Health Information Exchange (HIE) exhibits remarkable benefits for patient care such as improving healthcare quality and expediting coordinated care. The Office of the National Coordinator (ONC) for Health Information Technology is seeking patient-centric HIE designs that shift data ownership from providers to patients. There are multiple barriers to patient-centric HIE in the current system, such as security and privacy concerns, data inconsistency, timely access to the right records across multiple healthcare facilities. After investigating the current workflow of HIE, this paper provides a feasible solution to these challenges by utilizing the unique features of blockchain, a distributed ledger technology which is considered “unhackable”. Utilizing the smart contract feature, which is a programmable self-executing protocol running on a blockchain, we developed a blockchain model to protect data security and patients’ privacy, ensure data provenance, and provide patients full control of their health records. By personalizing data segmentation and an “allowed list” for clinicians to access their data, this design achieves patient-centric HIE. We conducted a large-scale simulation of this patient-centric HIE process and quantitatively evaluated the model's feasibility, stability, security, and robustness.

中文翻译：

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使用区块链技术的以患者为中心的健康信息交换框架。

健康信息交换（HIE）在患者护理方面显示出显着的优势，例如提高医疗质量和加快协调护理。国家卫生信息技术协调员办公室（ONC）正在寻求以患者为中心的HIE设计，以将数据所有权从提供者转移到患者。当前系统中以患者为中心的HIE存在多个障碍，例如安全性和隐私问题，数据不一致，无法跨多个医疗机构及时访问正确记录。在研究了HIE当前的工作流程之后，本文通过利用区块链的独特功能（一种被认为“不可破解”的分布式账本技术）为应对这些挑战提供了可行的解决方案。利用智能合约功能，这是一个运行在区块链上的可编程自执行协议，我们开发了一个区块链模型来保护数据安全和患者隐私，确保数据来源，并为患者提供对其病历的完全控制权。通过个性化数据分段和供临床医生访问其数据的“允许列表”，此设计实现了以患者为中心的HIE。我们对该以患者为中心的HIE过程进行了大规模仿真，并定量评估了该模型的可行性，稳定性，安全性和鲁棒性。