A Case Study for Blockchain in Healthcare: “SecureRx” Framework for a Patient- Centric Electronic Prescription System

Abstract

Currently, opioid use has become endemic in the U.S. Despite the crucial role that prescription drug monitoring programs (PDMPs) play in fighting opioid abuse, the program is often susceptible to several significant challenges. These challenges include the lack of interoperability between states, the vulnerability of the databases to cyber-attacks, difficulties in identity verification, and lack of data reliability and consistency. To solve these challenges, this research proposes the implementation of a decentralized blockchain-based prescription system that is integrable with the PDMP. The evaluation of the current implementations of PDMP systems was crucial in developing this research' methodology. Firstly, the research employs both qualitative and quantitative research approaches to uncover the significant factors that contribute to the limitations of the current electronic prescription systems. Often, most states in the U.S. implement their PDMP electronic databases that collect data on substances that have been dispensed within the state over a specific period. This model of data handling prohibits the interoperability between states in the fight against opioid abuse. Secondly, the research presents a framework for implementing a scalable monitoring process, which ensures the security of data related to a patient's prescription history. The proposed technological framework focuses on implementing a decentralized application (dApp), which is wholly based on the Ethereum blockchain. Lastly, a prototype application “SecureRx” was implemented and expected to reduce the misuse of opioids in the U.S. by allowing the efficient exchange of patient prescription data among healthcare providers regardless of geographical location variations. The findings of the research indicate that blockchain-based tools are effective in addressing the major limitations facing PDMPs. Firstly, through the application programming interface (API) tokens, interoperability between states was achieved, which allowed the seamless exchange of data between healthcare providers. Secondly, data reliability and consistency were achieved due to the Ethereum smart contract that simultaneously updates each stakeholder's electronic records in the prescription network. Next, the Ethereum smart contract allows the application to use public key infrastructure (PKI) for the management of identities. Lastly, PDMPs lack reliability and consistency in their patient data management as health providers are required to make manual entries of a patient's prescription information. The blockchain-based application solves this challenge by implementing an automatic process for the generation and storage of data. In this case, healthcare providers are responsible for the prescription they issue, which prohibits the issuance of illegal dosage of opioids. Currently, conventional PDMPs are inefficient in curbing the opioid pandemic afflicting the U.S. The inability of PDMPs to meet its objectives has resulted in an increase in the number of studies focusing on effective methods of mitigating the risks associated with opioids. Thus, to address the limitations of conventional PDMPs, this research presents a conceptual model for the implementation of an effective prescription system. The proposed prototype system is based on Ethereum technology, which offers a secure, accurate, and a reliable approach to managing opioid prescriptions. The above discussions demonstrate that a blockchain-based system can assist in the fight against the opioid abuse effective management of prescriptions. Hence, the main purpose of the research is to present a working prototype of a prescription application based on the Ethereum blockchain.