Efficient Clinical Data Sharing Framework Based on Blockchain Technology

2021 ◽  
Author(s):  
Karamo Kanagi ◽  
Cooper Cheng-Yuan Ku ◽  
Li-Kai Lin ◽  
Wen-Huai Hsieh
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Health Care Providers ◽  
Clinical Data ◽  
Data Exchange ◽  
Access Time ◽  
Health Examination ◽  
Care Providers ◽  
Blockchain Technology ◽  
Average Access Time

Abstract Background While electronic health records have been collected for many years in Taiwan, their interoperability across different health care providers has not been entirely achieved yet. The exchange of clinical data is still inefficient and time consuming. Objectives This study proposes an efficient patient-centric framework based on the blockchain technology that makes clinical data accessible to patients and enable transparent, traceable, secure, and effective data sharing between physicians and other health care providers. Methods Health care experts were interviewed for the study, and medical data were collected in collaboration with Ministry of Health and Welfare (MOHW) Chang-Hua hospital. The proposed framework was designed based on the detailed analysis of this information. The framework includes smart contracts in an Ethereum-based permissioned blockchain to secure and facilitate clinical data exchange among different parties such as hospitals, clinics, patients, and other stakeholders. In addition, the framework employs the Logical Observation Identifiers Names and Codes (LOINC) standard to ensure the interoperability and reuse of clinical data. Results The prototype of the proposed framework was deployed in Chang-Hua hospital to demonstrate the sharing of health examination reports with many other clinics in suburban areas. The framework was found to reduce the average access time to patient health reports from the existing next-day service to a few seconds. Conclusion The proposed framework can be adopted to achieve health record sharing among health care providers with higher efficiency and protected privacy compared to the system currently used in Taiwan based on the client–server architecture.

scholarly journals Interrelationships Between Patients’ Data Tracking Practices, Data Sharing Practices, and Health Literacy: Onsite Survey Study

10.2196/18937 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e18937
Author(s):  
Yuhan Luo ◽  
Chi Young Oh ◽  
Beth St Jean ◽  
Eun Kyoung Choe
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Data Sharing ◽  
Health Care Providers ◽  
Clinic Visit ◽  
Survey Study ◽  
Sufficient Information ◽  
Full Potential ◽  
Care Providers ◽  
Data Tracking

Background Although the use of patient-generated data (PGD) in the optimization of patient care shows great promise, little is known about whether patients who track their PGD necessarily share the data with their clinicians. Meanwhile, health literacy—an important construct that captures an individual’s ability to manage their health and to engage with their health care providers—has often been neglected in prior studies focused on PGD tracking and sharing. To leverage the full potential of PGD, it is necessary to bridge the gap between patients’ data tracking and data sharing practices by first understanding the interrelationships between these practices and the factors contributing to these practices. Objective This study aims to systematically examine the interrelationships between PGD tracking practices, data sharing practices, and health literacy among individual patients. Methods We surveyed 109 patients at the time they met with a clinician at a university health center, unlike prior research that often examined patients’ retrospective experience after some time had passed since their clinic visit. The survey consisted of 39 questions asking patients about their PGD tracking and sharing practices based on their current clinical encounter. The survey also contained questions related to the participants’ health literacy. All the participants completed the survey on a tablet device. The onsite survey study enabled us to collect ecologically valid data based on patients’ immediate experiences situated within their clinic visit. Results We found no evidence that tracking PGD was related to self-reports of having sufficient information to manage one’s health; however, the number of data types participants tracked positively related to their self-assessed ability to actively engage with health care providers. Participants’ data tracking practices and their health literacy did not relate to their data sharing practices; however, their ability to engage with health care providers positively related to their willingness to share their data with clinicians in the future. Participants reported several benefits of, and barriers to, sharing their PGD with clinicians. Conclusions Although tracking PGD could help patients better engage with health care providers, it may not provide patients with sufficient information to manage their health. The gaps between tracking and sharing PGD with health care providers call for efforts to inform patients of how their data relate to their health and to facilitate efficient clinician-patient communication. To realize the full potential of PGD and to promote individuals’ health literacy, empowering patients to effectively track and share their PGD is important—both technologies and health care providers can play important roles.

Inequalities in Health: What Health Systems Can and Cannot Do

1996 ◽  
Vol 1 (3) ◽  
pp. 179-182 ◽  
Author(s):  
Peggy Foster
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Health Status ◽  
Health Care Providers ◽  
Health Examination ◽  
Care Providers ◽  
Inequalities In Health ◽  
Department Of Health ◽  
The Uk

Health promotion activities are actively encouraged in most countries, including the UK. Meanwhile many health care providers and health experts are becoming increasingly concerned about the growing evidence of significant health inequalities between social groups in the UK, and in particular the strong association between relative deprivation and poor health. In 1995, a report for the British government entitled ‘Variations in health: What can the Department of Health and the NHS do?’, identified the need for the Department of Health and the NHS to play a key role in coordinating and implementing public health programmes intended to reduce inequalities in health. Examination of existing evidence on the effectiveness of health promotion and prevention programmes designed to improve the health status of the most vulnerable groups in society reveals very little evidence to support current enthusiasm for adopting public health strategies in order to reduce variations in health status between the affluent and the poor. Alternative and potentially more effective health care responses to inequalities in health status need to be considered.

scholarly journals Using Blockchain Technology to Mitigate Challenges in Service Access for the Homeless and Data Exchange Between Providers: Qualitative Study

10.2196/16887 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e16887
Author(s):  
Anjum Khurshid ◽  
Vivian Rajeswaren ◽  
Steven Andrews
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Data Exchange ◽  
Service Providers ◽  
Health Sector ◽  
Real Life ◽  
Homeless Population ◽  
Sensitive Information ◽  
Service Access ◽  
Blockchain Technology

Background In the homeless population, barriers to housing and supportive services include a lack of control or access to data. Disparate data formats and storage across multiple organizations hinder up-to-date intersystem access to records and a unified view of an individual’s health and documentation history. The utility of blockchain to solve interoperability in health care is supported in recent literature, but the technology has yet to be tested in real-life conditions encompassing the complex regulatory standards in the health sector. Objective This study aimed to test the feasibility and performance of a blockchain system in a homeless community to securely store and share data across a system of providers in the health care ecosystem. Methods We performed a series of platform demonstrations and open-ended qualitative feedback interviews to determine the key needs and barriers to user and stakeholder adoption. Account creation and data transactions promoting organizational efficiency and improved health outcomes in this population were tested with homeless users and service providers. Results Persons experiencing homelessness and care organizations could successfully create accounts, grant and revoke data sharing permissions, and transmit documents across a distributed network of providers. However, there were issues regarding the security of shared data, user experience and adoption, and organizational preparedness for service providers as end users. We tested a set of assumptions related to these problems within the project time frame and contractual obligations with an existing blockchain-based platform. Conclusions Blockchain technology provides decentralized data sharing, validation, immutability, traceability, and integration. These core features enable a secure system for the management and distribution of sensitive information. This study presents a concrete evaluation of the effectiveness of blockchain through an existing platform while revealing limitations from the perspectives of user adoption, cost-effectiveness, scalability, and regulatory frameworks.

scholarly journals Interrelationships Between Patients’ Data Tracking Practices, Data Sharing Practices, and Health Literacy: Onsite Survey Study (Preprint)

2020 ◽  
Author(s):  
Yuhan Luo ◽  
Chi Young Oh ◽  
Beth St Jean ◽  
Eun Kyoung Choe
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Data Sharing ◽  
Health Care Providers ◽  
Clinic Visit ◽  
Survey Study ◽  
Sufficient Information ◽  
Full Potential ◽  
Care Providers ◽  
Data Tracking

BACKGROUND Although the use of patient-generated data (PGD) in the optimization of patient care shows great promise, little is known about whether patients who track their PGD necessarily share the data with their clinicians. Meanwhile, health literacy—an important construct that captures an individual’s ability to manage their health and to engage with their health care providers—has often been neglected in prior studies focused on PGD tracking and sharing. To leverage the full potential of PGD, it is necessary to bridge the gap between patients’ data tracking and data sharing practices by first understanding the interrelationships between these practices and the factors contributing to these practices. OBJECTIVE This study aims to systematically examine the interrelationships between PGD tracking practices, data sharing practices, and health literacy among individual patients. METHODS We surveyed 109 patients at the time they met with a clinician at a university health center, unlike prior research that often examined patients’ retrospective experience after some time had passed since their clinic visit. The survey consisted of 39 questions asking patients about their PGD tracking and sharing practices based on their current clinical encounter. The survey also contained questions related to the participants’ health literacy. All the participants completed the survey on a tablet device. The onsite survey study enabled us to collect ecologically valid data based on patients’ immediate experiences situated within their clinic visit. RESULTS We found no evidence that tracking PGD was related to self-reports of <i>having sufficient information to manage one’s health</i>; however, the number of data types participants tracked positively related to their self-assessed <i>ability to actively engage with health care providers</i>. Participants’ data tracking practices and their health literacy did not relate to their data sharing practices; however, their ability to engage with health care providers positively related to their willingness to share their data with clinicians in the future. Participants reported several benefits of, and barriers to, sharing their PGD with clinicians. CONCLUSIONS Although tracking PGD could help patients better engage with health care providers, it may not provide patients with sufficient information to manage their health. The gaps between tracking and sharing PGD with health care providers call for efforts to inform patients of how their data relate to their health and to facilitate efficient clinician-patient communication. To realize the full potential of PGD and to promote individuals’ health literacy, empowering patients to effectively track and share their PGD is important—both technologies and health care providers can play important roles.

HealthChain: A Blockchain for Electronic Health Records (Preprint)

2019 ◽  
Author(s):  
Yonggang Xiao ◽  
Yanbing Liu ◽  
Yunjun Wu ◽  
Tun Li ◽  
Xingping Xian ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Functional Requirements ◽  
Care Providers ◽  
Health Records ◽  
Blockchain Technology ◽  
Distributed Ledger ◽  
Electronic Health

BACKGROUND The maintenance of accurate health records of patients is a requirement of health care professionals. Furthermore, these records should be shared across different health care organizations in order for professionals to have a complete review of medical history and avoid missing important information. Nowadays, health care providers use electronic health records (EHRs) as a key to accomplishment of these jobs and delivery of quality care. However, there are technical and legal hurdles that prevent the adoption of these systems, such as the concern about performance and privacy issues. OBJECTIVE The aim of this paper is to build and evaluate an experimental blockchain for EHRs, named HealthChain, which addresses the disadvantages of traditional EHR systems. METHODS HealthChain is built based on consortium blockchain technology. Specifically, three stakeholders, namely hospitals, insurance providers, and governmental agencies, form a consortium that operates under a governance model, which enforces the business logic agreed by all participants. Peer nodes host instance of the distributed ledger consisting of EHRs, and instance of chaincode regulating the permissions of participants; designated orderers establish consensus on the order of EHRs and then disseminate blocks to peers. RESULTS HealthChain achieves the functional and non-functional requirements. While it can store EHRs in distributed ledger and share them among different participants, it demonstrates superior features, such as privacy preserving, security, and high throughout. These are the main reasons why HealthChain is proposed. CONCLUSIONS Consortium blockchain technology can help build EHR system and solve the problems that prevent the adoption of traditional ones.

Role of multi-layer foam dressings with Safetac in the prevention of pressure ulcers: a review of the clinical and scientific data

2016 ◽  
Vol 25 (Sup1) ◽  
pp. S3-S23
Author(s):  
Phil Davies
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Clinical Data ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Scientific Data ◽  
Advisory Panel ◽  
Care Providers ◽  
Prevention Measures ◽  
Prevention Strategies

Background Despite the implementation of prevention strategies, pressure ulcers (PUs) continue to be a challenging health problem for patients (and their carers), clinicians and health-care providers. One area of growing interest is the use of prophylactic dressings (which were originally designed for the treatment of PUs and other wound types) as a component of standard prevention measures. Over the past few years, a large amount of scientific and clinical data relating to this subject has been published in peer-reviewed journals and presented at international meetings and conferences. A substantial proportion of these data relate to one group of dressings: multi-layer foam dressings with Safetac, which are manufactured by Mölnlycke Health Care (Gothenburg, Sweden). This evidence pool has influenced the experts involved in updating the Clinical Practice Guideline, produced by the National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance, on the prevention and treatment of PUs. The updated Guideline, published in 2014, recommends that, as part of their PU prevention regimens, clinicians should consider applying prophylactic dressings to bony prominences in anatomical areas that are frequently subjected to friction and shear. Aims A literature review was undertaken to identify clinical data from the entire evidence hierarchy, as well as scientific data from laboratory studies, on the use of multi-layer foam dressings with Safetac in the prevention of pressure ulceration. Method The MEDLINE (National Library of Medicine, Bethesda, US) and EMBASE (Elsevier BV, Amsterdam, Netherlands) bibliographic databases were searched. In addition, abstract books and proceedings documents relating to national and international conferences were scanned in order to identify presentations (i.e. oral, e-posters and posters) of relevance to the review. Results Clinical and health economic experts have undertaken numerous studies, including randomised controlled trials, to assess the efficacy and cost-effectiveness of using multi-layer foam dressings with Safetac as a component of standard PU prevention strategies. The results of these studies indicate that the application of multi-layer foam dressings containing Safetac can reduce the occurrence of PUs on anatomical locations such as the sacrum and the heel, and underneath medical devices. Scientists have also developed and used laboratory methods to gain a better understanding of how prophylactic dressings work. The results of these studies indicate that the composition of foam dressings containing Safetac (i.e. their multi-layer structure) sets them apart from other dressings due to their ability to mediate the effects of physical forces (i.e. pressure, friction and shear) and control microclimate, all of which contribute to pressure ulceration. Conclusion The evidence pool clearly indicates that the prophylactic use of multi-layer foam dressings with Safetac as a component of standard prevention measures is beneficial to the clinician, the health-care provider and the patient. It should be noted that the findings outlined in this review may not be transferable to other products as their makeup and components are likely to differ significantly from those of multi-layer foam dressings with Safetac. As the importance of evidence-based practice and the need for cost-effective care continues to grow, clinicians and provider should carefully consider this point when selecting prophylactic dressings for PU prevention.

scholarly journals Building robust and ethical vaccination verification systems

2020 ◽  
Author(s):  
Baobao Zhang ◽  
Laurin Weissinger ◽  
Johannes Himmelreich ◽  
Nina McMurry ◽  
Tiffany Li ◽  
...  
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Health Care Providers ◽  
Health Data ◽  
Ethical Principles ◽  
Educational Institutions ◽  
Care Providers ◽  
Verification Systems

As countries begin to vaccinate their populations against COVID-19, creating systems to verify vaccine records will be vital to reopening businesses, educational institutions, and travel. We consider the challenges of building vaccine record verification (VRV) systems that involve data sharing by health care providers, methods for verifying vaccine records, and regulation of how entities (e.g., workplaces, schools, businesses, and airlines) may request proof of vaccination. In particular, we focus on the opportunities and risks associated with digital vaccine passport apps. We propose three ethical principles to guide the building of VRV systems: 1) aligning systems with vaccine prioritization, 2) upholding fairness and equity, and 3) building trustworthy technology that protects the public's health data.

scholarly journals Using Blockchain Technology to Mitigate Challenges in Service Access for the Homeless and Data Exchange Between Providers: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Anjum Khurshid ◽  
Vivian Rajeswaren ◽  
Steven Andrews
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Data Exchange ◽  
Service Providers ◽  
Health Sector ◽  
Real Life ◽  
Homeless Population ◽  
Sensitive Information ◽  
Service Access ◽  
Blockchain Technology

BACKGROUND In the homeless population, barriers to housing and supportive services include a lack of control or access to data. Disparate data formats and storage across multiple organizations hinder up-to-date intersystem access to records and a unified view of an individual’s health and documentation history. The utility of blockchain to solve interoperability in health care is supported in recent literature, but the technology has yet to be tested in real-life conditions encompassing the complex regulatory standards in the health sector. OBJECTIVE This study aimed to test the feasibility and performance of a blockchain system in a homeless community to securely store and share data across a system of providers in the health care ecosystem. METHODS We performed a series of platform demonstrations and open-ended qualitative feedback interviews to determine the key needs and barriers to user and stakeholder adoption. Account creation and data transactions promoting organizational efficiency and improved health outcomes in this population were tested with homeless users and service providers. RESULTS Persons experiencing homelessness and care organizations could successfully create accounts, grant and revoke data sharing permissions, and transmit documents across a distributed network of providers. However, there were issues regarding the security of shared data, user experience and adoption, and organizational preparedness for service providers as end users. We tested a set of assumptions related to these problems within the project time frame and contractual obligations with an existing blockchain-based platform. CONCLUSIONS Blockchain technology provides decentralized data sharing, validation, immutability, traceability, and integration. These core features enable a secure system for the management and distribution of sensitive information. This study presents a concrete evaluation of the effectiveness of blockchain through an existing platform while revealing limitations from the perspectives of user adoption, cost-effectiveness, scalability, and regulatory frameworks.

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

Sign in / Sign up

Export Citation Format

Share Document