Developing a Mobile App for Monitoring Medical Record Changes Using Blockchain: Development and Usability Study

Area of Science:

• Health Informatics
• Blockchain Technology
• Patient-Centered Care

Background:

• Medical documents are often inaccessible despite the trend toward transparency.
• Blockchain technology offers immutable and transparent record-keeping solutions.

Purpose of the Study:

• To develop a blockchain-based system for monitoring medical document changes.
• To assess patients' ability to verify changes in their primary care clinical medical records using this system.

Main Methods:

• A system was developed using blockchain to monitor medical document changes, alerting patients via a mobile app.
• Participants' medical documents were processed using HL7 Fast Healthcare Interoperability Resources (FHIR), hashed, and transacted to the blockchain.
• The system verified document changes by querying the blockchain.

Main Results:

• 70 participants were enrolled; most desired a medical record monitoring system and opposed unauthorized changes.
• Digital literacy was generally fair among participants.
• An analysis of 44 active app users showed a mean usage of 5.1 times over 33.6 days, with satisfactory usability (System Usability Scale score of 63.21).

Conclusions:

• Patients expressed significant interest in a blockchain-based system for monitoring their medical records.
• The system effectively informs patients of record changes via an app without uploading sensitive data, enhancing transparency and patient empowerment.