A Secure Architecture for Interoperable Personal Health Records (PHR) Based on Blockchain and FHIR

Personal Health Records (PHRs) would empower patients play active role for quality healthcare provision and access for routine checkup and self-care management. There is a need to recognize security, privacy and interoperability issues for successful design, implementation and adoption of PHR at a wider scale. However, it is one of the greatest challenges to achieve interoperability, security and privacy simultaneously in healthcare domain. Health Level Seven (HL7) international standards body is working to propose interoperability standards for healthcare information systems. However, privacy and security need to be incorporated in the system design and implementation. This work focuses on designing HL7 compliant PHR with security and privacy using blockchain, which is a distributed ledger data storage mechanism. The scope of the paper is limited to a number of core functional requirements of Fast Healthcare Interoperability Resources (FHIR). The PHR models applications of blockchain to these requirements to propose base system architecture. Several tools support FHIR compliant development of HL7 family of standards. We analyzed existing blockchain based PHR and their data sharing services in the domain to integrate FHIR and blockchain technologies. The goal is to share patient's data to facilitate health services by designing for a trusted interoperable sharing of data among different custodians such as physicians and insurance companies. Simultaneously the proof of concept is created through prototype implementation using Python in the open source tool Spyder IDE.