Development of Blockchain-Based Health Information Exchange Platform Using HL7 FHIR Standards: Usability Test

Health information exchange can improve health outcomes and reduce unnecessary medical expenses. An important task in health information exchange is to prove data integrity and strengthen the right to self-determination of individuals. This can be addressed using blockchain technology and dynamic consents. We aimed to develop a blockchain-based mobile platform called HealthPocket to exchange reliable health information with proven integrity through a dynamic consent system based on the HL7 FHIR standards. Through HealthPocket, subjects can selectively provide their consent to share specific medical and PGHD through proper authorization, and each response is converted into the JSON format with FHIR compatibility. We conducted a usability test to demonstrate health information exchange between primary and tertiary medical institutions. A total of 116 subjects used the HealthPocket mobile application to selectively share health information for at least one month, and conducted a questionnaire about their experience. In addition, medical staff of the institution could access the medical information shared by the participants and use it for treatment. The user surveys for patients examined the perceived usefulness, perceived ease of use, and overall service satisfaction. The mean overall satisfaction with the health information exchange service was the highest (4.67 out of 5 points). As security, personal information protection, and interoperability are main concerns related to health information exchange, blockchain technology can provide suitable solutions. For instance, when health information is exchanged using blockchain technology, it is impossible to alter data blocks. Therefore, by using a blockchain-based platform and dynamic consent system, we ensured the integrity of medical data.