TY - JOUR AU - Lee, Sejong AU - Kim, Jaehyeon AU - Kwon, Yongseok AU - Kim, Teasung AU - Cho, Sunghyun PY - 2022 DA - 2022/3/22 TI -基于区块链的患者信息交换系统中的隐私保护:系统设计研究JO - J Med Internet Res SP - e29108 VL - 24is - 3kw -电子病历KW -联盟区块链KW -数据安全KW -医疗数据管理KW -隐私保护KW -智能合约KW -代理再加密KW -以患者为中心的医疗系统KW -星际文件系统AB -背景:随着医疗行业的日益复杂化，医疗人工智能、远程医疗、个性化医疗服务等各种先进医疗服务应运而生。由于先进的医疗服务使用诸如用户数据和电子医疗记录(emr)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。因此，医疗保健机构和医疗从业者正在研究各种机制和工具，以便将医疗数据无缝地输入他们的系统。但是，医疗数据中包含患者的敏感个人信息。因此，在满足医疗数据需求的同时保证安全是信息时代非常重要的问题，需要一个解决方案。目的:我们的目标是设计一个基于区块链的分散患者信息交换(PIE)系统，可以安全有效地共享电子病历。该系统通过包括数据加密和访问控制在内的医疗信息交换过程，保护了患者在电子病历中的隐私。方法:我们提出了一种基于区块链的电子病历共享系统，允许患者管理分散在多家医院的电子病历，并与其他用户共享。 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. SN - 1438-8871 UR - //www.mybigtv.com/2022/3/e29108 UR - https://doi.org/10.2196/29108 UR - http://www.ncbi.nlm.nih.gov/pubmed/35315778 DO - 10.2196/29108 ID - info:doi/10.2196/29108 ER -