Application of blockchain technology in strengthening health information system security: a case study of Mount Meru referral hospital

Abstract

Health information system (HIS) is a digital technology used in health care data management. Through literature review, it has been observed that HIS are facing security challenges. These challenges are based on centralized system architecture creating a target for malicious attacks. Despite of the effectiveness of this technology, still HIS are suffering from a lack of data privacy and confidentiality. This research developed a blockchain-based system integrated with the Government of Tanzania Hospital Management Information System. The study employed a qualitative research method where data were collected using interviews and document analysis. Execute-order-validate Fabric’s storage security architecture was implemented through private data collection. Privacy and confidentiality are attained through a private data policy. Network peers are decentralized with blockchain only for hash storage to avoid storage challenges. Cost-effectiveness is achieved through data storage within a database of a Hyperledger Fabric. The overall performance of Fabric is higher than Ethereum. Ethereum’s low performance is due to its execute-validate architecture which has high computation power with transaction inconsistencies. Health policymakers should be aware of blockchain technology and make use of the findings. The scientific contribution of this study is based on; the cost-effectiveness of secured data storage, the use of hashes of network data stored in each node, and low energy consumption of Fabric leading to high performance. The system is developed in an integrated data sharing architecture in a peer-to-peer, decentralized network environment. Data sharing and information exchange are maintained without central control, with improved security and privacy of the system.