The Application and Implementation of Blockchain Techniques in the

Medical Industry

Zihao Jing

Beihang University, Beijing 100191, China

Keywords: Blockchain Technology, Ethereum Smart Contracts, Electronic Medical Records, Electronic Vaccine

Passports.

Abstract: To explore the new application ideas that blockchain technology brings to the medical field, this paper ana-

lyzes the emergence and development of blockchain technology, paying attention to the gradual maturity of

this technology and its application in digital currency, digital identity verification, finance, trade and other

scenarios, has received extensive attention. In the medical field, although blockchain technology entered the

medical field relatively late, fortunately, blockchain technology may gradually replace HIE, APCD and other

medical and health organizations. In the future, it is no longer necessary to run an organization to verify the

identity of users. Credibility and veracity of information. Using blockchain technology not only saves costs

by eliminating these intermediaries, but also improves data security. This paper will analyze the system design

of electronic health records in detail. In particular, the consensus, immutability, and security of data systems

will be deeply explored. According to the structural design and research analysis of the vaccine passport, a

decentralized electronic vaccine passport application was created, using integrated frameworks and software

such as vue and nginx, and combined with the Ethereum public chain to create a multi-terminal instance

application platform, which is more vivid. The architectural approach of the system is clearly demonstrated.

These results are instructive to guide the application and expansion of blockchain technology in various as-

pects of the medical field.

1 INTRODUCTION

Since 2008, the blockchain technology represented by

Bitcoin has gradually developed into a hot topic in the

computer and software industry, making the Internet

usher in the era of web 3.0. Decentralization is the

core competitiveness of blockchain technology. At

the same time, cryptography and timestamp technol-

ogy are used to encrypt data, and realize decentralized

transactions and mutual recognition contracts in a

non-trusted system between nodes. It cleverly solves

the practical problems of high cost, limited data secu-

rity, and insufficient stability of trust in centralized

organizations and institutions. It has also promoted

the rapid development and popularization of block-

chain technology. Blockchain technology originated

from a Bitcoin-related article published by Satoshi

Nakamoto on the cryptography mailing group in 2008

(Yuan, 2016). As a result, the concept of Bitcoin ap-

peared, and blockchain technology entered people's

field of vision. Due to the complexity of blockchain

technology itself and the rapid development of block-

chain applications, there is no specific definition that

is uniformly recognized by the industry. It is gener-

ally believed that a distributed database system that is

decentralized, open, autonomous within the system,

and cannot be tampered with is the blockchain.

Table 1: Blockchain Development Stage

Blockchain Phase Represent Characterization Definition

Blockchain 1.0 Bitcoin Digital currency-focused, no apps Programmable Money

Blockchain 2.0 Ethereum Technology has been dramatically developed Programmable Finance

Blockchain 3.0 EOS Well-established and mature application Programmable Society

https://orcid.org/0000-0001-8272-654X

Jing, Z.

The Application and Implementation of Blockchain Techniques in the Medical Industry.

DOI: 10.5220/0012036800003620

In Proceedings of the 4th International Conference on Economic Management and Model Engineering (ICEMME 2022), pages 555-561

ISBN: 978-989-758-636-1

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

555

As shown in Table 1, after the origin of the tech-

nology, the blockchain has gone through three stages

of development, namely the blockchain 1.0, 2.0, and

3.0 sets (Wang, 2021). Blockchain 1.0 is the early

stage of accumulation of blockchain technology.

Technology has just started to develop. It is mainly

devoted to the application of digital currency such as

Bitcoin and explores some expansion applications

based on digital currency business models. The main

feature of Blockchain 2.0 is the emergence of smart

contracts. This programmable contract led to the

launch of Ethereum, essentially a digital token. De-

velopers can more easily customize their desired ap-

plications. The blockchain 3.0 is the stage when many

blockchain applications are mature and applied to

production and life. Applications using blockchain

technology have gradually developed into large-scale

commercial applications and penetrated public ser-

vice fields, e.g., medical care, education.

With the continuous development of blockchain

technology, in 2016, there were nearly 800 block-

chain-related enterprises worldwide, and the industry

scale reached 450 million US dollars (Siyal, 2019).

According to a survey report by CIC Consulting in

2021 (Siyal, 2019), blockchain technology is mainly

used in the medical field for electronic health cases,

DNA wallets, bitcoin payments, and drug anti-coun-

terfeiting. At the same time, due to the continuous im-

provement of the medical level, data plays an increas-

ingly important role in medical information such as

patient identity, past medical history, medical pay-

ment records and so on. However, medical data is also

a person's privacy. If leaked, attacked, or abused, it

will lead to unpredictable consequences. Blockchain

technology can play a role here, preventing infor-

mation leakage while performing information authen-

tication, and guaranteeing the standardized and or-

derly use of medical information.

For example, electronic medical records based on

blockchain technology can realize the access of third-

party data users to patient data information under the

premise of data security (Siyal, 2019). Besides, they

use searchable encryption technology to search nodes

on the blockchain, relying on key a certain index of

words. Re-encryption technology is also used for se-

cure access to patient data by third-party data users,

and the use of asymmetric encryption also ensures the

security of patient data and the usability of data users.

This paper is devoted to exploring the cutting-

edge application of blockchain technology in the

medical field, aiming at the general deficiencies and

defects of current ordinary electronic medical rec-

ords, such as high operating costs, insufficient decen-

tralization, insufficient recognition, and promotion,

and proposes efficient improvements. Electronic vac-

cine passports are a specific application of blockchain

technology in the medical field. The current vaccina-

tion certification is regionally recognized. That is,

consensus can be formed in a small area, but it isn’t

easy to popularize and apply in a larger area. Such

vaccination records require the existence of a mainte-

nance and operation authority to issue, operate and

maintain the vaccination record system. It may bring

problems such as high operating costs and poor data

security. For traditional electronic vaccination rec-

ords, this article will give a detailed design scheme

for vaccine passports based on blockchain technol-

ogy. Starting from the needs of practical problems,

gradually explore decentralized applications based on

blockchain 3.0, give the overall design and architec-

ture of the technology, and strive to create a consen-

sus vaccine passport system.

2 DESCRIPTION OF

BLOCKCHAIN AND SMART

CONTRACT

2.1 The Motivation of the Paper

The leading technologies applied in this electronic

vaccine passport are blockchain and smart contract

technologies. The following will introduce some

basic concepts and construction principles in the

blockchain. Blockchain technology uses distributed

nodes to store data and cryptographic encryption

technology without requiring an entity authority to re-

alize a decentralized and trustworthy system. Based

on proof of work, proof of stake, and DPoS algorithm

to form the theoretical basis of consensus. A sketch

of the block structure shows in Fig. 1.

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Figure 1: The structure of blocks.

As the name suggests, the main data of the block-

chain is in a chain-like structure. A complete block

contains a block header and a body, where the block

header contains the hash value, random number,

timestamp, and Merkle root of the previous block

through the hash function. The focus of blockchain is

on the use of hashing technology. By continuously

taking the hash value of each block, it ensures that the

existing blocks are immutable. The body part of the

block contains each transaction in the block, and these

transactions are formed into a Merkle tree, and the

root node of the tree records in the block header. One

needs to take the hash value of each block and record

it in the next block. In the next block, the hash value

and other data are used as parameters, and then the

hash value is taken and stored in the third adjacent

block. Such a mechanism guarantee that the data in

the blockchain cannot be tampered with. If the data in

a block in the chain is changed, the hash value calcu-

lated from this to be written to the following block

will change, thus causing the data in the next block to

change triggering a chain effect. After the hash value

changes, tampering will be discovered.

Blockchain 2.0 provides users with a programma-

ble system interface, which significantly expands the

scope of blockchain applications and dramatically en-

hances flexibility. The emergence of Ethereum and

smart contracts has enabled the realization of distrib-

uted applications with more powerful functions and

richer application scenarios based on smart contracts.

Szabo once proposed that a smart contract is a trans-

action agreement that can execute contract terms

through data calculation (Niu, 2022). A smart con-

tract is a computer protocol that provides personal-

ized writing and deployment (seen in Fig. 2). It is not

only widely used in financial business but also dis-

tributed computing systems and the Internet of

Things.

Figure 2: The generation process of smart contracts.

The specific implementation of smart contracts is

to convert abstractions such as markets, assets, and

behaviors into digital features by abstractly modeling

the target object. Then abstractly model the actual

logic of the target object, and use a language compat-

ible with smart contracts such as solidity to write

script programs. Afterward, the contract is released

and deployed on the blockchain, making it a consen-

sus and shared resource of the entire network. Calling

the data and functions in the contract needs to be trig-

gered by external events, the code inside the contract

is automatically generated and executed. Then the

state and data of the objects in the block are changed

to control the target object on the chain.

The Application and Implementation of Blockchain Techniques in the Medical Industry

557

2.2 Critical Technologies of Smart

Contracts

The essence of the smart contract is also the idea of

using the blockchain to ensure the security of the data

by calculating the hash value (Szabo, 1997).

Ethereum is a relatively mature platform for smart

contracts. It integrates and improves based on a

scripting language, cryptocurrencies and related pro-

tocols, enabling developers to flexibly design and de-

velop consensus-based, fully functional personalized

distributed applications. A typical data structure of

the contracts illustrated in Fig. 3.

The operating environment of Ethereum is real-

ized by the Ethereum Virtual Machine EVM, which

can provide a Turing-complete scripting language.

This mechanism, with accounts as the operation ob-

ject and the rich interface provision enable anyone to

use any tool to create distributed applications with

specific functions.

Figure 3. The data structure of smart contracts on the chain.

3 THE APPLICATION OF

BLOCKCHAIN IN THE

MEDICAL FIELD

The preservation of personal medical-related data is

crucial, and it is also the most direct application of

blockchain in the medical field. In the traditional

medical record recording system, the patient's medi-

cal record is recorded in the system of each hospital

he sees, which will cause the patient to not be able to

master his own medical record information and to

have his own accurate medical history. In order to

solve the confusion about the medical records of the

patients when they seek medical treatment, the use of

blockchain technology to save the medical records of

the patients can make the owner of the data for pa-

tients themselves, which is convenient for the patients

to manage and plan their medical health, which has

great advantages.

3.1 The Ideological Structure of

Electronic Health Medical Records

Presently, the electronic medical record based on

blockchain has had preliminary application and estab-

lished a relatively mature architecture of patient pri-

vate chain, hospital private chain, and public social

chain (Tang, 2021). After the patient visits the hospi-

tal, the hospital has the right to write the patient's

medical records into the patient's private chain.

Through the records in the private chain, patients can

have a comprehensive understanding of their medical

conditions and medical conditions, and then can view

their personal electronic medical records at any time.

Owing to the characteristics of the blockchain

technology itself, the written data will not be tam-

pered with and will be stored stably for a long time,

with higher authenticity and reliability. This makes

medical records more robust evidence, which can

play a catalytic or decisive role in resolving medical

disputes. Besides, the patient private chain applica-

tion should have the accuracy of file management. To

solve this problem, a unique medical identity identi-

fier of the patient, e.g., a medical identity ID, can be

bound by using the patient's identity certificate.

Meanwhile, some personal information of the patient

should be recorded in the private chain, such as photo,

name, gender, bound ID, and other information that

can identify the patient. If a hospital needs to access

a patient's medical record information, it must be au-

thorized by the patient. Therefore, the patient's per-

sonal medical information is in the hands of the pa-

tient, and the hospital can view the relevant infor-

mation only after the patient's authorization. At the

same time, after the medical treatment is completed,

the patient can close the approval of the hospital to

protect the personal information from being abused.

As for hospital private chain, in some medical sce-

narios, it is necessary for the hospital to store some

medical information. These are of great value to im-

proving hospital medical technology or investment in

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558

scientific research. Therefore, it is necessary to con-

sider the rational use of medical record data on the

premise of maximizing the protection of patients' per-

sonal information. Personal private information, in-

cluding the patient's name, contact information, work

situation, etc., will not be written on the blockchain,

while necessary information (e.g., medical process,

medication, and illness) will be recorded. When it is

essential to view the patient's personal information

(e.g., crucial medical research results, medical treat-

ment of similar conditions the patient's authorization

can be requested to obtain all the information.

In social public chain, medical records may not

only need to be circulated between patients and hos-

pitals, but other third-party institutions or government

departments also need to access patients' medical rec-

ords in specific scenarios, such as insurance company

claims, government visa issuance, and social medical

industry development and scheduling guidance.

Therefore, it is necessary to establish a public medical

information chain. A public chain system with rich

information can improve patients' understanding of

medical procedures and medicines while also allow-

ing the medical industry to improve its understanding

of the needs of patient groups so that relevant strate-

gies can be adjusted to respond to changes in medical

trends.

3.2 Electronic Medical Record Query

The electronic medical record query based on block-

chain technology has the advantages of high data se-

curity, convenient query, elevated platform portabil-

ity, and low cost (Xu, 2021). When blockchain tech-

nology is used in medical records, the way data is

stored will change significantly. Traditional data stor-

age is often local to a single or clustered server, data-

base, or client, and it will be challenging to maintain

its security once it receives a network attack or virus

intrusion and data tampering occurs. Applying the

three-layer blockchain technology discussed earlier

can ensure the access rights of personalized custom-

ized information while ensuring that the data is not

tampered with.

Queries using blockchain technology will be more

efficient and convenient (Tang, 2021). Data access

does not require the support of a third-party organiza-

tion, which cannot only reduce cost overhead but also

apply to a wider range of terminal applications. The

platform and framework of the client do not affect the

query and use of data, so that it can be widely used in

applications of various platforms. One can send re-

quests to the Ethereum JSON-RPC API via the HTTP

protocol to interact with the Ethereum platform.

4 EXAMPLE OF ELECTRONIC

VACCINE PASSPORT

To deeply explore the application of blockchain in the

medical field, this paper explores and designs the

overall architecture of a vaccine passport. Vaccine

passport is a potentially massive application of block-

chain in the medical field. This section will introduce

a feasible design architecture of vaccine passports to

show the details of the application of blockchain in

vaccine passport in detail, to highlight the promotion

and application value of blockchain in the medical

field.

4.1 Reason of Design

Vaccination records are currently regulated differ-

ently in different regions, which is inconvenient for

people traveling across regions (Xue, 2017). A con-

sensus vaccination record book needs to be created.

Blockchain has consensus-building mechanisms that

use hashes to ensure that the data that has been rec-

orded is not altered, which can ensure that vaccination

records that have been written are tamper-proof.

Hence, the consensus is formed. To implement the

idea, a Dapp was created in which users bind an

Ethereum account to the app and bind it with their real

passport to ensure that the record of the current ac-

count is theirs. The user uses the app account to ask

the hospital to add the vaccination record for them

when they get vaccinated, and displays the relevant

interface of the record information in the app when

they need to show the vaccination record.

4.2 DApp Design

The central architecture of the application consists of

four modules, which are the Ethereum blockchain,

smart contracts, cross-platform application modules,

and vaccine passport databases. This system has three

main users, patients, administrators, and hospitals.

There are different client portals for each user with

different functions and permissions. Effectively en-

sure data security and software stability.

The Application and Implementation of Blockchain Techniques in the Medical Industry

559

Figure 4: Functional use case diagram.

Figure 5: Vaccine Passport Technology Stack.

Fig. 4 shows the main working principle of the

system, which is a complete application from client to

server, with full design and function implementation.

The system can use the front-end framework vue3 to

create the client, use solidity to create smart contracts,

use javascript and typescript to create interactive pro-

grams, use Metamask App as a relay to publish trans-

actions, and use Axios to send requests to JSON-RPC

API to contact with Ethereum such as sending re-

quests uses interface eth_call to interact with the con-

tract (as exhibited in Fig. 5). The front-end part of the

application has been deployed to the relevant cloud

server so that one can access and use the application

through the URL. The contract part can be deployed

to Ethereum's main network using the remix IDE

when passes the software tests. The system will likely

be favored by WHO and other health organizations as

for simplicity and ease of use and high reliability.

Once the vaccine information is recorded, it cannot be

modified. It will be widely promoted and used to

solve the problem of vaccination records in various

regions the issue of being recognized by each other.

5 LIMITATIONS & FUTURE

WORKS OF BLOCKCHAIN IN

MEDICAL

The rapid development of blockchain technology is

evident to all. The wave of Web3.0 blockchain tech-

nology has gradually become the focus of research

and discussion. The application of blockchain in the

medical field has attracted wide attention (Zhang,

2019). The electronic medical records and electronic

vaccine passports in this article are the preliminary

exploration of blockchain technology in the medical

field, which can effectively meet the requirements of

privacy protection, build data sharing, have consen-

sus, and be widely used in time and region data sys-

tem (Wang, 2019). However, there is still a long way

to go to realize the medical big data system with the

whole society and even the whole world, and realize

the ultimate goal of smart medical care. In the process

of implementation and design, there will still be vari-

ous problems and challenges. With the further devel-

opment and iteration of blockchain technology, these

problems will be gradually solved. It is hoped that this

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560

article can provide help and inspiration for the appli-

cation of blockchain technology in the medical field

in the future.

6 CONCLUSION

In summary, the rapid development of blockchain

technology has promoted the application of block-

chain technology in all walks of life. With the surging

wave of blockchain technology, its application value

in the medical system has gradually emerged. It has

enormous potential application value in electronic

medical records, vaccine passports, DNA wallets, and

anti-counterfeiting medicine bottles. The immutable

and sharable nature of blockchain determines its po-

tential promotion properties for reaching consensus.

The implementation mechanism of smart contracts

can also ensure that the ownership of data is straight-

forward and precise while ensuring the efficient, con-

venient, and low-cost characteristics of data query.

Private chain, multi-layer blockchain structure com-

bined with a public chain to ensure data security and

stability. The application of blockchain technology in

the medical field will contribute to the construction of

a smart medical system, and play an effective role in

promoting active health care, epidemic control, med-

ical record recording, and medical data sharing.

REFERENCES

Niu, S., Chen, L., Li, W., et al.: Electronic medical record

data sharing scheme based on blockchain. Acta Auto-

matica Sinica, 48(8): 2028−2038 (2022).

Szabo, N.: Formalizing and securing relationships on public

networks. First monday (1997).

Siyal, A. A., Junejo, A. Z., Zawish, M., et al.: Applications

of blockchain technology in medicine and healthcare:

Challenges and future perspectives. Cryptography,

3(1), 3 (2019).

Tang, Y.: Application of blockchain technology in elec-

tronic medical record. Chinese Medical Records 6,1-

2+22 (2021).

Wang, J., Wu, Q., Cao, H.: Review of typical applications

of blockchain in China. Science, Technology and Econ-

omy, 5, 1-6 (2019).

Wang, H., Xu, Q., Zhou, A., et al.: The Development of

Blockchain and Its Application in Agriculture. Journal

of Agri‐cultural Big Data, 03(03):76-86 (2021).

Xu, D., Feng, D., Yan, X., Yu, G.: Autonomous manage-

ment of electronic medical records based on block-

chain. Chinese Journal of Digital Medicine 7,18-23

(2021).

Xue, T., Fu, Q., Wang, C., Wang, X..: A medical data shar-

ing model via blockchain. Acta Automatica Sinica,

43(9): 1555−1562 (2017).

Yuan, Y., Wang, F. Y.: Blockchain: the state of the art and

future trends. Acta Automatica Sinica, 42(4), 481-494

(2016).

Zhang, C., Li, Q., Chen, Z., Li, Z., Zhang, Z.: Medical

Chain: an alliance blockchain system for healthcare.

Acta Automatica Sinica, 2019, 45(8):

1495−1510(2019),

The Application and Implementation of Blockchain Techniques in the Medical Industry

561