Acta Informatica Pragensia 2023, 12(1), 160-178 | DOI: 10.18267/j.aip.1874769

Survey on Security and Interoperability of Electronic Health Record Sharing Using Blockchain Technology

Reval Prabhu Puneeth ORCID...1,2, Govindaswamy Parthasarathy ORCID...2
1 Department of Computer Science and Engineering, NMAM Institute of Technology, Nitte, India
2 School of Computing and Information Technology, REVA University, Karnataka, India

Blockchain is regarded as a significant innovation and shows a set of promising features that can certainly address existing issues in real time applications. Decentralization, greater transparency, improved traceability and secure architecture can revolutionize healthcare systems. With the help of advancement in computer technologies, most healthcare institutions try to store patient data digitally rather than on paper. Electronic health records are regarded as some of the most important assets in healthcare system and are required to be shared among different hospitals and other organizations to improve diagnosis efficiency. While sharing patients’ details, certain basic standards such as integrity and confidentiality of the information need to be considered. Blockchain technology provides the above standards with features of immutability and granting access to stored information only to authorized users. The examination approach depends on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (or PRISMA) rules and an efficient planned search convention is utilized to look through multiple scientific databases to recognize, investigate and separate every important publication. In this paper, we present a solid systematic review on the blockchain and healthcare domain to identify the existing challenges and benefits of applying blockchain technology in healthcare systems. More than 150 scientific papers published in the last ten years are surveyed, resulting in the identifications and summarization of observations made on the different privacy-preserving approaches and also assessment of their performances. We also present a significant architectural solutions of blockchain to achieve interoperability. Thereby, we attempt to analyse the ideas of blockchain in the medical domain, by assessing the advantages and limitations, subsequently giving guidance to other researchers in the area.

Keywords: Electronic healthcare records; EHR; Blockchain; Data privacy; Decentralize technology; Security; Interoperability.

Received: March 17, 2022; Revised: July 20, 2022; Accepted: July 26, 2022; Prepublished online: August 1, 2022; Published: April 19, 2023  Show citation

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Puneeth, R.P., & Parthasarathy, G. (2023). Survey on Security and Interoperability of Electronic Health Record Sharing Using Blockchain Technology. Acta Informatica Pragensia, 12(1), 160-178. doi: 10.18267/j.aip.187
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    References

    1. Akhter Md Hasib, K. T., Chowdhury, I., Sakib, S., Monirujjaman Khan, M., Alsufyani, N., Alsufyani, A., & Bourouis, S. (2022). Electronic Health Record Monitoring System and Data Security Using Blockchain Technology. Security and Communication Networks, 2022, e2366632. https://doi.org/10.1155/2022/2366632 Go to original source...
    2. Azaria, A. Ekblaw., T. Vieira., & Lippman, A. (2016). MedRec: Using Blockchain forMedical Data Access and Permission Management. In 2nd International Conference on Open and Big Data (pp. 25-30). IEEE. https://doi.org/10.1109/OBD.2016.11 Go to original source...
    3. Belchior, R., Vasconcelos, A., Guerreiro, S., & Correia, M. (2021). A Survey on Blockchain Interoperability: Past, Present, and FutureTrends. arXiv. https://doi.org/10.48550/arXiv.2005.14282 Go to original source...
    4. Boumezbeur, I., & Zarour, K. (2022). Privacy Preservation and Access Control for Sharing Electronic Health Records Using Blockchain Technology. Acta Informatica Pragensia, 11(1), 105-122. https://doi.org/10.18267/j.aip.176 Go to original source...
    5. Chelladurai, U., & Pandian, S. (2022). A novel blockchain based electronic health record automation system for healthcare. Journal of Ambient Intelligence and Humanized Computing, 13, 693-703. https://doi.org/10.1007/s12652-021-03163-3 Go to original source...
    6. Chenthara, S., Ahmed, K., Wang, H., Whittaker, F., & Chen, Z. (2020). Healthchain: A novel framework on privacy preservation of electronic health records using blockchain technology. PLOS ONE, 15(12), e0243043. https://doi.org/10.1371/journal.pone.0243043 Go to original source...
    7. Cunha, M., Mendes, R., & Vilela, J. P. (2021). A survey of privacy-preserving mechanisms for heterogeneous data types. Computer Science Review, 41, 100403. https://doi.org/10.1016/j.cosrev.2021.100403 Go to original source...
    8. Dubovitskaya, A., Shukla, R., Zambani, P. S., Schumacher, M., Aberer, K., Xu, Z., Idnani, N., Lachhani, R., Wang, F., Swaminathan, A., Jahangir, M., Baig, F., Chowdhry, K., Ryu, S., & Stoller, S. (2019). ACTION-EHR: Patient-Centric Blockchain-Based EHR Data Management for Cancer Care. Journal of Medical Internet Research, 22(8), e13598. https://doi.org/10.2196/13598 Go to original source...
    9. Faheem A. R., Maher O. Al-K., Waleed A. Z., Mohammad R. Al-M., Shadab A., & Ibrahim Al-S. (2021). Blockchain-Based Framework for Interoperable Electronic Health Record. Annals of the Romanian Society for Cell Biology, 25(3), 6486-6495.
    10. Fan, K., Wang, S., Ren, Y., Li, H., & Yang, Y. (2018). MedBlock: Efficient and Secure Medical Data Sharing Via Blockchain. Journal of Medical Systems, 42(8), Article 136. https://doi.org/10.1007/s10916-018-0993-7 Go to original source...
    11. Fang, H. S. A., Tan, T. H., Tan, Y. F. C., & Tan, C. J. M. (2021). Blockchain Personal Health Records: Systematic Review. Journal of Medical Internet Research, 23(4), e25094. https://doi.org/10.2196/25094 Go to original source...
    12. Garrido, A., Ramírez López, L. J., & Álvarez, N. B. (2021). A simulation-based AHP approach to analyze the scalability of EHR systems using blockchain technology in healthcare institutions. Informatics in Medicine Unlocked, 24, 100576. https://doi.org/10.1016/j.imu.2021.100576 Go to original source...
    13. GO. (2022, Jan 02). The Gene Ontology Resources. https://geneontology.org/
    14. Guo, R., Shi, H., Zhao, Q., & Zheng, D. (2018). Secure Attribute-Based Signature Scheme With Multiple Authorities for Blockchain in Electronic Health Records Systems. IEEE Access, 6, 11676-11686. https://doi.org/10.1109/access.2018.2801266 Go to original source...
    15. Hamid, H. A. A., Rahman, S. M. M., Hossain, M. S., Almogren, A., & Alamri, A. (2017). A Security Model for Preserving the Privacy of Medical Big Data in a Healthcare Cloud Using a Fog Computing Facility With Pairing-Based Cryptography. IEEE Access, 5, 22313-22328. https://doi.org/10.1109/ACCESS.2017.2757844 Go to original source...
    16. Haque, R., Sarwar, H., Kabir, S. R., Forhat, R., Sadeq, M. J., Akhtaruzzaman, Md., & Haque, N. (2020). Blockchain-Based Information Security of Electronic Medical Records (EMR) in a Healthcare Communication System. In Intelligent Computing and Innovation on Data Science, (pp. 641-650). Springer. https://doi.org/10.1007/978-981-15-3284-9_69 Go to original source...
    17. Hashim, F., Shuaib, K., & Sallabi, F. (2021). MedShard: Electronic Health Record Sharing Using Blockchain Sharding. Sustainability, 13(11), 5889. https://doi.org/10.3390/su13115889 Go to original source...
    18. Hathaliya, J. J., & Tanwar, S. (2020). An exhaustive survey on security and privacy issues in Healthcare 4.0. Computer Communications, 153, 311-335. https://doi.org/10.1016/j.comcom.2020.02.018 Go to original source...
    19. ICD. (2022, Jan 02). International Classification of Diseases, Version 10. https://bioportal.bioontology.org/ontologies/ICD10
    20. Kim, T.-H., Kumar, G., Saha, R., Rai, M. K., Buchanan, W. J., Thomas, R., & Alazab, M. (2020). A Privacy Preserving Distributed Ledger Framework for Global Human Resource Record Management: The Blockchain Aspect. IEEE Access, 8, 96455-96467. https://doi.org/10.1109/ACCESS.2020.2995481 Go to original source...
    21. Li, M., Yu, S., Zheng, Y., Ren, K., & Lou, W. (2013). Scalable and Secure Sharing of Personal Health Records in Cloud Computing Using Attribute-Based Encryption. IEEE Transactions on Parallel and Distributed Systems, 24(1), 131-143. https://doi.org/10.1109/tpds.2012.97 Go to original source...
    22. Liu, J., Huang, X., & Liu, J. K. (2015). Secure sharing of Personal Health Records in cloud computing: Ciphertext-Policy Attribute-Based Signcryption. Future Generation Computer Systems, 52, 67-76. https://doi.org/10.1016/j.future.2014.10.014 Go to original source...
    23. Lin, Q., Wang, H., Pei, X., & Wang, J. (2019). Food Safety Traceability System Based on Blockchain and EPCIS. IEEE Access, 7, 20698-20707. https://doi.org/10.1109/access.2019.2897792 Go to original source...
    24. Loukides, G., Liagouris, J., Gkoulalas-Divanis, A., & Terrovitis, M. (2014). Disassociation for electronic health record privacy. Journal of Biomedical Informatics, 50, 46-61. https://doi.org/10.1016/j.jbi.2014.05.009 Go to original source...
    25. Lyniate. (2022, Jan 2022). Rim Reference Information Model. https://www.lyniate.com/knowledge-hub/rimreference-information-model/
    26. Mahajan, H. B., Rashid, A. S., Junnarkar, A. A., Uke, N., Deshpande, S. D., Futane, P. R., Alkhayyat, A., & Alhayani, B. (2022). Integration of Healthcare 4.0 and blockchain into secure cloud-based electronic health records systems. Applied Nanoscience, in press. https://doi.org/10.1007/s13204-021-02164-0 Go to original source...
    27. Mamun, A. A., Azam, S., & Gritti, C. (2022). Blockchain-based Electronic Health Records Management: A Comprehensive Review and Future Research Direction. IEEE Access, 10, 5768-5789. https://doi.org/10.1109/access.2022.3141079 Go to original source...
    28. Mantey, E. A., Zhou, C., Srividhya, S. R., Jain, S. K., & Sundaravadivazhagan, B. (2022). Integrated Blockchain-Deep Learning Approach for Analyzing the Electronic Health Records Recommender System. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.905265 Go to original source...
    29. Mattila, V., Rahman A., Ma, D. P., & Gauri, P. (2022). Enhancing Transaction Throughput in Public Blockchain Network Using Nested Chains. International Journal of Social Sciences and Management Review. 5. 257-263. https://doi.org/10.37602/IJSSMR.2022.5218 Go to original source...
    30. Mayer, A. H., da Costa, C. A., & Righi, R. da R. (2019). Electronic health records in a Blockchain: A systematic review. Health Informatics Journal, 26(2), 1273-1288. https://doi.org/10.1177/1460458219866350 Go to original source...
    31. Mikula, T., & Jacobsen, R. H. (2018). Identity and Access Management with Blockchain in Electronic Healthcare Records. In 21st Euromicro Conference on Digital System Design (pp. 699-706). IEEE. http://doi.org/10.1109/DSD.2018.00008 Go to original source...
    32. Nchinda Ngek, E. S., Nsioge, R. M., Ngenge, M. B., & Kadia, B. M. (2019). An intriguing case of lichen simplex chronicus in an elderly sub-Saharan African with longstanding scabies and sensory neuropathy. Pan African Medical Journal, 34, Article 124. https://doi.org/10.11604/pamj.2019.34.124.19999 Go to original source...
    33. Oodle. ( 2022, Jan 15). Types of Blockchain and their importance in the digital world. https://blockchain.oodles.io/blog/types-of-blockchain-uses/
    34. OWL. (2022, Jan 02). Web Ontology Language. https://www.w3.org/OWL/
    35. Pilares, I. C. A., Azam, S., Akbulut, S., Jonkman, M., & Shanmugam, B. (2022). Addressing the Challenges of Electronic Health Records Using Blockchain and IPFS. Sensors, 22(11), 4032. https://doi.org/10.3390/s22114032 Go to original source...
    36. Puneeth, R.P., & Parthasarathy, G. (2021). A Comprehensive Survey on Privacy-Security and Scalability Solutions for Blockchain Technology. In Smart Intelligent Computing and Communication Technology (pp. 173-178). IOS Press. https://doi.org/10.3233/APC210031 Go to original source...
    37. Qiao, R., Luo, X.-Y., Zhu, S.-F., Liu, A.-D., Yan, X.-Q., & Wang, Q.-X. (2020). Dynamic Autonomous Cross Consortium Chain Mechanism in e-Healthcare. IEEE Journal of Biomedical and Health Informatics, 24(8), 2157-2168. https://doi.org/10.1109/jbhi.2019.2963437 Go to original source...
    38. Qu, W., Wu, L., Wang, W., Liu, Z., & Wang, H. (2020). A electronic voting protocol based on blockchain and homomorphic signcryption. Concurrency and Computation: Practice and Experience, 34(16), e5817. https://doi.org/10.1002/cpe.5817 Go to original source...
    39. Raikwar, M., Gligoroski, D., & Kralevska, K. (2019). SoK of Used Cryptography in Blockchain. IEEE Access, 7, 148550-148575. https://doi.org/10.1109/access.2019.2946983 Go to original source...
    40. Rajput, A. R., Li, Q., & Ahvanooey, M. T. (2021). A Blockchain-Based Secret-Data Sharing Framework for Personal Health Records in Emergency Condition. Healthcare, 9(2), 206. https://doi.org/10.3390/healthcare9020206 Go to original source...
    41. Shahnaz, A., Qamar, U., & Khalid, A. (2019). Using Blockchain for Electronic Health Records. IEEE Access, 7, 147782-147795. https://doi.org/10.1109/access.2019.2946373 Go to original source...
    42. SNOMED. (2022, Jan 02). SNOMED CT Standard Ontology Based on the Ontology for General Medical Science. https://bioportal.bioontology.org/ontologies/SCTO
    43. Sonkamble, R. G., Phansalkar, S. P., Potdar, V. M., & Bongale, A. M. (2021). Survey of Interoperability in Electronic Health Records Management and Proposed Blockchain Based Framework: MyBlockEHR. IEEE Access, 9, 158367-158401. https://doi.org/10.1109/access.2021.3129284 Go to original source...
    44. Sorace, J., Wong, H.-H., DeLeire, T., Xu, D., Handler, S., Garcia, B., & MaCurdy, T. (2019). Quantifying The Competitiveness Of The Electronic Health Record Market And Its Implications For Interoperability. International Journal of Medical Informatics, 136, 104037. https://doi.org/10.1016/j.ijmedinf.2019.104037 Go to original source...
    45. Tanwar, S., Parekh, K., & Evans, R. (2020). Blockchain-based electronic healthcare record system for healthcare 4.0 applications. Journal of Information Security and Applications, 50, 102407. https://doi.org/10.1016/j.jisa.2019.102407 Go to original source...
    46. Watford, S., Edwards, S., Angrish, M., Judson, R. S., & Paul Friedman, K. (2019). Progress in data interoperability to support computational toxicology and chemical safety evaluation. Toxicology and Applied Pharmacology, 380, 114707. https://doi.org/10.1016/j.taap.2019.114707 Go to original source...
    47. Xia, Q., Sifah, E., Smahi, A., Amofa, S., & Zhang, X. (2017). BBDS: Blockchain-Based Data Sharing for Electronic Medical Records in Cloud Environments. Information, 8(2), Article 44. https://doi.org/10.3390/info8020044 Go to original source...
    48. Yan, X., Wu, Q., & Sun, Y. (2020). A Homomorphic Encryption and Privacy Protection Method Based on Blockchain and Edge Computing. Wireless Communications and Mobile Computing, 2020, Article ID 8832341. https://doi.org/10.1155/2020/8832341 Go to original source...
    49. Yang, H., & Yang, B. (2017). A Blockchain-Based Approach to the Secure Sharing of Healthcare Data. In Proceedings of the Norwegian Information Security Conference 2017 (pp. 100-111). NIKS.
    50. Zhang, J., Li, Z., Tan, R., & Liu, C. (2021). Design and Application of Electronic Rehabilitation Medical Record (ERMR) Sharing Scheme Based on Blockchain Technology. BioMed Research International, 2021, Article ID 3540830. https://doi.org/10.1155/2021/3540830 Go to original source...
    51. Zhuang, Y., Sheets, L. R., Chen, Y.-W., Shae, Z.-Y., Tsai, J. J. P., & Shyu, C.-R. (2020). A Patient-Centric Health Information Exchange Framework Using Blockchain Technology. IEEE Journal of Biomedical and Health Informatics, 24(8), 2169-2176. https://doi.org/10.1109/jbhi.2020.2993072 Go to original source...

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