Inspiration

More than 700 million people, or 11% of the world population, still live in extreme poverty and are struggling to fulfil the most basic needs such as education or health. Access to good health and well-being is a human right, and that is why Hippocrates offers a new chance to ensure that everyone can access the highest standards of health and health care—not just the wealthiest.

Hippocrates provides an inexpensive distributed technology which is able to aid in patients´ diagnoses, based on their complete medical history. Medical records can also be created and/or modified in order to provide the medical staff with the most updated information. Hippocrates offers a unique certification system to ensure each medical record is authentic, immutable and unhackable.

Different from other Electronic Healthcare Records (EHR), Hippocrates uses a hybrid mechanism which is able to work in communities with low technology or without internet access. A typical patient’s medical record usually encompasses hundreds of pages and might even run into the thousands in the most extreme cases. Healthcare settings using Hippocrates are able to generate a modular passport for patients or legal guardians which includes their identity, their medical record and their prescriptions in a single unhackable document developed by smart contracts and distributed technology.

Assumptions

Hippocrates assumes that at least the medical staff have access to a minimum technology infrastructure: smartphones or computers with a Web3 provider such as Metamask; an IPFS node which allows the offline interoperability; and, proactive staff to be instructed about how to use Hippocrates. Patients or legal guardians do not need any computer skills as Hippocrates is designed by core to survive in the most reduced infrastructural environments. So as to provide poor communities with access to the highest standards of health and health care using a p2p foundation and blockchain technology.

Medical Passport Modules

Identity

Hippocrates passport provides an identity module where patients or legal guardians can have access to a self-sovereign identity built on top of the Ethereum Public Ledger.

Medical Record

Hippocrates passport grants accurate, updated and complete information about patients or legal guardians at healthcare settings.

Medical Prescription

Hippocrates passport contains a health-care program implemented by a physician or any other qualified practitioner in the form of detailed instructions that govern the plan of care for an individual patient.

Certification of Authenticity

Hippocrates passport produces a blockchain certification of the patient's data that can be proven using the Ethereum Public Ledger through the passport validation guidelines.

Qualified health-care practitioner signature

Hippocrates passport includes a signature provided by a qualified practitioner that can be proven using the Ethereum Public Ledger through the passport validation guidelines.

Solving the problem

Ensuring a healthy life and promoting well-being at all ages is important to build prosperous societies. However, despite great strides in improving people's health and well-being in recent years, inequalities still persist. More than six million children die before their fifth birthday each year, and only half of all women in developing regions have access to the health care they need. Epidemics like HIV/AIDS thrive in places where fear and discrimination limit people to receive the services they need to live healthily.

From Paper Records to EHR to Hippocrates

Standard paper records can be compromised in two ways: by being misplaced or being stolen (in the unlikely event of a break-in, civil war or natural disaster). On the other hand, traditional EHRs are at risk due to the increasing prevalence of cyber attacks. Hippocrates distributed technology stores an immutable version of the latest patient´s passport in a block of the Ethereum Public Ledger, which does not give any opportunity of compromising the sensitive data without reverting the entire Ethereum blockchain.

One of the biggest gripes against traditional paper records is that they are incredibly tedious to access and share. Obtaining a paper record involves, firstly, having to find it — possibly within a mound of files — and then, either mailing, faxing, or scanning the copies. On traditional EHRs, patients and medical staff can access information electronically. Hippocrates uses the best of both systems in a decentralized environment by establishing a private offline network using IPFS, managing the state of the medical records through smart contracts and granting access through a physical paper (with a QR code) without the need to use any technology resource.

How I built it

  • IPFS - for distributed p2p file sharing and encryption
  • Ethereum - for smart contracts
  • MySQL - for DB clinic management

Challenges I ran into

The biggest challenge I ran into was how to ensure the authenticity of a medical health record (passport) with no chance to allow fake records in the system. I had to create and prove validation guidelines which provided were zero risks of counterfeiting medical passports. This was achieved by asserting the source of the smart contracts used, the source of the identity issuing the passport, the integrity of the medical health record data and the source and integrity from the digital signature.

What I learned

I learned how to unlock the potential of distributed storage networks such as IPFS for certification purposes by combining it with smart contracts. Also, another lesson was creating simple UX for utilizing complex distributed technology resulted in comfortable user experience.

I learned the complexity of creating a self-sovereign identity to apply concepts in practice, such as administrative control by a single authority or multiple hierarchies.

What's next for Hippocrates To Success

Contact NGOs and volunteer camps to allow the software to be used and receive real feedback. Provide more guides to create a more frictionless induction. Present Hippocrates to charities and provide instruction about how to use the software.

Architecture

Flow-chart Diagram

Only qualified health-care practitioners previously registered in Hippocrates are able to log in. This enables a closed network where only professional medical staff are added from inside. When a doctor is issuing a Hippocrates medical passport is required that the patient inputs a password to encrypt his/her data.

This creates an interesting behaviour because only qualified health-care practitioners are able to generate passports for patients but only patients are able to unencrypt to access and read their medical health records. This is done to allow patients or legal guardians to be the real owners of their data. However, patients can physically decide to store their private keys to unencrypt their health records at their clinics, becoming the clinics the custodians of their patient's data. Flow-Chart Diagram

UML Sequence Diagram

Hippocrates is divided into 3 different layers:

Layer 1 | User Experience (UX) Layer

This layer is at the application level to create an intuitive user experience from the web browser. This layer is based on simplicity and designed to have full functionalities even on a smartphone device.

Layer 2 | Immutability Layer

This layer is at the protocol-stack level of the IPFS network. It requires to (a) have an IPFS node or (b) IPFS API access (such as Infura.io) to secure the immutability of the data through Kademlia tools, hashing mechanics and data gateways. This layer is in charge to secure the patient's data integrity and provide an offline network.

Layer 3 | Certification Layer

This layer is at the protocol-stack level of the decentralized public ledger of Ethereum. It requires to access an Ethereum synced node accessible through the Layer 1 (UX Layer) via any web3 provided such as MetaMask. This layer is in charge to store the proof of immutability (IPFS hash) from the patient medical passport into a block of the Ethereum blockchain using smart contracts.

UML Sequence Diagram

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