BlocHIE: a BLOCkchain-based platform for Healthcare Information Exchange论文 翻译 一点点理解

Abstract—Nowadays, a great number of healthcare data are generated every day from both medical institutions and individuals. Healthcare information exchange (HIE) has been proved to benefit the medical industry remarkably. To store and share such large amount of healthcare data is important while challenging. In this paper, we propose BlocHIE, a Blockchain-based platform for healthcare information exchange. First, we analyze the different requirements for sharing healthcare data from different sources. Based on the analysis, we employ two loosely-coupled Blockchains to handle different kinds of healthcare data. Second, we combine off-chain storage and on-chain verification to satisfy the requirements of both privacy and authenticability. Third, we propose two fairness-based packing algorithms to improve the system throughput and the fairness among users jointly. To demonstrate the practicability and effectiveness of BlocHIE, we implement BlocHIE in a minimal-viable-product way and evaluate the proposed packing algorithms extensively.
摘要目前，无论是医疗机构还是个人，每天都会产生大量的医疗保健数据。医疗信息交换（HIE）已被证明对医疗行业有显著的好处。存储和共享如此大量的医疗保健数据是非常重要的，同时也具有挑战性。在本文中，我们提出了一个基于区块链的医疗信息交换平台Blochie。首先，我们分析了共享来自不同来源的医疗保健数据的不同需求。根据分析，我们使用两个松散耦合的区块链来处理不同类型的医疗保健数据。第二，我们将链下存储和链上验证结合起来，以满足隐私和真实性的要求。第三，我们提出了两种基于公平性的打包算法，共同提高系统吞吐量和用户之间的公平性。为了证明Blochie的实用性和有效性，我们以最小可行的产品方式实现了Blochie，并对所提出的打包算法进行了广泛的评估。

I. INTRODUCTION

Healthcare has always been important to the society. Illness, accidents, and emergencies do arise every day, and the incurred ailments and diseases are supposed to be diagnosed, treated, and managed. In recent years, healthcare information exchange (HIE) among medical institutions has been proved to benefit the medical industry a lot 1] . First, HIE can enhance the understanding of each individual clinical trial. Second, the researchers can get scientific insights by analyzing a bunch of clinical trials. Third, the healthcare information interoperability between clinical research enterprises strengthens their collaborations. Besides utilizing the data shared by the medical institutions, daily data collection is also beneficial for personal healthcare. With the development of the Internet of things (IoT) technology [2] [3], numerous personal healthcare data are generated by the IoT devices every day [4]. The doctor can take advantage of these data for precision medicine [5]. That is, the doctor takes the individual variability in environment and lifestyle into consideration when conducting disease treatment or giving prevention advice. There is no doubt that the data from individuals and various medical institutions benefits healthcare. However, it is challenging to store and share such large amount of data. Early success in HIE arose from the field of cloud computing [6]. The idea to store the huge amount of data remotely rather than locally is simple but effective. The cloud service providers (CSPs) propose various schemes for reliable data storage and efficient data processing. Then the stakeholders choose a specific CSP by balancing various factors such as cost and reliability. It has been a trend to resort to CSPs when there are some data to be stored. The beneficiaries range from patients, medical institutions, and research institutions to big corporations. Therefore, the CSPs have been taking great responsibilities to provide a controlled, cross-domain and flexible HIE platform. However, the CSPs have been struggling a lot to provide data sharing service [7]. On the one hand, the cloud storage market has been dominated by the largest CSPs such Google, Dropbox, etc. They are unwilling to share their data with the small/medium ones and between themselves due to market competition. On the other hand, it is risky if the healthcare data, which is highly private information, is exposed to the malicious users unexpectedly. Fortunately, Blockchain technology, which starts at 2008 [8] and booms at 2014 [9], provides great potential for HIE through its attractive features such as security, privacy, decentralization, and immutability. Blockchain technology has been successfully applied in many areas. Bitcoin [8], as the first decentralized cryptocurrency, is also the first successful Blockchain application. After the boom of cryptocurrencies, it comes to the era of Blockchain 2.0 with the release of Ethereum [9]. During this time, a lot of Blockchain-based systems are proposed for the purpose of decentralization. The applications range from transportation [10], e-government [11] to education [12].
一、引言
医疗保健一直对社会很重要。疾病、事故和紧急情况每天都会发生，发生的疾病和疾病应该得到诊断、治疗和管理。近年来，医疗机构间的医疗信息交换（HIE）已被证明对医疗行业有很大的好处[1]。首先，HIE可以增强对每个临床试验的理解。其次，研究人员可以通过分析一系列临床试验获得科学见解。第三，临床研究企业之间的医疗信息互操作性加强了它们的合作。除了利用医疗机构共享的数据外，日常数据收集也有利于个人医疗保健。随着物联网技术的发展，物联网设备每天都会生成大量的个人医疗数据[4]。医生可以利用这些数据进行精确医学研究[5]。也就是说，医生在进行疾病治疗或提供预防建议时，考虑到环境和生活方式的个体差异。毫无疑问，来自个人和各种医疗机构的数据有益于医疗保健。然而，存储和共享如此大量的数据是一个挑战。HIE的早期成功来自云计算领域[6]。远程而非本地存储大量数据的想法简单但有效。云服务提供商（CSP）提出了各种可靠的数据存储和高效的数据处理方案。然后利益相关者通过平衡成本和可靠性等各种因素来选择特定的顾客服务提供商。当有一些数据需要存储时，求助于CSP已成为一种趋势。受益者包括病人、医疗机构、研究机构和大公司。因此，CSP一直在承担着提供一个受控的、跨领域的和
灵活的HIE平台。然而，CSP一直在努力提供数据共享服务[7]。一方面，云存储市场已经被谷歌、Dropbox等最大的CSP所垄断，由于市场竞争，他们不愿与中小型CSP以及他们之间共享数据。另一方面，如果医疗保健数据（高度私有的信息）意外地暴露于恶意用户，则存在风险。幸运的是，区块链技术始于2008年[8]和2014年[9]的蓬勃发展，通过其具有吸引力的特性，如安全性、隐私性、分散性和不可变性，为HIE提供了巨大的潜力。区块链技术已成功应用于许多领域。比特币[8]作为第一个分散的加密货币，也是第一个成功的区块链应用。加密货币繁荣后，随着以太坊的发布，进入区块链2.0时代[9]。在此期间，许多基于区块链的系统被提议用于去中心化。应用范围从交通[10]、电子政务[11]到教育[12]。
When Blockchain technology meets HIE, there are only few proposed systems [13][14] and they all suffer from the following two problems. First, they only consider to store and share the electronic medical records (EMRs) and ignore the useful and numerous personal healthcare data (PHD). The requirements to store and share the huge amount of PHD are significantly different from storing and sharing the EMRs, which brings new challenges in the aspect of system throughput and fairness. Second, the existing systems directly store the EMRs in the cloud environment with complicated access control mechanism to prevent undesired data dissemination. However, such system architecture heavily relies on the security of the cloud environment.
当区块链技术满足HIE时，所提议的系统很少[13][14]，它们都存在以下两个问题。首先，他们只考虑存储和共享电子病历（EMR），而忽略有用的和大量的个人医疗保健数据（PhD）。存储和共享海量phd的需求与存储和共享emr有很大的不同，这给系统吞吐量和公平性带来了新的挑战。第二，现有系统直接将EMR存储在云环境中，采用复杂的访问控制机制，防止不希望的数据传播。然而，这种系统架构严重依赖于云环境的安全性。
To address the issues mentioned above, we propose BlocHIE, a BLOCkchain-based platform for Healthcare Information Exchange. In the system architecture, we use two loosely-coupled Blockchain, namely EMR-Chain and PHDChain to store EMRs and PHD separately. For the EMR-Chain, we combine off-chain storage and on-chain verification to take care of both privacy and authenticability, which also removes the dependency on cloud services. For both of the EMR-Chain and PHD-Chain, we propose two fairness-based transaction packing algorithms to enhance the system throughput, and to
improve the fairness among the system users. The contributions of this paper are as follows:
• We analyzed the requirements for storing and sharing EMRs and PHD. Based on the analysis, we propose to use two loosely-coupled Blockchain, namely EMR-Chain and PHD-Chain, as the system architecture. The EMRChain stores EMRs from medical institutions while the PHD-Chain serves the data from individuals. The usage of multiple chains satisfies the different requirements of storing and sharing different data.
• We combine off-chain storage and on-chain verification in the EMR-Chain, which fulfills the requirements of privacy and authenticability, at the same time reduces