WiraChain: a blockchain and FHIR-based platform for improving clinical data interoperability in healthcare

Area of Science:

• Health Informatics
• Blockchain Technology
• Healthcare Interoperability

Background:

• Healthcare interoperability challenges lead to fragmented records and reduced efficiency.
• Existing theoretical frameworks and standards lack practical, implemented solutions for secure data exchange.
• Limited progress in practical, secure, and controlled healthcare data exchange systems.

Purpose of the Study:

• To develop and validate Wirachain, a decentralized application addressing healthcare data exchange limitations.
• To integrate blockchain technology with the HL7 FHIR standard for electronic health record management.
• To enable patient-controlled data access and ensure secure, interoperable clinical operations.

Main Methods:

• Developed Wirachain, a decentralized application combining blockchain and HL7 FHIR standards.
• Implemented patient-controlled permission management, authentication, and role-based access control.
• Utilized persistent storage with FHIR-compliant and traditional databases; validated with synthetic data and stress testing.

Main Results:

• Wirachain reliably managed access permissions and clinical data exchange across interoperable components.
• The system demonstrated efficient operation and secure data handling under simulated clinical workflows and increased load.
• Validation confirmed the system's performance under stress-testing scenarios.

Conclusions:

• Fully implemented blockchain-based solutions can effectively bridge conceptual interoperability frameworks and practical healthcare applications.
• Wirachain demonstrates the feasibility of combining blockchain and FHIR for secure, patient-centered, interoperable clinical operations.
• The study highlights a viable approach to overcoming healthcare data fragmentation and improving care continuity.