{"id":12663,"date":"2023-08-16T12:31:37","date_gmt":"2023-08-16T10:31:37","guid":{"rendered":"https:\/\/affidaty.io\/blog\/?p=12663"},"modified":"2023-08-18T14:57:24","modified_gmt":"2023-08-18T12:57:24","slug":"ehr-data-blockchain","status":"publish","type":"post","link":"https:\/\/affidaty.io\/blog\/en\/2023\/08\/ehr-data-blockchain\/","title":{"rendered":"Accountability: blockchain and electronic health record"},"content":{"rendered":"\n
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Talk of data<\/mark> <\/strong>is becoming more frequent. Data <\/strong>is gaining value and has been dubbed the oil of the 21st century. Every action, movement, choice made through digital interaction, every purchase, every search on any electronic device, any search engine, every internet access, every interaction mediated by a network-connected product (cellphone, Alexa, Apple Watch, cameras, electric cars, IoT, etc.), and every interaction and communication with a digital service: produces, modifies, and exchanges data.
Data <\/strong>is linked to a digital identity<\/mark> corresponding to a specific individual<\/mark>, and simultaneously stored in databases and physical servers spread across the Earth. These are all interconnected directly or indirectly in dematerialized structures known as the Cloud<\/mark>, forming dense electromagnetic networks and invisible nodes conventionally referred to as Artificial Intelligence<\/mark>.<\/p>\n\n\n\n

Until now, the largest clouds holding data <\/strong>for millions of individuals, organizations, agencies, industries, institutions, are owned by private companies: IBM, Google, Facebook, Microsoft, Amazon, Apple, just to name a few. These companies are adept at extracting (value) and aggregating data <\/strong>from people, strategically offering free services like “Social Media,” “WhatsApp,” “Twitter,” “Zoom,” “Google Maps,” “Instagram,” “ChatGPT4,” etc.<\/p>\n\n\n\n

Millions of apps are developed daily and offered for free as trials, with the only condition being installation on our phones and access to our contacts, photos, videos, audio recordings, and cameras. To ensure privacy<\/mark>, GDPR<\/mark> regulations were established, but people often don’t read the contracts for app licenses and accept the conditions dictated by the software owner with a click, authorizing them to access and sometimes take a part of our data <\/strong>or the data <\/strong>we generate.<\/p>\n\n\n\n

The problem is that this naivety, combined with widespread digital illiteracy, is leading to an increase in hacker<\/mark> attacks. Through a single contact with someone with limited digital knowledge, hackers manage to access private and even corporate databases, potentially disrupting or damaging complex digital systems of institutions or even entire states. The increasing complexity of our world often makes us unaware of the fact that the interdependence between the physical and digital dimensions renders each of us a potentially vulnerable node in the network, constantly exposed to risks we might not even be aware of, risks that could cause immeasurable damage such as password theft or, in more severe cases, identity theft.
To counter these dangers, each state is striving to make its digital systems more secure, reliable, flexible, and resilient, alternatives to systems produced and controlled by international big private players.<\/p>\n\n\n\n

In Italy, the Public System of Digital Identities (SPID<\/mark>) was established in 2015, a system to securely certify and track interactions between citizens and over 22,000 Italian public administrations (municipalities, regions, healthcare facilities, schools, universities, etc.). To ensure data <\/strong>security, protection, and preservation, the National Cybersecurity Agency (ACN<\/mark>) was established in 2021, and in 2022, the National Strategic Hub (PSN<\/mark>) was created. This cloud will gradually store all citizens’ and public administration data, including the ecosystem of health data <\/strong>(EDS<\/mark>), fed by electronic health records (FSE) of over 60 million citizens registered in the National Resident Population Registry (ANPR<\/mark>).<\/p>\n\n\n\n

In 2023, the National Registry of Public Administration Employees (PA) was launched. This will enable tracking and certifying data <\/strong>produced and\/or modified by each specific professional employed by the PA who provides a particular service to a registered user in ANPR.<\/p>\n\n\n\n

But how does all of this relate to blockchain<\/strong> and the EHR<\/strong>?<\/p>\n\n\n\n

Since the establishment of the National Health Service (SSN<\/mark>) in 1978, when a person encounters a health<\/mark> issue and interacts with one or more healthcare professionals in a specific public or accredited private healthcare facility, information and data <\/strong>related to that event<\/mark> are recorded. This is typically done on paper<\/mark>, known as a medical record, which can vary even within the same facility or between different healthcare facilities.<\/p>\n\n\n\n

To address these issues, the Electronic Health Record (EHR<\/strong>) project was initiated in 2012. This digital platform aimed to contain the medical history and health records of each citizen in standardized and native digital formats. The EHR<\/strong> would be fueled by interoperable, easily accessible and shareable, verified, acquired, produced, and\/or modified information and data <\/strong>from various healthcare professionals involved in a user\/patient’s care, updated in all other potential healthcare processes. However, over the following decade, each region and autonomous province in Italy developed regional EHR<\/strong>s with little progress, and it was only during the Covid-19 pandemic<\/mark> that the lack of communication between them was noticed. Realizing the state of the EHR<\/strong> prompted renewed interest from political representatives and decision-makers. The goals of the National Recovery and Resilience Plan (PNRR<\/mark>) were used to redefine the EHR<\/strong> in the Guidelines for EHR<\/strong> Implementation published in the Official Gazette on July 11, 2022. The EHR<\/strong> must become:
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