►
Description
Brazilian Health Service and Blockchain - Diógenes Firmiano, mbamobi
Brazilian Health Service has more than 360.000 organisations including more than 8000 hospitals. There are more than 2000 electronic medical records systems involved and there is a need of interoperability between those systems. The National Health Data Network is a platform based on Hyperledger Fabric blockchain to manage Eletronic Health Records(EHR) in order to create, manage consent and permission to EHR. It involves more than 5 Billion records a year and blockchain is responsible to guarantee security, EHR and consent immutability, log tracking and distribution of timeline of EHRs between all brazilian states and private health networks. The Health Data Network uses FHIR as pattern to handle medical information and provides interoperability between all participants. With this network, all patients should consent pratictioners or organisations to show EHRs and can allow or deny any single record in the network. The patient's timeline is stored in blockchain and smart contracts can handle security and consent to the whole network in order to guarantee that constraints are followed by all nodes.
----
Hyperledger – Open Source Blockchain Technologies
Hyperledger is an open source community focused on developing a suite of stable frameworks, tools and libraries for enterprise-grade blockchain deployments.
It serves as a neutral home for various distributed ledger frameworks including Hyperledger Besu, Fabric, Sawtooth, Indy, as well as tools like Hyperledger Avalon, Cactus and libraries like Hyperledger Aries, Ursa. Learn more about Hyperledger projects: https://www.hyperledger.org/use
Case Studies: https://www.hyperledger.org/learn/case-studies
Training & Certification: https://www.hyperledger.org/learn/training
Tutorials: https://www.hyperledger.org/use/tutorials
Webinars: https://www.hyperledger.org/learn/webinars
Events: https://www.hyperledger.org/events
Vendor Directory: https://www.hyperledger.org/use/vendor-directory
Subscribe to the Hyperledger Newsletter: https://www.hyperledger.org/newsletter
Follow-us on Twitter @Hyperledger
Learn about Hyperledger Membership: https://www.hyperledger.org/about/join
#Hyperledger #HyperledgerGlobalForum2020 #Blockchain
A
Okay,
thank
you
very
one
for
being
here.
Has
anyone
been
Brazil
before
one
two?
Three
four?
The
Brazilians
are
here
and
yeah?
Is
anyone
here
from
health
care
industry
one
two
three
so
I'm
gonna
talk
about
Brazilian
national
health
data
network,
I'm,
Georgie,
nice
I'm
from
a
company
in
Brazil.
We
are
hosted
in
Brasilia
and
the
capital
of
Brazil,
and
we
are
talking
about
a
little
bit
about
health
care
in
Brazil.
A
47%
of
Brazilian
citizens
will
be
over
40
years
in
2030
and
there's
a
big
problem
for
us.
Our
our
physicians
per
person
is
one
of
the
fewest
in
the
most
development
countries.
We
have
1.28
physician
for
thousand
of
inhabitants,
and
we
have
a
another
big
problem
here
that
our
health
facilities
does
not
use
a
lot
of
electronic
health
records.
Softwares,
for
example,
hospitals,
no
more
than
50
beds,
they
are
using
only
6%
of
health
record
systems
and
77%
is
only
in
paper.
A
More
than
150
million
people
were
attended
on
public
hospitals
and
public
institutions
and
public
health
facilities,
and
there
is
a
big
problem
for
Brazil,
because
when
we
talk
about
the
average
cost
of
treatments
in
public
hospitals,
when
I
talk
about
people
with
more
than
40
years,
they
will
spend
about
three
hundred
and
seventy
two
and
more
than
sixty
years.
Four
hundred
thirty
two
dollars
for
each
treatment
and
Brazil
could
not
afford
it.
A
So
the
the
people
could
not
afford
it
to
people
that
will
be
able
to
be
covered
by
private
plans
in
Brazil
in
2030
will
be
only
nine
percent,
so
there
there
will
be
a
big
problem,
maybe
ninety
one
percent
of
our
population.
We
could
not
afford
the
private
plans,
so
they
need
to
be
using
public
health
care.
Let's
talk
about
some
numbers
in
Brazil
in
Brazil,
we
have
about
five
billion
records
in
year
in
health
care
data
we
have
more
than
a
hundred
and
fifty
thousand
primary
health
facilities
and
more
than
eight
thousand
hospitals.
A
A
The
this
health
strategy
was
being
developed
since
2016,
and
on
on
last
year,
we
have
used
it
on
a
big
probe,
oblique
program.
There
is
the
Brazilian
data
network
and
the
the
main
goals
of
the
Brazilian
data
network
of
health
information.
We
should
promote
the
exchange
of
information
between
the
plants
of
the
health
care
network.
Brasilia
is
a
continental
country.
A
A
So
we
have
states
that
are
federated
like
here
in
United
States
and
they
have
their
own
laws
and
they
need
to
to
get
their
own
data.
So
the
clinical
documents
are
federated
through
the
network
and
the
timeline
of
the
patients
at
least
brooded
in
the
blockchain.
So
all
the
timeline
items
in
the
in
the
data
from
the
patient
would
be
stored
on
blockchain
and
their
clinical
document
itself
will
not
be
started
on
blockchain.
A
We
will
be
off
chain
and
we
needed
to
optimize
the
informations,
so
we
needed
to
adopt
and
standard
the
standard
that
we
choose
was
fire
I,
don't
know.
If
anybody
knows
fire
is
a
medical
standard
for
exchange
of
information,
and
maybe,
if
you
have
an
Apple
watch
or
a
Google
Galax
watch,
you
know
you,
your
watch
will
be
talking
fire.
They
will
be
sending
information
in
fire
to
our
network.
A
We
need
to
get
integration
and
by
using
api's,
only
two
to
heaven
as
X
as
an
example
for
you
in
Brazil,
there
are
more
than
2000
medical
software
that
I
use
it
by
hospitals
and
primary
health
facilities
in
solo.
So
we
needed
to
enforce
some
laws
and
some
interoperability
standards
and
to
provide
api's
in
order
to
these
facilities
can
plug
in
on
the
network,
and
we
are
using
data
analytics
and
artificial
intelligence
to
provide
health
care,
enhance
in
our
in
our
data
that
is
stored
and
we
need
to
optimize
the
service.
A
So
we
are
using
an
intelligent
patient
summary.
There
is
based
on
door
on
artificial
intelligence
in
a
native
cloud
interoperability.
We
are
using
an
agnostic
cloud
approach
and
we
tested
and
the
what
I'm
talking
here
is
on
production
at
the
moment
and
in
one
state
Alagoas
that
support
state
from
brazil.
But
this
poor
state.
A
We
have
more
than
two
million
records
stored
on
blockchain
at
the
moment
in
May,
we
are
going
to
production
in
the
nationwide
in
Brazil
and
with
more
than
100
million
records
on
the
blockchain,
and
our
strategy
need
to
to
get
the
patient
as
the
CEO
of
his
hornero
enforcing
the
strategy
of
a
patient.
So
we
provide
to
the
Sitton
an
app
and
with
this
app
he
can
know
what
is
going
on
with
him.
A
He
can
share
or
own
share
his
information
consent,
their
data
and
it
mandatory
for
us
in
a
in
a
political
that
is
strategy
for
Brazil
and
to
provide
preventive
medicine.
So
we
are
ready
for
smart
device
and
IOT
sensors,
as
I
told
you,
and
we
are
finishing
integration
with
Apple
watch
in
Galax
watch
in
order
to
this
information
could
be
uploaded
on
the
on
the
network
and
can
be
used
by
the
physicians,
the
petitioners
and
so
on
to
provide
health
care.
A
So
our
approach
in
blockchain
is
using
a
share
timeline
when
I
go
to
a
hospital
and
I
provide.
My
my
data
and
my
clinical
documents
are
stored
on
that
Hospital
and
I
need
to
go
to
an
emergency
and
so
on.
My
data
can
be
acquired
by
the
other
facility
because
the
timeline
of
the
patient
is
shared,
and
we
here
we
are
using
these
three
keywords
as
our
structure
and
that
the
block
recorded
on
a
network
cannot
be
changed
and
the
track
remain
intact.
A
There
is
a
main
key
characteristic
of
blockchain
and
the
outer
and
the
content
are
encrypted.
So
we
encrypt
data
before
it
goings
on
when
a
private
data
collection
that
the
approach
that
we're
using
here
and
then
we,
the
patient,
need
to
consent
their
data
to
be
used
by
some
physician
and
so
on,
and
in
Brazil
these
complied
with
GDP
our
roads
in
Brazil.
A
A
The
data
there
are
own
on
the
chain
is
only
some
index
data.
They
are
not
on
the
chain,
though,
that
the
clinical
documents
are
stored
off
the
chain
on
the
private
data
collection
and
they
are
encrypted
before
it
goes
on.
On
the
private
data
collection
and
the
our
structure
is
distributed,
the
blocks
are
destroyed
among
the
other
network
nodes,
so
we
have
state
clouds,
health
plans
and
large
hospitals
that
are
part
of
the
network
and
we
guarantee
access
and
reliability
of
information,
and
this
is
trackable.
A
The
information
is
recorded
in
a
chain
analysis
or
a
tracking,
without
the
possibility
of
changing
the
track
lock
when
insert
the
data.
In
summary,
we
have
a
our
EHRs
software.
There
are
inserting
data
on
a
on
an
API
there
exposed
and
the
the
Zechs
api
wrap-ups
the
the
hypo
ledger
from
inside
and
and
those
those
nodes
they
are
on
on
another
network.
There
are
another
set,
though,
but
by
from
outside
they
are
exact
accessible
only
by
the
EHR
servicing
and
then
to
create
the
data
we
verify.
A
So
another
question
that
is
always
asked
is
about
identity.
In
Brazil,
we
have
a
program
called
gov
dot,
BR
that
provides
digital
entity
identity
to
the
cost,
to
all
the
the
sit-ins
in
Brazil.
So
it's
okay!
So
with
this
program,
we
provide
some
some
information
that
I
use
it
by
by
the
government
from
the
the
social
number
that
is
the
CPF
in
Brazil
and
and
some
digital
information.
We
are
planning
to
to
integrate
this
information
with
biometric
information
that
I
use
it
to
vote
in
our
structures.
A
We
we
have
a
elections
that
that
store
biometric
information.
We
have
more
than
a
hundred
million
people
with
my
own
metric
information.
You
start
so
we
are
planning
to
integrate
this
to
our
digital
identity
program,
our
net
national
health
data
network,
we're
using
some
components
on
this
network.
So
at
this
moment
we
are
using
the
summers,
the
summary
of
the
cersei,
the
immunization
program,
education,
space
program,
exams,
performance
and
and
the
encounter
that
the
that
the
patient
has
did
did
and
then
we
are
planning
to
use
some
other
things
on
this
network.
A
Like
regulation,
medical
images,
medical
prescription,
notification
of
birth,
death,
I'm,
sorry,
notification,
General,
Street,
prescription
and
so
on
the
blocks
they
are
in
green.
They
are
readying
production,
the
blocks
they
are
in
in
yellow
and
the
blocks
they
are
in
white.
We
are
planning
to
roll
out
in
second
semester.
A
Our
strategy,
2d
DPR,
is
when
we
use
private
data
collection
and
in
Brazil
the
Brazilian
Minister
of
Health
doesn't
does
not
need
to
erase
data
if
patient
ones,
so
all
the
other
stuff
about
GDP
are.
We
are
doing
like
encrypted
data
before
it
going
into
the
private
data
collection,
storing
the
data
on
a
private
data
collection,
and
then
the
hash
of
the
the
head
start
is
going
on
the
blockchain,
but
the
hash
that
is
stored
on
blockchain
is
a
hash
that
is
generated
from
encrypted
data,
so
it
cannot
be
decrypted.
A
Let's
talk
about
performance,
our
structure.
At
this
moment
we
have
2,000
TPS
and
read
and
write
on
it
AWS
cloud.
We
are
using
raps
consensus
with
five
notes.
We
are
used
to
channels
the
timeline
channel
and
the
loud
Channel,
three
private
data
collections
and
couchdb
as
our
structure,
and
at
the
moment
we
are
using
three
peers
for
each
of
the
arcs
there
there
are
on
the
under
network.
We
are
we're.
Having
now
five
orgs
on
the
network,
that
rep
are
represented
by
five
states
and
each
of
them
have
three
beers.
A
We
are
using
fire
standard
for
pecking,
match
messages
in
Brazil
in
standard
and
in
our
structure.
We
are
using
these
objects
as
our
as
our
structure,
conditioning
counter
procedure,
observation,
immunization,
medication,
dispensing
composition
and
we're
using
clinical
documents.
Personal
health
started
from
a
smart
device
exams
and
observations
from
two
apps
yeah.
A
It
comes
unencrypted
in
the
first
moment
and
then
unencrypted,
and
then
we
encrypt
and
put
on
the
network.
Okay,
and
we
have
two
apps
that
we
we
hit.
We
have
developed
two
from
the
app
from
the
patient
and
to
the
doctor
and
they
can
put
our
preservation
and
so
on
and
and
access
the
timeline
and
I'm
gonna
show
you
a
little
bit
here.
We
expose
our
api's
with
micro
services
and
they
are
unable
to
work
with
certified
EMR
software
and
they
need
to
have
a
digital
certificate
to
send
information
to
our
network.
A
So
we
reinforce
that
all
of
the
software
there
are
going
to
be
using
the
network
need
to
have
their
digital
certificate
in
order
to
send
information
to
the
network,
and
we
have
an
agnostic
cloud
approach
tested
with
AWS
asher
in
google
cloud.
At
the
moment
our
architecture
are
using
Amazon,
but
there
are
some
states
that
are
planning
to
use
the
GCP
and
Azure
as
well.
A
Here's
one
of
the
apps
that
we
have
developed
and
the
connexxus
professional
it's
for
her
protection
errs
and
as
we
sing
there,
they
can
have
the
access
to
the
timeline.
They
can
have.
Those
information
they
are
consent
by
the
prediction
errs
so
so
from
the
patient's.
The
patient
needs
consent
that
information
to
the
prediction
er
in
order
for
him
to
access
that
timeline
on
on
his
app.
A
A
We
can
schedule
your
your
next
appointment
to
a
doctor
and
so
on
and
we
are
planning
to
use
some
other
features.
At
this
moment,
we
are
running
a
prove,
a
proof
of
concept
with
artificial
intelligence.
We
are
storing
the
anonymized
information
on
our
data
lake
and
then
we
are
using
some
machine
learning
strategies
and
so
many
AI
strategies
to
extract
some
information
from
this
data.
We
are
doing
some
other
stuff
like
using
this
data
on
a
graph
in
order
to
have
an
analysis
from
a
single
person.
So,
for
example,
I
have
all
my
data
there.
A
I
store
it
on
blockchain
and
then
I
need
some
protection.
There
need
to
access
my
data
and
have
some
analysis
on
that.
My
data
as
I
consent.
It
store
it
on
a
on
a
graph
database
and
this
graph
database.
We
then
doing,
for
instance,
and
so
on.
You
have
some
some
different
queries
that
can
be
done
by
by
the
by
those
physicians.
A
We
are
doing
some
biotech
stuff
too.
There
is
some
genetics.
There
are
plenty
to
be
used
to
be
stored.
They
are
in
proof
of
concept
too,
and
at
this
moment
we're
in
collaboration
with
IBM
doing
some
tests.
George
is
here
and
they
are
helping.
George
and
Barry
are
happiness
on
moving
to
fabric
2.0.
All
these
stretchers
is
developed
in
fabric,
so.
A
Okay,
let's
talk
a
little
bit
about
AI.
What
we're
doing
at
this
moment
we're
storing
all
the
data
that
we
have
is
around
two
years
of
data
that
we
are
using
at
this
moment
only
thrala
for
another
goes
there
the
first
state
we
have
more
than
2
million
records,
but
when
we
talk
about
all
the
Brazilian
stuff,
we
are
talking
about
more
than
10
billion
records.
There
are
going
to
be
stored
on
this
moment
and
we
are
putting
all
this
data
for
AI
in
a
data
Lake
in
them.
A
We
are
using
some
analysis
in
this
first
moment
to
have
analysts
by
political
political
issues
may
be
left.
For
example,
we
have
a
an
issue
about
coronavirus
and
you
have
to
get
this
information.
Where
are
those
possible
diagnosis
tests
that
can
be
used
to
help
Brazil
identifying
the
patients
that
could
have
Khurana
fears?
So
when
we
access
this,
this
data
we
use
some
strategist
we
are
using
this
with
Amazon
Amazon
is,
is
helping
us
on
getting
all
those
data
and
then
and
then
get
their
data
and
and
give
some
some
use
to
them.
A
A
A
Know
that
that
means
that
we
cannot
have
for
that,
a
specific
prediction:
ur
the
right
to
access,
but
if
it
if
it
was
some
urgent
care
and
so
on,
we
can
have
a
break
the
glass
situation,
the
break.
The
glass
situation
is
when
the
patient
needs
an
urgent
care.
Now,
maybe
he's
dying,
he's
going
on
on
a
hospital
he's
dying
and
the
the
prediction
er
goes
on
the
the
software
and
says
this
is
an
urgent
situation.
A
In
Brazil
we
have
a
assistant
called
golf
dot,
be:
are
there
are
there?
Every
citizen
can
have
a
an
account
on
this
system,
so
there
we
have
some
information
of
them
like
the
CPF.
There
is
our
social
number
and
a
lot
of
information
from
these
patients.
They
are
stored
on
just
on
this
golf
dot,
BR,
and
then
he
claimed
to
have
an
account
on
that
and
then,
but
he
need
his
email
confirm
some
information
and
then
he
can
log
in
on
the
on
the
on
the
app.
A
So
this
information
is
already
there
on
the
on
the
assistance
we
are
using
some
combine
and
system
databases
from
Brazil
the
database
from
for
an
hour,
lection
court.
The
database
is
from
our
economy
ministry,
the
database
from
a
lot
of
systems
from
our
from
our
health
care
ministry
and
so
on,
and
all
this
database
are
connected
in
order
to
have
this
golden
record
of
the
the
patient.
A
A
So
we
are
providing
better
api
is
in
better
systems
for
them
to
to
enhance
their
their
assistance
to
to
send
it,
but
if
they
don't
send
it
from
the
from
the
network
from
the
api's,
we
can
collect
their
information
from
this
database
so
where
we
plug
it
on
the
on
offline
batch
that
can
capture
the
the
information
from
the
private
plans
to
and
from
the
private
hospitals
to
the
network.
So
maybe
it
could
less
some
days,
but
the
information
will
be
there.
A
At
this
moment,
let
me
show
you
here
all
this
data
condition,
data
encounter
procedure,
observation,
immunization,
medication
dispensed
and
the
composition
to
compose
all
this
stuff
are
stored
on
our
network.
So
when
a
patient
goes
on
a
primary
health
facility
and
they
go
in
and
have
their
income
and
encounter
information
and
it's
stored
on
on
our
network-
and
maybe
he
can
have
a
procedure
like
I-
got
a
brute
blood
test
and
then
it's
stored
on
the
network,
and
then
we
can
have
some
immunization
stuff
and
any
store
on
the
network.
A
We
are
planning
to
roll
out
some
other
features
from
our
profile
to
the
end
of
the
year.
So
at
this
first
moment,
when
you
talk
about
profiles,
fire,
we
are
talking
about
around
20
objects
that
can
be
stored
on
the
network
at
this
moment
and
so
it'd
be
about
80%
of
the
procedures
on
the
on
the
network
are
covered
at
the
moment.
A
At
this
moment,
we're
we're
very,
very
own.
A
pilot.
Yes,
we
are
we're
planning
to
go
to
all
of
the
counter
is
is
a
very
big
country.
We
have
a
lot
of
issues
to
handle
on
this.
We
have
political
issues
where
there
is
very,
very
problematic
on
this
stuff.
We
have
technical
issues,
we
have
some
some
stuff
like
law
and
so
on
that
we
had
to
change
for.
A
For
this
first
part,
we
we
know
that
this
can
do
a
very
good
hand
sense
on
our
health
care
system
at
this
moment,
but
where
we're
planning
to
enhance
the
fire
profile,
we
are
planning
to
use
the
artificial
intelligence
stuff
to
enhance
the
continuity
of
care
and
and
so
on,
and
we
are.
We
have
some
some
partnerships.
A
We
have
a
personal
partnership
with
the
government
of
Denmark
and
all
of
them
are
helping
very
much
our
structure
and
and
I
think
you
know,
maybe
in
two
years
we'll
be
having
all
of
the
country
covered
and
maybe
with
80
or
more
percent
of
software,
because
we,
the
other
problem
that
we
have
here,
is
not
only
to
put
it
on
production,
but
we
have
to
go
to
all
the
primary
health
facility
and
go
there
and
say:
oh,
you
should
use
it.
So
how
can
we
help
you
to
use
it?