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1、ABlockchain-BasedApproachtoHealthInformationExchangeNetworksKevinPeterson,RammohanDeeduvanu,PradipKanjamala,andKellyBolesMayoClinicAbstractSharinghealthcaredatabetweeninstitutionsischallenging.Heterogeneousdatastructuresmayprecludecompatibility,whiledisparateuse
2、ofhealthcareterminologylimitsdatacomprehension.Evenifstructureandsemanticscouldbeagreedupon,bothsecurityanddataconsistencyconcernsabound.Centralizeddatastoresandauthorityprovidersareattractivetargetsforcyberattack,andestablishingaconsistentviewofthepatientrecord
3、acrossadatasharingnetworkisproblematic.InthisworkwepresentaBlockchain-basedapproachtosharingpatientdata.Thisapproachtradesasinglecentralizedsourceoftrustinfavorofnetworkconsensus,andpredicatesconsensusonproofofstructuralandsemanticinteroperability.1ProblemStatem
4、entCross-institutionalsharingofhealthcaredataisacomplexundertakingwiththepotentialtosigni cantlyincreaseresearchandclinicale ectiveness[1].Firstandforemost,institutionsoftenarereluctanttosharedatabecauseofprivacyconcerns[2],andmayfearthatsendinginformationwillgi
5、veothersacompetitiveadvantage[3].Next,evenifprivacyconcernscouldbeaddressed,thereisnobroadconsensusaroundthespeci ctechnicalinfrastructureneededtosupportsuchatask[4].Finally,healthcaredataitselfiscomplex,andsendinginformationacrossinstitutionalboundariesrequires
6、asharedunderstandingofbothdatastruc-turesandmeaning.Evenassumingdatacanbesharedecientlyandsecurely,theseinteroperabilityissuesleftuncheckedwilllimittheutilityofthedata.Despiteevidencethatthevalueofhealthcaredataexchangeislarge[5],theseissues,describedbelow,rema
7、insigni cantbarriers.1.1SecurityFailingtosecurethepatientrecordhas nancialandlegalconsequences,aswellasthepotentialtoimpactpatientcare.Securingtheelectronicmedicalrecordisachallengingtask[6],andtherami cationsofabreachareastrongdisincentivetosharingdata.Forthisw
8、ork,wefocusonbothprivacyandanonymityandhowtheyapplytodatasharing.Dataprivacyinvolvesensuringonlyauthorizedpartiesmayaccessthemedicalrecord.Thisimpactsanyhealthcaresys
