CN112349368A - Electronic health record authorization sharing and management system based on medical block chain - Google Patents

Electronic health record authorization sharing and management system based on medical block chain Download PDF

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CN112349368A
CN112349368A CN202011275393.9A CN202011275393A CN112349368A CN 112349368 A CN112349368 A CN 112349368A CN 202011275393 A CN202011275393 A CN 202011275393A CN 112349368 A CN112349368 A CN 112349368A
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patient
doctor
electronic health
medical
management system
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赵嘉然
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Fujian West Coast Health Management Co ltd
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Fujian West Coast Health Management Co ltd
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    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
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    • G06F—ELECTRIC DIGITAL DATA PROCESSING
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    • G06F16/20—Information retrieval; Database structures therefor; File system structures therefor of structured data, e.g. relational data
    • G06F16/27—Replication, distribution or synchronisation of data between databases or within a distributed database system; Distributed database system architectures therefor
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    • G06F21/00—Security arrangements for protecting computers, components thereof, programs or data against unauthorised activity
    • G06F21/30—Authentication, i.e. establishing the identity or authorisation of security principals
    • G06F21/31—User authentication
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    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F21/00—Security arrangements for protecting computers, components thereof, programs or data against unauthorised activity
    • G06F21/60—Protecting data
    • G06F21/62—Protecting access to data via a platform, e.g. using keys or access control rules
    • G06F21/6218—Protecting access to data via a platform, e.g. using keys or access control rules to a system of files or objects, e.g. local or distributed file system or database
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F21/00—Security arrangements for protecting computers, components thereof, programs or data against unauthorised activity
    • G06F21/60—Protecting data
    • G06F21/64—Protecting data integrity, e.g. using checksums, certificates or signatures
    • H—ELECTRICITY
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    • H04L—TRANSMISSION OF DIGITAL INFORMATION, e.g. TELEGRAPHIC COMMUNICATION
    • H04L63/00—Network architectures or network communication protocols for network security
    • H04L63/04—Network architectures or network communication protocols for network security for providing a confidential data exchange among entities communicating through data packet networks
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    • H—ELECTRICITY
    • H04—ELECTRIC COMMUNICATION TECHNIQUE
    • H04L—TRANSMISSION OF DIGITAL INFORMATION, e.g. TELEGRAPHIC COMMUNICATION
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Abstract

The invention relates to an electronic health file authorization sharing and management system based on a medical block chain, which comprises a user side, a medical information management system, a hybrid chain up-chain down medical information database and an identity authentication system, wherein the user side is connected with the medical information management system through a network; the user side comprises a patient side and a doctor side which are respectively used for carrying out the relevant operation of the electronic health record; the medical information management system is a platform for the user side to perform relevant operations and is used for sending the relevant operations to the hybrid uplink-downlink medical information database; the system is also an implementation platform of a distributed encryption and decryption module, cooperates with an identity authentication system, and is used for encrypting and decrypting the electronic health file of the patient and verifying the identity authenticity of the user side; the hybrid uplink-downlink medical information database consists of a block chain network and a cloud medical database; the identity authentication system consists of an identity verification center and a certificate issuing center. The system is beneficial to safely and quickly carrying out authorization and sharing of the electronic health files, and guarantees the privacy, the safety and the reliability of the electronic health files.

Description

Electronic health record authorization sharing and management system based on medical block chain
Technical Field
The invention belongs to the technical field of blockchains, and particularly relates to an electronic health file authorization sharing and management system based on a medical blockchain.
Background
In the prior art, health files and physical examination reports of patients are exchanged mainly through a hospital HIS system, patient information is subjected to closed circulation in the hospital HIS system, information sharing of a large health medical platform is avoided, and authorization and sharing of electronic health files cannot be achieved among different hospital HIS systems. In addition, electronic health archives are many to be saved in hospital local server or high in the clouds database, manage health archives's distribution through the HIS system, and data control right is mastered by the hospital alone, is difficult to guarantee patient's health archives's privacy and security, and has the problem of single point trouble.
Disclosure of Invention
The invention aims to provide an electronic health file authorization sharing and management system based on a medical block chain, which is favorable for safely and quickly carrying out electronic health file authorization sharing and ensures the privacy, the safety and the reliability of electronic health files.
In order to achieve the purpose, the invention adopts the technical scheme that: an electronic health file authorization sharing and management system based on a medical block chain comprises a user side, a medical information management system, a hybrid uplink-downlink medical information database and an identity authentication system;
the user side comprises a patient side and a medical service provider, namely a doctor side, the patient side and the doctor side are two main transaction initiators in the system, the patient side is used for browsing and authorizing the electronic health record, and the doctor side is used for creating, browsing and modifying the electronic health record;
the medical information management system is a platform for carrying out electronic health record related operation on a patient end and a doctor end and is used for sending the operation of the patient end and the doctor end to a hybrid chain up-chain down medical information database; the medical information management system is also an implementation platform of the electronic health file distributed encryption and decryption module, is cooperated with the identity authentication system, and is used for encrypting and decrypting the electronic health file of the patient and verifying the identity authenticity of the user side;
the hybrid uplink-downlink medical information database consists of a block chain network and a cloud medical database; the blockchain network is used to accomplish tasks including executing intelligent contracts, storing patient core medical data, verifying patient and doctor initiated operations, and adding new blockchain blocks; the cloud medical database is used for storing the linked medical data with the space occupation larger than a set value and generating a disposable URL (uniform resource locator) address for accessing the patient medical data stored in the cloud node under the link;
the identity authentication system consists of an identity verification center and a certificate issuing center; the identity authentication center is used for storing identity authentication materials related to the user and authenticating the identity information of the access user based on the stored identity authentication materials; the certificate authority provides effective identity certificates for participants in the block chain network on the basis of public key infrastructure, so that the identity verification center can recognize the identity of the participants and the authenticity of the user identity is guaranteed.
Further, the doctor end performs the operation related to the electronic health record in the system, and the method comprises the following steps:
A1) a doctor end logs in a medical information management system;
A2) the identity authentication system determines the authenticity of the identity of the doctor end by verifying the login information of the doctor end;
A3) after the verification is successful, the doctor end user logs in the medical information management system to create, browse or modify the electronic health record;
A4) the doctor end encrypts the related information of the electronic health record by using a symmetric key authorized by the patient, attaches signature information of the doctor end and then sends the signature information to a hybrid uplink-downlink medical information database;
A5) after receiving an operation application of a doctor end, a block chain network in a hybrid uplink-downlink medical information database verifies the authenticity of the identity of the doctor end through an identity authentication system according to signature information attached by a doctor;
A6) after the doctor identity verification is successful, the block chain network starts a consensus mechanism according to the intelligent contract content corresponding to the doctor operation so as to obtain the agreement of the peer node on the doctor operation;
A7) after the doctor operation is agreed, according to an intelligent contract, the block chain link points with the authorization permission of the patient add doctor operation generated data into respective block chains;
A8) if the doctor operates to create or modify the electronic health file, uploading data of which the space occupation is larger than a set value in the electronic health file to a cloud medical database; if the operation of the doctor is to browse the file, the cloud medical database returns a one-time URL address to the created new block;
A9) after the operation application of the doctor is linked to each block chain node, the block chain network sends a doctor related operation notice to the patient end through the medical information management system;
A10) and the block chain network returns the reply of the operation applied by the doctor to the doctor through the medical information management system so as to complete the closed loop of the electronic health record management at the doctor end.
Further, the patient end performs the electronic health record related operation in the system, which comprises the following steps:
B1) a patient logs in a medical information management system;
B2) the identity authentication system determines the authenticity of the identity of the patient end by verifying the login information of the patient;
B3) after the verification is successful, the patient end user logs in the medical information management system to browse or authorize the electronic health record operation;
B4) the authorization or browsing operation application of the patient end is attached with the signature information of the patient and sent to the block chain network through the medical information management system;
B5) after receiving the operation application of the patient end, the block chain network verifies the authenticity of the identity of the patient end according to the signature information attached to the patient through the identity authentication system;
B6) after the patient end identity verification is passed, the blockchain network sends a data calling application to the cloud medical database to obtain the relevant information of all the patient electronic health files;
B7) the hybrid uplink-downlink medical information database feeds back the operation result to the medical information management system; if the operation of the patient is authorization, returning an authorization success prompt; if the operation of the patient is to browse the file, the electronic health file is directly browsed in the medical information management system.
Furthermore, the electronic health file distributed encryption and decryption module is used for encrypting and decrypting all contents stored in the hybrid uplink-downlink medical information database and providing an identity for a user in the system; the electronic health file distributed encryption and decryption module guarantees safe sharing of the electronic health file through mixed use of an asymmetric encryption algorithm and a symmetric encryption algorithm and distribution of a secret key in the system.
Further, the specific steps of the user side generating the identity key in the medical information management system are as follows:
101) a user enters a medical information management system and registers an account by using a self identity;
102) the system being dependent on the identity of the userIdentification information generation identity identification key PAuWhile the system also generates an encryption key P for the user login informationpass(ii) a In addition, the system generates a pair of asymmetric public and private key pairs { P }pub，PpriH and a symmetric key PkThe system is used for sharing and encrypting the electronic health file;
103) system use PpubTo PkEncryption generation
Figure BDA0002778857610000031
Using PpassTo PpriPerform encryption generation
Figure BDA0002778857610000032
104) Generated secret key Ppub、
Figure BDA0002778857610000033
And
Figure BDA0002778857610000034
the information is packaged into a user registration request and then uploaded to an identity verification system;
105) after the identity authentication system receives the registration request, the system generates a new object on the block chain; including personal information of a user and a generated key P in an objectpubAnd
Figure BDA0002778857610000035
106) after the object is successfully generated, the system generates an identification certificate C for the user through a certificate authority to serve as an identification of the user in the block chain; identification certificate C is shared by public key P of userpubEncryption generation
Figure BDA0002778857610000036
Figure BDA0002778857610000037
And
Figure BDA0002778857610000038
stored in the authentication system for the user's identification.
Further, the key interaction steps of the patient authentication process in the system are as follows:
201) a user logs in a medical information management system;
202) the system generates a secret key P according to the login information of the userAuAnd PpassComparing the generated key with a stored key in an identity verification system to verify the authenticity of the user identity;
203) if the identity authentication fails, rejecting the user login request; if the authentication succeeds, the authentication system sends the encrypted identification certificate of the patient
Figure BDA0002778857610000041
And personal private key
Figure BDA0002778857610000042
Entering a medical information management system;
204) system use PpubAnd PpassKey pair encrypted identification certificate
Figure BDA0002778857610000043
And personal private key
Figure BDA0002778857610000044
Decrypting to obtain the user identification certificate C and the private key Ppri；
205) And the user acquires the identity recognition certificate C and obtains the permission of entering the block chain network.
Further, the system comprises the following specific steps of acquiring the authorization of the electronic health record of the patient by the doctor end user:
301) the doctor end initiates an electronic health record authorization request through the medical information management system;
302) the authorization request of the doctor is regarded as a block chain transaction and sent to a block chain network;
303) after the authorization transaction passes through a consensus mechanism in the block chain network, sending an authorization request of a doctor to a patient end;
304) if the patient end does not agree with the authorization, the process is terminated, and the system returns a notice of application rejection to the doctor end; if the patient agrees to the authorization, the patient end sends the shared secret key P to the blockchain network through the medical information management systemkA transaction request;
305) after the request is successfully sent, the medical information management system obtains the public key D of the medical end from the blockchain networkpub；
306) Secret key DpubAfter success, it is used to encrypt the patient key Pk(ii) a Generated encryption key
Figure BDA0002778857610000045
Is added to a shared key transaction generated in a blockchain network;
307) after the shared key transaction is sent to the blockchain network, according to the provision of the intelligent contract,
Figure BDA0002778857610000046
is added to the blockchain ledger; meanwhile, the doctor end user is added to the authorization list of the patient;
308) after the authorization is completed, the doctor end user receives an authorization success notice sent by the blockchain network through the medical information management system, and the doctor can obtain the permission of browsing the electronic health file of the patient.
Further, after obtaining the authorization of the electronic health record, the doctor initiates an application for browsing the patient record to the system, and the specific steps are as follows:
401) the medical end initiates an electronic health record browsing request through the medical information management system;
402) the medical information management system converts the doctor request into a block chain transaction and sends the block chain transaction to a block chain network;
403) after receiving a doctor request, an intelligent contract in the block chain network confirms whether the doctor is in an authorization list of a patient;
404) after the confirmation is passed, the blockchain network encrypts the patientElectronic health file
Figure BDA0002778857610000051
And an encryption key
Figure BDA0002778857610000052
Returning to the medical information management system of the doctor end;
405) public key D of system use doctor endpubDecrypting returned encryption keys
Figure BDA0002778857610000053
Deriving a secret Pk；
406) Key PkIs used for decrypting the electronic health record of the patient
Figure BDA0002778857610000054
Thereby finally obtaining the electronic health record R of the patient.
Further, the block chain link points of the block chain network are arranged in each hospital or community health service center, and all the nodes are connected with each other to form the block chain network.
Compared with the prior art, the invention has the following beneficial effects: the system can provide a safe and quick case authorization sharing mechanism for electronic health files existing in different hospital information management systems, and can provide electronic health files with consistent information and updated in real time for hospitals with different HIS systems on the premise of ensuring the privacy and the safety of electronic health cases of patients. The electronic health record encryption and decryption technology adopted by the system can ensure the privacy of the information of the relevant patients in the block chain network and the cloud database. Meanwhile, the authenticity of the user identity is guaranteed by establishing an identity authentication system, so that a malicious attacker is prevented from stealing the information of the patient. In addition, by establishing a hybrid uplink-downlink medical information database and combining the blockchain network with the cloud database, the content carrying capacity of the blockchain network is greatly improved, and the calling requirement of the electronic health record data is met. Therefore, the invention has strong practicability and wide application prospect.
Drawings
FIG. 1 is a system architecture diagram of an embodiment of the present invention.
Fig. 2 is a system work flow diagram of an embodiment of the present invention.
Detailed Description
The invention is described in further detail below with reference to the figures and the embodiments.
Referring to fig. 1, the present invention provides an electronic health record authorization sharing and management system based on a medical block chain, which includes a user end, a medical information management system, a hybrid uplink-downlink medical information database, and an identity authentication system.
The user side comprises a patient side and a medical service provider, namely a doctor side, the patient side and the doctor side are two main transaction initiators in the system, the patient side is used for browsing and authorizing the electronic health record, and the doctor side is used for creating, browsing and modifying the electronic health record.
The medical information management system is a platform for carrying out electronic health record related operation on a patient end and a doctor end and is used for sending the operation of the patient end and the doctor end to a hybrid chain up-chain down medical information database; the medical information management system is also an implementation platform of the electronic health record distributed encryption and decryption module, cooperates with the identity authentication system, and is used for encrypting and decrypting the electronic health record of the patient and verifying the identity authenticity of the user side.
The hybrid uplink-downlink medical information database is the core of the system and consists of a block chain network and a cloud medical database; the blockchain network is responsible for executing tasks such as intelligent contracts (Smart contracts), storing core medical data of patients, verifying operations (transactions) initiated by patients and doctors, adding new blockchain blocks and the like; the block chain links are arranged in each hospital or community health service center and are connected with each other to form a block chain network; the cloud medical database is used for storing the medical data under the chain, the occupied space of which is larger than a set value, such as an electronic Computed Tomography (CT) image, an X-ray film, Magnetic Resonance Imaging (MRI) and the like, and is also used for generating a disposable URL (uniform resource locator) address which is used for accessing the medical data of the patient stored in the cloud node under the chain.
The identity Authentication system consists of an identity Authentication center (Authentication Authority) and a certificate Authority (Certification Authority); the identity authentication center is used for storing identity authentication materials related to the user, such as a user name and a password, face identification information, fingerprint information and the like, and authenticating the identity information of the access user based on the stored identity authentication materials; the certificate authority provides effective identity certificates for participants in the block chain network on the basis of Public Key Infrastructure (Public Key Infrastructure), so that the identity of the participants can be identified by the identity verification center, and the authenticity of the identity of the users is guaranteed.
In the system of the present invention, the flow of the operations related to the electronic health record performed by the patient side and the doctor side is shown in fig. 2.
The doctor end carries out the operation related to the electronic health record in the system, and the operation comprises the following steps:
A1) the medical doctor end logs in the medical information management system through a user name and a password or face recognition and the like;
A2) the identity authentication system determines the authenticity of the identity of the doctor end by verifying the login information of the doctor end;
A3) after the verification is successful, the doctor end user logs in the medical information management system to create, browse or modify the electronic health record;
A4) the doctor end encrypts the related information of the electronic health record by using a symmetric key authorized by the patient, attaches signature information of the doctor end and then sends the signature information to a hybrid uplink-downlink medical information database;
A5) after receiving an operation application of a doctor end, a block chain network in a hybrid uplink-downlink medical information database verifies the authenticity of the identity of the doctor end through an identity authentication system according to signature information attached by a doctor;
A6) after the doctor identity authentication is successful, the block chain network starts a Consensus mechanism (Consensus Protocol) according to the intelligent contract content corresponding to the doctor operation so as to obtain the agreement of the peer node on the doctor operation;
A7) after the doctor operation is agreed, according to an intelligent contract, the block chain link points with the authorization permission of the patient add doctor operation generated data into respective block chains;
A8) if the doctor operates to create or modify the electronic health file, uploading data of which the space occupation is larger than a set value in the electronic health file to a cloud medical database; if the operation of the doctor is to browse the file, the cloud medical database returns a one-time URL address to the created new block;
A9) after the operation application of the doctor is linked to each block chain node, the block chain network sends a doctor related operation notice to the patient end through the medical information management system;
A10) the block chain network returns a reply of an operation applied by a doctor to the doctor through the medical information management system so as to complete the closed loop of the electronic health file management at the doctor end; for example, if the doctor requests to operate to view the patient's electronic health profile, the doctor may review the patient profile on the medical information management system.
The operation flow of the patient end user in the system is similar to that of the doctor end, but the patient end does not need to go through a consensus mechanism in the blockchain network when executing the operation application.
The patient end performs the electronic health record related operation in the system, and the method comprises the following steps:
B1) a patient logs in a medical information management system in a user name and password or face recognition mode and the like;
B2) the identity authentication system determines the authenticity of the identity of the patient end by verifying the login information of the patient;
B3) after the verification is successful, the patient end user logs in the medical information management system to browse or authorize the electronic health record operation;
B4) the authorization or browsing operation application of the patient end is attached with patient-specific signature information and is sent to the blockchain network through the medical information management system;
B5) after receiving the operation application of the patient end, the block chain network verifies the authenticity of the identity of the patient end according to the signature information attached to the patient through the identity authentication system;
B6) after the patient end identity verification is passed, the blockchain network sends a data calling application to the cloud medical database to obtain the relevant information of all the patient electronic health files;
B7) the hybrid uplink-downlink medical information database feeds back the operation result to the medical information management system; if the operation of the patient is authorization, returning an authorization success prompt; if the operation of the patient is to browse the file, the electronic health file is directly browsed in the medical information management system.
The electronic health file distributed encryption and decryption module is used for encrypting and decrypting all contents stored in the hybrid uplink-downlink medical information database and providing identification for users in the system.
The core of the electronic health file distributed encryption and decryption technology is that in an electronic health file authorization sharing and management system based on a medical block chain, the safe sharing of the electronic health file is guaranteed through the mixed use of an asymmetric encryption algorithm and a symmetric encryption algorithm and the specific distribution of a secret key.
1. Encryption and decryption process during user side registration
The specific steps of generating the identity key in the medical information management system by the user side are as follows:
101) a user enters a medical information management system and registers an account number, such as an identity card number, face identification information and the like, by using a special identity of the user;
102) the system generates an identification key P according to the user identification informationAuWhile the system also generates an encryption key P for the user login informationpass(ii) a In addition, the system generates a pair of asymmetric public and private key pairs { P }pub，PpriH and a symmetric key PkThe system is used for sharing and encrypting the electronic health file;
103) system use PpubTo PkEncryption generation
Figure BDA0002778857610000081
Using PpassTo PpriPerform encryption generation
Figure BDA0002778857610000082
104) Generated secret key Ppub、
Figure BDA0002778857610000083
And
Figure BDA0002778857610000084
the information is packaged into a user registration request and then uploaded to an identity verification system;
105) after the identity authentication system receives the registration request, the system generates a new object on the block chain; including personal information of a user and a generated key P in an objectpubAnd
Figure BDA0002778857610000085
106) after the object is successfully generated, the system generates an identification certificate C for the user through a certificate authority to serve as an identification of the user in the block chain; identification certificate C is shared by public key P of userpubEncryption generation
Figure BDA0002778857610000086
Figure BDA0002778857610000087
And
Figure BDA0002778857610000088
stored in the authentication system for the user's identification.
2. Encryption and decryption process during user terminal identity verification
The key interaction steps of the patient authentication process in the system are as follows:
201) a user logs in a medical information management system by using information such as account passwords or face recognition;
202) the system generates a secret key P according to the login information of the userAuAnd PpassComparing the generated key with a stored key in an identity verification system to verify the authenticity of the user identity;
203) If the identity authentication fails, rejecting the user login request; if the authentication succeeds, the authentication system sends the encrypted identification certificate of the patient
Figure BDA0002778857610000089
And personal private key
Figure BDA00027788576100000810
Entering a medical information management system;
204) system use PpubAnd PpassKey pair encrypted identification certificate
Figure BDA00027788576100000811
And personal private key
Figure BDA00027788576100000812
Decrypting to obtain the user identification certificate C and the private key Ppri；
205) And the user acquires the identity recognition certificate C and obtains the permission of entering the block chain network.
3. Encryption and decryption process during authorization of electronic health file
The system comprises the following specific steps that a doctor end user obtains the authorization of the electronic health record of a patient:
301) the doctor end initiates an electronic health record authorization request through the medical information management system;
302) the authorization request of the doctor is regarded as a block chain transaction and sent to a block chain network;
303) after the authorization transaction passes through a consensus mechanism in the block chain network, sending an authorization request of a doctor to a patient end;
304) if the patient end does not agree with the authorization, the process is terminated, and the system returns a notice of application rejection to the doctor end; if the patient agrees to the authorization, the patient end sends the shared secret key P to the blockchain network through the medical information management systemkA transaction request;
305) after the request is successfully sent, the medical information management system obtains the public key D of the medical end from the blockchain networkpub；
306) Secret key DpubAfter success, it is used to encrypt the patient key Pk(ii) a Generated encryption key
Figure BDA0002778857610000091
Is added to a shared key transaction generated in a blockchain network;
307) after the shared key transaction is sent to the blockchain network, according to the provision of the intelligent contract,
Figure BDA0002778857610000092
is added to the blockchain ledger; meanwhile, the doctor end user is added to the authorization list of the patient;
308) after the authorization is completed, the doctor end user receives an authorization success notice sent by the blockchain network through the medical information management system, and the doctor can obtain the permission of browsing the electronic health file of the patient.
4. Encryption and decryption process for browsing electronic health record
After obtaining the authorization of the electronic health record, a doctor initiates an application for browsing the patient record to the system, and the specific steps are as follows:
401) the medical end initiates an electronic health record browsing request through the medical information management system;
402) the medical information management system converts the doctor request into a block chain transaction and sends the block chain transaction to a block chain network;
403) after receiving a doctor request, an intelligent contract in the block chain network confirms whether the doctor is in an authorization list of a patient;
404) after the confirmation is passed, the blockchain network encrypts the electronic health record of the patient
Figure BDA0002778857610000093
And an encryption key
Figure BDA0002778857610000094
Returning to the medical information management system of the doctor end;
405) public key D of system use doctor endpubDecrypting returned encryption keys
Figure BDA0002778857610000095
Deriving a secret Pk；
406) Key PkIs used for decrypting the electronic health record of the patient
Figure BDA0002778857610000096
Thereby finally obtaining the electronic health record R of the patient.
The above are preferred embodiments of the present invention, and all changes made according to the technical scheme of the present invention that produce functional effects do not exceed the scope of the technical scheme of the present invention belong to the protection scope of the present invention.

Claims (9)

1. An electronic health record authorization sharing and management system based on a medical block chain is characterized by comprising a user side, a medical information management system, a hybrid chain up-chain down medical information database and an identity authentication system;
the user side comprises a patient side and a medical service provider, namely a doctor side, the patient side and the doctor side are two main transaction initiators in the system, the patient side is used for browsing and authorizing the electronic health record, and the doctor side is used for creating, browsing and modifying the electronic health record;
the medical information management system is a platform for carrying out electronic health record related operation on a patient end and a doctor end and is used for sending the operation of the patient end and the doctor end to a hybrid chain up-chain down medical information database; the medical information management system is also an implementation platform of the electronic health file distributed encryption and decryption module, is cooperated with the identity authentication system, and is used for encrypting and decrypting the electronic health file of the patient and verifying the identity authenticity of the user side;
the hybrid uplink-downlink medical information database consists of a block chain network and a cloud medical database; the blockchain network is used to accomplish tasks including executing intelligent contracts, storing patient core medical data, verifying patient and doctor initiated operations, and adding new blockchain blocks; the cloud medical database is used for storing the linked medical data with the space occupation larger than a set value and generating a disposable URL (uniform resource locator) address for accessing the patient medical data stored in the cloud node under the link;
the identity authentication system consists of an identity verification center and a certificate issuing center; the identity authentication center is used for storing identity authentication materials related to the user and authenticating the identity information of the access user based on the stored identity authentication materials; the certificate authority provides effective identity certificates for participants in the block chain network on the basis of public key infrastructure, so that the identity verification center can recognize the identity of the participants and the authenticity of the user identity is guaranteed.
2. The system for authorized sharing and management of an electronic health record based on a medical block chain as claimed in claim 1, wherein the doctor end performs the electronic health record related operation in the system including the following steps:
A1) a doctor end logs in a medical information management system;
A2) the identity authentication system determines the authenticity of the identity of the doctor end by verifying the login information of the doctor end;
A3) after the verification is successful, the doctor end user logs in the medical information management system to create, browse or modify the electronic health record;
A4) the doctor end encrypts the related information of the electronic health record by using a symmetric key authorized by the patient, attaches signature information of the doctor end and then sends the signature information to a hybrid uplink-downlink medical information database;
A5) after receiving an operation application of a doctor end, a block chain network in a hybrid uplink-downlink medical information database verifies the authenticity of the identity of the doctor end through an identity authentication system according to signature information attached by a doctor;
A6) after the doctor identity verification is successful, the block chain network starts a consensus mechanism according to the intelligent contract content corresponding to the doctor operation so as to obtain the agreement of the peer node on the doctor operation;
A7) after the doctor operation is agreed, according to an intelligent contract, the block chain link points with the authorization permission of the patient add doctor operation generated data into respective block chains;
A8) if the doctor operates to create or modify the electronic health file, uploading data of which the space occupation is larger than a set value in the electronic health file to a cloud medical database; if the operation of the doctor is to browse the file, the cloud medical database returns a one-time URL address to the created new block;
A9) after the operation application of the doctor is linked to each block chain node, the block chain network sends a doctor related operation notice to the patient end through the medical information management system;
A10) and the block chain network returns the reply of the operation applied by the doctor to the doctor through the medical information management system so as to complete the closed loop of the electronic health record management at the doctor end.
3. The system for authorized sharing and management of an electronic health record based on a medical blockchain as claimed in claim 1, wherein the patient end performs the electronic health record related operation in the system including the following steps:
B1) a patient logs in a medical information management system;
B2) the identity authentication system determines the authenticity of the identity of the patient end by verifying the login information of the patient;
B3) after the verification is successful, the patient end user logs in the medical information management system to browse or authorize the electronic health record operation;
B4) the authorization or browsing operation application of the patient end is attached with the signature information of the patient and sent to the block chain network through the medical information management system;
B5) after receiving the operation application of the patient end, the block chain network verifies the authenticity of the identity of the patient end according to the signature information attached to the patient through the identity authentication system;
B6) after the patient end identity verification is passed, the blockchain network sends a data calling application to the cloud medical database to obtain the relevant information of all the patient electronic health files;
B7) the hybrid uplink-downlink medical information database feeds back the operation result to the medical information management system; if the operation of the patient is authorization, returning an authorization success prompt; if the operation of the patient is to browse the file, the electronic health file is directly browsed in the medical information management system.
4. The medical blockchain-based electronic health file authorization sharing and management system according to claim 1, wherein the electronic health file distributed encryption and decryption module is configured to encrypt and decrypt all contents stored in the hybrid uplink-downlink medical information database and provide an identity for a user in the system; the electronic health file distributed encryption and decryption module guarantees safe sharing of the electronic health file through mixed use of an asymmetric encryption algorithm and a symmetric encryption algorithm and distribution of a secret key in the system.
5. The system for authorized sharing and management of an electronic health record based on a medical block chain as claimed in claim 4, wherein the specific steps of the user end generating the identity key in the medical information management system are as follows:
101) a user enters a medical information management system and registers an account by using a self identity;
102) the system generates an identification key P according to the user identification informationAuWhile the system also generates an encryption key P for the user login informationpass(ii) a In addition, the system generates a pair of asymmetric public and private key pairs { P }pub，PpriH and a symmetric key PkThe system is used for sharing and encrypting the electronic health file;
103) system use PpubTo PkEncryption generation
Figure FDA0002778857600000031
Using PpassTo PpriPerform encryption generation
Figure FDA0002778857600000032
104) Generated secret key Ppub、
Figure FDA0002778857600000033
And
Figure FDA0002778857600000034
the information is packaged into a user registration request and then uploaded to an identity verification system;
105) after the identity authentication system receives the registration request, the system generates a new object on the block chain; including personal information of a user and a generated key P in an objectpubAnd
Figure FDA0002778857600000035
106) after the object is successfully generated, the system generates an identification certificate C for the user through a certificate authority to serve as an identification of the user in the block chain; identification certificate C is shared by public key P of userpubEncryption generation
Figure FDA0002778857600000036
And
Figure FDA0002778857600000037
stored in the authentication system for the user's identification.
6. The system for authorized sharing and management of an electronic health record based on a medical block chain as claimed in claim 4, wherein the key interaction steps of the patient authentication process in the system are as follows:
201) a user logs in a medical information management system;
202) the system generates a secret key P according to the login information of the userAuAnd PpassComparing the generated key with a stored key in an identity verification system to verify the authenticity of the user identity;
203) if the identity authentication fails, rejecting the user login request; if the authentication succeeds, the authentication system sends the encrypted identification certificate of the patient
Figure FDA0002778857600000038
And personal private key
Figure FDA0002778857600000039
Entering a medical information management system;
204) system use PpubAnd PpassKey pair encrypted identification certificate
Figure FDA00027788576000000310
And personal private key
Figure FDA00027788576000000311
Decrypting to obtain the user identification certificate C and the private key Ppri；
205) And the user acquires the identity recognition certificate C and obtains the permission of entering the block chain network.
7. The system for sharing and managing electronic health record authorization based on medical blockchain according to claim 4, wherein the system comprises the following steps of acquiring the authorization of the electronic health record of the patient by the end-user of the doctor:
301) the doctor end initiates an electronic health record authorization request through the medical information management system;
302) the authorization request of the doctor is regarded as a block chain transaction and sent to a block chain network;
303) after the authorization transaction passes through a consensus mechanism in the block chain network, sending an authorization request of a doctor to a patient end;
304) if the patient end does not agree with the authorization, the process is terminated, and the system returns a notice of application rejection to the doctor end; if the patient agrees to the authorization, the patient end sends the shared secret key P to the blockchain network through the medical information management systemkA transaction request;
305) after the request is successfully sent, the medical information management system obtains the public key D of the medical end from the blockchain networkpub；
306) Secret key DpubAfter success, it is used to encrypt the patient key Pk(ii) a Generated encryption key
Figure FDA0002778857600000041
Is added to a shared key transaction generated in a blockchain network;
307) after the shared key transaction is sent to the blockchain network, according to the provision of the intelligent contract,
Figure FDA0002778857600000042
is added to the blockchain ledger; meanwhile, the doctor end user is added to the authorization list of the patient;
308) after the authorization is completed, the doctor end user receives an authorization success notice sent by the blockchain network through the medical information management system, and the doctor can obtain the permission of browsing the electronic health file of the patient.
8. The medical blockchain-based electronic health record authorization sharing and management system according to claim 4, wherein after obtaining the electronic health record authorization, the doctor initiates a request for browsing the patient record to the system as follows:
401) the medical end initiates an electronic health record browsing request through the medical information management system;
402) the medical information management system converts the doctor request into a block chain transaction and sends the block chain transaction to a block chain network;
403) after receiving a doctor request, an intelligent contract in the block chain network confirms whether the doctor is in an authorization list of a patient;
404) after the confirmation is passed, the blockchain network encrypts the electronic health record of the patient
Figure FDA0002778857600000045
And an encryption key
Figure FDA0002778857600000043
Returning to the medical information management system of the doctor end;
405) public key D of system use doctor endpubDecrypting returned encryption keys
Figure FDA0002778857600000044
Deriving a secret Pk；
406) Key PkIs used for decrypting the electronic health record of the patient
Figure FDA0002778857600000046
Thereby finally obtaining the electronic health record R of the patient.
9. The medical blockchain-based electronic health file authorization sharing and management system according to claim 1, wherein the blockchain link points of the blockchain network are arranged in each hospital or community health service center, and the nodes are connected with each other to form the blockchain network.
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