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

doi:10.16383/j.aas.c200359

基于区块链的电子医疗病历可控共享模型

doi: 10.16383/j.aas.c200359

张磊^1,,
郑志勇^{1, 2,},
袁勇^{1, 3,}

1.
中国人民大学数学学院北京 100872
2.
中国人民大学金融计算与数字工程教育部工程研究中心北京 100872
3.
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北京 100190

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, 中国人民大学数学学院教授. 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@ruc.edu.cn

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出版历程
- 收稿日期: 2020-05-27
- 录用日期: 2020-08-05
- 网络出版日期: 2021-10-13
- 刊出日期: 2021-10-13

A Controllable Sharing Model for Electronic Health Records Based on Blockchain

ZHANG Lei^1
,,
ZHENG Zhi-Yong^{1, 2
,},
YUAN Yong^{1, 3
,}

1.
College of Mathematics, Renmin University of China, Beijing 100872
2.
Engineering Research Center of Finance Computation and Digital Engineering, Ministry of Education, Renmin University of China, Beijing 100872
3.
State Key Laboratory for Management and Control of Complex Systems, Chinese Academy of Sciences, Beijing 100190

Funds: Supported by National Key Research and Development Program of China (2018AAA0101401) and Ministry of Education Key Projects of Industry-Academia-Research Innovation Fund (2019J01015)

More Information

Author Bio:
ZHANG Lei　Master student at the School of Mathematics, Renmin University of China. Her research interest covers blockchain and cryptography. Corresponding author of this paper

ZHENG Zhi-Yong　Professor at the School of Mathematics, Renmin University of China. His research interest covers analytic number theory and algebraic number theory, and he has made breakthrough contributions in the geometric theory of exponents and characteristic sums and analytic theory of functional domains

YUAN Yong　Associate professor at the State Key Laboratory for Management and Control of Complex Systems, Institute of Automation, Chinese Academy of Sciences. He is also the director of Technical Committee on Blockchain, Chinese Association of Automation, and professor at the School of Mathematics, Renmin University of China. He received his Ph.D. degree in computer software and theory from Shandong University of Science and Technology in 2008. His research interest covers social computing, computational advertising, and blockchain

摘要

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、云链协同的病历共享模型. 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. 病历共享模型利用聚类算法, 改进实用拜占庭共识算法, 使得各节点可以更高效地达成共识. 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, 本文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.
- 区块链 /
- 医疗数据共享 /
- 基于属性的加密 /
- 可搜索加密 /
- 访问控制
Abstract: Sharing electronic health records among medical institutions can help improve the accuracy of medical diagnosis and promote the development of public medical field. In practice, however, it is difficult to share health records among hospitals, and patients typically have no knowledge about the usage of their health records. In order to solve these problems, this paper proposes a patient-controllable sharing model for health records based on a collaborating cloud-blockchain architecture, in which hospitals form a consortium blockchain, and data can be stored in both on-chain and off-chain fashions. The cluster algorithm is used to improve the practical Byzantine fault tolerance algorithm, so that nodes can reach consensus more efficiently. In order to fulfill the controllability, we propose to use the attribute-based encryption scheme and multi-keyword encryption scheme to encrypt health records, so that patients can define their access policies, and users can safely and accurately retrieve the encrypted health records. Considering the dynamic updating of user properties, we design an attribute updating sub-protocol. Finally, we evaluate the security and performance of our model, and also analyze its advantages and disadvantages.
- Blockchain /
- medical data sharing /
- attribute-based encryption /
- searchable encryption /
- access control

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图 1 EHR数据共享模型的逻辑框架

Fig. 1 The logic framework of EHR data sharing model

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图 2 数据混合存储结构

Fig. 2 Hybrid structure for data storage

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图 3 医疗数据块和摘要数据块

Fig. 3 Medical data block and digest data block

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图 4 共识节点结构

Fig. 4 The structure of the consensus nodes

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图 5 改进的PBFT算法

Fig. 5 Process of improved PBFT

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图 6 改进共识算法的通信次数

Fig. 6 The communication time of improved PBFT

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表 1 不同方案之间的比较

Table 1 Comparison between different models

功能	文献 [14]	文献 [23]	文献 [26]	文献 [27]	文献 [30]	本文
基于区块链	否	是	是	是	是	是
细粒度访问控制	是	是	是	否	是	是
隐私保护	是	是	是	是	是	是
可搜索加密	否	否	否	是	否	是
支持属性更新	是	是	否	否	否	是
数据防篡改	否	是	是	否	是	是
智能合约	否	是	否	否	否	否

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表 2 当前EHR共享面临的问题及模型应对的方法

Table 2 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

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