Decentralised provenance for healthcare data

Area of Science:

• Health Informatics
• Blockchain Technology
• Data Management

Background:

• Electronic Healthcare Records (EHRs) are fragmented across facilities, creating data silos and safety risks.
• Existing systems lack clinical context presentation, hindering effective data utilization.
• Need for secure, interoperable, and patient-centric EHR management solutions.

Purpose of the Study:

• To design and implement a blockchain-based platform for EHR provenance tracking.
• To ensure compliance with healthcare standards and patient-informed consent.
• To address challenges in EHR interoperability and clinical context.

Main Methods:

• Leveraged international standards: Integrating the Healthcare Enterprise (IHE), Health Level Seven International (HL7), and Fast Healthcare Interoperability Resources (FHIR).
• Developed a blockchain platform using Hyperledger Fabric with a smart contract for W3C PROV management.
• Integrated a Java Proxy for intercepting document submissions/retrievals and a service for PROV document retrieval.

Main Results:

• Successfully integrated the decentralized platform with the SpiritEHR engine and a CDA repository.
• Observed minimal processing time overhead (milliseconds) for data reading/writing using a cloud-based blockchain.
• Demonstrated transparent usage of provenance data for decision-making, data reconciliation, and consent auditing.

Conclusions:

• A blockchain-based solution effectively manages EHR provenance, enhancing data integrity and security.
• The platform integrates seamlessly into routine healthcare operations using international standards.
• This approach facilitates transparent data management, respecting patient consent preferences.