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Abstract
<p class="first" id="d4851012e51">The electronic sharing of medical imaging data is
an important element of modern healthcare
systems, but current infrastructure for cross-site image transfer depends on trust
in third-party intermediaries. In this work, we examine the blockchain concept, which
enables parties to establish consensus without relying on a central authority. We
develop a framework for cross-domain image sharing that uses a blockchain as a distributed
data store to establish a ledger of radiological studies and patient-defined access
permissions. The blockchain framework is shown to eliminate third-party access to
protected health information, satisfy many criteria of an interoperable health system,
and readily generalize to domains beyond medical imaging. Relative drawbacks of the
framework include the complexity of the privacy and security models and an unclear
regulatory environment. Ultimately, the large-scale feasibility of such an approach
remains to be demonstrated and will depend on a number of factors which we discuss
in detail.
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