A Controllable Secure Blockchain-Based Electronic Healthcare Records Sharing Scheme

The sharing of electronic healthcare records (EHRs) is important to healthcare and medical research. However, institutions are faced with difficulties in privacy protection and efficiently secure data exchange. The main objective of this study is to propose a controllable secure blockchain-based EHRs sharing scheme. For this purpose, blockchain technologies are combined with interplanetary file systems (IPFS) to provide efficient secure EHRs sharing. Firstly, the IPFS-based EHR file system (IEFS) is designed to save and share large-size EHR files among medical institutions. With the high-throughput content-addressed block storage model and appropriate redundant backup of IPFS, IEFS is tamper-resistant and free of a single point of failure. Secondly, the blockchain is used to implement the blockchain-based EHR abstract system (BEAS) to manipulate EHR abstracts access. In BEAS, the EHR file addresses generated by IEFS are encrypted and saved in EHR abstracts for privacy protection. Since EHR abstracts are encrypted by patients' public keys, the sharing of EHR files is under the control of patients. In our experiment, a prototype system is developed to validate the proposed scheme. The experimental results showed that (1) EHRs are securely shared under the control of patients and (2) EHR files are retrieved at an acceptable speed supported by IPFS technology. In this paper, solutions to some important practical issues such as incapacitated patients, encryption key forgetting/missing, and efficient interaction of doctors with EHRs sharing scheme are also seriously discussed.