eHealth Integrity Model Based on Permissioned Blockchain

(1) Background: Large eHealth systems should have a mechanism to detect unauthorized changes in patients’ medical documentation, access permissions, and logs. This is due to the fact that modern eHealth systems are connected with many healthcare providers and sites. (2) Methods: Design-science methodology was used to create an integrity-protection service model based on blockchain technology. Based on the problem of transactional transparency, requirements were specified and a model was designed. After that, the model’s security and performance were evaluated. (3) Results: a blockchain-based eHealth integrity model for ensuring information integrity in eHealth systems that uses a permissioned blockchain with off-chain information storage was created. In contrast to existing solutions, the proposed model allows information removal, which in many countries’ eHealth systems is a legal requirement, and is based on a blockchain using the Practical Byzantine Fault Tolerant algorithm. (4) Conclusion: A blockchain can be used to store medical data or only security-related data. In the proposed model, a blockchain is mainly used to implement a data-integrity service. This service can be implemented using other mechanisms, but a blockchain provides a solution that does not require trusted third parties, works in a distributed eHealth environment, and supports document removal