Secure decentralized decisions to enhance coordination in consolidated hospital systems

Abstract Shared decision making has become a crucial solution to build a consolidated healthcare system. While there is some research in the healthcare literature discussing the advantages and disadvantages of shared decision making, its efficiency has not been addressed quantitatively. In this paper, we propose a Decentralized Patients Assignment System (DPAS) as a universal decentralized decision making architecture. It utilizes the blockchain technology, machine learning, and integer programing to enhance coordination among healthcare providers and patients in consolidated hospital systems. To test the efficiency of the proposed DPAS, a prototype system is developed using an Agent-based model and Ethereum and is compared to the current practice of central referral systems in consolidated hospital systems. The agent-based model consists of four agents including patients, physicians, hospitals, and miners interacting within a decentralized system. The proposed system highlights the importance of interoperability and consensus among healthcare agents in the decision making process. The results demonstrate the DPAS efficiency in decreasing computational time and rejection rates for patients transfer.

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