基于区块链技术的缺血性卒中医疗质量评价应用初探

目的 在保障敏感数据不脱离敏感域的前提下，在多中心架构中，利用区块链技术开展缺血性卒中 医疗质量评价。 方法 采用数据网关和安全沙箱建立“敏感域-公开域”隔离带，使用“阅后即焚”思想防止数据泄 露，利用区块链和智能合约技术对数据和算法的调用进行跟踪记录。 结果 区块链秒平均写入通量达到9000条记录，特征检索时间不高于10 ms，能够在多中心协作和 敏感信息受控场景中，开展缺血性卒中医疗质量指标评价。系统在三家医疗机构的数据中完成初步 验证。 结论 融合区块链、智能合约、安全沙箱、摘要生成等技术手段，可以在多中心架构上，初步实现缺 血性卒中医疗质量指标评价，为进一步应用知识提取、数字化追溯和跨域投放，助力医疗质量持续 改进奠定技术支撑。     

OmniPHR: A distributed architecture model to integrate personal health records

The advances in the Information and Communications Technology (ICT) brought many benefits to the healthcare area, specially to digital storage of patients’ health records. However, it is still a challenge to have a unified viewpoint of patients’ health history, because typically health data is scattered among different health organizations. Furthermore, there are several standards for these records, some of them open and others proprietary. Usually health records are stored in databases within health organizations and rarely have external access. This situation applies mainly to cases where patients’ data are maintained by healthcare providers, known as EHRs (Electronic Health Records). In case of PHRs (Personal Health Records), in which patients by definition can manage their health records, they usually have no control over their data stored in healthcare providers’ databases. Thereby, we envision two main challenges regarding PHR context: first, how patients could have a unified view of their scattered health records, and second, how healthcare providers can access up-to-date data regarding their patients, even though changes occurred elsewhere. For addressing these issues, this work proposes a model named OmniPHR, a distributed model to integrate PHRs, for patients and healthcare providers use. The scientific contribution is to propose an architecture model to support a distributed PHR, where patients can maintain their health history in an unified viewpoint, from any device anywhere. Likewise, for healthcare providers, the possibility of having their patients data interconnected among health organizations. The evaluation demonstrates the feasibility of the model in maintaining health records distributed in an architecture model that promotes a unified view of PHR with elasticity and scalability of the solution.     

基于区块链和物联网技术的新冠病毒感染密切接触者隔离智能监控系统的设计

目的研究基于区块链和物联网的新冠病毒密切接触者智能监控系统。方法通过物联网设备收集隔离者的位置和生理数据,利用区块链保障信息安全,以智能合约实现分析与监控。结果物联网设备采集隔离者的数据,主设备对信息进行整合与格式化,传输到区块链的智能合约,智能合约会根据预先确定的阈值进行比较分析,再分别向隔离者、防疫中心显示警报,同时智能合约会生成一个事件存储在区块链中,并存储在与区块链相链接的电子健康记录中,确保数据安全。结论本系统实现了在保护隔离者隐私性和安全性的前提下对隔离者进行有效的实时监控。     

融媒体时代专业期刊学术共同体的发展瓶颈与因应之策

【目的】 探究融媒体背景下专业期刊如何借助新媒体工具构建新型学术共同体,以及对原有功能进行优化的路径。【方法】 通过文献综述溯源专业期刊学术共同体概念的内涵,分析当前专业期刊学术共同体的发展现状,进而提出融媒体背景下此类共同体转型提升的策略。【结果】 融媒体环境下专业期刊学术共同体可通过内外圈层逐步建设,采取创新同行评议,联合选题策划,驱动二次传播的策略提升其品牌影响力。【结论】 专业学术期刊共同体的建设被置于媒介融合的新趋势下,办刊人既需要跳出原有流程、思维,又需要坚持学术导向,回归学术价值,以打造新型学术共同体为己任。     

Is blockchain ready for orthopaedics? A systematic review

IntroductionThe unique attributes of distributed ledger blockchain systems including robust security, immutability, transparency, and decentralisation, make them highly suitable solutions for many healthcare-related problems. This review examines the potential applications for blockchain technology in the field of orthopaedics, by taking a systematic approach to the evolving blockchain literature and mapping potential use cases against the current needs of orthopaedic practice.MethodA literature search was performed using Pubmed, EMBASE, OVID and the Cochrane library with the primary aim of identifying detailed accounts of blockchain solutions and use cases in healthcare. These articles were then reviewed and mapped against current orthopaedic practice to illustrate applications specific to that specialty.ResultsOne hundred and forty-one papers were identified which described case studies, simulations, or detailed proposals of blockchain solutions in healthcare. Most studies described blockchain solutions at the simulated or prototype testing phase, with only 10 case studies describing blockchains in “real-world” use. The most frequently cited use cases for blockchain technology involved the storage, security and sharing of electronic medical records. Other blockchain solutions focused on the “Internet of Things”, research, COVID 19, supply chains and radiology. There were no solutions focusing specifically on orthopaedics. Many of the described blockchain solutions had considerable scope for application in orthopaedic practice however, providing the potential for greater inter-institutional collaboration, cross border data exchange, enhanced patient participation, and more robust and transparent research practices.ConclusionBlockchain solutions for healthcare are increasing in number and scope and have multiple applications relevant to orthopaedic practice. The orthopaedic community needs to be aware of this innovative and growing field of computer science so that surgeons can leverage the power of blockchain safely for the future of orthopaedics.     

The pharmacist's guide to the future: Are we there yet?

The future of community pharmacy has always been a matter of concern for academics and practitioners alike. Recently, a paper published in this Journal brought to the discussion the importance of new technologies, such as Artificial Intelligence and Blockchain, and the emergence of market forces like Amazon or Google, to the future of the pharmacy profession. In this commentary, we offer our view about the subject, specifically focusing in the practice area of Community Pharmacy. Our choice takes into account the fact that this by far the most numerous group within the profession, and where the fear of redundancy has always been looming since the start of the Industrial Revolution. Envisioned technologies will become a reality, but by now are not mature enough to be the disrupters everyone expects. Moreover, without major shifts in the legal environment regulating the organization of health care and the provision of medicines, big players will find it difficult to substitute pharmacies. As for pharmacists, they have always adapted to the challenges presented by technological revolutions. We argue that for the coming Patient Centred era, it is more important to continue to focus on the sustainability of an enhanced role for community pharmacists, providing services that highlight pharmacists' social role, measuring outcomes, and managing populations’ health.     

How a Blockchain Approach Can Improve Data Reliability in the COVID-19 Pandemic

The rapid spread of COVID-19 made it necessary to quickly collect and share viral genomic sequences, sometimes making quantity prevail over the quality of information. Can research pay this price? Blockchain technology, based on the concept of a ledger that guarantees the authenticity and traceability of information, could be the best applicable solution.     

区块链技术及其在医疗领域的价值研究

阐述区块链技术概念、原理及特点,介绍区块链+医疗模式及其应用,包括建立个人健康数据库、打造智能化医疗救助平台,以及构建开放的医疗健康资源互助共享中心,分析区块链技术在医疗领域应用面临的挑战。     

区块链技术赋能学术期刊深度融合发展的模式与路径研究

【目的】探讨利用区块链技术解决学术期刊出版面临困境的方式,为促进区块链与学术期刊深度融合发展提供参考。【方法】依据区块链技术特性,结合学术期刊发展难题和大量学术出版区块链应用案例,提出区块链与学术期刊出版融合发展的路径。【结果】提出链上多元化业务主体参与模式、学术期刊出版产业联盟、可自由访问的学术资源库、多向多元学术评价体系等去中心化的新出版模式;梳理链上身份认证、资源内容的数字指纹、新的版权保护模式等可防篡改的学术期刊出版存证模式;提出动态开放的出版流程、众筹和精准定位的出版新模式、新型版权治理机制等新型学术期刊出版机制。最后指出区块链与我国学术期刊深度融合发展的可行性、难点及其应对策略。【结论】去中心化有助于解决学术出版集中化与分散化并存的难题,共识机制、加密技术和时间戳可解决作者作品认证难及侵权问题,利用通证经济和智能合约可实现新的出版模式并改革版权体系。     

Blockchain in pharmaceutical life cycle management

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