2021 Volume E104.D Issue 11 Pages 1839-1849
A private decentralized e-health environment, empowered by blockchain technology, grants authorized healthcare entities to legitimately access the patient's medical data without relying on a centralized node. Every activity from authorized entities is recorded immutably in the blockchain transactions. In terms of privacy, the e-health system preserves a default privacy option as an initial state for every patient since the patients may frequently customize their medical data over time for several purposes. Moreover, adjustments in the patient's privacy contexts are often solely from the patient's initiative without any doctor or stakeholders' recommendation. Therefore, we design, implement, and evaluate user-defined data privacy utilizing nudge theory for decentralized e-health systems named PDPM to tackle these issues. Patients can determine the privacy of their medical records to be closed to certain parties. Data privacy management is dynamic, which can be executed on the blockchain via the smart contract feature. Tamper-proof user-defined data privacy can resolve the dispute between the e-health entities related to privacy management and adjustments. In short, the authorized entities cannot deny any changes since every activity is recorded in the ledgers. Meanwhile, the nudge theory technique supports providing the best patient privacy recommendations based on their behaviour activities even though the final decision rests on the patient. Finally, we demonstrate how to use PDPM to realize user-defined data privacy management in decentralized e-health environments.
