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摘要: 以区块链为数据存储平台的电子病历系统是当下研究的热点. 存储在区块链上的数据是不可变的, 这加强了数据的安全性. 提出了一个基于区块链的电子病历数据共享方案, 实现了患者和第三方数据用户在不侵犯患者隐私的前提下共享患者电子病历. 使用私有链与联盟链构造方案的系统模型, 医院服务器上存储患者的电子病历密文, 私有链上存储患者病历密文的哈希值和关键字索引, 联盟链上存储由关键字索引构成的安全索引. 同时利用可搜索加密技术实现了联盟链上对关键字的安全搜索, 运用代理重加密算法实现了第三方数据用户对患者电子病历的共享. 通过数值实验对方案进行了性能评估.Abstract: The electronic medical record system with blockchain as the data storage platform is a key research topic. The data stored in the blockchain is immutable and strengthens the security of data. This paper proposes an electronic medical record data sharing scheme based on blockchain. The scheme enables patients and third-party data users to share the patient＇s electronic medical records without infringing the patient＇s privacy. This paper construct system model by the private blockchain and consortium blockchain, and stores the patient＇s electronic medical record ciphertext on the hospital server. The hash of the patient＇s medical record ciphertext and the keyword index are stored in the private blockchain, and the security index consisting of the keyword index is stored in the consortium blockchain. At the same time, the searchable encryption technology is used to implement secure search of keywords in the consortium blockchain, the proxy re-encryption algorithm realizes the sharing of electronic medical records of patients by third-party data users. The performance evaluation of the scheme is carried out by numerical simulation.
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Key words:
- Electronic medical record /
- blockchain /
- proxy re-encryption /
- searchable encryption /
- data sharing
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表 1 私有链的数据结构
Table 1 Private chain data structure
时间戳 块头 交易 块标识 块大小 前块哈希 块产生者身份 患者伪身份 关键字索引 密文哈希 块产生者签名 t ${ID_b}$ size hash 医生${ID}$ ${ID_a}$ ${(C_{a_1},C_{a_2})}$ hash${(C_{a_0})}$ 医生签名 
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表 2 联盟链的数据结构
Table 2 Consortium chain data structure
时间戳 块头 交易 块标识 块大小 前块哈希 块产生者身份 安全索引 块产生者签名 t 联盟链块${ID}$ size hash 医院服务器${ID}$ ${T_{Xa}=(ID_b,ID_a,(C_{a_1},C_{a_{2}}))}$ 服务器签名
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表 3 功能特性比较
Table 3 Comparisons of functional properties
功能特性 文献[5] 文献[12] 文献[25] 文献[26] 文献[27] 文献[28] 本文方案 区块链 $\times$ $\checkmark$ $\checkmark$ $\times$ $\times$ $\times$ $\checkmark$ 访问控制 $\checkmark$ $\checkmark$ $\checkmark$ $\checkmark$ $\checkmark$ $\checkmark$ $\checkmark$ 隐私保护 $\checkmark$ $\checkmark$ $\checkmark$ $\checkmark$ $\checkmark$ $\checkmark$ $\checkmark$ 安全搜索 $\checkmark$ $\checkmark$ $\times$ $\times$ $\checkmark$ $\checkmark$ $\checkmark$ 第三方数据共享 $\times$ $\times$ $\times$ $\times$ $\checkmark$ $\checkmark$ $\checkmark$
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表 4 常用密码算法的计算成本 (ms)
Table 4 The computational cost of common cryptographic algorithms (ms)
操作 $T_{p}$ $T_{e}$ $T_m$ $T_h$ 时间 4.064 1.655 0.013 0.006
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表 6 本方案算法各个阶段的时间成本 (毫秒)
Table 6 Time cost of each phase in the scheme (ms)
算法 系统建立 数据加密 私有链验证 联盟链验证 陷门生成 测试 解密 1 解密 2 $n$= 10 20 218 4 73 36 42 7 10 $n$= 20 21 412 3 142 72 83 8 11 $n$= 30 20 614 5 213 105 125 7 11 $n$= 40 20 825 4 285 145 167 7 11 $n$= 50 21 1021 4 365 172 212 7 11
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