A Decentralized Electronic Prescription Management System

The ongoing digital transformation of the medical sector requires solutions that are convenient and efficient for all stakeholders while protecting patients' sensitive data. One example involving both patients and health professionals that has already attracted design-oriented research are medical prescriptions. However, current implementations of electronic prescriptions typically create centralized data silos, leaving user data vulnerable to cybersecurity incidents and impeding interoperability. Research has also proposed decentralized solutions based on blockchain technology as an alternative, but privacy-related challenges have either been ignored or shifted to complex or yet non-standardized solutions so far. This paper presents a design and implementation of a system for the exchange of electronic prescriptions based on the combination of two blockchains and a digital wallet app. Our solution combines the bilateral, verifiable, and privacy-focused exchange of information between doctors, patients, and pharmacies based on a verifiable credential with a token-based, anonymized double-spending check. Our qualitative and quantitative evaluations suggest that this architecture can improve existing approaches to electronic prescription management by offering patients control over their data by design, a sufficient level of performance and scalability, and interoperability with emerging digital identity management solutions for users, businesses, and institutions.