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Abstract

The increased use of advanced technologies by consumers and hospitals is moving care closer to patients, and the challenge is one of how patient data can be shared with external care providers and patients. To support care continuity, patient data include both clinical data used by external care providers and non-clinical data used by social care providers. Care coordination of a patient outside a hospital requires peer-to-peer connectivity among a number of these clinical and social care providers, using a digital platform that aligns their goals and assigns their resource sharing responsibilities. With no single entity supporting such care coordination, most hospitals currently distribute this responsibility to several of its provider partners and patients. Such a division of responsibility with no real time feedback leads to discontinuous resource sharing, localized data analysis, and challenges in tailoring care to improve health outcomes. The goal of this paper is to propose a blockchain architecture model that uses a number of constructs for creating and assigning ownership to patient data so it can support peer-to-peer resource sharing and uses smart contracts to support goal alignment. Using two blockchain applications implemented in Hyperledger and illustrating their potential representation using the constructs in multi-chain, we develop a conceptual model for developing blockchain applications in general to support continuity of care. The generalizability of this model is illustrated by applying these constructs to four additional healthcare applications. Finally, we conclude the paper with a discussion of the limitations and directions for future research.