Decentralised Provenance for Healthcare exchange services

Andrea Margheri
Cyber Security Southampton
3 min readMay 11, 2018


Or, participating in the ONC Data Provenance Challenge and beyond

As part of the blockchain research we are carrying out in the Cyber Security group at the University of Southampton, I had the opportunity to work with the international Hyper E-Health team formed by US and Austrian colleagues to participate to the

Oh the Places Data Goes: Health Data Provenance Challenge.

The competition was being hosted by the U.S.A’s Department of Health and Human Services Office of the National Coordinator for Health Information Technology (ONC) as it sought to find innovative and standardised solutions for the improvement and collection of healthcare data.

The Hyper E-health was one of four winners of the first phase and awarded $20,000. Here some details on the project.

The Hyper E-health Project

The Hyper E-Health project proposal is based on existing healthcare standards as

  • epSOS the first large scale pilot (connecting almost all the EU member states) that provided the first interoperability specifications based on IHE for Patient Summary and e-Prescriptions cross-border exchange
  • e-SENS cross-vertical pilot project that used the IHE process to further enhance and secure the cross-border healthcare exchange
  • eHealth Digital Service Infrastructure the body of the EU commission which is operating under the “New EIF” the Cross-Border e-Health Information Services (CBeHIS)
  • The Trillium Bridge the EU-US initiative for the trans-Atlantic healthcare exchange
  • NwHIN the backbone of the interoperability in the United States of America

Building on these standards, the Open Provenance model PROV is integrated to manage the distributed creation, storage and exchange of medical records. Towards the realisation of a decentralised provenance management for cross-organisation healthcare exchanges, the solution features the Hyperledger Fabric blockchain system which underpins the overall sharing infrastructure.

Overall, it aims at integrating data provenance technology solutions in cross-organisation sharing of healthcare data.

Here a brief video made by the team presenting the developed solution

The Hyper E-health solution for data provenance

PROV templates were developed to support the creation, storage and exchange of medical records stored in the form of CDA (Clinical Data Architecture). Fabric smart-contracts were used to decentralise the creation and retrieval of such PROV templates, hence creating an interoperable infrastructure supporting informed medical decisions.

Medical decision making must ensure patients’ safety. Just knowing the results of specialistic treatments is not enough to ensure that: data can be corrupted or issued by untrusted entities — think to all the remote medical devices nowadays in use! There is a need to provide additional metadata establishing the trust of such medical data. Provenance and blockchain ensure trustworthy medical decision making.

PROV ensures via provenance documents that all activities executed on medical records are described with adequate metadata and semantically linked to CDA and the activities of the involved agents (gp, specialists, pharmacitsts, etc.).

Blockchain ensures via smart-contracts the management of PROV documents such that no single entity can corrupt or subvert the provenance information of CDAs.

Check out our smart-contract code here

The solution is integrated with standard healthcare exchange protocols, enhancing shared medical data with provenance information. The usability of the solution is hence ensured avoiding any change in the end user experience.

Next Steps

The Hyper E-health solution is still being developed and thanks to a newly started collaboration with Grapevine we are now integrating this solution with a new Ethereum-based solution aiming at facilitating and monetising data healthcare exchanges.

Check out this Grapevine Orchestration Engine application for further details

Find out more about the Oh the Places Data Goes: Health Data Provenance Challenge at: