Telemedicine application, aimed to strengthen trust to remote medical treatment

To create a solution that guarantees safe and reliable medical records storage.

Remote medicine solves the problem of quality medical services availability for the countries where life standards are not at the highest level. Modern technologies help to create a high-speed data transmission network, even in the regions where communication lines need to be built from scratch. It is much easier to give the population access to remote consultations of qualified specialists than to build a network of fully-featured clinics all over the country.

The establishment of a trusting relationship between a doctor and a patient is one of the core problems of telemedicine. Mentally, it is really hard for a patient to trust a doctor from the screen and to establish mutual emotional contact in such circumstances. 

Although, in most countries where telemedicine is allowed, the medical practice of such doctors is regulated by law no less strictly than the activity of usual clinics, the “screen doctor” is perceived as less reliable and regular than a doctor who is visited in a cabinet. The conservatism of a certain part of the population and rejection to build online communications shouldn't be underestimated.

Nevertheless, for a successful business maintenance in this field, it is very important to provide the patients with some additional arguments in order to gain their trust.

We suggested to our client to emphasize that all personal information of the patient, from his registration data, diagnosis, screenings and examination results, to the prescribed treatment, will be stored so securely that no change might be made without patient noticing. And besides, nothing can be removed - any action done by the doctor during the treatment process is recorded in the storage once and for all. There is no way for a doctor to deny something that was done according to his/her appointment.

So, the patient receives a full guarantee of secure storing of all the medical records that might be used in the future: while visiting another doctor, for an insurance company or for the disputing doctor’s actions, as well as in a court, demanding compensation.

Development of the application, providing reliable data protection and storage on the basis of Blockchain technology. 

In order to create such a reliable storage we offered to use blockchain technology. AWS supports such blockchain implementations as Hyperledger Fabric. This way of implementation suits our solution as it doesn't require organization of the mining process and has a modular architecture making it “configurable”, for example, the implementation of the customer control module to operate consensus process for the transaction confirmation, or your own user authorization model if, for some reason, you are not satisfied with the standard one.

For keeping information in a reliable blockchain-based data storage, we have identified the following entities:

• all examinations prescribed by the doctor - both the fact of the appointment and its results;
• the diagnosis made by the doctor;
• prescriptions made by the doctor.

We declined the idea to keep all the video records of medical consultation sessions in order to avoid the excessive increase of data amount in a storage.

For the communication purposes, another Amazon technology was used - Amazon Chime, which is a CPaaS (Communication Platform as a Service). This platform provides the organization of audio and video conferences between patients and doctors.

Use of Hyperledger Fabric for data storage, encrypted HTTPS protocol and AWS Cognito service for secure user authorization and authentication. CloudFront service and Amazon Chime Platform implementation.

 Our application consists of four main parts:

• A mobile application enabling patients to view a list of doctors registered in the system, to select a doctor for a consultation and to book medical appointment. A patient can request a medical report with all documentation attached, and receive it digitally -  as a link to a disk space in the cloud.
• A web application for a doctor's registration in a network, defining specialization and diploma, viewing a list of registered patients, arranging appointments, as well as personal patient records.
• Another client part is a web application implementing an administrative interface for the network management.
• The backend part, which is hosted in the Amazon cloud.

The fact that we are building a solution based on AWS gives us access to a large variety of services with ready-to-use high-quality technologies that help us to focus on clients' business challenges.

Let's take a closer look at this issue.

Personal data protection is one of the main problems that must be resolved by any medical system. Powered by AWS, we protect personal data of our users at all stages of their interaction with the system, providing communication with the server part via the encrypted HTTPS protocol and implementing the AWS Cognito service for secure user authorization and authentication. All users data is stored, and transmitted between the cloud and the client side in encrypted format.

The response time of our application does not depend on the location of the user's request due to CloudFront service implementation.

We use Hyperledger Fabric to store medical records securely. 

We use Amazon Chime for communication between users of the system.