Purpose
What the ledger is for
Blockchain is used here for a narrow and defensible purpose: making after-the-fact alteration of critical records detectable rather than merely prohibited, and enforcing consent rules automatically rather than by policy documentation.
It is not used as a database. Clinical records are not written to it.
| Element | Approach |
|---|---|
| Platform | Selected per deployment from Ethereum, Hyperledger Fabric or comparable frameworks, according to scalability, security, consensus mechanism and interoperability requirements. |
| Smart contracts | Automate business logic and enforce rules: consent management, data access control, event logging and transaction validation. |
| Decentralised storage | IPFS or Storj for large-volume data requiring redundancy and integrity. |
| Consensus | Selected against the governance model of the participating institutions. |
| What is anchored | Integrity hashes, consent transitions, access anchors and custody events. |
| What is never anchored | Names, identifiers, clinical detail, or anything that would make the ledger a permanent record of an individual. |
Method
Ten steps to integration
- Define use cases. Identify where the ledger adds value — secure data storage, consent management, audit trails, interoperability.
- Select platform. Choose against scalability, security, consensus and interoperability requirements.
- Design architecture. Network structure, consensus mechanism, smart contract design and data storage model, with privacy, access control and regulatory compliance considered from the outset.
- Develop smart contracts. Automate business logic and enforce rules for consent, access control, event logging and transaction validation.
- Integrate with BAEMS. Connect ledger components to backend systems, databases and interfaces; configure APIs and synchronisation.
- Implement security. Encryption, digital signatures, access controls and multi-factor authentication.
- Test and validate. Unit, integration and end-to-end testing of ledger features within the clinical system.
- Deploy to production. With configuration, monitoring and maintenance procedures in place.
- Train and drive adoption. Ledger concepts, functionality and best practice for clinical and administrative users.
- Monitor and maintain. Continuous monitoring for performance, security and compliance, with updates as needed.
Delivery
Implementation timeline
| Phase | Duration |
|---|---|
| Blockchain platform selection | 2–4 weeks |
| Smart contract development | 6–8 weeks |
| Blockchain integration | 4–6 weeks |
| Security and compliance | 4–6 weeks |
| Testing and validation | 4–6 weeks |
| Deployment and go-live | 2–4 weeks |
Resources required
Blockchain developer or architect, smart contract developer, security specialist, compliance officer, and a project manager.