A Ledger of Me: Personalizing Healthcare Using Blockchain Technology

Personal Health Records (PHRs) have the potential to give patients fine-grained, personalized and secure access to their own medical data and to enable self-management of care. Emergent trends around the use of Blockchain, or Distributed Ledger Technology, seem to offer solutions to some of the problems faced in enabling these technologies, especially to support issues consent, data exchange, and data access. We present an analysis of existing blockchain-based health record solutions and a reference architecture for a “Ledger of Me” system that extends PHR to create a new platform combining the collection and access of medical data and digital interventions with smart contracts. Our intention is to enable patient use of the data in order to support their care and to provide a strong consent mechanisms for sharing of data between different organizations and apps. Ledger of Me is based on around the principle that this combination of event-driven smart contracts, medical record data, and patient control is important for the adoption of blockchain-based solutions for the PHR. The reference architecture we present can serve as the basis of a range of future blockchain-based medical application architectures.

[1]  Leslie Lamport,et al.  The Byzantine Generals Problem , 1982, TOPL.

[2]  T. Greenhalgh,et al.  “Personalising” NHS information technology in England , 2014, BMJ : British Medical Journal.

[3]  Julia Adler-Milstein,et al.  Making IT work - harnessing the power of health information technology ti improve care in England , 2016 .

[4]  Robert L. Drury,et al.  unraveling health as a complex adaptive system data mining cloud computing machin learning and biosensors as synergistic technologies , 2017 .

[5]  K. Shadan,et al.  Available online: , 2012 .

[6]  Bradley Malin,et al.  Between Access and Privacy: Challenges in Sharing Health Data , 2018, Yearbook of Medical Informatics.

[7]  Lucy Yardley,et al.  Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop , 2017, Journal of medical Internet research.

[8]  Andrew Lippman,et al.  A Case Study for Blockchain in Healthcare : “ MedRec ” prototype for electronic health records and medical research data , 2016 .

[9]  Cicely Marston,et al.  Patient and public attitudes towards informed consent models and levels of awareness of Electronic Health Records in the UK , 2015, Int. J. Medical Informatics.

[10]  Karl J. O'Dwyer,et al.  Bitcoin mining and its energy footprint , 2014 .

[11]  F. Godlee.  What can we salvage from care.data? , 2016, British Medical Journal.

[12]  I. Damgård,et al.  The protocols. , 1989, The New Zealand nursing journal. Kai tiaki.

[13]  Christian Cachin,et al.  Architecture of the Hyperledger Blockchain Fabric , 2016 .

[14]  J. Ainsworth,et al.  Commercial use of health data—A public “trial” by citizens' jury , 2019, Learning health systems.

[15]  M. Iansiti,et al.  The Truth about Blockchain , 2017 .

[16]  Vitalik Buterin.  A NEXT GENERATION SMART CONTRACT & DECENTRALIZED APPLICATION PLATFORM , 2015 .

[17]  Mody,et al.  Bitcoin and Blockchain : A peer to peer electronic cash system , 2018 .

[18]  Marie Lynn Miranda,et al.  Geographic health information systems: a platform to support the 'triple aim'. , 2013, Health affairs.

[19]  Christian Catalini,et al.  Blockchain Technology for Healthcare: Facilitating the Transition to Patient-Driven Interoperability , 2018, Computational and structural biotechnology journal.

[20]  Catherine Harvey,et al.  Effectiveness of Fluticasone Furoate-Vilanterol for COPD in Clinical Practice. , 2016, The New England journal of medicine.

[21]  Ben Goldacre,et al.  Big health data: the need to earn public trust , 2016, British Medical Journal.

[22]  J. Gagné.  Literature Review , 2018, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[23]  W. McGuire,et al.  Formula versus donor breast milk for feeding preterm or low birth weight infants. , 2014, The Cochrane database of systematic reviews.

[24]  Alexander Hörbst,et al.  Adult patient access to electronic health records , 2017 .

[25]  Computer error may have led to incorrect prescribing of statins to thousands of patients , 2016, British Medical Journal.

[26]  Patient access to Electronic Health Records , 2022 .

[27]  D. Brailer.  Interoperability will bind together a wide network of real-time, life- critical data that not only transform but become health care. , 2005 .

[28]  Adam Bosworth,et al.  What it takes: characteristics of the ideal personal health record. , 2009, Health affairs.

[29]  Anastas Mishev,et al.  Blockchain solutions for big data challenges: A literature review , 2017, IEEE EUROCON 2017 -17th International Conference on Smart Technologies.