JMIR Publications

ABSTRACT

Background:

2019 novel Coronavirus (COVID-19), which presumably originated in bats and transmitted to humans through unknown mechanisms in Wuhan, Hubei province, China in December 2019, has affected more than 180 countries and territories around the world. On March 11, 2020, World Health Organization (WHO) characterized the COVID-19 outbreak as a pandemic. This is the first pandemic known to be caused by a new coronavirus. While the complete clinical picture with regard to COVID-19 is not fully known, based on currently available information, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. The emergence and rapid widespread of COVID-19 are not only becoming a new public health crisis, but also wreaking havoc on the global economy and industries. However, disease investigation, patient-tracking mechanisms and the transmission of case reports seem to both labor-intensive and slow.

Objective:

The ongoing pandemic is putting healthcare systems under strain worldwide and forcing hospitals and other medical facilities to scramble to make sure data can be shared effectively. The primary aim of this study is to design a Global Infectious Disease Surveillance and Case Tracking system capable of facilitating detection and control of COVID-19 transmission. A blockchain-based architecture is built to protect the security and guarantee the correctness of International Patient Summary (IPS).

Methods:

An International Patient Summary (IPS) which is an electronic health record extract containing essential healthcare information about a subject of care be used in this study . IPS is designed for supporting the use case scenario for ‘unplanned, cross border care’. It is intended to be international, i.e., to provide generic solutions for global application beyond a particular region or country. The design, global scope, and utility of IPS towards unplanned cross border care, potential for re-use makes it suitable to be a situation like COVID-19. A Fast Healthcare Interoperability Resources (FHIR) confirmed IPS, including symptoms, therapies, medications, laboratory data, can be transferred and exchanged on the platform for ease of access by the physicians efficiently. Patient data are de-identified to protect privacy. All system be protected by blockchain architecture, including data encryption, validation, and exchange or trasfer record. Members of the Centers for Disease Control and Prevention (CDC) around the countries will be able to carry out risk control and track high-risk groups using tracking module in the system.

Results:

This study designs an international patient summary that complies with infectious disease surveillance and clinically meaningful data according to the IPS HL7-FHIR guideline. In order to achieve the purpose of global COVID-19 surveillance and enhance health resilience, global infectious disease information exchange must be enacted. The COVID-19 surveillance system was built and designed based on the blockchain architecture. IPS is used to exchange case study information among physicians. When physicians pass system verification, they can upload the case IPS and get IPS data of other global cases from the system. The system includes daily IPS uploading and the enhancement plan, which covers real-time uploading through interoperations of the clinic system with the module based on the Open API architecture. The authenticated physician can use this system to share and exchange patient IPS to provide international references. Through the treatment of different cases, drug treatments, and exchange of patient treatment results, the disease spread can be controlled, and treatment methods can be funded. From the establishment of the infectious disease case tracking module, and according to the location information of IPS, we can track the moving paths of infectious disease cases. The location information recorded in the blockchain is for all users to check the location information for different cases. The case tracking module is established for CDC members to track cases and prevent the spread of a disease. Based on this module, CDC members can identify the cases’ moving path and design a case tracking plan.

Conclusions:

This study has created an IPS of infectious disease for physicians to access when treating COVID-19 patients. We also established a secure blockchain architecture for the protection of IPS and completed the application of patient moving path tracking. The results of this research can help health authorities quickly respond to the transmission and spread of any unknown disease and provide a good platform for information retrieval on disease transmission. Another benefits from this system is that it can help public health researchers to form a study trial and analysis data from different countries. One of the effective means in fighting an unknown virus could be by means of a common forum to facilitate mutual sharing of experiences, best practices, therapies for patients, possible useful medications and outcomes from clinical interventions being trailed in various countries in a secure, trustworthy manner. The platform suggested in our study can become an effective tool to facilitate global collaboration, cooperation and collective evidence-based efforts to address the unprecedented situation created by COVID-19.