Certain Investigations on Leveraging Blockchain Technology for Developing Electronic Health Records

R.Kalaipriya¹, S.Devadharshini², R.Rajmohan³, M.Pavithra⁴, Dr.T.Ananthkumar⁵

Research Student^1,2, Associate Professor³, Assistant Professor^4,5

Department of CSE^1,2,3,4,5

IFET College of Engineering^1,2,3,4,5

Villupuram, India

r.99kalai@gmail.com, dharshu0018@gmail.com, rjmohan89@gmail.com, pavimuthu27@gmail.com, ananth.eec@gmail.com

Abstract— This paper exhibits a Blockchain-based design for our current Electronic Health Records (EHR) frameworks. Electronic Health Records commonly comprise extremely penetrating and precarious records associated with patients. It needs to track all the events that occurred in the records to achieve data integrity for secure transactions. To solve these problems, we proposed two smart agreements, classified contracts, and user record associated contracts. The classified contract involves organizing the records in a distributed ledger format with secured interventions of Doctors and healthcare providers. The user record associated contracts validate the transactions requested by the concerned miners. We evaluate the proposed architecture by realizing the Hyper ledger framework, which includes Hyperledger explorer, composer, and caliper. Compared to conventional EHR frameworks, the suggested structure with the employment of the Blockchain has improved efficiency and security for storing electronic health records.

Keywords— Electronic health information, secure transaction, Blockchain, smart contracts, Hyper ledger;

                                                                                                                                                                I.      Introduction

Health records are the most sensitive documents allied to patients, which is recurrently pooled amongst doctors, healthcare providers, pharmacists for effective diagnosis and treatment. For the secure storage of data, we need to maintain the privacy and security of patient records and past information in clinical rehearses. Electronic Health Records should contain the patient portal with doctor visits, lab results, diagnosis of the diseases which are used to access anywhere and anytime through the peer to peer services. [1] Utilizing a blockchain can be made interoperability to avoid any privacy and security issues. It contains inherent integrity and fits with legitimate guidelines. Extended interoperability gains secure information related to patient records. Much information has problems with tracking and data storing. To solve these privacy issues, [7] they introduced smart agreements intensively. They are classified contracts, user record associated contracts utilized to track all patient records and maintain data integrity over the health information for secure transactions. We evaluate the proposed architecture by realizing the hyper ledger framework, which includes Hyperledger explorer, composer, caliper. The model is utilizing explorer to manage the web-based application, composer to create smart contracts and caliper to maintain blockchain performance over the network. Other models are having only the accessing rules and assigning roles to the users. Some data integrity issues may occur. Our proposed framework indulges with the availability, interoperability, and integrity of accessing patient records, processing blocks with the system functions such as add, read, and updates the records. The blockchain involves with a cryptographic algorithm to achieve the data integrity with extended security. The Hyperledger fabric is a private network, any transaction done between two participants it will store the details between the two individual miners, and their security envisioned the whole records of the patients either through transaction or risk assessments. The fabric network need not maintain the suspended consensus rule on every node participated in the transaction. The transaction permission has been declared by the Hyperledger Burrow individually; it is a single binary distribution on following consensus rules to be accessed via the Tendermint algorithm. For every transaction, each data processed within the smart contracts to achieve on-chain proposal transactions.

The section of this paper is organized as follows, and section II narrates related works on EHR utilizing different tools over the network. Section III describes the processing flow of modules with consensus rules and roles assigned to the users, section IV reviews tool analysis, and requirements for proposed system implementation. Section V settles the paper with impending investigations.

                                                                                                                                                              II.    Related Work

This section reviews related works of Blockchain technology employed in health records.  Azaria et al. [2] proposed a decentralized record executive framework to deal with EHRs. The structure gives patients a permanent log and simple admittance to their restorative data. Measa et al. [6] recommended a blockchain-based answer for distributing strategies for communicating to get privileges of assets and permitting rights among clients, the policies and the reasons has been exposed in a distributed form. The creators displayed a Bitcoin-based confirmation idea usage without any investigation or assessment. Wang et al. [4] proposed a mobile application based on blockchain consensus for patients to enable them to share medical records with Indicator centric schema that has been used to organize the patient’s data in an easy way to avoid the Intermediaries interventions. Xia et al.[7] proposed a patient-driven framework using a cryptographic algorithm to restrict unauthorized users’ details of the sharing of patient data between the Healthcare and the cloud service custodians to improve Data privacy while distributing medical records. It is the most prominent way to access the own files and maintains through the needs of the Patients. Wang et al. [8] described a blockchain Architecture for data distribution in Peer to Peer network collaborating Ethereum and encryption technology contains the roles for the users to avoid unauthorized validation by making smart contracts for each transaction is secured with the database server under the control and policies of smart agreements. Rodriguez Merchan et al [3] described the blockchain application in Healthcare Architecture involves to create the revolution in medical data by analyzing patient records, payment details stored in a block is easy to retrieve and shared with other communities makes convenience to the Doctors and Patients. Marella et al [5] described the assets in transaction and response time while adding blocks to maintain the security and privacy for a long time, using server-based maintenance for the medical records. F.Angeletti [9] describes the blockchain environment healthcare records exchange framework under the Proof of work concepts to maintain records by giving challenges to each node of the system and creates Hash code to maintain the good privacy records.

The existing system focused only on role assignment and access rules for the users, and data transaction performance is decreased due to the number of simulated users. These performances are realized in the proposed framework.

Fig. 1. An overview of blockchain Architecture for proposed system implementation

                                                                                                                                              III.   Proposed Methodology

In this paper, we introduce Blockchain architecture for Electronic Health Record maintenance. Blockchain realizes the decentralized approach over the peer to peer services across various data related to patients. Data Transparency can be achieved through distributed database access. The model has some properties on maintaining logs of patients and interpreted to store patient records from the hospital databases. A block contains data, previous hash code, and block hash value. Each hash code has been generated using the cryptographic algorithm[7]. The model consists of three modules Graphical user interface layer, Hybrid Blockchain layer, Smart contract layer. Each layer performs various mechanisms related to user needs. The primary function of GUI intended to intermingle with the system and accomplish some errands such as add, update, read et al. related to patient records. The method based on access through a browser, which is technically known to be as Distributed Application. GUI also contains login credentials for the roles assigned to the users. The Hybrid blockchain layer performs transactions in Fig.1 that will be needed by the users as a system function to add or delete the patient records. When the user request a patient record, it will be transferred through smart contract layer where the roles are verified each task having some identity, in the first contract it checks the status related to the user if it is matched it tends to enter next arrangement where it checks the particular role is assigned for the specific patient if it is validated, a block is created or deleted by performing some consensus rules, The framework will display requested record. Blockchain plays a vital role in user validation.

Fig. 2. BlockChain process using Smart Contracts

A.    Blockchain architecture

Blockchain is a chain of the block that provides a secure transaction; also, it is a decentralized approach. Each block is linked together in a specific order by the generated hash value; blockchain has some consensus rules to conduct system functions for validating transaction requests. When the user requests a transaction, a block sends to each node in the network, performs block validation and allows block into the chain. Blockchain has some key features regarding security, integrity, anonymity to avoid unauthorized user validation. These features made the blockchain into a feasible solution for secure transactions, for security and privacy purpose, blockchain uses SHA-256 cryptographic algorithm [7]. SHA expanded as Secure Hashing Algorithm; a single way function converts record into a 256 bits hash value for the architecture of decentralized.

In this proposed methodology, the smart contracts using classified contracts and associated user contracts, which involve the validation of the Doctor and the patient ID, which includes pertaining to the useful information.[Fig2] While adding the block, the classified contract includes entering the

Doctor ID and Patient ID it validates the environment of the User associated record metadata information involves to pertain the functional transaction within the allotted patient ID and Doctor ID

B.    Consensus Rules

The blockchain technology uses consensus rules[11] to maintain and to validate the transaction when the user requests any transaction, consensus rules to be performed the most important consensus rule is Proof of Work, which intended to give the challenges to peer networks, the peers should find the code and submit it to the proof of work. If it is valid, it will enter into the block. Otherwise, the block is denied.

C.    Smart contracts

A smart contract is known as the chain code [10], which is used to execute some rules of the system function. A smart contract tends to maintain the required operations in a scalable framework when the user requests a transaction; it will run the section of code. It is the most important agreement in the blockchain technology.

D.    Hyperledger framework

Hyperledger is an open-source project used to make the blockchain-based relations, Hyperledger has some tools to explore the health records sensitively they are,

• Hyperledger Explorer involves creating a web-based application on the evolved environment.
• Hyperledger Composer is used to building business networks.
• Hyperledger caliper intended to degree the enactment of the blockchain network.
• Hyperledger Ursa involves maintaining and ignoring the hashing functions.

1)   Hyperledger Fabric: Hyperledger Fabric is an undefended cradle based private network [10] developed by IBM for the many sectors such as Health care, Industries to Speed up the transactions. It reduces the number of Trust levels and maintains Scalability to achieve customized participation with clients. Smart contracts play a significant role, a chain code agreement that executes the pre-assigned conditions. At the same runtime, the relationship between the two clients and the data sharing can be monitored, and Scalability increased unconditionally.

2)   Hyperledger Sawtooth: Hyperledger sawtooth offers a Flexible architecture to maintain the smart contracts in a separate chain code without separate the core system for much functionality. It uses proof of Elapsed time algorithm to maintain security; it is better than the Proof of work algorithm in terms of generating hash codes for every peer connection with the network. It also supports the Byzantine Fault Tolerance consensus rules. Sawtooth allows the transaction to be added to the existing block or to be denied.

3)   Hyperledger Caliper: Hyperledger caliper involves measuring the performance of the implemented work with the help of tools that have been monitored with the predefined use cases. Obtained accuracy values may intend to give the transaction accuracy status after the performance metrics have been evaluated under the caliper platform. It contains two processes Caliper master and Caliper worker to support the message transport module. Caliper is a multi-Platform architecture to increase extensibility and flexibility in terms of performance measurements.

4)   Hyperledger composer: Hyperledger composer is a javascript written platform with many inbuilt tools maintained for the development of business networks. In the health care sector, records have been shared among various parties to analyze and perform the activities needed for the situation with multiple peers.

                                                                                                                                                       IV.   Simulation Model

In this proposed framework, by using the following configuration, the underlying Hardware required for system implementation indulged with Intel Core 7 processor with Linux operating system having 8 GB memory. The blockchain-based patient records implemented using the hyper ledger framework. A Hyper ledger is an open-source project development platform for Blockchain-based relations. The performances related to GUI can be achieved by Hyper ledger explorer to create the web-based application, Hyper ledger composer is a collaboration tool to create smart contracts for secure transactions. In Table 1 and fig. 3, Hyper ledger caliper is used to measure the performance of the Blockchain, such as Transaction deployment time, throughput, and latency. Hyper ledger ensures the transaction efficiency in the form of system function to validate the authorized users [Table 2 and Fig 4].

• Transaction performance

Fig. 3. Transaction performance for the proposed framework

• Response Time Comparison

Fig. 4. Average response time for Transactions

                                                                                                                                       V.    Conclusion and Future work

In this proposed framework, realizing the hybrid architecture of blockchain technology using Ledger framework to add, update, and securely view the patient records. The blockchain is utilizing smart agreements to validate the patient records to build a chain in the perspectives of data integrity, security, and anonymity. Record tracking realizes within the smart policies to evaluate the secure storage of EHR and also transaction performance is increased. The blockchain exhibits a decentralized approach in maintaining patient records to achieve the required throughput, transaction, and response time.

References

• Kamau, C. Boore, E. Maina, and S. Njenga, “Blockchain technology: Is this the solution to emr interoperability and security issues in developing countries?” in 2018 IST-Africa Week Conference (IST-Africa). IEEE, 2018, pp. Page–1.
• Azaria, A. Ekblaw, T. Vieira, and A. Lippman, “Medrec: Using blockchain for medical data access and permission management,” in 2nd International Conference on Open and Big Data (OBD). IEEE, 2016, pp. 25–30.
• Roman-Belmonte, J.M.; De la Corte-Rodriguez,H.;Rodriguez Merchan, E.C.C.; la Corte-Rodriguez,H.;Carlos Rodriguez-Merchan, E.
• How Blockchain Technology Can Change Medicine. Postgrad. Med. 2018,130, 420–427
• Yue, H. Wang, D. Jin, M. Li, and W.Jiang,”Healthcare datagateways: found healthcare intelligence on blockchain with novel privacy risk control,”Journal of Medical Systems, vol. 40, no. 10, p. 218 (8 pages), 2016.
• Dagher, G.G.; Mohler, J.; Milojkovic, M.; Marella, P.B.; Marella, B. Ancile: Privacy-Preserving Framework for Access Control and Interoperability of Electronic Health Records Using Blockchain Technology. Sustain. Cities Soc. 2018, 39, 283–297.
• Li, M. Nejad, and R. Zhang, “A blockchain-based architecture for traffic signal control system,” IEEE ICIOT, 2019.
• https://www.cnil.fr/en/blockchainand-gdpr-solutions-responsible use blockchain -context-personal-data.
• Ouaddah, A. Abou Elkalam, and A. Ait Ouahman, “Fairaccess: a new blockchain-based access control framework for the internet of things,” Security and Communication Networks, vol. 9, no. 18, pp. 5943–5964, 2016.
• BlocHIE: a BLOCkchain-based platform for healthcare information Exchange, in:J. Shan, C. Jiannong, W. Hanqing, Y. Yanni, M. Mingyu, H. Jianfei (Eds.), 2018 IEEE International Conference on Smart Computing (SMARTCOMP), 18-20 June 2018, LosAlamitos, CA, USA: IEEE Computer Society, 2018.
• [Online] Available at :https://www.hyperledger.org/projects/fabric