HEALTHCHAIN: A Patient Centric Blockchain Based Web Application For Maintaining Electronic Healthcar

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HEALTHCHAIN: A Patient Centric Blockchain Based Web Application For Maintaining Electronic Healthcare Records.

4 Vice principal, Department of Information Technology, Shri Bhagubhai Mafatlal Polytechnic, Mumbai, India

5Department of Information Technology, Atharva College of Engineering, Mumbai, India

Abstract Our web application “Healthchain: Your data our responsibility”. This framework centers around creating privacy to patient clinical records utilizing 'Blockchain Technology'. Patient privacy or classification is one among the preeminent vital support points in medical services. Safeguarding the individual subtleties of a patient isn't only a question of moral regard, it's vital for bond trust between the specialist and patient. This blockchain based E-health record system will provide deep mutual trust between the doctor and patient. This project will permit patients to have the control of producing, overseeing and imparting EHR's to the approved care giver Doctor. In addition, the medical care specialist and suppliers of medical care administration access these EHR's across the abroad, the progress program of medical care arrangement is relied upon to be accomplished.

Keywords Healthcare, Blockchain, medical records, trust, security, privacy.

1. INTRODUCTION

As the world is evolving drastic changes in the healthcaresystemarewidelyseenandareequallybeing adopted by people around the globe. We can’t deny the fact that the traditional healthcare system is quite extensively preferred by people who aren’t that much aware about the latest technology. Especially the people living in the rural areas however favour the medical recordsonpaperordonemanuallybythehospitals.The Revolutionary change in the Healthcare sector began in themid1960’sconventionallyknowntoallasElectronic Healthcare Records or Electronic Medical Records. E HealthRecords(EHRs)offersaeasytoaccessandhandy medical record storage capability, which enhances traditional medical records of the patient which are available on paper to be electronically accessible on the web.AnElectronicHealthRecord (EHR)isan electronic rendition of a patient's clinical history, and may incorporate every one of the key regulatory clinical informationapplicable tothatindividual'sconsideration under a specific specialist, including progress notes, issues, meds, past clinical history, vaccinations, lab

informationandradiologyreports. ButsincetheseEHRs are developed for hospitals they are considered to be centralised, as these EHRs are managed by a hospital management team. Every new technology or invention comes with pros and cons and the downfall of centralised EHRs is the storage facility, chances of the system being hacked and easily being vulnerable to illegal access by people outside the organisation. This is where blockchain in healthcare was brought into existence in 2012. And since then the concept of decentralised EHRs were introduced to all. Now coming to the reason for developing this web based application named Heathchain, it is thought that health information technology, particularly electronic health records (EHR) willimprovethehealthcarefacilitiesforbothdoctorand patient in a convenient and secure guarantee responsibility and transparency in the manner. The major rule of this project is to parade of information trade,reviewingtrailsinanunchangingway.Tomakeit userfriendlyandefficientwehaveevenaddedspeechto textfeaturesinourwebapplication.

A. Blockchain

SincetheadvancementofBitcoin,acomputerizeddigital currency, in 2008, Blockchain innovation has situated itself in the point of convergence of interest among a different scope of specialists and professionals. Blockchain is a decentralized record that stores all exchanges that have been made on top of a shared organization in a safe, certain and straightforward way. The fundamental benefit of Blockchain over the current innovations is that it empowers the two gatherings to make exchanges over the Internet safely without impedance of any mediator party. The exclusion of the outsider can decrease the handling cost while working on the security and effectiveness of exchanges. Blockchainisreformingdifferententerprises,goingfrom finance, Internet of Things (IoT), medical services, notoriety frameworks, and production network the board.

Itisworthfocusingonthatinnovationorganizationsand monetary administrations put more than $1 billion just in 2016 into conveying Blockchain and it is very

unsurprising that this sum will be expanding drastically throughout the following not many years. The fast development of Blockchain innovation over the new years has opened up a lot of exploration holes and headings for the examination local area. Thus, an amazingmeasureofexplorationtrieshavebeendirected insidetheareaofBlockchainasoflate.[5]

B. Bigchain

BigchainDB[1] fills a hole in the decentralization environment: a decentralized data set, at scale. The BigchainDB configuration begins with a circulated data set (DB), and through a bunch of advancements adds blockchain attributes: decentralized control, unchanging nature, and creation and development of computerized resources.BigchainDBacquiresattributesofpresentday conveyed data sets: straight scaling in throughput and limit with the quantity of nodes, a full featured NoSQL question language, productive questioning, and permissioning.BigchainDBisreciprocaltodecentralized handlingstageslikeEthereum,anddecentralizedrecord frameworks like InterPlanetary File System (IPFS). Maybe than attempting to increase blockchain innovation, BigchainDB begins with a "major information"disseminateddataset,andaddsblockchain qualities. It evades the innovation decisions that plague Bitcoin, like full replication. Since the large information DBhasitsownimplicitagreementcalculationto endure amiable issues, we misuse that arrangement straightforwardly.We"move" ofthecalculationtoallow it to choose which exchanges to compose, and what the square request is. We prohibit private, shared correspondencebetweenthenodeswiththeexceptionof by means of the DB's underlying correspondence, for incredible investment funds in intricacy and for diminished security risk . This implies that noxious nodescan'tsendonemessagetopartoftheorganization and distinctive message to other piece of the organization.Everytimeanode"talks,"alltheotherscan tunein.

C. IPFS

IPFS(Interplanetary File System)[2] gives a circulated recordstorageframeworkwhichworkswithassociation with the P2P network. The IPFS ascertains the special Hash of a record which is available to every one of the friends in the network. The hash gets altered each time the record gets refreshed. The IPFS is considered as the foundation of web 3.0 which gives a P2P decentralized record storage framework and content addressable method to get to the put away document. IPFS works with the appropriated hash table which is substantially more productive than BitTorrent, and Git document stockpiling framework. IPFS is otherwise called a form controlled framework which guarantees the security, dependability, and versatility looked by the current

record stockpiling and sharing framework. A similar exchange has the very hash in the IPFS that guarantees the originality of the record. The IPFS hash gets dispersed to every one of the equals which likewise guaranteestheconsistencyamongthecompanions.

Interplanetary File framework gives high throughput content tended to obstruct capacity model which guarantees security of exchanges. IPFS gives a high throughput as far as access utilizing content tended to impede capacity model, we additionally notice that capacity is another test in blockchain innovation attributabletotheannexjusthighlights.

D. Express

Express[2] is a trivial and versatile Node.js web applicationframeworkthatgivesalivelycourseofaction of features to cultivate web and compact applications. It works with the quick advancement of Node based Web applications. Following are a portion of the center highlightsofExpressstructure

• Permits to set up middlewares to react to HTTP Requests.

•Portraysacoordinatingtablewhichisusedtoperform differentoperationssubjecttoHTTPMethodandURL.

• Permits to powerfully deliver HTML Pages dependent onpassingcontentionstolayouts.

E. MongoDB

One of MongoDB's essential objectives is to give prevalent execution, MongoDB can progressively fill the record, yet additionally preallocation of information documents to exploit extra space in return for stable execution. MongoDB utilizes as much memory as the reserve, attempting to naturally choose the right list for each question. To put it plainly, MongoDB in all parts of theplanistoguaranteehissteadyexhibition.[4]

MongoDB is quite possibly the most well known NoSQL data set, whose fundamental target is to overcome any issues between key esteem stores with elite and adaptability and conventional RDBMS with rich administration, and take the benefits of both in one. MongoDB framework comprises of the customer application,thedrivers,datasetadministrationprogram Mongod, data set directing project A MongoDB framework holds a bunch of information bases, every datasetholdsabunchofassortments,anassortmentisa bunchofrecords,eacharchiveisabunchoffields,anda field is a key esteem pair, key is the name of the field with the string type, esteem is the information of the fieldandcan beanysort.MongoDButilizesBSON asthe information stockpiling and organization move design for archives. BSON is a parallel encoded serialization of

JSON like records, which stores key esteem pair in twofold byte with the way in to a string type and the worthtoanykindincludingexhibitandreport.[3]

2. PROBLEM STATEMENT

Patientsfaceavitalneedtoemphasisinonthesubtleties of their own medical care and reestablish the board of theirownclinicalinformation.Asofnowthemajorityof the medical care associations utilize a centralized technique for saving patient's data, indicative reports, andspecialist'ssprescription Sinceitisanincorporated framework there are odds of information getting spilled or misused for different reasons as patients don't have powerovertheirinformationandfurthermoretradingof the recorded information is tedious and an unpredictable interaction. The cutting edge medical servicesframeworkisinvolvingcomputerizedstrategies for keeping up with patient's wellbeing records. Nonetheless, in current circumstance patients disperse their clinical information during life occasions, making theirinformationmovefromonespecialist/medicalcare association to another. Determined to manage these issues, we are making an application by changing the incorporated framework to a decentralized framework utilizing Blockchain innovation. The quick improvement of blockchain innovation advances medical services, including clinical records along with patient related information.

3. LITERATURE REVIEW

Blockchain based EHRs have been implemented on a wider scale and are really brought into existence by a few companies. This section focusesonthesehealthcare applications and how well they have used blockchain to provide security and maintain the privacy of EHRs. Utilizing blockchaininnovation,MedRec hasshownhow standards of decentralization may be applied to largescale information the board in an EMR framework. MedRec shows an inventive methodology for dealing withclinical records, giving auditability,interoperability andavailabilitybymeansof a farreachinglog.Intended for record adaptability and granularity, MedRec empowers patient information sharing and motivations for clinical analysts to support the framework. They anticipate formalizing an onboarding system for clinical examination "excavators", and investigating mining information financial matters. Soon, they expect to complete client studies to survey the attainability of the framework and to check patient and supplier interest. This might incorporate collaborating with nearby medical care bodies, and mimicking parts of framework proficiency in nature.[6] Another such framework that completelyfocusesonsecurityisMeDShareaframework that highlights the issue of clinical information dividing between clinical large information caretakers in a trust

less climate. The framework is blockchain based and gives information provenance, examining, and control for shared clinical information in cloud archives among enormous information elements. MeDShare supervises the information for malignant use from an information trustee organisation. In MeDShare, information changes and sharing from one person to the next, alongside all activities performed on the MeDShare framework, are recorded in a carefully designed way. The plan utilizes smart contracts and an entrance control tool to adequately follow the conduct of the information and renounce admittance to culpable elements on identification of infringement of authorizations on information. The presentation of MeDShare is tantamount to current state of the art answers for information dividing between cloud specialist organizations. By executing MeDShare, cloud specialist organizationsanddifferentinformationgatekeeperswill actuallywanttoaccomplishinformationprovenanceand inspection while at the same time offering clinical information to individual like exploration and clinical organizations with insignificant danger to information security.[7]

BHEEM: Blockchain based system for productive capacity and upkeep of EHRs. Here, the patient is provided the full control and responsibility for records and he can also check and monitor the exchanges that are attempted over it Unapproved access by different entertainers is additionally limited and a feeling of decentralization while comprising certain hubs with an ad libbed authority is accomplished. This examination shown that it would be profoundly far fetched to totally shroud all data and keep an open and interoperable framework, however by utilizing smart contracts to isolate data, the proposed system actually offers critical securityprotectionandinformationtrustworthiness.

BHEEM additionally infer that total encryption of the records and keeping up with convenience can't go connected at the hip and there is a compromise that should be taken into consideration by the organization administrator. In future, they might investigate the commonsenseofutilizingthedifferentialsecuritymodel and attempt to build up the connection between the clamorandsizeofblockchain.[8]

4. PROPOSED SYSTEM

a. System Architecture

Fig1SystemArchitecture

Healthcare focuses on developing deep mutual trust between the doctor and the patient over sharing the MedicalRecordsDigitallyusingBlockchainTechnology.

ThepatientmedicalreportsarestoredinIPFSandtheID Hash Timestamp and Description generated of the file are stored in BigchainDB Blockchain Network. The databaseisusedonlytosavetheuserinformationforthe securityofthecryptographickeys.

A transfer transaction will take place when the patient willgiveaccess,revokeaccessandwhenthedoctorgives theprescription

E Healthcareconsistsoftwomodules:

1) Patient:

After the patient successfully logs in, the credentials (username/password) entered by the patient are stored in MongoDB. For security, after sign up a 2 Step Verification(OTP)willbesentonpatient’senteredEmail Address. The patient will enter its personal medical detailsanduploadthemedical record whichcanconsist of reports, images, pdfs, etc. The file uploaded will be stored in IPFS but the ID, Hash, Timestamp and Auto description generated will be stored in Blockchain BigchainDB. A doctors list will be available for the patient and based on the requirement the patient can choose one doctor and give access of its medical record to the doctor and hence a transfer transaction will take place. The file’s encrypted hash will be stored in BigchainDB and decrypted view in IPFS. If a patient has previous medical history/records then it can view and

upload it if required. The patient has the flexibility to uploadindividualaswellasmultiplerecordsatthesame time. The patient can then view the prescription uploadedbythedoctorwhichwillbestoredin.Oncethe treatment is done, the patient will revoke access of the medicalrecordsandtherecordfromthedoctorslistwill enterintotherevokelistinBigchainDB.

2) Doctor:

Oncethedoctorsuccessfullylogsin,amedicalrecordlist of access granted by the patient will be available for the doctor from which the doctor will select an individual patient record. Using the speech to text feature the doctorwillgivetheprescriptionwhichwillbeencrypted andstoredinBigchainDBandthenatransfertransaction willtakeplace.Beforegivingtheprescription,thedoctor can view patient profile details as well. If there is an emergency the doctor will send the mail to the patient’s email ID and then the patient will get a mail along with anemergencygiveaccessofmedicalrecordspage.

3) SHA 256

SHA 256 represents Secure Hash Algorithm 256 bit and is a sort of hash work normally utilized in Blockchain A hash work is a sort of numerical capacity which transforms information into a unique finger impression of that information called a hash. It resembles an equation or calculation which takes the info information and transforms it into a yield of a fixed length, which addresses the unique finger impression of theinformation.Theinfoinformationcaninarealsense beanyinformation, regardlessofwhether it's the whole Encyclopedia Britannica, or simply the number '1'. A hashcapacitywillgiveasimilarhashforasimilarinfoin every case regardless of when, where and how you run the calculation. Similarly strangely, assuming even one personintheinformationtextorinformationischanged, theyieldhashwillchange.SHA 256worksinthewayof MD4, MD5, and SHA 1: The message to be hashed is initial (1) cushioned with its length so that the outcome is a different of 512 pieces in length, and afterward (2) parsed into 512 cycle message blocks M(1) ; M(2) ;:::;M(N) . The message blocks are handled each in turn: Beginning with a fixed starting hash esteem H (0), consecutively figure H(i) = H(i1) + CM(i) (H(i1)); where CistheSHA 256pressureworkand+impliesword wise mod 232 expansion. H(N) is the hash of M.Figures and Tables.

B. Flowchart:

FlowchartofDataatPatientSide.

Once, the patient visits the Healthchain web application and either sign in or sign up if not visited earlier. After the whole sign in process, the patient has to go through

the two step verification and enter the OTP he/she receivedontheiremailid.Thenoncetheprocessisdone, heorshecanuploadtheirmedicalreportsintheformof pdforimage.Orsimplyviewtheirpastmedicalhistoryif already they are using Healthchain. Patients can check the available Doctor’s list for their treatment. Once that particular doctor is selected, patient can transfer single ormultiplemedicalrecordstodoctorsfortheiropinions and prescriptions. During the treatment if the doctor sends the prescription via Healthchain to the patient’s side, he/she can easily view the prescription and take the needed medication. As Healthchain is a patient centric healthcare application, the patient is completely in charge of his/her medical records and can revoke accessfromthedoctorwhenever,hefeelstheneedtodo so.

Healthchain application, he has to create his profile by enteringallthiseducationalandprofessionaldetails.

Once the Doctor logs into his profile, he will see a list of patients that are interested in his treatment and have givenaccessoftheirmedicalrecordstohim.Herecomes the Speech to text feature for prescribing the medications and giving treatment related opinion to the patient.Thedoctorcanseehispatient’sprofileandhave accessorhismedicalreportsandevendownloadthemif required for the treatment procedure. We also have included a special feature that is the emergency feature. This feature comes in action when the doctor feels like there is an emergency for his ex patient and needs to haveaccessoverhismedicalrecord,hewillthensendan emergency to the patient’s relative or whosoever concerned.Amailwillbesenttothatpersonaskinghim tograntaccessofthemedicalrecordstothedoctor.

Fig.2Flowchart(PatientSide)

Flowchart of Data at Doctor Side:

Once, the doctor visits the Healthchain web application and either sign in or sign up if not visited earlier. After the whole sign in process, the patient has to go through the two step verification and enter the OTP he/she received on their email id. If a new Doctor visits the

Fig.3Flowchart(Doctor’sSide)

C. Use Case Diagram

GraphicalviewofhowthepatientusesHealthchainfrom theirside.

PATIENT’S SIDE



First the user needs to signup/login on our platform.

On login, user can upload their medical records onourplatform

User will have various options like to find doctorsontheplatformortoviewtheirmedical record.

Users can also give/revoke access of their medicalrecordsfrom/toadoctor.

User can then view the prescriptions provided tothembythedoctors.

DOCTOR’S SIDE

First the user needs to login/signup on our platform.

On login, doctors can see the patient’s medical recordsandtheirhistory.

Doctor can then send prescription (also use speechtotextfeatureforsimplicitypurpose)to patients.

In case of any emergency like accident, doctor can raise an emergency option which is present on our platform and the permission for accessing the medical history of patient will be senttothepatient’sfamilymembers.

Fig10.MongoDB

5. SYSTEM REQUIREMENTS

H/W system configuration: The project has been developed on HP Pavilion 15 cc19tx laptop. The laptop has the following specifications:

1. Intel Core i5 5th generation processor @1.60GHz1.80Ghz 2.8GBRAM

LinuxOperatingSystemhasbeenusedwithaversion.

•RAM:2GB+

•SecondaryMemory:1GB+

• PC or Laptop with 2GHz+ or higher processor clock speedrecommended(singleordualprocessorsystem)

•1+GBGraphicCard(1.40GHzGraphicsProcessor)

•800x600ResolutionDisplayforMonitor. S/Wsystemconfiguration:

VI. CONCLUSION

ThePaperPurposesAnElectronicHealthRecordSystem Based On Blockchain Which Allows Users To Remotely And Securely Store Important Medical Records And Access It Anytime And Anywhere. Blockchain Helps Us ToAchieveScalabilityAndAccessControlInTheFieldOf Medical Records. The patient can permit or revoke access from the particular doctor anytime. This is how

International Research Journal of Engineering and Technology (IRJET) e-ISSN: 2395-0056

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we have aimed to keep the patient as the center of our application.Usinghealthchainthepatientcaneasilyfind a specialist, take consultation and prescriptions there andthere.Getsecondadvicefromotherdoctorsaswell. Lastly the emergency feature that wehave incorporated can be considered as a game changer in the field of healthcare. Scope Of Electronic Health Record Includes Using Machine Learning Algorithms To Get A Quick OverviewOfPatient’sMedicalHistoryAndAlsoUsingAi At The Doctor’s End To Suggest Medicines And Precautions.

REFERENCES

1]Trent McConaghy, Rodolphe Marques, Andreas M¨uller, Dimitri De Jonghe, T. Troy McConaghy, Greg McMullen, Ryan Henderson, Sylvain Bellemare,and Alberto Granzotto, “BigchainDB: A Scalable Blockchain Database”,Whitepaper,2016,[Online]

Available:https://git.berlin/bigchaindb/site/raw/commi t/b2d98401b65175f0fe0c169932ddca0b98a456a6/_src /whitepaper/bigchaindb whitepaper.pdf

2] Randhir Kumar, Rakesh Tripathi, Implementation of Distributed File Storage and “Access Framework using IPFS and Blockchain” , 2019 Fifth International ConferenceonImageInformationProcessing(ICIIP)

3] Yunhua Gu1,Xing Wang,Shu Shen,Jin Wang,Jeong Uk Kim, “Analysis of Data Storage Mechanism in NoSQL Database MongoDB”, 2015 International Conference on ConsumerElectronics Taiwan(ICCE TW),pp.70 71

4] Li Liang,Ligu Zhu, Wenqian Shang,Dongyu Feng, Zida Xiao, “ExpressSupervisionSystemBasedonNodeJSand MongoDB“,CIS2017,May24 26,Wuhan,China,pp 607 608

5]Mohammad Dabbagh(Member, IEEE), Mehdi Sookhak(Member, IEEE), Nader Sohrabi Safa “The EvolutionofBlockchain:ABibliometricStudy”,2019,pp 19212

6]AsaphAzaria,ArielEkblaw,ThiagoVieiraandAndrew Lippman, “MedRec: Using Blockchain for Medical Data Access and Permission Management”, 2016, 2nd InternationalConferenceonOpenandBigData,pp.25 26

7]Qi Xia, Emmanuel Boateng Sifah, Kwame Omono Asamoah, Jianbin Gao, Xiaojiang Du, Mohsen Guizani, “MeDShare: Trust Less Medical Data Sharing Among CloudServiceProvidersviaBlockchain”,2017,pp.1 7

8] Jayneel Vora, Anand Nayyar, Sudeep Tanwar, Sudhanshu Tyagi, Neeraj Kumar, M. S. Obaidat.,“BHEEM: A Blockchain based Framework for Securing Electronic HealthRecords”,2018

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