Decentralized Electronic Health Records on NeoFS (OpenEHR over the blockchain)

[grantshares-dapp]

Abstract

ipEHR is about putting patients first, but gives opportunities to all parties of the medical market to establish trustless, safe, event-based data exchange respecting data sovereignty. Patients have full unalienable control over their health records and other parties can establish event-based interaction with ZK data feeds.

Under this grant we plan to add and test the NeoFS as a decentralized EHR repository.

Proposal Information

Description

Today common HMS applications store patients’ data in a local or a cloud DB which creates significant security, reliability and operational risks. Centralized storage and access rights administration of sensitive medical data creates additional challenges:

-    Administrative overheard due to the rights provisioning on per patients/per record level.

-    Patients lack control and visibility over who has access to their data which goes against natural data subject rights.

-    Superuser access for DB and LDAP (access rights catalogue) create additional security risks.

-    In case of a data breach full registry will be compromised.

 

On the other hand the entire Health industry is characterized by revenue growth slowdown and increase of operating costs. Companies of the Health sector, medical insurance and pharmaceutical industries seek to use AI and bring more automation into their complex and often archaic processes. However, their efforts have been made ineffective by poor quality and availability of personal medical data caused by a combination of institution- or practitioner-centric architecture of most of the existing IT systems and a large number of independent and disconnected service providers. This results in data that is unstructured, ridden with mistakes and duplications, of unknown validity and relevance, with gaps, no timing of entrees and changes, kept by independent and unrelated organizations.

 

In today's ever-evolving healthcare landscape OpenEHR specification stands as a versatile solution, offering transformative advantages, promoting interoperability, data quality, and patient-centered care. It's poised to shape the future of healthcare positively, but still there are some tasks to be solved.

 

Bela Supernova has suggested that a public blockchain can help open access to the technology for a wider range of medical entities as well as individuals. This will address both the issues of interaction between medical market institutions and the development and access to a unified medical data repository. With the support of Better Care, BSN has developed and tested the concept of a decentralized Electronic Health Records data warehouse with the OpenEHR standard inside – the ipEHR (Inter Planetary Electronic Health Records, in line with the technology underlying decentralized data storage, IPFS).

 

The IPEHR proposes an alternative way of storing the data registry: personal EHRs are stored in a blockchain (currently Filecoin) and accessed directly by stakeholders according to their access rights granted by EHRs owners (patients). Access rights and documents’ indexes are stored in smart contracts (currently FEVM). Every data subject has full unalienable control over his data and manage access rights on a personal level.

Until today BSN have developed a PoC with described main features:

1. A decentralized encrypted data storage on the FIL network using the OpenEHR format (we’ve implemented AQL according to the openEHR protocol: sufficient to demonstrate the system's capabilities to integrate with OpenEHR compatible HMS applications and store EHR files in the
   FIL network);

2. A client app for access management to private EHRs with decentralized access rights;

3. EHR indexes Smart Contract for ZK Data Exchange;

4. A ChainLink publisher that pushes public statistical data from stored EHRs to the Chainlink network;

Here’s the Github repo of the project: https://github.com/bsn-si/IPEHR-gateway

Here’s a short demo video: https://youtu.be/qZQ8BWzT4SU

Motivation

Currently, ipEHR is in the Proof of Concept stage and the team is heading to piloting with Health industry partners.

One of the current tasks is to diversify the technology by adopting the ipEHR to different storage networks. This, first of all, will allow to overcome Filecoin constraints like targeting to large files storage, hours-long contracts signing or poor file lifecycle management.
Secondly, we believe that such diversification can dramatically increase the availability of ipEHR for users by removing the “vendor lock” for the blockchain infrastructure used.

Goals

The main goal of the project is to benefit from Workers’ Compensation, Casualty and Health Insurance value creation as a provider of the enabling technological solution.

Workers‘ Compensation Insurance, today a $50 billion industry, stands to more than double its value over the next few years if it uses the opportunity to modernize its operations using blockchain, smart contracts and AI as enablers. Health and Casualty Insurance sectors are much larger, experience very similar challenges and ipEHR could lately expand to these sectors as well as to re-insurance after we establish good traction in WCI.
For the operating blockchain ipEHR in next few years could bring dramaticlal increaese to the transactions and stored capacities count.

Deliverables & Roadmap

Right now, the ipEHR project is in its Proof of Concept (POC) state, so the user’s accounts (represented by user wallets and OpenEHR IDs) are managed centralized on the ipEHR gateway.

Under this grant BSN will complete the following tasks:

-add functionality to the ipEHR gateway to store personal EHRs in the NeoFS with accounts represented by the Neo wallets;

-deploy the ipEHR smart contracts to the Neo network.

Milestone 1 – NeoFS integration

Estimated duration: up to 2 months

FTE: 2,25

Costs: 18,000 USD (estimated as 160 hours(FTE) * 2,25* 50USD/hour)

The solution will encrypt personal EHR data with Neo user’s key on the ipEHR gateway and store it in the NeoFS.
This deliverable will include the following:

• Changing the built in user registration algorithm from FIL wallet creation to that used in the Neo network;
• Changing the Lotus Node API to the NeoFS API for working with files and redeveloping the download algorithm (this point will eliminate IPFS);
• Changing the file search algorithm from IPFS+FIL to direct search in the NeoFS;
• Redevelopment of the smart contract, that will store documents meta data according to the NeoFS specifics.

Additionally we will develop the deleting files functionality according to the NeoFS documentation, as this function is not considered by the current solution with FIL.

Milestone 2 – Smart contracts fork to Neo

Estimated duration: up to 2 months

FTE: 2

Costs: 16,000 USD (estimated as 160 hours(FTE) * 2 * 50USD/hour)

ipEHR operates with 4 smart contracts:
EHR indexer: 0x28668f2C40b7FB018F109cC5b2A14C951ff78c91

Users: 0x1B89Ec21E1A0e3E85038daEdf5cA3feF4F087957

AccessStore: 0x380ce0529022b4DeEE67A601D1FA1be3B3d2D781

DataStore: 0x906e66Cb9937c1891aC63576B8C082eedB37DF1e

We will redevelop and deploy these contracts to the Neo test net according to the Neo specifics.

Deliverables Verifiability

We will provide inline documentation of the code and a basic tutorial that explains how the developed features work. Core functions will be covered by unit tests to ensure new functionality and robustness. We will describe how to run these tests. Each milestone will be presented with the corresponding .md file in the mail Github repository with all related info and a demo video.

Budget Plan

• The grant will be supported by 1 PM, 3 developers and 1 QA. The whole budget will be spent for the team salary. The price is based on the FTE count and the 50USD/hour rate.

About You / Your Organization

• Entity Name: BELA SUPERNOVA, sistemske rešitve d.o.o. (Slovenia)
• Website: https://bsn.si
• GitHub Organization (if applicable): https://github.com/bsn-si

Short-Bio

Through the years, BSN has emerged as a valuable contributor to web3 ecosystems, establishing ourselves as a trusted partner for developing customized and corporate blockchain solutions. In our portfolio, we showcase a range of successful corporate crypto solutions, alongside open source projects that have been developed under grants programs from esteemed entities like FileCoin, ChainLink, Polkadot, Tgrade and SIA.

Portfolio of Projects / Past Experience

1. Our team has developed the DOINGUD NFT marketplace: https://doingud.com/

2. We are currently developing a browser extension based light data wallet for the SIA network, that doesn't need a local SIA node for storing files: https://github.com/bsn-si/sia-datawallet-extension

3. We have delivered several dapps on the POC stage:

• coupon system for cash-to-crypto on-ramp OCEX (Ink!): https://github.com/bsn-si/ocex-activation

• ZK evidence of delivery for crypto delivery services Figaro (CosmWasm!): https://github.com/bsn-si/figaro-cli

• a blockchain based password manager Rubeus Keeper (Ink!): https://github.com/bsn-si/rubeus-client

• a crypto based p2p messenger Diffy chat (Substrate): https://github.com/Belsoft-rs/diffychat-client

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Proposal Info 📋

• Proposal Type: request-for-funding

• Amount Requested: 5000

• Token: 0xef4073a0f2b305a38ec4050e4d3d28bc40ea63f5 (NEO)

• Receiver Address: Ni3ZCGAUtRgCThMiB9gBizhn83iTaHEWaC (0x7cad32062bdc97d69782624533c2f4a06a11c2f2)

• Created by: @dsrdrk11a 🚀

• Raw Intents: 👀

[ {
  "target_contract" : "0x6276c1e3a68280bc6c9c00df755fb691be1162ef",
  "method" : "releaseTokens",
  "params" : [ {
    "type" : "Hash160",
    "value" : "ef4073a0f2b305a38ec4050e4d3d28bc40ea63f5"
  }, {
    "type" : "Hash160",
    "value" : "7cad32062bdc97d69782624533c2f4a06a11c2f2"
  }, {
    "type" : "Integer",
    "value" : "5000"
  } ],
  "call_flags" : 15
} ]

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👇 React with 👍 if you liked it, or 👎 if you think this proposal can be enhanced!

[roman-khimov]

The concept is appealing, but:

• anything health-related is heavily regulated everywhere, so unless there is some clear way to integrate this somewhere it's likely to stay at POC stage
• the budget requested is not a small one (for Grantshares), either it needs to be reduced or split among several smaller proposals
• the project is rather big in scope, but I don't see bsn.si being concentrated on it specifically

Too risky for me.

[dsrdrk11a]

@roman-khimov thank you for your opinion.
You are right - health industry is heavily regulated. We see the US market as our target, specifically the WorkComp industry, as you can see in our application. We have discussed this with some key persons of this market and our solution could fit all the regulations. So now we are in the process of securing a pilot with a blood analysis lab. I can not public the details now, as we have an NDA, but this pilot is about making a decentraized repository of medical data, that can be accessed by other players.

What about other projects - I've just showed our competences in web3 technologies, but the ipEHR project has a separate team working on it. Generally our company was born from a classic software development company under customers' RFPs, so we have plenty of experience and I showed just those parts, that were developed under an open source license. Within the company there are always 3-4 separate teams, united only by common CTO, PO and a delivery lead.

[csmuller]

I like the project and it's goals and I would def like to see NeoFS being used additionally to Filecoin/IPFS. But, I also agree with @roman-khimov that at this PoC stage this grant would be risky for GrantShares. As far as I can tell the project was funded by grants so far. Although you are doing a pilot now, the future success of the project seems very uncertain to me.
IMO, it makes more sense to prove the value of the product on the market first before technically improving it by integrating Neo and NeoFS.