一种病人可控的电子病历安全访问方案

部分病人对其电子病历访问有全程管控的特殊需求，而现有云环境下的电子病历共享系统却无法满足这一需求，于是提出了一种基于超级账本和星际文件系统的电子病历安全访问方案HyperEHR.该方案设计了由病历请求者所在机构以及病人双重审核且由病人决定病历最终访问权的方法.为保证跨机构之间的医疗数据安全互访，将病历生成、更新以及访问等信息存储在联盟链区块中，而将各医院、诊所产生的具体病历信息和访问控制策略加密存储在云端星际文件系统中.系统实现及分析表明：该方案有较好的可扩展性、互操作性及安全性，可满足病人对其医疗数据访问的管控，有效防止病历隐私泄露.

A Patient-Controlled Security Access Mechanism for Electronic Health Records

In the existing cloud environment, the special requirements of patients to make full control of his/her electronic health record can hardly be fulfilled. In order to solve this problem, a secure access scheme HyperEHR based on Hyperledger fabric and interplanetary file system (IPFS) is proposed. In the proposal, the medical record requester first needs to obtain the consent of his/her organization, and the patient have the final right to make the decision of accessing permission. To ensure the security of cross-organization medical data access, information like medical record generation, update and access is stored in collaborative blockchain. Moreover, specific medical record information and access control policies generated by hospitals and clinics are encrypted and stored in the cloud interplanetary file system. System implementation and analysis show that the scheme has good scalability, interoperability and security. HyperEHR can not only help patient to make control of his/her medical data accessing, but also prevent the privacy disclosure of electronic health record effectively.