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基于区块链的电子医疗病历可控共享模型

张磊 郑志勇 袁勇

张磊, 郑志勇, 袁勇. 基于区块链的电子医疗病历可控共享模型. 自动化学报, 2020, 41(x): 1−11
引用本文: 张磊, 郑志勇, 袁勇. 基于区块链的电子医疗病历可控共享模型. 自动化学报, 2020, 41(x): 1−11
Zhang Lei, Zheng Zhi-Yong, Yuan Yong. A controllable sharing model for electronic health recordsbased on blockchain. Acta Automatica Sinica, 2020, 41(x): 1−11
Citation: Zhang Lei, Zheng Zhi-Yong, Yuan Yong. A controllable sharing model for electronic health recordsbased on blockchain. Acta Automatica Sinica, 2020, 41(x): 1−11

基于区块链的电子医疗病历可控共享模型

基金项目: 国家重点研发计划(2018AAA0101401), 教育部产学研创新基金重点项目(2019J01015)资助
详细信息
    作者简介:

    张磊:中国人民大学硕士研究生, 主要研究方向为区块链及密码学. 本文通信作者. E-mail: zhangleizl@ruc.edu.cn

    郑志勇:中国人民大学数学学院院长. 主要研究方向为解析数论与代数数论, 在指数和与特征和的几何理论以及函数域的解析理论等领域上有突破性贡献. E-mail: zhengzy@ruc.edu.cn

    袁勇:中国科学院自动化研究所 复杂系统管理与控制国家重点实验室副研究员, 中国自动化学会区块链专委会主任. 2008年获得山东科技大学计算机软件与理论专业博士学位. 主要研究方向为社会计算, 计算广告学与区块链. E-mail: yong.yuan@ia.ac.cn

A Controllable Sharing Model for Electronic Health Recordsbased on Blockchain

Funds: Supported by National Key R&D Program of China (2018AAA0101401), Ministry of Education Key Projects of Industry-Academia-Research Innovation Fund(2019J01015)
  • 摘要: 电子医疗病历共享能够提高医疗诊断的准确性, 促进公共医疗领域的发展. 针对目前普遍存在的不同医院之间病历共享困难、病人无法掌握其病历的使用情况等问题, 本文提出了病人可控的、云链协同的病历共享模型, 由各级医院组成联盟区块链, 病历数据实行链上、链下混合存储. 利用聚类算法, 改进实用拜占庭共识算法, 使得各节点可以更高效的达成共识. 将基于属性的加密方案与多关键词加密方案结合进行病历加密, 实现了数据可控共享, 病人可自主定义访问策略, 同时用户可以对加密病历进行安全、精确检索. 考虑到用户属性的动态更新, 设计了属性更新子协议. 最后评估了模型的安全性和性能, 并分析了模型的优劣势.
  • 图  1  EHR数据共享模型的逻辑框架

    Fig.  1  The logic framework of EHR data sharing model

    图  2  数据混合存储结构

    Fig.  2  Hybrid structure for data storage

    图  3  (a) 医疗数据块 (b) 摘要数据块

    Fig.  3  (a) Medical data block (b) Digest data block

    图  4  共识节点结构

    Fig.  4  The structure of the consensus nodes

    图  5  改进的PBFT算法

    Fig.  5  Process of improved PBFT

    图  6  改进共识算法的通信次数

    Fig.  6  The communication time of improved PBFT

    表  1  null改进PBFT算法的通信次数

    Table  1  The communication time of the improved PBFT algorithm in total nodes are 2000

    聚类K值 10 20 40 50
    通信次数 80110 20420 6640 5750
    下载: 导出CSV

    表  2  不同方案之间的比较

    Table  2  Comparison between different models

    文献
    功能
    屠袁飞[14] Xia[23] Shen [26] 刘格昌[27] 罗文俊[30] 本文
    基于区块链
    细粒度访问控制
    隐私保护
    可搜索加密
    支持属性更新
    数据防篡改
    智能合约
    下载: 导出CSV

    表  3  当前EHR共享面临的问题及模型应对的方法

    Table  3  The problems of EHR sharing and how to deal with the model

    类型 面临问题 模型应对方法
    患者参与度 目前患者无法完全掌握其电子病历的使用情况. 本文利用CP-ABE方案设计了病人可控的EHR分享方案,
    病人可自主设置访问控制, 决定谁可以访问病历.
    隐私保护 EHR存储着大量隐私信息, 在数据共享时可能会遭到攻击.
    以及病人和用户在分享和访问电子病历时,
    其身份信息应该受到保护.
    本文利用加密算法将EHR进行加密, 确保数据的保密性;
    利用签名算法及将数据hash值记录在区块链网络上,
    保证数据的完整性及可审计性. 同时, 通过加密及属性
    分配保护病人及数据用户的隐私信息.
    数据互操作性 目前不同医院之间数据流动性太差, 当病人就诊时,
    其在另一个医院的就诊记录不能被及时分享.
    同时, 数据的完整性没有办法保障.
    本文提出了云链协同的存储方式, 利用CP-ABE方案进行数据加密,
    病人设置访问策略, 决定谁可访问数据, 实现不同医院的病历
    进行共享. 用户可利用可搜索加密方案, 对密文进行搜索.
    医疗纠纷 当医患之间发生矛盾时, 其提供病历的真实性无法确认. 本文利用区块链存储病历的hash值, 防止数据被篡改,
    保障数据的真实性.
    下载: 导出CSV
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  • 收稿日期:  2020-05-27
  • 录用日期:  2020-08-05

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