基于区块链的医疗数据共享模型研究

薛腾飞; 傅群超; 王枞; 王新宴

doi:10.16383/j.aas.2017.c160661

基于区块链的医疗数据共享模型研究

doi: 10.16383/j.aas.2017.c160661

薛腾飞^1,2, ,,
傅群超^1,2,,
王枞^1,2,,
王新宴^3,

1.
北京邮电大学软件学院北京 100876
2.
可信分布式计算与服务教育部重点实验室北京 100876
3.
空军总医院北京 100142

基金项目:

科技基础性工作专项 2015FY111 700-06

详细信息

作者简介:
傅群超    北京邮电大学软件学院博士研究生.主要研究方向为医学文本处理.E-mail: fu92811@163.com

王枞    北京邮电大学软件学院教授.主要研究方向为医疗大数据分析, 智能控制与网络信息安全.E-mail:huhx@sina.com

王新宴    国家科技基础条件平台人口与健康空军总医院平台中心主任, 空军总医院特诊科主任.主要研究方向为高血压的精准诊断, 健康溯源大队列研究.E-mail:wangxinyan@china.com

通讯作者:
薛腾飞北京邮电大学软件学院博士研究生.主要研究方向为区块链应用和共识机制.本文通信作者.E-mail:tffeiba@126.com

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出版历程
- 收稿日期: 2016-09-18
- 录用日期: 2017-04-21
- 刊出日期: 2017-09-20

A Medical Data Sharing Model via Blockchain

XUE Teng-Fei^{1,2
, ,},
FU Qun-Chao^{1,2
,},
WANG Cong^{1,2
,},
WANG Xin-Yan^3
,

1.
School of Software, Beijing University of Posts and Telecommunications, Beijing 100876
2.
Key Laboratory of Trustworthy Distributed Computing and Service, Ministry of Education, Beijing 100876
3.
Air Force General Hospital, Beijing 100142

Funds:

Science and Technology Basic Work 2015FY111 700-06

More Information

Author Bio:
     Ph. D. candidate at the School of Software, Beijing University of Posts and Telecommunications. His main research interest is medical text processing. E-mail:

    Professor at the School of Software, Beijing University of Posts and Telecommunications. His research interest covers medical data analysis, intelligent control, and network information security.E-mail:

    Director of the Center for National Science and Technology Basic Condition Platform Population and Health Air Force General Hospital Platform and director of the Air Force General Hospital Special Clinic Department. Her research interest covers accurate diagnosis and treatment of hypertension and study of large queues on the health traceability. E-mail:

Corresponding author: XUE Teng-Fei Ph. D. candidate at the School of Software, Beijing University of Posts and Telecommunications. His research interest covers blockchain application and consensus mechanism. Corresponding author of this paper.E-mail:tffeiba@126.com

摘要

摘要: 根据医疗行业现状，不难发现各医疗机构间共享数据困难，因为医疗数据的校验、保存和同步一直是一个难点.病人、医生以及研究人员在访问和共享医疗数据时存在严格的限制，这一过程需要花费大量的资源和时间用于权限审查和数据校验.本文提出一个基于区块链的医疗数据共享模型，具有去中心化、安全可信、集体维护、不可篡改等特点，适用于解决各医疗机构数据共享的难题.本文详细介绍了模型的组件以及实现原理.将现有医疗机构进行分类，配合使用改进的共识机制实现了方便、安全、快捷的数据共享.此外，通过对比医疗数据共享存在的问题，分析了本模型的优势以及带来的影响.
- 医疗数据 /
- 区块链 /
- 共识机制 /
- 共享模型
Abstract: According to the status quo of medical industry, verification, storage and synchronization of clinical data are difficult, therefore, clinic data sharing between institutions become a challenging task. There are many restrictions in data access and sharing for patients, doctors and even researchers, which results in a high cost of both resources and time for authority authentication and verification. To solve this problem, we propose a blockchain-based medical data sharing model, with advantages of decentralization, high security, collective maintenance and tamper resistance. We discuss the critical principles and components of this model in detail. Furthermore, we improve the consensus mechanism so as to better match different types of medical institutions for a more convenient, secure and faster data sharing. In addition, the merits and impacts of this model are presented and analyzed by comparisons in terms of existing issues in medical data.
- Medical data /
- blockchain /
- consensus mechanism /
- sharing model
注释:

1) 本文责任编委王飞跃

HTML全文

图 1 2008 ~ 2015年护理医院采用基础版EHR与采用\\标准版EHR的占比情况^[1]

Fig. 1 Percent of non-federal acute hospitals with adoption of at least a basic EHR with notes system and possession of a certified EHR: 2008 ~ 2015^[1]

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图 2 不同类型医院采用基础版HER的百分比情况^[1]

Fig. 2 Percent of non-federal acute care hospitals with adoption of at least a basic EHR system by hospital type^[1]

下载: 全尺寸图片幻灯片

图 3 医疗数据共享模型结构

Fig. 3 The framework of the medical data sharing model

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图 4 存储记录信息的Merkle树

Fig. 4 Merkle tree of the storage structure

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图 5 医疗数据存储层级结构

Fig. 5 Medical data storage hierarchy structure and details

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表 1 模型与现有解决方案对比

Table 1 The model is compared to existing solutions

	基于区块链	共识机制	专为医疗问题设计	减轻主链压力	私有链
Factom^[17]	否	无	否	是	否
MedRec^[9]	是	POW	是	否	否
ModelChain^[8]	是	POI	是	否	是
MDSM	是	改进DPOS	是	是	是

下载: 导出CSV

表 2 当前面临的问题以及模型应对的方法

Table 2 The problems faced and the coping methods of the model

类型	面临问题	模型应对方法及分析
隐私和安全	信任和访问控制	提倡医疗数据电子化, 医疗数据由可信的代理负责记录
	黑客攻击和医疗数据保护	采用非对称加密技术加密数据
	不可抵赖性	周期性将信息锚定到比特币公链, 借助公链实现不可篡改
医疗数据滥用和诈骗	被滥用, 追责困难	模型是轮流责任制, 采用区块链技术方便追责
	记录难以辨识	数字化电子病历即时存储, 机器可识别易辨认
	不正当收费, 虚假声明等	每种类型客户端均可快捷查询, 获得统一且可信的结果
用户参与度	用户无法管理自身的健康数据	完全由用户管理自己的医疗数据, 代理重加密实现权利委托
用户参与度	公共卫生相关研究与用户无直接关联	开放自己的医疗数据, 做为研究素材推动相关研究
	数据分别存储在不同的数据中心, 形成数据孤岛共享困难	模型打通各医疗机构之间的数据孤岛, 实现方便的数据互操作
互操作性, 可访问性, 数据完整性	各机构权限不明确, 数据所属权不明确	医疗联合服务器负责代理记账, 审计服务器负责校验记账.客户端分不同类型, 支持不同的访问限制.另外, 明确各个医疗机构的职责, 方便外部审计.
	数据容易丢失, 造成数据不完整	分布式的存储节点, 保证数据的多重备份
规则	不同的数据标准和共享规则	统一的数据查询接口, 统一的数据标准, 可以实时数据共享

下载: 导出CSV

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