A secure and interoperable blockchain-based information sharing system for healthcare providers in developing countries

Systems in the health sector are very crucial for human life and they should be efficient, reliable and secure. Unfortunately, electronic health record (EHR) systems do not work effectively when managing multi-institutional medical records. The EHR, which is a digital system in which patient health information is systematically stored. The information stored includes medical history, laboratory test results, demographics, and billing information, poses problems to patients related to interoperability, privacy, and data integrity. Most solutions to these threats focus on a centralized architecture that faces a single point of failure and internal threats, such as unreliable system administrators. The promising solution that many researchers are interested in is the use of blockchains. However, in developing countries, and particularly in sub-Saharan Africa, very little attention has been given to the issues of interoperability, privacy and data integrity for EHRs using blockchain technology. As such, this research has designed and developed self-sovereign identity management and secure information sharing system for health systems in developing countries, based on blockchain technology, which helps to solve the mentioned problems. The study used a Design Science Research (DSR) methodology to develop solutions to the research problem through three sub studies. The first and the second sub studies conducted under problem awareness and suggestion phases of DSR, and third sub study conducted under development and evaluation phases of DSR. The first sub study deal with the assessment of three most common blockchain based healthcare systems (MedicalChain, Patientory, and MediLedger). The second sub study studies the problem of existing EHR systems in Tanzania regarding privacy issues in identity management and secure sharing of medical data from one healthcare facility to the other. The third sub study deal with the development of two systems, one for identity management using blockchain (self-sovereign identity), and one for secure sharing of medical data from one healthcare facility to another through blockchain technology. The systems provide additional privacy protection tools to the existing infrastructures. They reduce development cost, transparency, data integrity, protection against single-point-offailure vulnerabilities, and prevention of internal threats such as untrusted system administrators. The systems will make the existing and future health information systems trustable to healthcare service providers and the end-users of the healthcare systems. Also, will help the stakeholders in the healthcare sector to properly manage the healthcare systems.