Integrating Blockchain Technologies with the Italian EHR Services

The increase of population life expectancy and of patient mobility makes necessary the development of new reliable and trust models for health provision within a patient-centric approach. For this reason, many proposals have been carried out to make the current healthcare systems able to collect and analyze the great amount of patient clinical data produced by the health organizations in an interoperable way and according to shared processes. However, despite the ability of collecting such clinical data, approaches aimed at assuring that these data are produced strictly following quality processes still lack. This work presents a permissioned blockchain architecture designed to assure integrity of data and processes related to Electronic Health Records coherent with the Italian Interoperability Infrastructure. The proposed architecture is compliant with both the Italian Regulation on Electronic Health Record and the European Regulation on privacy. A proof-of-concept prototype implemented on the top of Hyperledger Fabric framework validates the feasibility of the proposed architecture against two relevant use cases, showing that the application of blockchain technology to the healthcare sector could provide important benefits in terms of process and data integrity and quality. Keywords—electronic health record; blockchain; patient-centric architecture