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Electronic Health Records (EHR) have a distributed nature and can be managed by distinct affinity domains. Sharing patient health information across distinct organisations helps to deliver a well-informed diagnosis, improving the quality of healthcare service. The federation of those information systems can take the form of a distributed database where data are partitioned and possibly replicated across distinct computational systems. However, the benefits of having a distributed system, such as consistency, availability, and data protection, are mostly absent. This article proposes a distributed database consensus protocol designed to improve the performance of EHR insertion operations, a particularly critical issue in medical imaging cases due to the data volume. It explores the personal and non-transferable nature of EHR and the proposed methodology reduces the data contention through data isolation, improving the overall retrieval performance and detection of misbehaving parties. Furthermore, the proposal follows the recent European General Data Protection Regulation (GDPR), which states that appropriate mechanisms should be used in order to protect data against accidental loss, destruction, or damage, using appropriate technical or organisational measures.

A Performant Protocol for Distributed Health Records Databases