Generalizable Layered Blockchain Architecture for Health Care Applications: Development, Case Studies, and Evaluation

Area of Science:

• Health Informatics
• Blockchain Technology
• Distributed Systems

Background:

• Healthcare data coordination is crucial for emerging applications but hindered by distrust.
• Blockchain offers security, immutability, and decentralization to build trust between data providers and receivers.
• Existing blockchain designs lack a robust architecture for practical healthcare application development and performance testing.

Purpose of the Study:

• To develop a generalized, layered blockchain architecture for healthcare applications.
• To provide data coordination functions including requests, permissions, exchange, and tracking.
• To create a practical framework for developers to implement and test blockchain-based health solutions.

Main Methods:

• An augmented, 3-layered blockchain architecture was implemented on a private network.
• The architecture integrates fundamental blockchain settings, smart contracts, Node.js, web3.js, and web technologies.
• Two example applications, health information exchange and clinical trial recruitment, were developed and tested.

Main Results:

• The architecture successfully validated 331,142 simulated health information exchange requests with an average exchange time of 11.27 seconds.
• A clinical trial recruitment simulation demonstrated successful information delivery and permission granting in an average of 3.07 seconds.
• Performance testing confirmed the stability, efficiency, and scalability of the proposed blockchain system.

Conclusions:

• A generalized layered blockchain architecture is proposed, enabling healthcare application development without deep blockchain expertise.
• The architecture provides essential blockchain features for the health technology community.
• Case studies validated the architecture's feasibility and performance in health information exchange and clinical trial recruitment.