- Title
- Applying blockchain technology to aspects of electronic health records in South Africa: lessons learnt
- Creator
- Adlam, Ryno
- Subject
- Blockchains (Databases)
- Subject
- Database security Data protection Medical records -- Data processing
- Date Issued
- 2020
- Date
- 2020
- Type
- Thesis
- Type
- Masters
- Type
- MIT
- Identifier
- http://hdl.handle.net/10948/45996
- Identifier
- vital:39405
- Description
- The purpose of this study was to explore the applicability of blockchain technology as a viable alternative for the secure storage and distribution of electronic health records in a South African context. The adoption of electronic health records (EHRs) has grown over recent years. Electronic health records (EHRs) can be seen as electronic versions of patients’ medical history. EHRs promise benefits such as improving the quality of care, reducing medical errors, reducing costs, saving time, and enhancing the availability and sharing of medical records. Blockchain, in simple terms, could be seen as a distributed database controlled by a group of individuals. Blockchain technology differs from other distributed ledger technology by bundling unrelated data into blocks that are chained together in a linked-list manner, hence the name blockchain. Blockchain technology strives to provide desirable features, such as decentralization, immutability, audibility, and transparency. EHRs are traditionally constructed with a cloud-based infrastructure to promote the storing and distribution of medical records. These medical records are commonly stored in a centralized architecture, such as a relational database. The centralized architecture employed by EHRs may present a single point of failure. These kinds of failures may lead to data-breaches. The cloud-based infrastructure is effective and efficient from an availability standpoint. The increased availability of electronic health records has brought forth challenges related to the security and privacy of the patient’s medical records. The sensitive nature of EHRs attracts the attention of cyber-criminals. There has been a rise in the number of data breaches related to electronic health records. The traditional infrastructure used by electronic health records can no longer ensure the privacy and security of patient’s medical records. To determine whether blockchain is a viable alternative to these approaches, the main objective of this study was to compile a technical report on the applicability of aspects of blockchain technology to the secure storage and distribution of electronic health records. The study first conducted a literature review to gather background on the current state of electronic health records and blockchain technology. The results of the literature review were used to compile an initial report. Experiments were conducted with various aspects of blockchain technology to build a technical baseline and to ultimately validate the initial report. The insights gained from the experiments served to refine the initial report into a final technical report. The final deliverable of this study was to devise a technical report. The technical report serves as a generalized overview of the applicability of blockchain technology as a secure storage and distribution mechanism for electronic health records. The main topics covered by the technical report to outline the applicability of blockchain technology to EHRs are as follows: authentication, authorization, audit log, storage and transactions. The insights gained from the study illustrate that permissioned blockchain technology can enhance the traditional AAA security scheme employed by traditional EHRs. The AAA security scheme entails the use of certificate-based authentication and attributebased access control for authorization. Audit logs can be stored in a semi-decentralized architecture that can enhance the security and privacy of audit logs. Using blockchain technology for storing electronic health records might not be a viable alternative to traditional EHRs architecture. Blockchain technology violates certain privacy regulations as information is stored in a permanent manner. Furthermore, blockchain technology is not optimized for dealing with large volumes of data. However, blockchain technology could be used to store a cryptographic hash of electronic health records to ensure the integrity of records. Permissioned blockchain technology can enhance the EHRs transaction process by transacting health records in a peer-to-peer infrastructure. In doing so, the above-mentioned AAA security scheme can enhance the security, confidentiality, and integrity of electronic health records shared across organizational bounds.
- Format
- xiv, 124 leaves
- Format
- Publisher
- Nelson Mandela University
- Publisher
- Faculty of Engineering, the Built Environment and Technology
- Language
- English
- Rights
- Nelson Mandela University
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | SOURCE1 | Adlam, R 213397609 Dissertation April 2020.pdf | 1 MB | Adobe Acrobat PDF | View Details Download |