Securing Electronic Health Records (EHR) based on Blockchain

Technology

Submitted by

Most Nargees Jahan Nipa

Margia Akter Mimta
Md. Mehedi Hassan Jamee

A thesis report submitted to the Information and Communication Engineering in

partial fulfilment of the requirements for the degree of Bachelor of Science in

Information and Communication Technology

Supervised by

K M Akkas Ali
Professor
Institute of Information Technology
Jahangirnagar University

Department of Information and Communication Technology

Faculty of Science and Technology
BANGLADESH UNIVERSITY OF PROFESSIONALS
December 2022
 APPROVAL

The thesis titled “Securing Electronic Health Records (EHR) based on

Blockchain Technology” submitted by Most Nargees Jahan Nipa, Roll No: 19511040,

Session: 2018-19, Margia Akter Mimta, Roll No: 19511039, Session: 2018-19 and Md.

Mehedi Hassan Jamee, Roll No: 18511018, Session: 2017-18, has been accepted as

satisfactory in partial fulfillment of the requirement for the degree of Bachelor of Science

in Information and Communication Technology on 3rd January, 2022.

K M Akkas Ali
Professor
Institute of Information Technology
Jahangirnagar University

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 DECLARATION

We hereby declare that this thesis is our original work, and we have written it in its entirety.

I have duly acknowledged all the sources of information which have been used in the

thesis. The thesis (fully or partially) has not been submitted for any degree or diploma in

any university or institute previously:

Most Nargees Jahan Nipa

ID: 19511040
Department of Information & Communication Technology
Faculty of Science and Technology
Bangladesh University of Professionals
01 December 2019

Margia Akter Mimta

ID: 19511039
Department of Information & Communication Technology
Faculty of Science and Technology
Bangladesh University of Professionals
01 December 2019

Md. Mehedi Hassan Jamee

ID: 18511018
Department of Information & Communication Technology
Faculty of Science and Technology
Bangladesh University of Professionals
01 December 2019

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 ACKNOWLEDGEMENTS

Firstly, we are grateful to Almighty Allah for our good health and well-being that

were necessary to complete the thesis. We would like to express our sincere gratitude

to our supervisor, K M Akkas Ali, Professor, Institute of Information Technology,

Jahangirnagar University, for his continuous support, great encouragement, patience

and immense knowledge. His affectionate guidance helped us in all the time of study

and writing of this thesis. We could not have imagined having a better supervisor

and mentor.

There are several people who have been important in completion of this

dissertation, both academically and personally. This work and the time that we have

spent in research work, would have been poorer without them. Our sincere thanks

go to the Department of Information and Communication Technology of Bangladesh

University of Professionals for providing their enormous support during the thesis

work.

Last but not the least, we would like to thank our families for their unceasing

encouragement, appreciable patience, support and attention. Our sincere thanks also

go to our course mates for their constant support, assistance and suggestions during

our thesis.

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 ABSTRACT

Electronic Health Record (EHR) traditionally uses centralized techniques for

collecting, storing, and processing data. It increases the risk of a single point of

failure and exposes the system to various internal and external data breaches that

endanger their reliability and availability. Blockchain is an emerging technology

that can solve these issues due to its immutability and architectural features, which

prevents record manipulation or alterations. This paper discusses how the blockchain

technology can be used to transform the EHR systems and could be a solution of

these issues. A system is developed for managing medical records based on

blockchain technology. This work proposes a new incentive mechanism that

leverages the degree of health providers regarding their efforts on maintaining

medical records and creating new blocks. Cryptographic keys and a peer-to-peer

network are used with a shared ledger digital signature for ensure the security of the

system. To automate the functionality of the defined system, An Etherium based

smart contracts has created. Along with the initial evaluation results of the

proposed system, the challenges and limitations are discussed as well as the future

research directions in this promising area.

Keywords: Blockchain, Electronic Health Records, Incentive Mechanism,

Cryptographic keys, peer-to-peer, digital signature, smart contracts

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 TABLE OF CONTENTS

APPROVAL II

DECLARATION III

ACKNOWLEDGEMENT IV

ABSTRACT V

TABLE OF CONTENTS VI

LIST OF FIGURES X

LIST OF TABLES XII

LIST OF ABBREVIATIONS XIII

CHAPTER 1 INTRODUCTION 1

1.1 Overview 1

1.2 Motivation of The Study 1

1.3 Problem Statement 3

1.4 Blockchain-based Strategies in Healthcare 4

1.5 Objective of The Study 5

1.6 Our Contributions in Healthcare System 6

1.7 Organization of the Thesis Paper 6

CHAPTER 2 LITERATURE OVERVIEW 8

2.1 Overview 8

2.2 eHealth system 8

2.2.1 Electronic Health Record (EHR) 8

2.2.2 mHealth 9

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 2.2.3 Bioinformatics 9

2.2.4 Telemedicine 9

2.3 Existing System Models 9

2.3.1 Centralized and a decentralized 10

2.3.2 Decentralized network mechanism 11

2.3.3 Distributed system 12

2.3.4 Blockchain 13

2.4 Related Work 14

CHAPTER 3 BACKGROUND TOOLS AND TECHNOLOGIES 19

3.1 Overview 19

3.2 Tools 19

3.2.1 Testing libraries 19

3.2.1.1 Visual studio 19

3.2.1.2 Nodejs v8.10.0+ 19

3.2.1.3 NPM 19

3.2.1.4 Ganache 20

3.2.1.5 METAMASK 21

3.2.1.6 MYSQL-server 21

3.3 Supported Features 21

3.4 Technologies 22

3.4.1 Blockchain 22

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 3.4.1.1 Cryptographic keys 22

3.4.1.2 A peer to peer network 23

3.4.1.3 Store the transactions and records 23

3.4.1.4 Workflow 23

3.4.1.5 Hash Encryptions 24

CHAPTER 4 SYSTEM ARCHITECTURE AND MODEL 25

4.1 Overview 25

4.2 Experimental Setup 25

4.3 Goal 25

4.4 E-Health Blockchain Architecture 26

4.4.1 The hardware layer 27

4.4.2 The data layer 27

4.4.3 The network layer 28

4.4.4 The consensus Layer 28

4.4.5 The Application Layer 29

4.5 Architecture 29

4.5.1 A system using public blockchain 30

4.5.2 Workflow 31

4.5.3 UML diagrams 34

4.6 Experimental model 36

4.7 Data preparation 43

4.7.1 Accounts 43
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 4.7.2 Private keys 44

4.8 Sorting and Cost analysis 46

CHAPTER 5 RESULT AND DISCUSSION 49

5.1 Overview 49

5.2 Security Analysis of the Proposed Model 49

5.2.1 Integrity 49

5.2.2 Confidentiality 49

5.2.3 Availability 50

5.2.4 Scalability 50

5.2.5 Cost 51

5.2.6 Major Differences 53

CHAPTER 6 CONCLUSION LIMITATION AND FUTURE WORK 54

6.1 Limitation 55

6.2 Future Work 55

REFERENCES 56

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 LIST OF FIGURES

Fig.No. Title Page No.

1.1 SWOT analysis of blockchain-based 4

applications in the context of healthcare

2.1 Centralized server 9

2.2 Decentralized server 10

2.3 Distributed system 11

2.4 Blockchain 13

4.1 Proposed Blockchain Architecture 26

4.2 Block creation by hashing 31

4.3 Workflow diagram 33

4.4 Use case diagram 34

4.5 Class diagram 35

4.6 Model diagram for patient address genaration 36

4.7 Model diagram for record shared of the patient 37

4.8 Model diagram for digital signature 37

4.9 Model diagram for records view 38

4.10 Conducting error for wrong address 39

4.11 Patient address to connect the doctor 39

4.12 Patient address added successfully 40

4.13 Model diagram for new record 41

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4.14 Model diagram for permisssion 42

4.15 Model diagram for new record view 42

4.16 Model diagram for another patient details 43

4.17 Account and balance details 44

4.18 Private key generation 45

4.19 Cost analysis 47

4.20 Tx-Hash transaction for 10 accounts 47

4.21 Sending ETH in Patient account to doctor 47

using METAMASK

4.22 Transactions 48

4.23 Activity log 48

5.1 Bitcoin network Energy consumption 51

5.2 Ethereum network Energy consumption 52

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 LIST OF TABLES

Table No. Title Page No.

4.1 Difference of Public, Consortium and Private 30

blockchain architecture

4.2 Cost analysis of Ethereum 46

5.1 Cost of Sorting 52

5.2 Traditional System Versus Blockchain system 53

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 LIST OF ABBREVIATION

EMR Electronic Medical Record

EHR Electronic Health Record

IPFS Inter Planetary File System

PHR Personal Health Record

P2P Peer to Peer

SWOT Strengths, Weaknesses, Opportunities and Threats

IoT The internet of things

Intel (R) Registered trademark by intel

Core (TM) Trade mark

CPU Central processing unit

RAM Random Access Memory

GHz Giga Hertz

IDE Integrated Development Environment

VS Visual Studio

E-Health Electric Health

POW Proof Of Work

POS Proof of Stake

UI/UX User Interface/ User Experience

LPWA Low Power Wide Area Network

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NVM Network Value to Metcalfe

ETH Electric TeleHealth

GWEI Giga And Wei

MS Milli second

Tx-Hash Transaction Hash

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