The University of Southampton
University of Southampton Institutional Repository

Decentralised provenance for healthcare data

Decentralised provenance for healthcare data
Decentralised provenance for healthcare data
Objective: the creation and exchange of patients’ Electronic Healthcare Recordshave developed significantly in the last decade. Patients’ records are howeverdistributed in data silos across multiple healthcare facilities, posing technicaland clinical challenges that may endanger patients’ safety. Current healthcaresharing systems ensure interoperability of patients’ records across facilities, butthey have limits in presenting doctors with the clinical context of the data in therecords. We design and implement a platform for managing provenance track-ing of Electronic Healthcare Records based on blockchain technology, compliantwith the latest healthcare standards and following the patient-informed consentpreferences.

Methods: the platform leverages two pillars: the use of international standards such as Integrating the Healthcare Enterprise (IHE), Health Level Seven In-ternational (HL7) and Fast Healthcare Interoperability Resources (FHIR) toachieve interoperability, and the use of a provenance creation process thatby-design, avoids personal data storage within the blockchain. The platformconsists of: (1) a smart contract implemented within the Hyperledger Fabricblockchain that manages provenance according to the W3C PROV for medical document in standardised formats (e.g., a CDA document, a FHIR resource, aDICOM study, etc.); (2) a Java Proxy that intercepts all the document submis-sions and retrievals for which provenance shall be evaluated; (3) a service usedto retrieve the PROV document.

Results: we integrated our decentralised platform with the SpiritEHR engine,an enterprise-grade healthcare system, and we stored and retrieved the avail-able documents in the Mandel’s sample CDA repository1, which contained noprotected health information. Using a cloud-based blockchain solution, we ob-served that the overhead added to the typical processing time of reading andwriting medical data is in the order of milliseconds. Moreover, the integrationof the Proxy at the level of exchanged messages in EHR systems allows trans-parent usage of provenance data in multiple health computing domains such asdecision making, data reconciliation, and patient consent auditing.

Conclusions: by using international healthcare standards and a cloud-basedblockchain deployment, we delivered a solution that can manage provenance ofpatients’ records via transparent integration within the routine operations onhealthcare data.
1386-5056
Margheri, Andrea
05cfbda3-2bbf-4080-a834-e8701bedf5b9
Masi, Massimiliano
5044db32-a791-43b9-b7fb-5d80892f908e
Miladi, Abdallah
5bd7a89f-e99f-4d4e-9f26-161d9b290ad5
Sassone, Vladimiro
df7d3c83-2aa0-4571-be94-9473b07b03e7
Rosenzweig, Jason
e3b1e32a-83fc-4cf9-bf96-27755a62918a
Margheri, Andrea
05cfbda3-2bbf-4080-a834-e8701bedf5b9
Masi, Massimiliano
5044db32-a791-43b9-b7fb-5d80892f908e
Miladi, Abdallah
5bd7a89f-e99f-4d4e-9f26-161d9b290ad5
Sassone, Vladimiro
df7d3c83-2aa0-4571-be94-9473b07b03e7
Rosenzweig, Jason
e3b1e32a-83fc-4cf9-bf96-27755a62918a

Margheri, Andrea, Masi, Massimiliano, Miladi, Abdallah, Sassone, Vladimiro and Rosenzweig, Jason (2020) Decentralised provenance for healthcare data. International Journal of Medical Informatics, 141, [104197]. (doi:10.1016/j.ijmedinf.2020.104197).

Record type: Article

Abstract

Objective: the creation and exchange of patients’ Electronic Healthcare Recordshave developed significantly in the last decade. Patients’ records are howeverdistributed in data silos across multiple healthcare facilities, posing technicaland clinical challenges that may endanger patients’ safety. Current healthcaresharing systems ensure interoperability of patients’ records across facilities, butthey have limits in presenting doctors with the clinical context of the data in therecords. We design and implement a platform for managing provenance track-ing of Electronic Healthcare Records based on blockchain technology, compliantwith the latest healthcare standards and following the patient-informed consentpreferences.

Methods: the platform leverages two pillars: the use of international standards such as Integrating the Healthcare Enterprise (IHE), Health Level Seven In-ternational (HL7) and Fast Healthcare Interoperability Resources (FHIR) toachieve interoperability, and the use of a provenance creation process thatby-design, avoids personal data storage within the blockchain. The platformconsists of: (1) a smart contract implemented within the Hyperledger Fabricblockchain that manages provenance according to the W3C PROV for medical document in standardised formats (e.g., a CDA document, a FHIR resource, aDICOM study, etc.); (2) a Java Proxy that intercepts all the document submis-sions and retrievals for which provenance shall be evaluated; (3) a service usedto retrieve the PROV document.

Results: we integrated our decentralised platform with the SpiritEHR engine,an enterprise-grade healthcare system, and we stored and retrieved the avail-able documents in the Mandel’s sample CDA repository1, which contained noprotected health information. Using a cloud-based blockchain solution, we ob-served that the overhead added to the typical processing time of reading andwriting medical data is in the order of milliseconds. Moreover, the integrationof the Proxy at the level of exchanged messages in EHR systems allows trans-parent usage of provenance data in multiple health computing domains such asdecision making, data reconciliation, and patient consent auditing.

Conclusions: by using international healthcare standards and a cloud-basedblockchain deployment, we delivered a solution that can manage provenance ofpatients’ records via transparent integration within the routine operations onhealthcare data.

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Decentralised Provenance for Healthcare Data - Accepted Manuscript
Restricted to Repository staff only until 8 June 2021.
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More information

Accepted/In Press date: 23 May 2020
e-pub ahead of print date: 8 June 2020
Published date: September 2020

Identifiers

Local EPrints ID: 442359
URI: http://eprints.soton.ac.uk/id/eprint/442359
ISSN: 1386-5056
PURE UUID: 7a810576-df8e-4aeb-b906-6072b846efc2

Catalogue record

Date deposited: 14 Jul 2020 16:31
Last modified: 06 Oct 2020 21:12

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Contributors

Author: Andrea Margheri
Author: Massimiliano Masi
Author: Abdallah Miladi
Author: Vladimiro Sassone
Author: Jason Rosenzweig

University divisions

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