UNIVERSITY OF EMBU

ADOLI BENARD LUSISA

B141/20108/2020
BACHELOR OF SCIENCE IN INFORMATION
TECHNOLOGY
COMPUTING AND INFORMATION TECHNOLOGY
SCHOOL OF PURE AND APPLIED SCIENCES
BLOCKCHAIN
BLOCKCHAIN MEDICAL RECORDS SYSTEM
DECLARATION
I, hereby declare that the following Proposal represents my own work and ideas unless otherwise
cited. This proposal is submitted in partial fulfillment of the requirements of Bachelor of science
in Information Technology at the University of Embu

I affirm that this proposal is an original work and has not been submitted, in part or whole, for any
other assessment or purpose.

Name: ADOLI BENARD LUSISA

Reg no: B141/20108/2020

Signed: ___________________________

Date: _____________________________

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Table of Contents
DECLARATION ............................................................................................................................. i
ABSTRACT ................................................................................................................................... iv
CHAPTER ONE ............................................................................................................................. 1
INTRODUCTION .......................................................................................................................... 1
1.0 Background of the Study ....................................................................................................... 1
1.1 Problem Statement ................................................................................................................ 1
1.2 Objectives .............................................................................................................................. 2
1.3 Scope and Limitation of the Study ........................................................................................ 2
1.4 Justification ........................................................................................................................... 2
CHAPTER TWO ............................................................................................................................ 4
LITERATURE REVIEW ............................................................................................................... 4
2.0 Introduction ........................................................................................................................... 4
2.1 Global Review ....................................................................................................................... 5
2.2 Regional Review ................................................................................................................... 6
2.3 Local Review......................................................................................................................... 8
2.4 Analysis, Comparison and criticism on existing projects ..................................................... 9
2.5 Identification of Gaps .......................................................................................................... 12
2.6 Establishing the Need for the Current System (Conclusion) .............................................. 13
CHAPTER THREE ...................................................................................................................... 15
METHODOLOGY ....................................................................................................................... 15
3.0 Introduction ......................................................................................................................... 15
3.1 Locality of the Project and Beneficiaries ............................................................................ 15
3.2 Data Collection .................................................................................................................... 15
3.3 Data Analysis ...................................................................................................................... 16
3.4 System analysis ................................................................................................................... 17
3.5 System Design ..................................................................................................................... 17
3.6 Testing Plan ......................................................................................................................... 19
3.7 System Development........................................................................................................... 20
REFERENCES ............................................................................................................................. 21
APPENDIX ................................................................................................................................... 22

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List of Tables
Table 1 Comparative Analysis of Blockchain-Based Medical Record Initiatives ........................................ 9
Table 2 Budget plan .................................................................................................................................... 22

List of Figures

Figure 1 Use case diagram .......................................................................................................................... 18

Figure 2 Context diagram ........................................................................................................................... 19
Figure 3 Gantt chart .................................................................................................................................... 22

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ABSTRACT
This proposal aims to develop a Blockchain Medical Records System designed to revolutionize
healthcare data management. The primary objectives are to establish a secure, interoperable, and
patient-centric system for storing and sharing medical data while empowering patients with control
over their information. This project addresses the pressing need for enhanced data security and
accessibility in the face of escalating healthcare data breaches and system inefficiencies.

The justification for this endeavor lies in the imperative transformation of healthcare data
management. Leveraging blockchain technology promises heightened security, patient privacy
control, improved interoperability among healthcare providers, and increased transparency in data
transactions. The anticipated benefits include unparalleled data security, patient-driven data
sharing, streamlined healthcare delivery, and reinforced transparency in the healthcare industry.

Methodologically, this project will undertake a comprehensive approach involving extensive

research, analysis, system design, iterative development cycles, and stringent security
implementations. The expected output entails the creation of an innovative system using
blockchain technology to ensure data integrity, confidentiality, and ease of access for patients,
healthcare providers, and administrative staff. This solution aligns with the institution's vision for
efficient healthcare service delivery and provides a foundation for further advancements in the
healthcare ecosystem.

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CHAPTER ONE

INTRODUCTION
1.0 Background of the Study
The global healthcare market is expanding at an unprecedented rate, driven by evolving medical
needs and demographic shifts . This escalating demand for healthcare services has highlighted the
need for a more efficient and secure medical record management system.

However, traditional methods of paper-based and centralized electronic record-keeping are

proving inadequate in the face of these challenges (Andoni et al., 2019). Paper-based records are
cumbersome, inefficient, and prone to loss or damage. Centralized electronic record systems are
vulnerable to data breaches and can be difficult for patients to access.

Blockchain technology has the potential to address these shortcomings and revolutionize the way
medical records are stored and managed. Blockchain is a distributed ledger technology that is
secure, tamper-proof, and transparent. This makes it ideal for storing sensitive medical data.

A blockchain-based medical record system would allow patients to have more control over their
own medical data and to choose who they share it with. It would also make it easier for healthcare
providers to share medical data with each other, which would improve the delivery of healthcare

1.1 Problem Statement

Existing medical record systems are fragmented, insecure, and inefficient. This leads to a number
of problems, including: Privacy breaches: Electronic medical records (EMRs) contain a wealth of
sensitive personal information, such as a patient's medical history, demographics, and financial
information. Existing EMR systems are vulnerable to data breaches, which can put patients'
privacy at risk. If a data breach occurs, patients' personal information could be stolen and used for
identity theft or other fraudulent purposes.

Mismatch or unsynchronized health records: Patients often have multiple healthcare providers,
each with their own medical record system. This can lead to mismatch or unsynchronized health
records, which can negatively affect the delivery of effective healthcare. For example, a patient
may see a new doctor who does not have access to their complete medical history, which could
lead to misdiagnosis or missed diagnoses.

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Centralized point of failure: Centralized medical record systems are a single point of failure. If this
system goes down, patients may not be able to access their medical records. This could be a major
problem in an emergency situation, when patients need access to their medical records quickly and
easily.

These problems highlight the need for a new type of medical record system that is secure,
interoperable, and accessible. A blockchain-based medical record system could address all of these
problems. Blockchain is a distributed ledger technology that is secure, tamper-proof, and
transparent. This makes it ideal for storing and sharing sensitive medical data.

1.2 Objectives
To develop a blockchain-based medical record system that provides a secure, interoperable, and
accessible way for patients and healthcare providers to store and share medical data.

To implement security features that protect patient data from unauthorized access and tampering,
while also giving patients control over their own data.

1.3 Scope and Limitation of the Study

Scope:

This study will develop a blockchain-based medical record system that provides a secure,
interoperable, and accessible way for patients and healthcare providers to store and share medical
data. The system will be designed to be scalable and user-friendly, and it will be implemented
using the Etherum blockchain platform.

Limitations:

This study will focus on the development of the blockchain-based medical record system itself. It
will not evaluate the impact of the system on the delivery of healthcare. Additionally, the study
will be limited to the development of a prototype system. A larger scale study would be needed to
evaluate the system's performance and usability in a real-world setting.

1.4 Justification
The imperative nature of this project is evident in the face of a rapidly evolving healthcare
landscape, burgeoning data breaches, and the inefficiencies plaguing centralized record-keeping
systems. The Blockchain Medical Record System holds the potential to transform healthcare data
management by ensuring patient privacy, enhancing data security, and facilitating seamless

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information access. By aligning with the evolving needs of the healthcare industry, this project
underscores its commitment to delivering high-quality, secure, and patient-centric care in an
increasingly digital world.

Blockchain technology has the potential to revolutionize the way medical records are stored and
managed. A blockchain-based medical record system would offer a number of benefits over
existing medical record systems, including:

Security: Blockchain technology is very secure. It would be very difficult to hack or tamper with
medical data stored on a blockchain.

Privacy: Patients would have control over their own medical data and who they share it with.

Interoperability: Blockchain would make it easier for healthcare providers to share medical data
with each other. This would improve the delivery of healthcare, especially for patients who see
multiple providers.

Transparency: Blockchain is a transparent technology. This means that all transactions on a

blockchain are visible to everyone. This could help to reduce fraud and improve accountability in
the healthcare industry.

Privacy breaches: Blockchain technology would protect patient data from unauthorized access and
tampering. This would help to keep patient data safe and secure.

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CHAPTER TWO

LITERATURE REVIEW
2.0 Introduction
In today's rapidly evolving healthcare landscape, the management of medical records has become
increasingly complex and integral to the quality and safety of patient care. The advent of
blockchain technology, with its inherent features of immutability, security, and decentralization,
has opened new avenues for the transformation of medical record management. This chapter
presents a comprehensive review of the existing body of literature that explores the intersection of
blockchain technology and healthcare data, specifically focusing on the development and
implementation of blockchain-based medical record systems.

The objective of this literature review is twofold. First, it seeks to provide a historical perspective
on the evolution of technology within the healthcare sector, highlighting the challenges and
limitations of traditional electronic medical record (EMR) systems. By understanding the historical
context, we can better appreciate the urgency and significance of transitioning to innovative
solutions such as blockchain-based medical record systems.

Second, this chapter aims to critically analyze and synthesize the key findings, trends, and insights
from scholarly research, industry reports, and case studies in the field of healthcare and blockchain
technology globally, regionally and locally. We delve into the applications of blockchain
technology in healthcare, with a specific focus on its potential to address long-standing issues
related to data security, patient privacy, interoperability, and regulatory compliance. By examining
the existing literature, we identify gaps, challenges, and areas that require further exploration,
setting the stage for the subsequent chapters of this proposal.

As we navigate the rapidly changing landscape of healthcare and technology, it is imperative to

understand the current state of blockchain in healthcare, its implications for medical record
management, and the benefits it promises to deliver. This literature review serves as the foundation
upon which our proposed blockchain-based medical record system project is built, illuminating
the path toward a more secure, efficient, and patient-centric healthcare data management solution.

In the following sections, we will explore the historical evolution of healthcare data management,
the role of blockchain technology in addressing pertinent challenges, and the emerging
opportunities for innovation within the healthcare sector.

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2.1 Global Review
In the rapidly evolving landscape of healthcare data management, blockchain technology has
gained prominence as a secure and transparent solution for the storage and sharing of medical
records. This section presents an overview of notable global projects and initiatives that utilize
blockchain technology to enhance the integrity and accessibility of medical records.

2.1.1 Medchain project

MedChain is a pioneering initiative that aims to revolutionize the way medical data is exchanged
globally. Built on the Ethereum blockchain, MedChain offers a decentralized and secure platform
for healthcare providers, patients, and insurers to access and share medical records. The project
ensures data privacy through patient consent mechanisms while enabling real-time access to
critical patient information during emergencies.

MedChain has demonstrated remarkable success in reducing data breaches and errors in medical
records. It has gained significant attention and support from various healthcare institutions due to
its ability to improve data interoperability and patient care coordination.

2.1.2 Akiri medical chain

Operates a network-as-a-service tailored explicitly for the healthcare industry, prioritizing the
secure transportation of patient health data. Unlike traditional systems, Akiri neither stores nor
centralizes data but functions as a network and protocol to configure data layers in real time,
ensuring the verification of data sources and destinations. This real-time verification aligns with
the crucial need in healthcare for instantaneous and secure data exchange while adhering to policies
and ensuring authorized access at the point of need.

2.1.3 Guardtime

Plays a pivotal role in assisting healthcare entities and governments in adopting blockchain for
robust cybersecurity measures. The company's involvement in implementing blockchain within
healthcare systems, notably in Estonia and the United Arab Emirates, highlights its dedication to
bolstering data security and integrity. Guardtime’s emphasis on leveraging blockchain to fortify

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cybersecurity resonates with the critical need for data protection and privacy within healthcare
systems, crucial in safeguarding sensitive patient information.

2.1.4 MediBloc

MediBloc, a South Korean blockchain-based healthcare project, places patients at the center of
their healthcare data management. The platform empowers individuals to control their medical
records and decide who can access them. Built on a custom blockchain, MediBloc focuses on data
ownership and patient-driven consent.

MediBloc has gained recognition for its patient-centric approach and its commitment to data
privacy. It has provided a model for patient empowerment and control over their healthcare
information, reducing the risk of unauthorized access and enhancing patient trust in the healthcare
system.

These projects illustrate the global impact and innovation surrounding blockchain-based medical
record systems. They showcase the diverse approaches to addressing data security,
interoperability, and patient consent. Each project has made substantial contributions to the field
by improving the integrity, accessibility, and security of medical records on a global scale.

2.2 Regional Review

Blockchain technology has found relevance in healthcare systems across the African continent,
addressing the unique challenges faced by healthcare providers, governments, and patients. The
adoption of blockchain-based medical record systems is a growing trend, contributing to the
advancement of healthcare data management in Africa.

2.2.1 Blockchain for Giving Patients Control Over Their Medical Records

Madine et all (2020) proposed an Ethereum blockchain-based smart contracts to give patients
control over their data in a manner that is decentralized, immutable, transparent, traceable, trustful,
and secure. The proposed system employs decentralized storage of interplanetary file systems
(IPFS) and trusted reputation-based re-encryption oracles to securely fetch, store, and share
patients' medical data. We present algorithms along with their full implementation details. We
evaluate the proposed smart contracts using two important performance metrics, such as cost and

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correctness. Furthermore, we provide security analysis and discuss the generalization aspects of
our solution. We outline the limitations of the proposed approach. The project developed a
blockchain project that stimulated patients to have more control on their data and it was a big
revolutionized in most parts of the medical industry

2.2.2 Blockchain-Driven Telemedicine

Several African countries, including Nigeria, South Africa, and Kenya, have embraced blockchain
technology to facilitate telemedicine. Blockchain-based telemedicine platforms provide secure
access to medical records and enable remote consultations, particularly in underserved and rural
areas, extending healthcare access to remote communities.

Blockchain-driven telemedicine initiatives have significantly improved healthcare accessibility in

Africa. Patients can consult with healthcare professionals from the comfort of their homes, which
is especially critical in regions with limited access to healthcare facilities.

2.2.3 African Union's Continental eHealth Strategy

The African Union (AU) has introduced a Continental eHealth Strategy that encourages member
countries to adopt digital health solutions, including blockchain, to enhance healthcare data
management and service delivery. The strategy aims to create a harmonized approach to eHealth
across the continent.

The AU's Continental eHealth Strategy reflects a commitment to advancing healthcare systems
through technology adoption. It sets the stage for the integration of blockchain solutions in
healthcare across Africa, with an emphasis on data security and interoperability.

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The initiatives and developments across Africa highlight the continent's proactive approach to
harnessing blockchain technology to address healthcare challenges. These projects emphasize the
need for secure and interoperable medical record systems, cross-border data sharing, and improved
healthcare accessibility. They demonstrate the potential of blockchain to improve healthcare
services, especially in remote and underserved areas.

2.3 Local Review

In Kenya, the integration of blockchain technology into healthcare data management is gaining
traction, driven by a commitment to enhance healthcare service delivery, data security, and patient
care. This section highlights key local initiatives and developments.

2.3.1 The AfyaRekod

AfyaRekod was founded in 2019 as an Adanian Lab start-up with seed funding from Mac Venture
Capital and Next Chymia. John Kamara, the CEO of Adanian Labs, saw first-hand how the lack
of medical records and static data could lead to poor medical management. Kamara refers to his
friend who died after receiving the wrong medical intervention in an emergency.

Consequently, Kamara built an AI platform that would track health data, aimed at bridging the gap
between health care and treatment, anywhere, anytime for patients, medical professionals,
providers and organizations.

Medical records are a vital tool in managing health, notifying healthcare professionals of
medications, chronic illness, past problems and procedures and ultimately allowing them to
determine the most accurate course of treatment. Misdiagnosis is a serious misstep and can lead to
a delay in treatment of the real condition.

Over and above patients securely managing their health records, including prescriptions and
hospital visit summaries, the AfyaRekod Universal Patient Portal offers a secure, decentralised,
multilingual and intelligent telehealth solution, health resources, symptom trackers, reminders and
notifications, as well as the mobility of the record across multiple channels and devices. Though
any patient can use these tools, it is especially useful for patients with chronic illness, parents,
pregnant women, and patients with hereditary diseases.

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2.3.2 Blockchain innovations

Drawing inspiration from successful initiatives in neighboring countries like Tanzania and
Uganda, local organizations in our region have embarked on pioneering efforts leveraging
blockchain technology to revolutionize healthcare delivery.

Inspired by challenges of wastage and fraud in aid distribution, similar to those observed in
Tanzania, innovative projects have emerged targeting vulnerable pregnant women within our local
communities. These initiatives focus on leveraging blockchain to create comprehensive medical
ledgers, ensuring timely pre- and postnatal care and meticulous monitoring of both mother and
child health. Such interventions have effectively addressed the critical issue of missed medical
attention for newborns, aligning with our community's healthcare needs.

Moreover, akin to the digitization endeavors undertaken by AID: Tech with Tanzania's NHIF,
local organizations are striving to harness blockchain's potential for streamlining access to
healthcare services. These efforts center on enabling digital identity linkage with healthcare
accounts, facilitating prompt patient identification, service verification, and direct payment
mechanisms. This local adaptation aims to enhance transparency, efficiency, and accuracy in
healthcare service delivery, presenting a promising step toward combating fraud and improving
healthcare record management within our region.

Furthermore, the introduction of Mediconnect in Uganda has sparked local interest in deploying
blockchain to track and manage drug distribution. This project's success story has inspired our
community's interest in leveraging similar blockchain-driven solutions to curtail counterfeit drugs
and elevate the efficiency of our healthcare system's supply chain.

2.4 Analysis, Comparison and criticism on existing projects

Table 1 Comparative Analysis of Blockchain-Based Medical Record Initiatives

Technology
Project/Initiative Objectives Used Key Findings

Global Initiatives

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 Technology
Project/Initiative Objectives Used Key Findings

- Decentralized, secure platform for

data sharing. - Emphasizes patient
Revolutionize consent for privacy. - Reduces data
global medical Ethereum breaches and errors in medical
MedChain data exchange blockchain records.

- Prioritizes patient control over data.

Empower patients - Enhances data privacy and patient
in managing Custom trust. - Reduces unauthorized access
MediBloc healthcare data blockchain to healthcare information.

- Does not store data; ensures real-

time verification of sources and
destinations. - Prioritizes secure and
Secure instantaneous data exchange. -
transportation of Network-as-a- Ensures policy adherence and
Akiri patient health data Service authorized access at the point of need.

- Dedicated to enhancing data

security and integrity in healthcare
Implement systems. - Involved in significant
blockchain for blockchain implementation in
robust healthcare, highlighting a
cybersecurity in Cybersecurity commitment to bolstering data
Guardtime healthcare solutions protection.

Regional
Initiatives

- Improved healthcare accessibility. -

Across African Enhance Blockchain Focus on secure, interoperable
Continent healthcare data adoption systems and data sharing. - Adoption

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 Technology
Project/Initiative Objectives Used Key Findings

management in of the African Union's eHealth

Africa Strategy for integrating technology
within the continent's healthcare
systems.

Local Initiatives
(Kenya)

- Empowers patients with control

over records. - Offers multilingual
Improve medical telehealth solutions and symptom
management AI platform, tracking. - Focuses on chronic illness
through data decentralized management and patient-driven
AfyaRekod tracking system healthcare solutions.

- Addresses specific challenges like

prenatal/postnatal care, patient
Use blockchain for Adaptation of identification, and drug distribution. -
Local Blockchain targeted healthcare blockchain Tailored solutions for localized
Innovations improvements technology healthcare challenges in Kenya.

Critique of the Global, Regional, and Local Reviews:

Global Initiatives:

The global initiatives, namely MedChain, HashHealth Consortium, and MediBloc, exhibit
commendable efforts in revolutionizing healthcare data management on a larger scale. These
projects prioritize objectives such as global data exchange, unified networks, and patient
empowerment. Leveraging established technologies like Ethereum, Hyperledger Fabric, and
custom blockchains, they aim to enhance data security, reduce breaches, and foster patient trust.
However, while they showcase successes in reducing breaches, improving interoperability, and

11
enhancing patient trust, challenges related to scalability, widespread adoption, and seamless
integration into existing healthcare infrastructures persist.

Regional Initiatives:

Across the African continent, regional initiatives focus on improving healthcare accessibility,
fostering interoperable systems, and integrating technology via strategies such as the African
Union's eHealth initiative. These initiatives demonstrate a commitment to addressing specific
challenges faced by the region. They highlight successes in improving healthcare accessibility,
emphasizing secure and interoperable systems, and setting the stage for technology integration.
However, challenges in ensuring widespread adoption, seamless integration, and compliance with
diverse regional regulations remain critical hurdles.

Local Initiatives

In Kenya, local initiatives like AfyaRekod and projects inspired by neighboring countries exhibit
adaptability and focus on addressing specific healthcare challenges. These projects, utilizing AI
platforms, decentralized systems, and tailored solutions, target chronic illness management,
prenatal care, and counterfeit drug combat. They present solutions customized to local needs,
empowering patients and enhancing healthcare delivery. Yet, similar challenges persist, including
scalability, seamless integration into existing systems, and ensuring compliance with local
regulations.

2.5 Identification of Gaps

As we evaluate the global, regional, and local initiatives in Africa, several gaps and challenges
emerge. Identifying these gaps is crucial for understanding the areas where further improvement
and innovation are needed:

2.5.1 Interoperability and Standardization

Global Gap: Despite the advancements in blockchain-based medical record systems, achieving
cross-platform interoperability remains a significant challenge. Different projects often utilize
diverse blockchain technologies, making data sharing and collaboration complex.

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Regional Gap: Standardization of data formats and protocols across African countries is essential
to enable seamless cross-border data exchange, which currently faces regulatory and technical
obstacles.

Local Gap: In Kenya and other African nations, healthcare institutions may use various platforms,
complicating data sharing among local providers. Standardization is crucial to ensure a unified
system.

2.5.2 Data Privacy and Consent Management

Global Gap: While projects like MedChain and MediBloc focus on patient data control, challenges
persist in ensuring that patient consent mechanisms are robust and universally adopted.

Regional Gap: Across Africa, there is a need for clear and standardized regulations concerning
patient data privacy and consent, especially in cross-border healthcare scenarios.

Local Gap: In Kenya, patient data privacy and consent frameworks need enhancement and
standardization to protect patient rights and facilitate secure data sharing.

2.5.3 Data Security and Scalability

Global Gap: Ensuring the security and scalability of blockchain networks, especially in global
projects like the HashHealth Consortium, remains a significant concern.

Regional Gap: African projects must overcome technical challenges to ensure that blockchain
networks can handle the increasing volume of healthcare data.

Local Gap: Local initiatives in Kenya need to focus on enhancing data security and scalability to
support the growing demand for healthcare services.

2.6 Establishing the Need for the Current System (Conclusion)

The identified gaps in the existing blockchain-based medical record initiatives within Africa, both
globally and regionally, underscore the pressing need for a comprehensive and cohesive system.
While these projects have made remarkable strides in improving healthcare data management,
several challenges must be addressed to create a truly integrated and secure ecosystem.

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The current system, which we propose to develop, aims to bridge these gaps by offering a
blockchain-based medical record system that addresses the unique challenges faced in Africa,
particularly in Kenya. It will prioritize:

Interoperability and Standardization: Our system will be designed to facilitate cross-platform

interoperability and adhere to standardized data formats and protocols, promoting seamless data
exchange across the continent.

Data Privacy and Consent Management: We will implement robust patient consent mechanisms
and work in tandem with regulatory authorities to ensure data privacy and consent standards are
consistently met.

Data Security and Scalability: Our system will prioritize data security and scalability, providing a
robust platform that can accommodate the increasing volume of healthcare data.

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CHAPTER THREE

METHODOLOGY
3.0 Introduction
In this chapter we will dive into the structured methodology employed in the implementation of
this Blockchain medical record system. The methodology chapter serves as a guiding compass,
outlining the precise steps, frameworks, and strategies deployed throughout the project lifecycle.
From the initial analysis to the final deployment and beyond, this section provides an intricate
insight into the thoughtfully crafted blueprint that ensures the efficiency, security, and adaptability
of the Blockchain Medical Records System.

3.1 Locality of the Project and Beneficiaries

The Blockchain Medical Records System is strategically designed for deployment within Kenya
and caters not only to its inhabitants but also extends its impact to various stakeholders within the
healthcare ecosystem. Beyond the primary users patients, healthcare professionals, and institutions
this system is envisioned to benefit the entire community, fostering a comprehensive
transformation in healthcare accessibility, quality, and efficiency.

In essence, the Blockchain Medical Records System is not just a technological advancement; it's
a catalyst for societal progress, reshaping the healthcare narrative within Kenya and beyond. Its
impact extends beyond mere users, aiming to elevate the entire healthcare ecosystem, fostering
trust, efficiency, and inclusivity for a healthier community.

3.2 Data Collection

3.2.1 Target group

For data collection purposes, the primary target group includes students, faculty members, and
administrative staff affiliated with Embu University's healthcare services. These groups
encompass individuals whose medical records and interactions within the university healthcare
system are vital for understanding the practical implications and requirements of the Blockchain
Medical Records System.

3.2.2 Sampling Method

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A random sampling method will be employed to ensure a representative selection of participants
within each target group. This approach minimizes bias and ensures that each member of the
population has an equal chance of being included in the data collection process. The randomness
of this method enhances the validity of the data collected, providing a comprehensive view of
diverse perspectives and experiences within the university community.

3.2.3 Data Collection Method

Data collection will predominantly utilize structured questionnaires distributed among the target
groups. These questionnaires will be designed to gather quantitative data, capturing opinions,
preferences, and concerns regarding the current healthcare record system and expectations from
the proposed blockchain-based solution. Additionally, open-ended questions will provide
respondents with the opportunity to elaborate on their experiences, ensuring a nuanced
understanding of their perspectives.

This robust data collection approach, centered on questionnaires, aims to gather comprehensive
insights into stakeholders' perspectives. It ensures that the Blockchain Medical Records System is
precisely tailored to address the specific needs and challenges prevalent within Embu University's
healthcare ecosystem, fostering a more informed and effective implementation strategy.

3.3 Data Analysis

The data collected through questionnaires will encompass quantitative responses, including
ratings, Likert scales, and categorical data regarding the current healthcare record system and
expectations from the proposed blockchain-based solution. Open-ended responses will provide
qualitative insights, offering deeper perspectives and potential contextual nuances regarding user
experiences.

Analysis Method:

The data analysis will incorporate both quantitative and qualitative methodologies. Quantitative
data will be statistically analyzed using descriptive statistics, including mean, median, mode, and
frequency distributions. This analysis aims to identify trends, patterns, and correlations within the
responses, providing a quantitative understanding of stakeholders' opinions and preferences.

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Simultaneously, qualitative data obtained from open-ended questions will undergo thematic
analysis. This qualitative approach involves coding and categorizing responses to identify
recurring themes, emerging patterns, and nuanced insights. The Human-Computer Interaction
(HCI) principles will guide the analysis, ensuring a user-centric perspective in understanding
stakeholders' experiences and expectations.

3.4 System analysis

For the system analysis phase, the chosen model is the Waterfall Model due to its sequential and
structured approach. This model delineates clear phases requirements, design, implementation,
testing, and maintenance allowing for a linear progression from one phase to the next. The decision
to opt for the Waterfall Model is rooted in its simplicity and suitability for a project like the
Blockchain Medical Records System, where a systematic and well-defined approach is crucial. Its
sequential nature enables a comprehensive understanding of requirements upfront, ensuring
meticulous planning before moving to subsequent phases, ultimately fostering a more controlled
and manageable development process.

3.5 System Design

3.5.1 Functional Requirements

The system design for the Blockchain Medical Records System entails several critical functional
requirements specific to blockchain integration. Ensuring the immutability of medical records
within the blockchain network is paramount, requiring a system that prevents any alteration or
deletion once records are added, thus guaranteeing data integrity and authenticity. Additionally,
the decentralized storage of these records across multiple nodes within the blockchain network is
fundamental, reducing the risk of a single point of failure and fortifying data security. Utilizing a
consensus mechanism is essential for validation and addition of new records to the blockchain,
ensuring collective agreement within the network on the legitimacy of transactions. Furthermore,
employing smart contracts to manage access control assures that only authorized personnel can
view specific records, enhancing privacy and security measures.

3.5.2 Non-Functional Requirements

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Complementing the functional aspects, the system design incorporates pivotal non-functional
requirements pertinent to blockchain implementation. Emphasizing transaction throughput, the
system aims for high-speed processing of data transactions within the blockchain network to
facilitate swift interactions. Robust security measures through cryptographic mechanisms ensure
the confidentiality and integrity of medical data stored on the blockchain. Scalability is imperative,
demanding a network architecture capable of accommodating potential increases in the volume of
medical records and user interactions without compromising performance. Efficiency in the
consensus mechanism becomes crucial, necessitating validation and addition of transactions while
minimizing energy consumption or optimizing participation based on the chosen consensus
algorithm. Maintaining low network latency in transaction confirmations remains a priority to
ensure timely validation and inclusion of records in the blockchain. Additionally, adherence to
interoperability standards facilitates seamless integration with existing healthcare systems,
ensuring compatibility and efficient data exchange with external platforms.

Use case diagram

Figure 1 Use case diagram

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Context diagram

Figure 2 Context diagram

3.6 Testing Plan

The testing plan for the Blockchain Medical Records System at Embu University focuses on two
crucial phases: unit testing and system testing.

Unit testing will validate the functionalities of individual components within the system. Each unit,
such as data entry modules, access control mechanisms, and blockchain integration components,
will undergo rigorous testing to ensure they perform as intended. This phase aims to identify and
rectify any bugs or inconsistencies at the component level, guaranteeing that each unit operates
accurately and independently within the system.

System testing will evaluate the integrated system as a whole, ensuring that all units function
cohesively and meet the specified requirements. This phase involves testing the interactions
between different modules, verifying data flow, and validating the system's behavior in various
scenarios. It includes functional testing to confirm that the system aligns with functional

19
requirements, as well as performance testing to assess its responsiveness, scalability, and overall
reliability under normal and peak usage conditions.

3.7 System Development

For the backend development, leveraging Solidity as the primary coding language for smart
contract creation proves pivotal. Solidity, tailored for blockchain platforms like Ethereum, ensures
secure execution of smart contracts essential for managing and enforcing rules within the
blockchain network. JavaScript complements Solidity by facilitating the development of logic that
interacts with the blockchain network, orchestrating system functionalities seamlessly.

The system's database architecture benefits from the adaptability and scalability of NoSQL
databases, particularly MongoDB. Its flexibility in handling diverse and unstructured medical data
aligns with the requirements of storing and managing healthcare records within the blockchain
framework. Moreover, the decentralized nature of blockchain might involve considering
distributed ledger technologies for storing immutable records across multiple network nodes.

Incorporating HTML5, CSS3, and JavaScript for front-end development ensures the creation of
an intuitive and responsive user interface. These front-end languages play a crucial role in crafting
a user-friendly interaction experience, allowing efficient interaction with the blockchain-based
medical records system. Additionally, Node.js serves as a facilitator for server-side operations,
optimizing real-time interactions and streamlining data flow between the front and back ends.

20
REFERENCES
Andoni, M., Robledo, M., López, I., & Hernández, A. B. (2019). Blockchain technology: A new
opportunity for healthcare systems. International Journal of Medical Informatics, 124, 168-176.

Madine, M. M., Battah, A. A., Yaqoob, I., Salah, K., Jayaraman, R., Al-Hammadi, Y., ... &
Ellahham, S. (2020). Blockchain for giving patients control over their medical records. IEEE
Access, 8, 193102-193115.

Tanwar, S., Parekh, K., & Evans, R. (2020). Blockchain-based electronic healthcare record system
for healthcare 4.0 applications. Journal of Information Security and Applications, 50, 102407.

Usman, M., & Qamar, U. (2020). Secure electronic medical records storage and sharing using
blockchain technology. Procedia Computer Science, 174, 321-327.

Widhawati, R., Khoirunisa, A., Santoso, N. P. L., & Apriliasari, D. (2022, February). Secure
system medical record with blockchain system: Recchain framework. In 2022 International
Conference on Science and Technology (ICOSTECH) (pp. 1-8). IEEE.

Chen, Y., Ding, S., Xu, Z., Zheng, H., & Yang, S. (2019). Blockchain-based medical records
secure storage and medical service framework. Journal of medical systems, 43, 1-9.

21
APPENDIX
Appendix 1

Gantt chart

Figure 3 Gantt chart

Appendix 2
Budget plan

Table 2 Budget plan

Expense Category Details Estimated Cost

Hardware Laptop for Development Already have
External Hard Drive (for 5000
backups)
Software and Tools Development Tools and IDE Vs code
Blockchain Platform/Node Meta task
Learning Resources Online Courses or Tutorials Free

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 Miscellaneous Contingency for Additional 1000
Expenses
Total Estimated Budget 6000

Appendix 3
Questionnaire for Data Collection

1. Demographic Information:

Age: ……………………………….

Gender ………………………………

Occupation ………………………………...

Are you a student/faculty/staff or other at Embu University? (Select one)

2. Current Healthcare Record Management:

a). How do you currently access your medical records?

Physically at the healthcare center

Digitally through an online portal

I do not have access to my medical records

3. Challenges with Current System:

What challenges have you faced with the existing healthcare record system? (Select all that apply)

Difficulty in accessing records

Security concerns with data privacy

Inefficiency in record retrieval

Lack of transparency in data management

Other (please specify): _____________________

4. Expectations from a Blockchain-Based System:

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What features would you expect from a new blockchain-based medical record system? (Select all
that apply)

Enhanced data security and privacy

Ease of access to medical records

Transparency in record management

Integration with other healthcare services

Other (please specify): _____________________

5. Usability Preferences:

How often would you prefer to access your medical records?

Rarely (once a year or less)

Occasionally (few times a year)

Frequently (monthly)

Regularly (weekly or more)

6. Feedback on Blockchain Implementation:

Do you have any concerns or reservations about implementing a blockchain-based medical record
system? (Yes/No)

If yes, please specify: _____________________________

7. Improvements or Additional Features:

Are there any specific improvements or additional features you would like to see in the new
system?

8. Overall Satisfaction:

On a scale of 1 to 5, how satisfied are you with the current medical record management system

24