Designing a Private and Secure Personal Health Records Access Management System: A Solution Based on IOTA Distributed Ledger Technology.

The privacy and security of patients' health records have been an ongoing issue, and researchers are in a race against technology to design a system that can help stop the compromising of patient data. Many researchers have proposed solutions; however, most solutions have not incorporated potential parameters that can ensure private and secure personal health records management, which is the focus of this study. To design and develop a solution, this research thoroughly investigated existing solutions and identified potential key contexts. These include IOTA Tangle, Distributed Ledger Technology (DLT), IPFS protocols, Application Programming Interface (API), Proxy Re-encryption (PRE), and access control, which are analysed and integrated to secure patient medical records, and Internet of Things (IoT) medical devices, to develop a patient-based access management system that gives patients full control of their health records. This research developed four prototype applications to demonstrate the proposed solution: the web appointment application, the patient application, the doctor application, and the remote medical IoT device application. The results indicate that the proposed framework can improve healthcare services by providing immutable, secure, scalable, trusted, self-managed, and traceable patient health records while giving patients full control of their own medical records.

Addressing the Challenges of Electronic Health Records Using Blockchain and IPFS.

Electronic Health Records (EHR) are the healthcare sector's core digital strategy meant to improve the quality of care provided to patients. Despite the benefits afforded by this digital transformation initiative, adoption among healthcare organizations has been slower than desired. The sheer volume and sensitive nature of patient records compel these organizations to exercise a healthy amount of caution in implementing EHR. Cyberattacks have also increased the risks associated with non-optimal EHR implementations. An influx of high-profile data breaches has plagued the sector during the COVID-19 pandemic, which put the spotlight on EHR cybersecurity. One objective of this research project is to aid the acceleration of EHR adoption. Another objective is to ensure the robustness of the system to resist malicious attacks. For the former, a systematic review was used to unearth all the possible causes why the adoption of EHR has been anemic. In this paper, sixty-five existing proposed EHR solutions were analyzed and it was found that there are fourteen major challenges that need to be addressed to reduce friction and risk for health organizations. These were privacy, security, confidentiality, interoperability, access control, scalability, authentication, accessibility, availability, data storage, data ownership, data validity, data integrity, and ease of use. We propose EHRChain, a new framework that tackles all the listed challenges simultaneously to address the first objective while also being designed to achieve the second objective. It is enabled by dual-blockchains based on Hyperledger Sawtooth to allow patient data decentralization via a consortium blockchain and IPFS for distributed data storage.