@文章{信息:doi/10.2196/29108，作者=“Lee Sejong and Kim, jaehyun and Kwon, Yongseok and Kim, Teasung and Cho, Sunghyun”，标题=“基于区块链的患者信息交换系统的隐私保护:系统设计研究”，期刊=“J Med Internet Res”，年=“2022”，月=“3”，日=“22”，卷=“24”，数=“3”，页=“e29108”，关键词=“电子病历;财团区块链;数据安全;医疗数据管理;隐私保护;聪明的合同;代理re-encryption;以患者为中心的医疗体系;背景:随着医疗行业的日益成熟，出现了医疗人工智能、远程医疗、个性化医疗等各种先进医疗服务。由于先进的医疗服务使用用户数据和电子病历(EMRs)等医疗数据来提供服务，因此对医疗数据的需求也在迅速增加。 As a result, health care institutions and medical practitioners are researching various mechanisms and tools to feed medical data into their systems seamlessly. However, medical data contain sensitive personal information of patients. Therefore, ensuring security while meeting the demand for medical data is a very important problem in the information age for which a solution is required. Objective: Our goal is to design a blockchain-based decentralized patient information exchange (PIE) system that can safely and efficiently share EMRs. The proposed system preserves patients' privacy in the EMRs through a medical information exchange process that includes data encryption and access control. Methods: We propose a blockchain-based EMR-sharing system that allows patients to manage their EMRs scattered across multiple hospitals and share them with other users. Our PIE system protects the patient's EMR from security threats such as counterfeiting and privacy attacks during data sharing. In addition, it provides scalability by using distributed data-sharing methods to quickly share an EMR, regardless of its size or type. We implemented simulation models using Hyperledger Fabric, an open source blockchain framework. Results: We performed a simulation of the EMR-sharing process and compared it with previous works on blockchain-based medical systems to check the proposed system's performance. During the simulation, we found that it takes an average of 0.01014 (SD 0.0028) seconds to download 1 MB of EMR in our proposed PIE system. Moreover, it has been confirmed that data can be freely shared with other users regardless of the size or format of the data to be transmitted through the distributed data-sharing technique using the InterPlanetary File System. We conducted a security analysis to check whether the proposed security mechanism can effectively protect users of the EMR-sharing system from security threats such as data forgery or unauthorized access, and we found that the distributed ledger structure and re-encryption--based data encryption method can effectively protect users' EMRs from forgery and privacy leak threats and provide data integrity. Conclusions: Blockchain is a distributed ledger technology that provides data integrity to enable patient-centered health information exchange and access control. PIE systems integrate and manage fragmented patient EMRs through blockchain and protect users from security threats during the data exchange process among users. To increase safety and efficiency in the EMR-sharing process, we used access control using security levels, data encryption based on re-encryption, and a distributed data-sharing scheme. ", issn="1438-8871", doi="10.2196/29108", url="//www.mybigtv.com/2022/3/e29108", url="https://doi.org/10.2196/29108", url="http://www.ncbi.nlm.nih.gov/pubmed/35315778" }