以患者为中心基于IPFS和区块链的医疗信息共享方案  

Patient-centric medical information sharing scheme based on IPFS and blockchain

作　　者：杜晓玉[1,2] 刘帅起 韩志杰 霍振祥 王玉璟 DU Xiaoyu;LIU Shuaiqi;HAN Zhijie;HUO Zhenxiang;WANG Yujing(School of Computer and Information Engineering,Henan University,Kaifeng Henan 475004,China;Henan Engineering Research Center for Industrial Internet of Things,Zhengzhou Henan 450046,China;School of Software,Henan University,Kaifeng Henan 475004,China)

机构地区：[1]河南大学计算机与信息工程学院,河南开封475004 [2]河南省工业互联网工程技术研究中心,郑州450046 [3]河南大学软件学院,河南开封475004

出　　处：《计算机应用》2024年第10期3122-3133,共12页journal of Computer Applications

基　　金：河南省重点研发与推广专项(232102211009,232102210071,222102210272);开封市科技计划发展项目(2201010)。

摘　　要：医疗机构之间的电子病历(EMR)存储与共享,对实现跨院诊断和分级诊疗至关重要,可以有效减轻患者的负担和避免重复检查。针对EMR难以安全存储和共享的问题,提出一种以患者为中心基于星际文件系统(IPFS)和区块链的EMR安全存储与高效共享(PCIB-MIS)方案。首先,应用混合加密策略,以安全存储与共享EMR,缩减加解密时间;其次,通过区块链存储EMR的密文索引;再次,结合联盟链与私有链以降低存储压力,EMR索引存于医院私有链;最后,EMR密文存放于IPFS,确保数据安全和不可篡改。当需要跨院调取EMR时,进行以联盟链为中心的跨链调用与代理重加密。安全性分析与实验结果表明,仅被授权医生可获取患者病历;与公钥加密算法RSA相比,将加解密时间降低至毫秒级别;与将EMR单一存放于区块链上的方案相比,节省了98.8%的区块存储空间。所提方案可以实现病历安全存储与共享,大幅压缩EMR加解密时间和减轻区块链存储压力。The storage and sharing of Electronic Medical Records(EMR)among healthcare institutions plays a crucial role in achieving cross-hospital diagnosis and hierarchical treatment,effectively reducing the burden on patients and avoiding redundant examinations.To address the difficulty of securely storing and sharing EMR,a patient-centric scheme for secure storage and efficient sharing of EMR,based on the InterPlanetary File System(IPFS)and blockchain,named Patient-Centric Medical Information Sharing based on IPFS and Blockchain(PCIB-MIS),was proposed.First,a hybrid encryption strategy was employed,securely storing and sharing EMR while reducing the time for encryption and decryption.Then,the ciphertext index of EMR was stored using blockchain technology.Next,a combination of consortium and private blockchains was utilized to decrease storage pressure,with EMR indices being stored on hospitals’private chains.Finally,EMR ciphertext was stored on IPFS,ensuring data security and immutability.When retrieval of EMR across hospitals was needed,cross-chain calls and proxy re-encryption centered around the consortium chain were conducted.Security analysis and experimental results demonstrate that only authorized physicians could access patient records.Compared to the public key encryption algorithm RSA(Rivest-Shamir-Adleman)scheme,the encryption and decryption time are reduced to milliseconds,and storing EMR on this system saves 98.8%of block storage space compared to storing it solely on the blockchain.The proposed scheme effectively achieves secure storage and sharing of medical records,substantially compresses EMR encryption and decryption time,and alleviates blockchain storage pressure.

关 键 词：区块链 星际文件系统 混合加密 医疗信息共享 可搜索加密 

分 类 号：TP309.2[自动化与计算机技术—计算机系统结构]