 to October 2020. A combination of terms related to "electronic health records", "artificial intelligence" and "cancer" was used to search for these publications. RESULTS Of the 1034 articles considered, 148 met the inclusion criteria. The review has shown that ensemble methods and deep learning were on the rise. It presented the representative literatures on the subfield of cancer diagnosis, treatment and care. In addition, the vast majority of studies in this area were based on private institutional databases, resulting in poor portability of the proposed methodology process. CONCLUSIONS The use of new methods and electronic health records data sharing and fusion were recommended for future research. With the help of specialists, artificial intelligence and the mining of massive electronic medical records could provide great opportunities for improving cancer management.

HealthChain: A Blockchain for Electronic Health Records (Preprint)

2019 ◽  
Author(s):  
Yonggang Xiao ◽  
Yanbing Liu ◽  
Yunjun Wu ◽  
Tun Li ◽  
Xingping Xian ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Functional Requirements ◽  
Care Providers ◽  
Health Records ◽  
Blockchain Technology ◽  
Distributed Ledger ◽  
Electronic Health

BACKGROUND The maintenance of accurate health records of patients is a requirement of health care professionals. Furthermore, these records should be shared across different health care organizations in order for professionals to have a complete review of medical history and avoid missing important information. Nowadays, health care providers use electronic health records (EHRs) as a key to accomplishment of these jobs and delivery of quality care. However, there are technical and legal hurdles that prevent the adoption of these systems, such as the concern about performance and privacy issues. OBJECTIVE The aim of this paper is to build and evaluate an experimental blockchain for EHRs, named HealthChain, which addresses the disadvantages of traditional EHR systems. METHODS HealthChain is built based on consortium blockchain technology. Specifically, three stakeholders, namely hospitals, insurance providers, and governmental agencies, form a consortium that operates under a governance model, which enforces the business logic agreed by all participants. Peer nodes host instance of the distributed ledger consisting of EHRs, and instance of chaincode regulating the permissions of participants; designated orderers establish consensus on the order of EHRs and then disseminate blocks to peers. RESULTS HealthChain achieves the functional and non-functional requirements. While it can store EHRs in distributed ledger and share them among different participants, it demonstrates superior features, such as privacy preserving, security, and high throughout. These are the main reasons why HealthChain is proposed. CONCLUSIONS Consortium blockchain technology can help build EHR system and solve the problems that prevent the adoption of traditional ones.

scholarly journals Designing to Inform: Toward Conceptualizing Practitioner Audiences for Socio-technical Artifacts in Design Science Research in the Information Systems Discipline

10.28945/2143 ◽  
2015 ◽  
Author(s):  
Andreas Drechsler
Keyword(s):  
Information Systems ◽  
Design Science ◽  
Science Research ◽  
Design Science Research ◽  
Future Research ◽  
Explicit Consideration ◽  
Practice Gap ◽  
Technical Artifacts ◽  
Group 2 ◽  
Theory Practice Gap

This paper identifies areas in the design science research (DSR) subfield of the information systems (IS) discipline where a more detailed consideration of practitioner audiences of socio-technical design artifacts could improve current IS DSR research practice and proposes an initial conceptualization of these audiences. The consequences of not considering artifact audiences are identified through a critical appraisal of the current informing science lenses in the IS DSR literature. There are specific shortcomings in four areas: 1) treating practice stakeholders as a too homogeneous group, 2) not explicitly distinguishing between social and technical parts of socio-technical artifacts, 3) neglecting implications of the artifact abstraction level, and 4) a lack of explicit consideration of a dynamic or evolutionary fitness perspective of socio-technical artifacts. The findings not only pave the way for future research to further improve the conceptualization of artifact audiences, in order to improve the informing power – and thus, impact on practice and research relevance – of IS DSR projects; they can also help to bridge the theory-practice gap in other disciplines (e.g. computer science, engineering, or policy-oriented sociology) that seek to produce social and/or technical artifacts of practical relevance. A revised version of this paper was published in Informing Science: the International Journal of an Emerging Transdiscipline, Volume 18, 2015

Data Security in Electronic Health Records

2011 ◽  
pp. 1934-1947
Author(s):  
Stefane M Kabene ◽  
Raymond W. Leduc ◽  
Candace J Gibson
Keyword(s):  
Electronic Health Records ◽  
Health Information ◽  
Data Security ◽  
Value Added ◽  
Personal Health Information ◽  
Personal Health ◽  
Health Records ◽  
Healthcare Facilities ◽  
Shared Information ◽  
Electronic Health

Traditionally, patient information has been recorded on paper and stored in file folders at healthcare facilities and within physicians’ offices. The implementation of electronic health records (EHRs), the lifetime record of an individual’s health and health services delivered, allows for information to be stored on computers and offers the opportunity to store considerably more data, in much less space, with new efficiencies and value added as information is easier to access, legible, timely, non-redundant and readily available. However, there are many issues to consider with the implementation of a fully shared EHR. The protection of the information contained in the record is of the utmost importance as individuals stand to become quite vulnerable if that personal health information is compromised or accessed by unauthorized users. Therefore, one of the goals of this chapter is to uncover ways in which personal health information is being protected in EHR systems. The second objective, a broader one, examines what regulations, legislation and policies are in place that remove some of the uncertainty and risk and make the use of shared information safe and secure. Many of the techniques and technologies used so far are adopted from the corporate world, where data security has been an issue for some time. Current legislation in the United States and Canada at both the federal and state/provincial levels has addressed the general principles of data security and privacy but are still lacking in specifics with regard to cross-jurisdictional sharing of health information and the implementation and use of EHRs. Many of the researchers and studies on the subject find this to be one of the most important areas of concern moving forward. The opportunities for EHR implementation and use are exciting as they have the strong potential to improve both individual health care and population health, but without proper regulation and policies in place it is possible that the risks may outweigh the benefits.

scholarly journals Evaluating the Use of Electronic Health Records for Type 2 Diabetes Surveillance in 2 California Counties, 2010-2014

2017 ◽  
Vol 132 (4) ◽  
pp. 463-470 ◽  
Author(s):  
Maxwell J. Richardson ◽  
Stephen K. Van Den Eeden ◽  
Eric Roberts ◽  
Assiamira Ferrara ◽  
Susan Paulukonis ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Clinical Diagnosis ◽  
Family Income ◽  
Census Data ◽  
Diabetes Prevalence ◽  
Future Research ◽  
Test Results ◽  
Health Records ◽  
Hba1c Test ◽  
Electronic Health

Objectives: Electronic health records (EHRs) and electronic laboratory records (ELRs) are increasingly seen as a rich source of data for performing public health surveillance activities and monitoring community health status. Their potential for surveillance of chronic illness, however, may be underused. Our objectives were to (1) evaluate the use of EHRs and ELRs for diabetes surveillance in 2 California counties and (2) examine disparities in diabetes prevalence by geography, income, and race/ethnicity. Methods: We obtained data on a clinical diagnosis of diabetes and hemoglobin A1c (HbA1c) test results for adult members of Kaiser Permanente Northern California living in Contra Costa County or Solano County at any time during 2010-2014. We evaluated the validity of using HbA1c test results to determine diabetes prevalence, using clinical diagnoses as a gold standard. We estimated disparities in diabetes prevalence by combining HbA1c test results with US Census data on income, race, and ethnicity. Results: When compared with a clinical diagnosis of diabetes, data on a patient’s 5-year maximum HbA1c value ≥6.5% yielded the best combination of sensitivity (87.4%) and specificity (99.2%). The prevalence of 5-year maximum HbA1c ≥6.5% decreased with increasing median family income and increased with greater proportions of residents who were either non-Hispanic black or Hispanic. Conclusions: Timely diabetes surveillance data from ELRs can be used to document disparities, target interventions, and evaluate changes in population health. ELR data may be easier to access than a patient’s entire EHR, but outcome metric validation with diabetes diagnoses would need to be ongoing. Future research should validate ELR and EHR data across multiple providers.

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