CN111540449A - Electronic medical record sharing method based on block chain, electronic medical record interface and system - Google Patents
Electronic medical record sharing method based on block chain, electronic medical record interface and system Download PDFInfo
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Abstract
The electronic medical record is converted into a uniform format through the electronic medical record data interface and the intelligent contract and is stored on the block chain, and the electronic medical record is shared by using the block chain technology aiming at the problems in document sharing, so that the data is unique and credible, cannot be tampered, and is safe and reliable; the medical record submission information and the retrieval information are clear at a glance, so that the audit of a supervision department is facilitated; the cost of interface development and maintenance, central system and database maintenance work and software and hardware investment in the existing sharing mode is greatly saved.
Description
Technical Field
The invention relates to the field of electronic information sharing, in particular to an electronic medical record sharing method, an electronic medical record interface and an electronic medical record system based on a block chain technology.
Background
At present, hospitals all use electronic medical record systems, the data volume generated by the electronic medical record systems is larger and larger, and the sharing range is wider and wider. In order to interconnect and interwork the health information, a series of sharing specifications and sharing modes are generated. The state has issued documents such as electronic medical record shared document specification for providing data standard support, but there is no relevant regulation on the sharing mode. The current sharing methods are roughly two, namely a point-to-point sharing method and a center sharing method.
Peer-to-peer sharing is mostly used among peer organizations. When the document needs to be shared, the sharing parties can perform document transmission point to point and have copies of the document at the same time. This can be done quickly as long as the sharing parties agree well. However, the disadvantage is obvious, that is, two sharing parties need to maintain their own copies, so the contents of the copies are inconsistent, and it is difficult to decide who owns the document only reliably. In addition, as the number of sharing parties increases, maintenance costs will rise dramatically.
The upper and lower mechanisms mostly adopt a central sharing mode. Subordinate organizations upload documents to an upper level center, and only the upper level center has a relatively full set of documents and absolute control over the documents, while subordinate organizations do not enjoy the benefits of shared documents. Moreover, due to centralization of data, documents are easy to tamper, and security is difficult to guarantee.
Disclosure of Invention
A block chain-based electronic medical record sharing method is characterized in that:
s1, organizing the electronic medical record shared document;
developing an interface for receiving the electronic medical record, and receiving the electronic medical record submitted by the electronic medical record system;
the hospital modifies the electronic medical record system of the unit and develops a data adapter according to the requirement of receiving an electronic medical record interface; when a doctor archives an electronic medical record, the electronic medical record system converts the electronic medical record data A1 into a format specified by an electronic medical record interface through a data adapter, and the electronic medical record data is converted into formatted electronic medical record data A2;
the electronic medical record system belongs to a third-party electronic medical record system, belongs to the existing system of a hospital, and belongs to the prior art.
The electronic medical record filing is an event of the existing hospital electronic medical record system, and is characterized in that medical records are stored after a doctor finishes diagnosis and treatment of a patient or when the patient is discharged from the hospital, and the medical records are stored in the hospital electronic medical record system data.
The requirements of the electronic medical record interface refer to a unified electronic medical record data format, the format uses the existing standards of national electronic medical record shared data sets or CDR and the like, and can be defined by self, as long as the format is determined before access, and once the format is determined, all electronic medical record systems adopt the unified format.
The data adapter is used for converting data formats and converting hospital electronic medical record data into data formats specified by the electronic medical record interface.
When the electronic medical record documents are shared, the electronic medical record system firstly organizes the electronic medical record documents according to a certain format. The format can use the existing standard of national electronic medical record shared data set or CDR, etc., and can be defined by self as long as the format is defined well before access. Once the appointment is made, all electronic medical record systems adopt a uniform format.
S2 signature and encryption document step
The hospital electronic medical record system signs the formatted electronic medical record data A2, encrypts the signed electronic medical record data A2 to form signed and encrypted electronic medical record data A3, and submits the signed and encrypted electronic medical record data A3 to an electronic medical record interface;
the existing hospital electronic medical record system signs the electronic medical record data: the electronic signature is an electronic signature of an electronic document by a cryptographic technique, is not a digital image of a written signature, is similar to a handwritten signature or a seal, and can be called an electronic seal. The existing electronic medical record systems of hospitals all have the function of electronic signature. The technology belongs to the prior art, only uses the technology, and the invention does not innovate the technology.
The existing hospital electronic medical record system encrypts electronic medical record data, namely: the medical record data is changed into messy code (encrypted) to be transmitted by using technical means. The encryption technology is the main security measure adopted by electronic commerce, is the most common security measure, changes important data into messy codes (encryption) by using technical measures for transmission, and restores (decrypts) by using the same or different measures after reaching a destination. The encryption technology belongs to the prior art, the encryption technology is only used, and the encryption technology is not innovated.
S3 procedure for saving upper chain
The electronic medical record interface carries out uplink storage on the encrypted electronic medical record data A3;
the uplink storage refers to storing the encrypted electronic medical record data A3 on a blockchain by using an intelligent contract and an electronic medical record interface, wherein the blockchain comprises a built-in database, and the encrypted electronic medical record data A3 is stored in the built-in database of the blockchain;
the electronic medical record interface is used for receiving encrypted electronic medical record data A3 sent by the hospital electronic medical record system, the electronic medical record interface calls an intelligent contract, and the intelligent contract stores the encrypted electronic medical record data A3 in a block chain;
the electronic medical record interface comprises an electronic medical record storage module, an electronic medical record retrieval module, an application management module, an authority management module, a relational database service module, a data cache service module, a block chain service module and an open API service module;
the electronic medical record storage module is used for calling an intelligent contract, storing encrypted electronic medical record data A3 and storing the encrypted electronic medical record data A3 in a block chain;
the electronic medical record retrieval module is used for receiving a retrieval request sent by the hospital electronic medical record, taking out the electronic medical record meeting the conditions through an intelligent contract, and sending the taken electronic medical record meeting the conditions to the hospital electronic medical record system;
an application management module: the hospital electronic medical record system instance has a unique application credential which identifies the identity of the access system and can exchange a temporary access token by using the electronic medical record interface through the credential;
the example of the hospital electronic medical record system refers to an electronic medical record system of a certain unit, and specifically refers to an electronic medical record system of each hospital. Example information of the hospital electronic medical record system comprises information such as a hospital name, a hospital address, a hospital application certificate, a hospital contact way and the like.
The application credential refers to the unique identity of the electronic medical record system of each hospital.
The temporary access token refers to a token which can access the electronic medical record interface within a certain period of time in exchange for identity identification.
The authority management module: the electronic medical record management system is used for controlling the access authority of electronic medical record retrieval and electronic medical record storage services of electronic medical record interfaces accessed to electronic medical record systems of various hospitals;
relational database service: the electronic medical record interface stores the business data by using a relational database and applies the related data; the business data comprises an electronic medical record abstract, a log and application information;
the electronic medical record abstract refers to abstract information in electronic medical records in electronic medical record systems of various hospitals, and the log refers to events of the electronic medical records, time for retrieving the electronic medical records, information of operators, IP addresses and operation contents; the application information refers to example information of electronic medical record systems of various hospitals;
data caching service: is a public infrastructure network, is a service which can access data at high speed; the data caching service is one of middleware services and provides an on-line distributed caching capability with instant use, safety, reliability, elastic capacity expansion and convenient management; the electronic medical record interface manages the access token through a data cache service;
block chain service: the system is a public infrastructure network, and is a public infrastructure network which can provide low-cost development, deployment, operation and maintenance, intercommunication and supervision alliance chain application; the electronic medical record interface stores and accesses the electronic medical record by using a block chain service;
and (3) opening an API: the electronic medical record interface provides an open API for an electronic medical record system needing to be accessed; the API, namely the Application Programming Interface, is an Application program Interface, is a plurality of predefined functions or refers to the engagement agreement of different components of a software system; the interface provides applications and developers the ability to access a set of routines based on certain software or hardware without having to access native code or understand the details of the internal workings;
the intelligent contract is a section of code on the block chain, provides functions of electronic medical record storage and electronic medical record retrieval, and comprises an electronic medical record storage contract and an electronic medical record retrieval contract, the block chain comprises a data storage and retrieval module, the electronic medical record storage contract is in butt joint with the block chain data storage module, and the electronic medical record retrieval contract is in butt joint with the block chain data retrieval module; the electronic medical record interface enables the block chain data storage module through an electronic medical record storage contract and stores the electronic medical record on the block chain; the electronic medical record interface starts the block chain retrieval module through an electronic medical record retrieval contract to retrieve the electronic medical record stored on the block chain;
s4 step of authorizing retrieval of block chain electronic medical record
When a requester needs to retrieve the block chain electronic medical record, the hospital electronic medical record system is in butt joint with the electronic medical record retrieval module through the electronic medical record interface, the electronic medical record retrieval module is in butt joint with the intelligent contract to obtain the electronic medical record stored on the block chain, and the electronic medical record interface sends the obtained electronic medical record to the requester; the requester refers to an operator of each hospital electronic medical record system client; the electronic medical record client is client software installed at a doctor PC (personal computer) end or a mobile end, and the client software is client software of the hospital electronic medical record system.
The invention also provides a block chain-based electronic medical record storage and retrieval interface, which comprises an electronic medical record storage module, an electronic medical record retrieval module, an application management module, an authority management module, a relational database service, a data cache service, a block chain service and an open API service;
the electronic medical record storage module is used for calling an intelligent contract, storing encrypted electronic medical record data A3 and storing the encrypted electronic medical record data A3 in a block chain;
the electronic medical record retrieval module is used for receiving a retrieval request sent by the hospital electronic medical record, taking out the electronic medical record meeting the conditions through an intelligent contract, and sending the taken electronic medical record meeting the conditions to the hospital electronic medical record system;
an application management module: the hospital electronic medical record system instance has a unique application credential which identifies the identity of the access system and can exchange a temporary access token by using the electronic medical record interface through the credential;
the authority management module: the electronic medical record management system is used for controlling the access authority of electronic medical record retrieval and electronic medical record storage services of electronic medical record interfaces accessed to electronic medical record systems of various hospitals;
relational database service: the electronic medical record interface stores the business data by using a relational database and applies the related data; the business data comprises an electronic medical record abstract, a log and application information;
the electronic medical record abstract refers to abstract information in electronic medical records in electronic medical record systems of various hospitals, and the log refers to events of the electronic medical records, time for retrieving the electronic medical records, information of operators, IP addresses and operation contents; the application information refers to example information of electronic medical record systems of various hospitals;
data caching service: is a public infrastructure network, is a service which can access data at high speed; the data caching service is one of middleware services and provides an on-line distributed caching capability with instant use, safety, reliability, elastic capacity expansion and convenient management; the electronic medical record interface manages the access token through a data cache service;
block chain service: the system is a public infrastructure network, and is a public infrastructure network which can provide low-cost development, deployment, operation and maintenance, intercommunication and supervision alliance chain application; the electronic medical record interface stores and accesses the electronic medical record by using a block chain service;
and (3) opening an API: the electronic medical record interface provides an open API for an electronic medical record system needing to be accessed; the API, namely the Application Programming Interface, is an Application program Interface, is a plurality of predefined functions or refers to the engagement agreement of different components of a software system; the interface provides applications and developers the ability to access a set of routines based on certain software or hardware without having to access native code or understand the details of the internal workings;
the intelligent contract is a section of code on the block chain, provides functions of electronic medical record storage and electronic medical record retrieval, and comprises an electronic medical record storage contract and an electronic medical record retrieval contract, the block chain comprises a data storage and retrieval module, the electronic medical record storage contract is in butt joint with the block chain data storage module, and the electronic medical record retrieval contract is in butt joint with the block chain data retrieval module; the electronic medical record interface enables the block chain data storage module through an electronic medical record storage contract and stores the electronic medical record on the block chain; the electronic medical record interface enables the block chain retrieval module through an electronic medical record retrieval contract to retrieve and read the electronic medical record stored on the block chain.
The invention also provides an electronic medical record sharing system of the block chain, which comprises the electronic medical record interface.
Has the advantages that: the electronic medical records are converted into the electronic medical records in the electronic medical record systems of various hospitals through the electronic medical record data interface and the intelligent contract and are stored on the block chain in a unified format, and even if the hospitals adjust or modify the electronic medical records for a long time, the adjusted electronic medical records can be synchronously stored on the block chain, and modification traces can be left at the same time. Other hospitals or the hospital can call the electronic medical records stored on the block chain through the electronic medical record data interface and the intelligent contract when calling the electronic medical records. Therefore, the problem of the traditional sharing mode is solved. Based on the method and the system for storing the block chain electronic medical records, the shared electronic medical records are unique, and the electronic medical records retrieved by hospitals through the block chain are completely consistent. Because of the restriction to the structure of the blockchain, data on the chain can only be added and cannot be modified or deleted. Once the transaction is completed, the data is synchronized to all nodes, and the aim of directly tampering the block data in some nodes by technical means so as to tamper the whole data cannot be achieved, because the block chain can automatically correct the wrong block data, and the data of all nodes is ensured to be correct. Therefore, the problems that data centralization is realized, documents are easy to tamper, and safety is difficult to guarantee are solved.
The method realizes the sharing of the electronic medical record documents by using the block chain technology aiming at the problems in the document sharing, ensures that the data is unique and credible, cannot be falsified, and is safe and reliable; the medical record submission information and the retrieval information are clear at a glance, so that the audit of a supervision department is facilitated; the cost of interface development and maintenance, central system and database maintenance work and software and hardware investment in the existing sharing mode is greatly saved.
Drawings
FIG. 1 is a schematic flow chart of a block chain-based electronic medical record sharing method;
FIG. 2 is a schematic diagram of an electronic medical record interface;
FIG. 3 is a flow chart of a method for storing and retrieving a blockchain electronic medical record.
Detailed Description
Example 1
As shown in fig. 1, 2, and 3, a block chain-based electronic medical record sharing method is characterized in that:
s1, organizing the electronic medical record shared document;
developing an interface for receiving the electronic medical record, and receiving the electronic medical record submitted by the electronic medical record system;
the hospital modifies the electronic medical record system of the unit and develops a data adapter according to the requirement of receiving an electronic medical record interface; when a doctor archives an electronic medical record, the electronic medical record system converts the electronic medical record data A1 into a format specified by an electronic medical record interface through a data adapter, and the electronic medical record data is converted into formatted electronic medical record data A2;
the electronic medical record system belongs to a third-party electronic medical record system, belongs to the existing system of a hospital, and belongs to the prior art.
The electronic medical record filing is an event of the existing hospital electronic medical record system, and is characterized in that medical records are stored after a doctor finishes diagnosis and treatment of a patient or when the patient is discharged from the hospital, and the medical records are stored in the hospital electronic medical record system data.
The requirements of the electronic medical record interface refer to a unified electronic medical record data format, the format uses the existing standards of national electronic medical record shared data sets or CDR and the like, and can be defined by self, as long as the format is determined before access, and once the format is determined, all electronic medical record systems adopt the unified format.
The data adapter is used for converting data formats and converting hospital electronic medical record data into data formats specified by the electronic medical record interface.
When the electronic medical record documents are shared, the electronic medical record system firstly organizes the electronic medical record documents according to a certain format. The format can use the existing standard of national electronic medical record shared data set or CDR, etc., and can be defined by self as long as the format is defined well before access. Once the appointment is made, all electronic medical record systems adopt a uniform format.
Steps for signing and encrypting a document
The hospital electronic medical record system signs the formatted electronic medical record data A2, encrypts the signed electronic medical record data A2 to form signed and encrypted electronic medical record data A3, and submits the signed and encrypted electronic medical record data A3 to an electronic medical record interface;
the existing hospital electronic medical record system signs the electronic medical record data: the electronic signature is an electronic signature of an electronic document by a cryptographic technique, is not a digital image of a written signature, is similar to a handwritten signature or a seal, and can be called an electronic seal. The existing electronic medical record systems of hospitals all have the function of electronic signature. The technology belongs to the prior art, only uses the technology, and the invention does not innovate the technology.
The existing hospital electronic medical record system encrypts electronic medical record data, namely: the medical record data is changed into messy code (encrypted) to be transmitted by using technical means. The encryption technology is the main security measure adopted by electronic commerce, is the most common security measure, changes important data into messy codes (encryption) by using technical measures for transmission, and restores (decrypts) by using the same or different measures after reaching a destination. The encryption technology belongs to the prior art, the encryption technology is only used, and the encryption technology is not innovated.
Step of uplink saving
The electronic medical record interface carries out uplink storage on the encrypted electronic medical record data A3;
the uplink storage refers to storing the encrypted electronic medical record data A3 on a blockchain by using an intelligent contract and an electronic medical record interface, wherein the blockchain comprises a built-in database, and the encrypted electronic medical record data A3 is stored in the built-in database of the blockchain;
the electronic medical record interface is used for receiving encrypted electronic medical record data A3 sent by the hospital electronic medical record system, the electronic medical record interface calls an intelligent contract, and the intelligent contract stores the encrypted electronic medical record data A3 in a block chain;
the electronic medical record interface comprises an electronic medical record storage module, an electronic medical record retrieval module, an application management module, an authority management module, a relational database service module, a data cache service module, a block chain service module and an open API service module;
the electronic medical record storage module is used for calling an intelligent contract, storing encrypted electronic medical record data A3 and storing the encrypted electronic medical record data A3 in a block chain;
the electronic medical record retrieval module is used for receiving a retrieval request sent by the hospital electronic medical record, taking out the electronic medical record meeting the conditions through an intelligent contract, and sending the taken electronic medical record meeting the conditions to the hospital electronic medical record system;
an application management module: the hospital electronic medical record system instance has a unique application credential which identifies the identity of the access system and can exchange a temporary access token by using the electronic medical record interface through the credential;
the example of the hospital electronic medical record system refers to an electronic medical record system of a certain unit, and specifically refers to an electronic medical record system of each hospital. Example information of the hospital electronic medical record system comprises information such as a hospital name, a hospital address, a hospital application certificate, a hospital contact way and the like.
The application credential refers to the unique identity of the electronic medical record system of each hospital.
The temporary access token refers to a token which can access the electronic medical record interface within a certain period of time in exchange for identity identification.
The authority management module: the electronic medical record management system is used for controlling the access authority of electronic medical record retrieval and electronic medical record storage services of electronic medical record interfaces accessed to electronic medical record systems of various hospitals;
relational database service: the electronic medical record interface stores the business data by using a relational database and applies the related data; the business data comprises an electronic medical record abstract, a log and application information; the relational database service is a database stored on a cloud storage server or a cloud storage disk array.
The electronic medical record abstract refers to abstract information in electronic medical records in electronic medical record systems of various hospitals, and the log refers to events of the electronic medical records, time for retrieving the electronic medical records, information of operators, IP addresses and operation contents; the application information refers to example information of electronic medical record systems of various hospitals;
the blockchain provides a service for a third party, and is a shared database which is stored on a cloud storage server or a cloud storage disk array.
Data caching service: the data caching service is a database stored on a cloud storage server or a cloud storage disk array. The data caching service is one of middleware services and provides an on-line distributed caching capability with instant use, safety, reliability, elastic capacity expansion and convenient management; the electronic medical record interface manages the access token through a data cache service;
block chain service: the system is a public infrastructure network, and is a public infrastructure network which can provide low-cost development, deployment, operation and maintenance, intercommunication and supervision alliance chain application; the electronic medical record interface stores and accesses the electronic medical record by using a block chain service;
and (3) opening an API: the electronic medical record interface provides an open API for an electronic medical record system needing to be accessed; the API, namely the Application Programming Interface, is an Application program Interface, is a plurality of predefined functions or refers to the engagement agreement of different components of a software system; the interface provides applications and developers the ability to access a set of routines based on certain software or hardware without having to access native code or understand the details of the internal workings;
the intelligent contract is a section of code on the block chain, provides functions of electronic medical record storage and electronic medical record retrieval, and comprises an electronic medical record storage contract and an electronic medical record retrieval contract, the block chain comprises a data storage and retrieval module, the electronic medical record storage contract is in butt joint with the block chain data storage module, and the electronic medical record retrieval contract is in butt joint with the block chain data retrieval module; the electronic medical record interface enables the block chain data storage module through an electronic medical record storage contract and stores the electronic medical record on the block chain; the electronic medical record interface enables the block chain retrieval module through an electronic medical record retrieval contract to retrieve and read the electronic medical record stored on the block chain.
Further, as shown in fig. 3, the electronic medical record system client sends a request for storing an electronic medical record to the electronic medical record server, the electronic medical record server uses an identity credential to exchange a temporary access token with the application management module according to the request of the electronic medical record system client, the application management module verifies the identity of a caller with the authority management module, the authority management module returns a verification result to the application management module, if the application management module passes the verification, the temporary access token is returned to the electronic medical record system, the electronic medical record system obtains an access authority, the electronic medical record system requests the electronic medical record storage module to store the electronic medical record, and the electronic medical record storage module stores the electronic medical record to the block chain through an intelligent contract.
The hospital electronic medical record system comprises an electronic medical record system client and an electronic medical record server, wherein the electronic medical record server is installed on a hospital server, and the electronic medical record system client is installed on a PC (personal computer) end or a mobile end of each doctor or a PC end or a mobile end of an operator.
Step of authorizing retrieval of block chain electronic medical record
When a requester needs to retrieve the block chain electronic medical record, the hospital electronic medical record system is in butt joint with the electronic medical record retrieval module through the electronic medical record interface, the electronic medical record retrieval module is in butt joint with the intelligent contract to obtain the electronic medical record stored on the block chain, and the electronic medical record interface sends the obtained electronic medical record to the requester; the requester refers to an operator of each hospital electronic medical record system client; the electronic medical record client is client software installed at a doctor PC (personal computer) end or a mobile end, and the client software is client software of the hospital electronic medical record system.
Further, as shown in fig. 3, the electronic medical record system client sends a request for retrieving the block chain electronic medical record to the electronic medical record server, the electronic medical record server uses the identity credential to change the temporary access token to the application management module according to the request of the electronic medical record system client, the application management module verifies the identity of the caller to the authority management module, the authority management module returns a verification result to the application management module, if the application management module passes the verification, the temporary access token is returned to the electronic medical record system, the electronic medical record system obtains the retrieval authority, the block chain sends the electronic medical record requested to be retrieved to the electronic medical record system server through the application management module, and the electronic medical record system server sends the electronic medical record requested to be retrieved to the client;
the invention relates to a block chain-based electronic medical record storage method, which converts electronic medical records in electronic medical record systems of hospitals into uniform formats through electronic medical record data interfaces and intelligent contracts and stores the electronic medical records in a block chain. Other hospitals or the hospital can call the electronic medical records stored on the block chain through the electronic medical record data interface and the intelligent contract when calling the electronic medical records. Therefore, the problem of the traditional sharing mode is solved. Based on the method and the system for storing the block chain electronic medical records, the shared electronic medical records are unique, and the electronic medical records retrieved by hospitals through the block chain are completely consistent. Because of the restriction to the structure of the blockchain, data on the chain can only be added and cannot be modified or deleted. Once the transaction is completed, the data is synchronized to all nodes, and the aim of directly tampering the block data in some nodes by technical means so as to tamper the whole data cannot be achieved, because the block chain can automatically correct the wrong block data, and the data of all nodes is ensured to be correct. Therefore, the problems that data centralization is realized, documents are easy to tamper, and safety is difficult to guarantee are solved.
Example 2:
the traditional electronic medical record sharing method mainly adopts two modes of point-to-point sharing and center sharing, and does not use a block chain technology, so that the sharing steps are completely different. The blockchain technique itself has no distinction between conventional and modern techniques, and thus does not talk about conventional blockchain techniques. The invention has the innovation point that the block chain technology is applied to electronic medical record sharing, a set of new electronic medical record sharing process is formed, and the problems of complex document maintenance, insufficient document safety and the like in the traditional sharing mode are solved.
The example comprises the following four steps:
s1, organizing electronic medical record documents;
when the electronic medical record documents are shared, the electronic medical record system firstly organizes the electronic medical record documents according to a certain format. The format can use the existing standard of national electronic medical record shared data set or CDR, etc., and can be defined by self as long as the format is defined well before access. Once the appointment is made, all electronic medical record systems adopt a uniform format.
S2, signing and encrypting the document;
the electronic medical record system firstly signs and encrypts the document to be uploaded before sharing the document. Signing the document with the doctor's private key indicates the author of the document and encrypting the document with the patient's private key indicates the owner of the document. When sharing, the private key of the sharer is used for signing the sharing operation, and the data integrity and the validity of the sharing operation are verified before the sharing operation is used for uplink after data transmission. These information are organized into shared operation metadata to be submitted along with the document.
S3, saving the upper chain;
and submitting the encrypted document, the signature of the document and other metadata to a server, performing signature verification on the submitted data by the server, storing the document data in an object storage, and storing the metadata in a block chain.
S4, authorizing to retrieve the document;
when other doctors want to refer to the medical record documents of the patients, the referring application is sent out in the electronic medical record system, and if the doctor has the right to refer, the block chain can return the encrypted medical record documents. After the patient authorizes, the system can decrypt the file, and the doctor can see the content of the medical record file which is required to be called.
The electronic medical record system of the hospital organizes the electronic medical record data according to a specified format when the medical record is filed, then carries out signature encryption, submits the encrypted data to the electronic medical record interface, and the electronic medical record interface calls an intelligent contract after receiving the encrypted electronic medical record data and stores the electronic medical record in a block chain. When the electronic medical record system of the hospital needs to check the electronic medical records of other hospitals, the electronic medical record system requests the corresponding electronic medical records from the electronic medical record interface, and the electronic medical record interface inquires medical records meeting the conditions from the block chain through an intelligent contract after receiving the request and returns the medical records to the requested electronic medical record system.
The electronic medical record document is mainly generated in outpatient service and hospitalization, so the uplink access point selects two action points of 'outpatient service end' and 'hospitalization medical record filing'. These two points are chosen because the medical record data is the most complete and not modified basically, so that the integrity and accuracy of the uplink data can be ensured. Of course, the document that has been linked up can be submitted again, and the block chain will completely store the information of linked up every time it is submitted.
The format and scope of the uplink data may be organized in a manner required by the relevant specifications or agreed upon by the current healthcare facility alliance. After the document data is organized at the corresponding action point, the document creator's private key is used to sign the data first, and then the patient's public key is used to encrypt the data. This ensures the validity, privacy and security of data that cannot be viewed by unauthorized entities or individuals. Different granularities can be used to organize the data according to actual conditions, and the higher the granularity is, the finer the authorization control is supported. Each time the submitted data is signed by the private key of the submitter, the submitted data is used for verifying the validity of the whole submitted data during uplink.
And carrying out chain winding operation through the intelligent contract after the data processing is finished. Because the intelligent contract itself is a piece of code executed on the blockchain, the code content and the deployment operation are completely transparent, all organizations can supervise the content and the operation condition of the intelligent contract, and the intelligent contract cannot perform any unauthorized operation. During chaining, the intelligent dating uses the public key of the submitter to perform signature verification on the overall submitted data to ensure that the chaining data is effective. And for the document, the intelligent contract cannot decrypt and view the content of the document, so that the privacy of the data is ensured. Each time the data is linked up, a new version is generated, the old version cannot be covered, and each version can be stored on the blockchain in detail and permanently, cannot be deleted and cannot be tampered.
When the medical record documents are retrieved, only authorized organizations or individuals can obtain data through the intelligent contracts, and meanwhile, the information related to retrieval actions is recorded in the intelligent contracts. According to the operation records on the block chain, the supervisor can clearly grasp the action history of submitting, retrieving and the like of the medical record documents.
The electronic medical record sharing mode based on the block chain can well solve the problems existing in the existing mode, can save the input cost while providing the reliable, credible and traceable electronic medical record sharing document service, and is very favorable for the first realization and the later maintenance.
Example 3:
as shown in fig. 2 and 3, the present invention further provides a block chain based saving and retrieving electronic medical record interface, which includes an electronic medical record saving module, an electronic medical record retrieving module, an application management module, an authority management module, a relational database service, a data caching service, a block chain service, and an open API service;
the electronic medical record storage module is used for calling an intelligent contract, storing encrypted electronic medical record data A3 and storing the encrypted electronic medical record data A3 in a block chain;
the electronic medical record retrieval module is used for receiving a retrieval request sent by the hospital electronic medical record, taking out the electronic medical record meeting the conditions through an intelligent contract, and sending the taken electronic medical record meeting the conditions to the hospital electronic medical record system;
an application management module: the hospital electronic medical record system instance has a unique application credential which identifies the identity of the access system and can exchange a temporary access token by using the electronic medical record interface through the credential;
the authority management module: the electronic medical record management system is used for controlling the access authority of electronic medical record retrieval and electronic medical record storage services of electronic medical record interfaces accessed to electronic medical record systems of various hospitals;
relational database service: the electronic medical record interface stores the business data by using a relational database and applies the related data; the business data comprises an electronic medical record abstract, a log and application information;
the electronic medical record abstract refers to abstract information in electronic medical records in electronic medical record systems of various hospitals, and the log refers to events of the electronic medical records, time for retrieving the electronic medical records, information of operators, IP addresses and operation contents; the application information refers to example information of electronic medical record systems of various hospitals;
data caching service: is a public infrastructure network, is a service which can access data at high speed; the data caching service is one of middleware services and provides an on-line distributed caching capability with instant use, safety, reliability, elastic capacity expansion and convenient management; the electronic medical record interface manages the access token through a data cache service;
block chain service: the system is a public infrastructure network, and is a public infrastructure network which can provide low-cost development, deployment, operation and maintenance, intercommunication and supervision alliance chain application; the electronic medical record interface stores and accesses the electronic medical record by using a block chain service;
and (3) opening an API: the electronic medical record interface provides an open API for an electronic medical record system needing to be accessed; the API, namely the Application Programming Interface, is an Application program Interface, is a plurality of predefined functions or refers to the engagement agreement of different components of a software system; the interface provides applications and developers the ability to access a set of routines based on certain software or hardware without having to access native code or understand the details of the internal workings;
the intelligent contract is a section of code on the block chain, provides functions of electronic medical record storage and electronic medical record retrieval, and comprises an electronic medical record storage contract and an electronic medical record retrieval contract, the block chain comprises a data storage and retrieval module, the electronic medical record storage contract is in butt joint with the block chain data storage module, and the electronic medical record retrieval contract is in butt joint with the block chain data retrieval module; the electronic medical record interface enables the block chain data storage module through an electronic medical record storage contract and stores the electronic medical record on the block chain; the electronic medical record interface enables the block chain retrieval module through an electronic medical record retrieval contract to retrieve and read the electronic medical record stored on the block chain.
Example 4:
the invention also provides an electronic medical record sharing system of the block chain, which comprises the electronic medical record interface in embodiment 3.
Claims (6)
1. A block chain-based electronic medical record sharing method is characterized by comprising the following steps:
s1, organizing the electronic medical record shared document;
developing an interface for receiving the electronic medical record, and receiving the electronic medical record submitted by the electronic medical record system;
the hospital modifies the electronic medical record system of the unit and develops a data adapter according to the requirement of receiving an electronic medical record interface; when a doctor archives an electronic medical record, the electronic medical record system converts the electronic medical record data A1 into a format specified by an electronic medical record interface through a data adapter, and the electronic medical record data is converted into formatted electronic medical record data A2;
s2 signature and encryption document step
The hospital electronic medical record system signs the formatted electronic medical record data A2, encrypts the signed electronic medical record data A2 to form signed and encrypted electronic medical record data A3, and submits the signed and encrypted electronic medical record data A3 to an electronic medical record interface;
s3 procedure for saving upper chain
The electronic medical record interface carries out uplink storage on the encrypted electronic medical record data A3;
the uplink storage refers to storing the encrypted electronic medical record data A3 on a blockchain by using an intelligent contract and an electronic medical record interface, wherein the blockchain comprises a built-in database, and the encrypted electronic medical record data A3 is stored in the built-in database of the blockchain;
the electronic medical record interface is used for receiving encrypted electronic medical record data A3 sent by the hospital electronic medical record system, the electronic medical record interface calls an intelligent contract, and the intelligent contract stores the encrypted electronic medical record data A3 in a block chain;
s4 step of authorizing retrieval of block chain electronic medical record
When a requester needs to retrieve the block chain electronic medical record, the hospital electronic medical record system is in butt joint with the electronic medical record retrieval module through the electronic medical record interface, the electronic medical record retrieval module is in butt joint with the intelligent contract to obtain the electronic medical record stored on the block chain, and the electronic medical record interface sends the obtained electronic medical record to the requester; the requester refers to an operator of each hospital electronic medical record system client; the electronic medical record client is client software installed at a doctor PC (personal computer) end or a mobile end, and the client software is client software of the hospital electronic medical record system.
2. The block chain-based electronic medical record sharing method according to claim 1, wherein: in step S2, the electronic medical record interface includes an electronic medical record storage module, an electronic medical record retrieval module, an application management module, an authority management module, a relational database service, a data cache service, a block chain service, and an open API service;
the electronic medical record storage module is used for calling an intelligent contract, storing encrypted electronic medical record data A3 and storing the encrypted electronic medical record data A3 in a block chain;
the electronic medical record retrieval module is used for receiving a retrieval request sent by the hospital electronic medical record, taking out the electronic medical record meeting the conditions through an intelligent contract, and sending the taken electronic medical record meeting the conditions to the hospital electronic medical record system;
an application management module: the hospital electronic medical record system instance has a unique application credential which identifies the identity of the access system and can exchange a temporary access token by using the electronic medical record interface through the credential;
the authority management module: the electronic medical record management system is used for controlling the access authority of electronic medical record retrieval and electronic medical record storage services of electronic medical record interfaces accessed to electronic medical record systems of various hospitals;
relational database service: the electronic medical record interface stores the business data by using a relational database and applies the related data; the business data comprises an electronic medical record abstract, a log and application information;
the electronic medical record abstract refers to abstract information in electronic medical records in electronic medical record systems of various hospitals, and the log refers to events of the electronic medical records, time for retrieving the electronic medical records, information of operators, IP addresses and operation contents; the application information refers to example information of electronic medical record systems of various hospitals;
data caching service: is a public infrastructure network, is a service which can access data at high speed; the data caching service is one of middleware services and provides an on-line distributed caching capability with instant use, safety, reliability, elastic capacity expansion and convenient management; the electronic medical record interface manages the access token through a data cache service;
block chain service: the system is a public infrastructure network, and is a public infrastructure network which can provide low-cost development, deployment, operation and maintenance, intercommunication and supervision alliance chain application; the electronic medical record interface stores and accesses the electronic medical record by using a block chain service;
and (3) opening an API: the electronic medical record interface provides an open API for an electronic medical record system needing to be accessed; the API, namely the Application Programming Interface, is an Application program Interface, is a plurality of predefined functions or refers to the engagement agreement of different components of a software system; the interface provides applications and developers the ability to access a set of routines based on certain software or hardware without having to access native code or understand the details of the internal workings;
the intelligent contract is a section of code on the block chain, provides functions of electronic medical record storage and electronic medical record retrieval, and comprises an electronic medical record storage contract and an electronic medical record retrieval contract, the block chain comprises a data storage and retrieval module, the electronic medical record storage contract is in butt joint with the block chain data storage module, and the electronic medical record retrieval contract is in butt joint with the block chain data retrieval module; the electronic medical record interface enables the block chain data storage module through an electronic medical record storage contract and stores the electronic medical record on the block chain; the electronic medical record interface enables the block chain retrieval module through an electronic medical record retrieval contract to retrieve and read the electronic medical record stored on the block chain.
3. The block chain-based electronic medical record sharing method according to claim 1, wherein: the step 3 comprises the following steps:
the electronic medical record system client sends a request for storing an electronic medical record to the electronic medical record server, the electronic medical record server uses an identity credential to exchange a temporary access token for an application management module according to the request of the electronic medical record system client, the application management module verifies the identity of a caller to an authority management module, the authority management module returns a verification result to the application management module, if the application management module passes the verification, the application management module returns a temporary access token to the electronic medical record system, the electronic medical record system obtains an access authority, the electronic medical record system requests the electronic medical record storage module to store the electronic medical record, and the electronic medical record storage module stores the electronic medical record to a block chain through an intelligent contract;
the hospital electronic medical record system comprises an electronic medical record system client and an electronic medical record server, wherein the electronic medical record server is installed on a hospital server, and the electronic medical record system client is installed on a PC (personal computer) end or a mobile end of each doctor or a PC end or a mobile end of an operator.
4. The block chain-based electronic medical record sharing method according to claim 1, wherein: the step 4 comprises the following steps:
the electronic medical record system client sends a request for retrieving the block chain electronic medical record to the electronic medical record server, the electronic medical record server uses an identity credential to exchange a temporary access token with an application management module according to the request of the electronic medical record system client, the application management module verifies the identity of a caller with an authority management module, the authority management module returns a verification result to the application management module, if the verification is passed, the application management module returns the temporary access token to the electronic medical record system, the electronic medical record system obtains the retrieval authority, the block chain sends the electronic medical record requested to be retrieved to the electronic medical record system server through the application management module, and the electronic medical record system server sends the electronic medical record requested to be retrieved to the client;
the hospital electronic medical record system comprises an electronic medical record system client and an electronic medical record server, wherein the electronic medical record server is installed on a hospital server, and the electronic medical record system client is installed on a PC (personal computer) end or a mobile end of each doctor or a PC end or a mobile end of an operator.
5. A block chain based preservation and retrieval electronic medical record interface is characterized in that the electronic medical record interface comprises an electronic medical record preservation module, an electronic medical record retrieval module, an application management module, an authority management module, a relational database service module, a data cache service module, a block chain service module and an open API service module;
the electronic medical record storage module is used for calling an intelligent contract, storing encrypted electronic medical record data A3 and storing the encrypted electronic medical record data A3 in a block chain;
the electronic medical record retrieval module is used for receiving a retrieval request sent by the hospital electronic medical record, taking out the electronic medical record meeting the conditions through an intelligent contract, and sending the taken electronic medical record meeting the conditions to the hospital electronic medical record system;
an application management module: the hospital electronic medical record system instance has a unique application credential which identifies the identity of the access system and can exchange a temporary access token by using the electronic medical record interface through the credential;
the authority management module: the electronic medical record management system is used for controlling the access authority of electronic medical record retrieval and electronic medical record storage services of electronic medical record interfaces accessed to electronic medical record systems of various hospitals;
relational database service: the electronic medical record interface stores the business data by using a relational database and applies the related data; the business data comprises an electronic medical record abstract, a log and application information;
the electronic medical record abstract refers to abstract information in electronic medical records in electronic medical record systems of various hospitals, and the log refers to events of the electronic medical records, time for retrieving the electronic medical records, information of operators, IP addresses and operation contents; the application information refers to example information of electronic medical record systems of various hospitals;
data caching service: is a public infrastructure network, is a service which can access data at high speed; the data caching service is one of middleware services and provides an on-line distributed caching capability with instant use, safety, reliability, elastic capacity expansion and convenient management; the electronic medical record interface manages the access token through a data cache service;
block chain service: the system is a public infrastructure network, and is a public infrastructure network which can provide low-cost development, deployment, operation and maintenance, intercommunication and supervision alliance chain application; the electronic medical record interface stores and accesses the electronic medical record by using a block chain service;
and (3) opening an API: the electronic medical record interface provides an open API for an electronic medical record system needing to be accessed; the API, namely the Application Programming Interface, is an Application program Interface, is a plurality of predefined functions or refers to the engagement agreement of different components of a software system; the interface provides applications and developers the ability to access a set of routines based on certain software or hardware without having to access native code or understand the details of the internal workings;
the intelligent contract is a section of code on the block chain, provides functions of electronic medical record storage and electronic medical record retrieval, and comprises an electronic medical record storage contract and an electronic medical record retrieval contract, the block chain comprises a data storage and retrieval module, the electronic medical record storage contract is in butt joint with the block chain data storage module, and the electronic medical record retrieval contract is in butt joint with the block chain data retrieval module; the electronic medical record interface enables the block chain data storage module through an electronic medical record storage contract and stores the electronic medical record on the block chain; the electronic medical record interface enables the block chain retrieval module through an electronic medical record retrieval contract to retrieve and read the electronic medical record stored on the block chain.
6. A blockchain electronic medical record sharing system comprising the electronic medical record interface of claim 4.
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Denomination of invention: A blockchain based electronic medical record sharing method, electronic medical record interface, and system Granted publication date: 20231020 Pledgee: Nanjing Bank Co.,Ltd. Nanjing North Branch Pledgor: Shentai Health Technology (Nanjing) Co.,Ltd. Registration number: Y2024980005062 |
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