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Microsoft Word - HS2061 IS Project Management-Individual assignment 1- Case study analysis T1-2017(1).doc FACULTY OF HIGHER EDUCATION Individual assignment 1 - Case study analysis HS2061 Information Systems Project Management Trimester 2 2018 Date Due: Friday Week 5 by 5:00 PM Marks Weighting 10% Student Name (Block letters) Student Number: ___________________________ _____________ HS2061 IS Project Management – Assignment 1 T2 2018 1 1. Develop a system scope document Using the MedRec Case Study provided, develop a system scope document. This document must include a section for each of the following: • the business problem, • a statement of purpose, • the benefits of a new system • the system capabilities and what it must achieve as a minimum Ensure you use business language and write in the third person (avoid the use of I or we). A business report format should be followed. Word limit: 500 – 1000 words Marking Criteria ASSESSMENT 1 CRITERIA N/A Poor Fair Good Very Good Excellent Scope Document Statement of Purpose (1) Business problem (2) Business Benefits (2) System capabilities (2) Exclusions (1) Document Format Document Presentation Good layout Grammar & Spelling (2). Deduction for late, copied, or plagiarised work (up to total marks earned) Total out of 10 A Case Study for Blockchain in Healthcare: “MedRec” prototype for electronic health records and medical research data White Paper Ariel Ekblaw*, Asaph Azaria*, John D. Halamka, MD†, Andrew Lippman* *MIT Media Lab, †Beth Israel Deaconess Medical Center August 2016 Note: The abstract and first three sections of this white paper are drawn from a peer-reviewed, formally accepted paper, presently being prepared for publication with IEEE through their Open & Big Data Conference, August 22-24, 2016. MedRec: Using Blockchain for Medical Data Access and Permission Management IEEE Original Authors: Asaph Azaria, Ariel Ekblaw, Thiago Vieira, Andrew Lippman This material is adapted and included here with permission of the IEEE, including permission for publication by the ONC Blockchain Challenge if selected. Abstract A long-standing focus on compliance has traditionally constrained development of fundamental design changes for Electronic Health Records (EHRs). We now face a critical need for such innovation, as personalization and data science prompt patients to engage in the details of their healthcare and restore agency over their medical data. In this paper, we propose MedRec: a novel, decentralized record management system to handle EHRs, using blockchain technology. Our system gives patients a comprehensive, immutable log and easy access to their medical information across providers and treatment sites. Leveraging unique blockchain properties, MedRec manages authentication, confidentiality, accountability and data sharing—crucial considerations when handling sensitive information. A modular design integrates with providers' existing, local data storage solutions, facilitating interoperability and making our system convenient and adaptable. We incentivize medical stakeholders (researchers, public health authorities, etc.) to participate in the network as blockchain “miners”. This provides them with access to aggregate, anonymized data as mining rewards, in return for sustaining and securing the network via Proof of Work. MedRec thus enables the emergence of data economics, supplying big data to empower researchers while engaging patients and providers in the choice to release metadata. The purpose of this paper is to expose, in preparation for field tests, a working prototype through which we analyze and discuss our approach and the potential for blockchain in health IT and research. 1. Introduction EHRs were never designed to manage multi-institutional, life time medical records. Patients leave data scattered across various organizations as life events take them away from one provider's data silo and into another. In doing so they lose easy access to past data, as the provider, not the patient, generally retains primary stewardship (either through explicit legal means in over 21 states, or through default arrangements in the process of providing care) [1]. Through the HIPAA Privacy Rule, providers can take up to 60 days to respond (not necessarily to comply) to a request for updating or removing a record that was erroneously added [2]. Beyond the time delay, record maintenance can prove quite challenging to initiate as patients are rarely encouraged and seldom enabled to review their full record [1], [2]. Patients thus interact with records in a fractured manner that reflects the nature of how these records are managed. Interoperability challenges between different provider and hospital systems pose additional barriers to effective data sharing. This lack of coordinated data management and exchange means health records are fragmented, rather than cohesive [3]. Patients and providers may face significant hurdles in initiating data retrieval and sharing due to economic incentives that encourage “health information blocking.” A recent ONC report details several examples on this topic, namely health IT developers interfering with the flow of data by charging exorbitant prices for data exchange interfaces [4]. When designing new systems to overcome these barriers, we must prioritize patient agency. Patients benefit from a holistic, transparent picture of their medical history [3]. This proves crucial in establishing trust and continued participation in the medical system, as patients that doubt the confidentiality of their records may abstain from full, honest disclosures or even avoid treatment. In the age of online banking and social media, patients are increasingly willing, able and desirous of managing their data on the web and on the go [3]. However, proposed systems must also recognize that not all provider records can or should be made available to patients (i.e. provider psychotherapy notes, or physician intellectual property), and should remain flexible regarding such record-onboarding exceptions [5], [6]. Medical records also prove critical for research. The ONC's report emphasizes that biomedical and public health researchers “require the ability to analyze information from many sources in order to identify public health risks, develop new treatments and cures, and enable precision medicine” [4]. Though some data trickles through to researchers from clinical studies, surveys and teaching hospitals, we note a growing interest among patients, care providers and regulatory bodies to responsibly share more data, and thus enable better care for others [7], [4]. In this work, we explore a blockchain structure applied to EHRs. We build on this distributed ledger protocol originally associated with Bitcoin [8]. The blockchain uses public key cryptography to create an append-only, immutable, timestamped chain of content. Copies of the blockchain are distributed on each participating node in the network. The Proof of Work algorithm used to secure the content from tampering depends on a “trustless” model, where individual nodes must compete to solve computationally-intensive “puzzles” (hashing exercises) before the next block of content can be appended to the chain. These worker nodes are known as “miners,” and the work required of miners to append blocks ensures that it is difficult to rewrite history on the blockchain. Our MedRec blockchain implementation addresses the four major issues highlighted above: fragmented, slow access to medical data; system interoperability; patient agency; improved data quality and quantity for medical research. We build on the work of Zyskind et al. [9] to assemble references to data and encode these as hashed pointers onto a blockchain ledger. We then organize these references to explicitly create an accessible bread crumb trail for medical history, without storing raw medical data on the blockchain. Our system supplements these pointers with on-chain permissioning and data integrity logic, empowering individuals with record authenticity, auditability and data sharing. We build robust, modular APIs to integrate with existing provider databases for interoperability. A novel data-mining scheme is proposed to sustain the MedRec network and bring open, big data to medical researchers. We present MedRec not as the panacea for medical record management, but as a foray into this space to demonstrate innovative EHR solutions with blockchain technology. 2. System Implementation 2.1 Overview For MedRec, the block content represents data ownership and viewership permissions shared by members of a private, peer-to-peer network. Blockchain technology supports the use of “smart contracts,” which allow us to automate and track certain state transitions (such as a change in viewership rights, or the birth of a new record in the system). Via smart contracts on an Ethereum blockchain [10], we log patient-provider relationships that associate a medical record with viewing permissions and data retrieval instructions (essentially data pointers) for execution on external databases. We include on the blockchain a cryptographic hash of the record to ensure against tampering, thus guaranteeing data integrity. Providers can add a new record associated with a