Survey on Security and Interoperability of Electronic Health Record Sharing Using Blockchain Technology

Blockchain is regarded as a significant innovation and shows a set of promising features that can certainly address existing issues in real time applications. Decentralization, greater transparency, improved traceability and secure architecture can revolutionize healthcare systems. With the help of advancement in computer technologies, most healthcare institutions try to store patient data digitally rather than on paper. Electronic health records are regarded as some of the most important assets in healthcare system and are required to be shared among different hospitals and other organizations to improve diagnosis efficiency. While sharing patients' details, certain basic standards such as integrity and confidentiality of the information need to be considered. Blockchain technology provides the above standards with features of immutability and granting access to stored information only to authorized users. The examination approach depends on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (or PRISMA) rules and an efficient planned search convention is utilized to look through multiple scientific databases to recognize, investigate and separate every important publication. In this paper, we present a solid systematic review on the blockchain and healthcare domain to identify the existing challenges and benefits of applying blockchain technology in healthcare systems. More than 150 scientific papers published in the last ten years are surveyed, resulting in the identifications and summarization of observations made on the different privacy-preserving approaches and also assessment of their performances. We also present a significant architectural solutions of blockchain to achieve interoperability. Thereby, we attempt to analyse the ideas of blockchain in the medical domain, by assessing the advantages and limitations, subsequently giving guidance to other researchers in the area.