Blockchain-Based Architecture Design for Personal Health Record: Development and Usability Study.
Background: The importance of blockchain-based architectures for personal health record (PHR) lies in the fact that they are thought and developed to allow patients to control and at least partly collect their health data. Ideally, these systems should provide the full control of such data to the re...
| Publicado en: | Journal of Medical Internet Research Vol. 24; no. 4 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
JMIR Publications Inc.
Apr2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156677784&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156677784 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14394456 DNC jtl: Journal of Medical Internet Research issn: 14394456 maglogo: N pubinfo: dt: Apr2022 vid: 24 iid: 4 pid: 21567 pub: JMIR Publications Inc. place: Toronto, Ontario artinfo: ui: 156677784 156677784 NLM35416782 156677784 10.2196/35013 NLM35416782 156677784 ppct: 1 formats: tig: atl: Blockchain-Based Architecture Design for Personal Health Record: Development and Usability Study. aug: au: Costa, Thiago Bulhões da Silva Shinoda, Lucas Moreno, Ramon Alfredo Krieger, Jose E Gutierrez, Marco affil: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil sug: subj: Medical Records, Personal Health Care Delivery Human Comparative Studies Multicenter Studies Evaluation Research Validation Studies Clinical Assessment Tools Personal Resource Questionnaire ab: Background: The importance of blockchain-based architectures for personal health record (PHR) lies in the fact that they are thought and developed to allow patients to control and at least partly collect their health data. Ideally, these systems should provide the full control of such data to the respective owner. In spite of this importance, most of the works focus more on describing how blockchain models can be used in a PHR scenario rather than whether these models are in fact feasible and robust enough to support a large number of users.Objective: To achieve a consistent, reproducible, and comparable PHR system, we build a novel ledger-oriented architecture out of a permissioned distributed network, providing patients with a manner to securely collect, store, share, and manage their health data. We also emphasize the importance of suitable ledgers and smart contracts to operate the blockchain network as well as discuss the necessity of standardizing evaluation metrics to compare related (net)works.Methods: We adopted the Hyperledger Fabric platform to implement our blockchain-based architecture design and the Hyperledger Caliper framework to provide a detailed assessment of our system: first, under workload, ranging from 100 to 2500 simultaneous record submissions, and second, increasing the network size from 3 to 13 peers. In both experiments, we used throughput and average latency as the primary metrics. We also created a health database, a cryptographic unit, and a server to complement the blockchain network.Results: With a 3-peer network, smart contracts that write on the ledger have throughputs, measured in transactions per second (tps) in an order of magnitude close to 102 tps, while those contracts that only read have rates close to 103 tps. Smart contracts that write also have latencies, measured in seconds, in an order of magnitude close to 101 seconds, while that only read have delays close to 100 seconds. In particular, smart contracts that retrieve, list, and view history have throughputs varying, respectively, from 1100 tps to 1300 tps, 650 tps to 750 tps, and 850 tps to 950 tps, impacting the overall system response if they are equally requested under the same workload. Varying the network size and applying an equal fixed load, in turn, writing throughputs go from 102 tps to 101 tps and latencies go from 101 seconds to 102 seconds, while reading ones maintain similar values.Conclusions: To the best of our knowledge, we are the first to evaluate, using Hyperledger Caliper, the performance of a PHR blockchain architecture and the first to evaluate each smart contract separately. Nevertheless, blockchain systems achieve performances far below what the traditional distributed databases achieve, indicating that the assessment of blockchain solutions for PHR is a major concern to be addressed before putting them into a real production. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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