I JMIR Publications基于区块链的患者信息交换系统中的卡塔尔世界杯8强波胆分析隐私保护:系统设计研究%A Lee,Sejong %A Kim, jaehyun %A Kwon,Yongseok %A Kim,Teasung %A Cho,Sunghyun %+汉阳大学计算机科学与工程系，55，京畿道安山市常绿区汉阳大学路，KS009，韩国，82 31 400 5670，chopro@hanyang.ac.kr %K电子病历%K consortium区块链%K数据安全%K医疗数据管理%K隐私保护%K智能合约%K代理重加密%K以患者为中心的医疗系统%K星际文件系统%D 2022 %7 22.3.2022 %9原创论文%J J Med Internet Res %G英文%X背景:随着医疗产业的日益成熟，各种先进的医疗服务如医疗人工智能、远程医疗、个性化医疗保健服务等应运而生。今天，对医疗数据的需求也在迅速增加，因为先进的医疗服务使用用户数据和电子医疗记录(EMRs)等医疗数据来提供服务。因此，医疗保健机构和医疗从业人员正在研究各种机制和工具，以便将医疗数据无缝地输入到他们的系统中。但是，医疗数据包含患者敏感的个人信息。因此，在满足医疗数据需求的同时确保安全性是信息时代需要解决的一个非常重要的问题。目的:我们的目标是设计一个基于区块链的去中心化患者信息交换(PIE)系统，可以安全有效地共享EMRs。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。 Methods: We propose a blockchain-based EMR-sharing system that allows patients to manage their EMRs scattered across multiple hospitals and share them with other users. 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. %M 35315778 %R 10.2196/29108 %U //www.mybigtv.com/2022/3/e29108 %U https://doi.org/10.2196/29108 %U http://www.ncbi.nlm.nih.gov/pubmed/35315778