Designing and testing a blockchain application for patient identity management in healthcare

Anjum Khurshid; Cole Holan; Cody Cowley; Jeremiah Alexander; Daniel Toshio Harrell; Muhammad Usman; Ishav Desai; John Robert Bautista; Eric Meyer

doi:10.1093/jamiaopen/ooaa073

Designing and testing a blockchain application for patient identity management in healthcare

JAMIA Open. 2021 Feb 9;4(3):ooaa073. doi: 10.1093/jamiaopen/ooaa073. eCollection 2021 Jul.

Authors

Anjum Khurshid¹, Cole Holan¹, Cody Cowley¹, Jeremiah Alexander¹, Daniel Toshio Harrell¹, Muhammad Usman², Ishav Desai¹, John Robert Bautista³, Eric Meyer³

Affiliations

¹ Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA.
² Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA.
³ School of Information, The University of Texas at Austin, Austin, Texas, USA.

Abstract

Objective: Healthcare systems suffer from a lack of interoperability that creates "data silos," causing patient linkage and data sharing problems. Blockchain technology's unique architecture provides individuals greater control over their information and may help address some of the problems related to health data. A multidisciplinary team designed and tested a blockchain application, MediLinker, as a patient-centric identity management system.

Methods: The study used simulated data of "avatars" representing different types of patients. Thirty study participants were enrolled to visit simulated clinics, and perform various activities using MediLinker. Evaluation was based on Bouras' criteria for patient-centric identity management and on the number of errors in entry and sharing of data by participants.

Results: Twenty-nine of the 30 participants completed all study activities. MediLinker fulfilled all of Bouras' criteria except for one which was not testable. A majority of data errors were due to user error, such as wrong formatting and misspellings. Generally, the number of errors decreased with time. Due to COVID-19, sprint 2 was completed using "virtual" clinic visits. The number of user errors were less in virtual visits than in personal visits.

Discussion: The evaluation of MediLinker provides some evidence of the potential of a patient-centric identity management system using blockchain technology. The results showed a working system where patients have greater control over their information and can also easily provide consent for use of their data.

Conclusion: Blockchain applications for identity management hold great promise for use in healthcare but further research is needed before real-world adoption.

Keywords: blockchain; health information; identity; mobile application; patient consent.