Viability of Decentralized Regulatory-compliant Electronic Health Record Systems: A Survey

This paper provides a comprehensive review of contemporary standards, technologies, and proposals in decentralized electronic health records systems. Foundational concepts such as blockchain technology and smart contracts are explored, followed by an examination of current U.S. legislation governing the storage and transfer of patient health information. The study proceeds with an in-depth analysis of technology standards that have shaped the healthcare industry's approach to managing health data. Implementation technologies of blockchain, including Ethereum and Hyperledger, are highlighted, showcasing recent advancements in decentralized systems. The importance of encryption protocols in preserving the privacy and integrity of personal health information is underscored. Major decentralized data storage techniques, such as IPFS, are introduced to address the need for secure storage solutions. The paper then compares and contrasts current proposals using blockchain technology for healthcare purposes, employing a custom performance metric to evaluate their efficacy. In conclusion, the paper outlines future directions that leverage the strengths of existing proposals while addressing challenges in decentralized electronic health records systems.