Decoding the hype: Blockchain in Healthcare - A Software Architecture for the provision of a patient summary to overcome interoperability issues.

Abstract

There is hardly any human activity which has not been positively affected by digital technologies impacting the access and exchange of information. Specifically, within the healthcare sector major improvements could be achieved. Nowadays nearly all medical records are kept in an electronic healthcare record (EHR) systems improving the access to clinical data intending to streamline costs. Electronic Health Care Records (EHRs) are however largely non-portable and kept on the systems where they have been created mainly due to interoperability, security, and liability reasons. This is resulting in a lack of medical quality for the patient and an increase of healthcare costs since the information transfer among different healthcare providers, spread over different locations, is highly dependent on the patient who is not considered as data owner and may not be aware of certain treatments received. The objective of this thesis was to investigate how interoperability challenges within the context of Electronic Health Care Record systems can be overcome considering the patient as the owner of his patient data by taking advantage of the Blockchain technology. In this research a software architecture has been developed from the context-, functional- and informational perspective to treat the described problem. A thorough description has been pro-vided as to which modules are needed to assure a proper data extraction, mapping, monitoring, user access management and intervention with the Blockchain. The proposed architecture has been evaluated based on an Architecture Trade-off analysis method which revealed, that the architecture is capable of overcoming interoperability issues by using the openEHR reference model in combination with a permissioned Blockchain solution that has been designed according to the requirements provided by the ISO 18308. The trade-off anal-ysis revealed most strengths within the area of communication impacting the performance and medico-legal quality attributes. Furthermore, the study revealed, that Security & Privacy comes with the price of impacting the performance and the other way around. In conclusion, it is possible to overcome interoperability issues by using the Blockchain technolo-gy for a variety of use-cases, such as the provision of a patient summary, as described within this thesis. Challenges, such as proper authorisation procedures and a mechanism to create commu-nity incentivises to maintain decentralised networks need to be further elaborated.