Design of an Architecture Contributing to the Protection and Privacy of the Data Associated with the Electronic Health Record

Abstract

The Electronic Health Record (EHR) has brought numerous challenges since its inception that have prevented a unified implementation from being carried out in Colombia. Within these challenges, we find a lack of security, auditability, and interoperability. Moreover, there is no general vision of the patient’s history throughout its life since different systems store the information separately. This lack of unified history leads to multiple risks for patients’ lives and the leakage of private data because each system has different mechanisms to safeguard and protect the information, and in several cases, these mechanisms do not exist. Many researchers tried to build multiple information systems attempting to solve this problem. However, these systems do not have a formal and rigorous architectural design to analyze and obtain health needs through architectural drivers to construct robust systems to solve these problems. This article describes the process of designing a software architecture that provides security to the information that makes up the Electronic Health Record in Colombia (EHR). Once we obtained the architectural drivers, we proposed Blockchain mainly due to its immutable distributed ledger, consensus algorithms, and smart contracts that securely transport this sensitive information. With this design decision, we carried out the construction of structures and necessary architectural documentation. We also develop a Proof of Concept (POC) using Hyperledger Fabric according to the literature analysis review in order to build a primary health network, in addition to a Smart Contract (Chaincode) using the Go programming language to perform a performance evaluation and do a safety analysis that demonstrates that the proposed design is reliable. The proposed design allows us to conclude that it is possible to build a secure architecture that protects patient health data privacy, facilitating the EHR’s construction in Colombia.

Keywords

• software architecture
• blockchain
• electronic health records
• hyperledger fabric
• security
• attribute driven design