Blockchain and Smart Contracts in a Decentralized

Health Infrastructure

Sergey P. Novikov1, Oleg D. Kazakov2, Natalya A. Kulagina3, Natalya Yu. Azarenko4

Bryansk State Technological University of Engineering
Bryansk, Russia
1
[email protected], [email protected], [email protected], [email protected]

Abstract - Today digitalization penetrates into all spheres of doctor and the patient, release from the "paper" work at a
human activity. The volume of digital data is increasing. patient's reception, and, ultimately, the liquidation of queues in
Therefore, it is necessary to use innovative methods of medical institutions.
information processing. This is important for the effective
management of socio-economic systems. The urgent task is to One of the most important tasks of the federal program
ensure the security of storage of digital assets. System analysis of "Digital Economy of the Russian Federation" for the period
blockchain technology is carried out. The authors substantiate until 2025 [23] is the development of digital healthcare. The
the effectiveness of the use of lockers for the safe storage and section "Digital Healthcare" focuses on the organization of
transmission of information. The advantages and prospects of accessible medical care for citizens at where it shall require
implementation blockchain in the management of social and meeting the criteria of modern times, personalization,
economic systems are presented. The purpose of this study is to precautionary, workability and safety. To provide citizens with
investigate the effectiveness of blockchain in the health care continuity in the provision of medical assistance, medical
system. The article presents a model of the decentralized organizations of all forms of the ownership must be connected
infrastructure of the health care system. Interaction of to the IEMK USIHS (integrated electronic medical card of the
participants within the model provides solutions to existing unified state information system in the healthcare sector), but
problems. The article presents the scheme of the distributed data subject to the patient's consent to processing his data
register for creation of the electronic medical card of the patient.
electronically.
An algorithm for the use of smart contracts in the health care
system has been developed. The results of the research prove the In order to achieve the set goals, it is necessary to form a
effectiveness of the blockade technology for storing records of single digital environment of the healthcare system that allows
electronic medical records of patients. a patient to effectively interact with the medical institution. In
conditions when there is a growth in both incomes and the
Keywords – blockchain; digital register; smart contract; number of middle class, people start to spend more on health
electronic medical card (EMC); digitalization of medicine; digital care and seek to receive better services. Consumers are no
healthcare
longer passive patients, they are increasingly interested in the
process of providing services, waiting for treatment with the
I. INTRODUCTION help of new technologies and demanding better information.
Nowadays development of information and
telecommunication technologies is at an enormous pace and One of the first tasks is almost complete digitization of the
covers almost all the aspects of the socio-economic activities of document circulation of the entire health care system. The next
a person. Digital economy has replaced digitalization, thanks to step is the integration of digital technologies into the health
which it became possible to create qualitatively new models of infrastructure management system. In this regard, there are
business, trade, production, to change the format of education, acute questions about the storage of personal data, providing
public health, public administration and communication professional access to them, security of information. We
between people. believe that the solution of the set tasks is possible only in the
context of creating a decentralized health infrastructure on a
The main goal of modernization of domestic health care digital basis.
system is to improve accessibility and quality of medical care
for a wide range of people [2]. A large-scale reform of In the framework of the study, we will consider the
medicine in Russia provides for the solution not only of the possibility of creating such an infrastructure based on
material and technical problems of polyclinics, hospitals and blockchain technology and smart contracts. Such a system will
dispensaries. Intellectual aspects of improving the organization create an effective mechanism for the exchange of medical
of medical care are much more important: firstly, the doctor- information, improve the integrity of data, reduce transaction
patient relationship, And first of all, the relationship of the costs and will help to avoid the third-party services involved in
the management of public health. All the organizations that
provide medical services, including insurance companies, and
This work was supported by the RFBR grant 18-41-320003\18
directly the citizens seeking medical care should be the key

697 978-1-5386-6757-6/18/$31.00 ©2018 IEEE

players in such a system. Maintaining the proposed system in a B. Blockchain technology in socio-economic systems
workable state will require the introduction of innovative management
technologies for working with digital information. Such Development of the blockchain-technology is associated
technologies should provide exceptional reliability and security with the appearance of a crypto-currency. In 2008, Satoshi
of information storage, its relevance, reliability, availability Nakamoto article appeared on the Internet: "Bitcoin: A Peer-to-
and high speed of network processing. In addition, the creation Peer Electronic Cash System" [11]. The article presented
of a digital patient-oriented protocol will allow to optimize principles of building a peer-to-peer payment system with the
relationships between all the concerned parties in the health ability to make electronic transactions between its participants,
sector. bypassing intermediaries in the form of financial institutions.
To solve the set tasks and to test the hypothesis about the Thus, initially the blockchain technology was widely used in
possibility of using blockchain technology and smart contracts the financial sphere and led to the appearance of crypto-
in the organization of decentralized infrastructure of the currencies, the most famous of which is a bitcoin. However,
healthcare system, we will conduct a study of the practice of the obvious advantages of blockchain technology (openness,
using modern digital technologies for reliable and safe storage transparency, high level of security and security of ongoing
of information in public networks and ensure effective transactions) prompted IT specialists to search for opportunities
exchange of professional information between all the for its implementation in various areas of socio-economic
participants of the digital environment of the social and relations of modern society [12].
economic system. At the beginning of 2016, the report " Distributed ledger
II. BLOCKCHAIN-TECHNOLOGY AS A technology: beyond the Block chain" was published in the UK
COMMUNICATIONAL BASIS FOR SOCIO-ECONOMIC [5], which represents a study conducted by the State Science
Administration under the leadership of the UK Government
SYSTEMS MANAGEMENT
Chief Scientific Adviser, Sir Mark Wolport. The report, in
A. Blockchain technology particular, notes that the main task of the state is to develop a
Blockchain-technology has made a breakthrough in the clear concept of how distributed ledger technology can
field of reliable storage of information in public networks [6]. improve business processes of government bodies and how it
Blockchain is a type of distributed database where records are can be used to provide services to citizens.
grouped into blocks. Each block is linked to the previous one So far blockchain technology has come a long way from
using a hash key [10]. This ensures that the information within transforming from individual transactions with bitcoin crypto
the block can not be changed without changing the information currency to the base of creating flexible platforms and building
stored in subsequent blocks. The chain of blocks is stored on a system around them in order to accumulate the development
the node computer (Node) of each participant of the system, of adapted applications for their subsequent implementation in
forming a distributed data register. When adding a new block, a wide range of industries. In the book "Blockchain. Blueprint
copies of the entire block chain are updated for each for a New Economy” researcher and founder of the blockchain
participant. Consensus on what types of blocks and research institute Melanie Swan, identifies three conditional
transactions can be part of a blockchain is automatically areas for the application of this technology [22]:
achieved according to whether most block chain holders agree
with the proposed blocks or not. The novelty of the blockchain • Blockchain 1.0 - crypto-currency transactions (crypto-
technology is that it becomes possible to install business logic currencies are used in various applications related to
in the transaction itself. The block contains a set of records and financial transactions, for example, the system of
new blocks are added strictly to the end of the chain. This transfers and digital payments) [9];
distinguishes this technology from the traditional databases • Blockchain 2.0 - smart contracts (applications in the
where business logic is installed in the database itself or in field of economy, markets and finance working with
software. various types of instruments - shares, bonds, futures,
Advantages of the blockchain technology: mortgages, titles, assets and contracts) [15];
1. Decentralization, which minimizes the risk of failure of • Blockchain 3.0 - applications, the scope of which goes
work in case of failure of a separate system. beyond financial transactions and markets (extends to
the areas of public administration, health, science, etc.)
2. Increased security through the use of cryptography in the [1].
implementation of each transaction.
Since the scope of blockchain technology has expanded
3. Impossibility to change the data of the approved block. This significantly, the main trend is not the emergence of new
is achieved by the fact that the hash of the identifier of each crypto currency as means of payment but the creation of multi-
block is calculated on the basis of the cumulative data hash of functional platforms that act as an infrastructure for a whole
the entire block and the hash of the identifier of the previous range of business applications [3]. This became possible in the
block. new version of Blockchain 3.0 based on the Erachain platform,
4. Transparency, as all actions are documented and available which for the first time provided an opportunity to work within
for all the participants of the system. the framework of legal norms, taking into account the
provisions of federal laws of the Russian Federation No. 152-
FZ "On Personal Data" and No. 63-FZ "On Electronic

698
Signatures". Unique protocol and regulatory support of data of electronic medical records of patients.
Erachain made it attractive for commercial enterprises, public Skvortsova emphasized that the system of storing
organizations of any type and government structures. medical cards would be maximally depersonalized, and
that would preserve medical confidentiality. In this case,
C. C. Global experience of using blockchain technology patients will be able to determine for themselves what
and smart contracts in the healthcare industry part of the information from their medical cards they
want to disclose [19]. Previously, Vladimir Demin,
Nowadays digital technologies based on blockchain and
adviser to the chairman of the board of
smart contracts are widely used in the healthcare industry:
Vnesheconombank, announced plans to introduce
- Active researches on the use of distributed ledgers in the
distributed ledger technology into the system of the
healthcare industry are conducted by a Dutch company
Ministry of Health [21]. According to the expert’s
Royal Philips. The company's division, Philips
opinion cards on the blockchain will allow to eliminate
Healthcare, has launched the Blockchain Research Lab,
the paper bureaucratic "red tape" in medical institutions
a research laboratory that investigates the use of
and to focus doctors’ efforts on healthcare delivery.
blockchain in medicine.
The analysis of using the blockchain technology has
- A blockchain-platform, in which patients' medical
revealed that nowadays it’s been defined as a separate
records can be seen in real time operates in Estonia.
technology, which can be used outside the framework of the
Blockchain technology Guardtime and eHealth
crypto-currency. It’s mostly used when it is necessary to
Foundation ensures safety, transparency and integrity of
optimize the relationship between participants in socio-
medical information, protecting data from unforeseen
economic systems. Analysis of the blockchain technology
changes or deletions due to hacker attacks, system
advantages confirms the previously suggested hypothesis that
failures and malicious programs [20].
this technology will allow to solve the issues of reliability and
- A work on the project of placing all the medical records "transparency" of information storage on the relationships of
in the country in the block chain is being held in the subjects of socio-economic systems in public networks.
UAE, in cooperation with the Estonian company However, successful implementation of the blockchain
Guardtime. The idea is to make it easier for doctors to technology will require a combination of public administration
access all the information about the patient and reduce to protect participants in the system and concerned parties and
the need to collect various information [18]. regulation to ensure resilience to system risks as well as
protection against the use in criminal activities.
- In the US, the Ministry of Health calls for the
modernization of medical records system and for III. PECULIARITIES OF IMPLEMENTATION OF
transferring them into a blockchain. [16] The BLOCKCHAIN TECHNOLOGY AND SMART
Department of Health initiated a competition of research CONTRACTS IN THE SYSTEM OF HEALTH CARE
works in the field of applying blockchain technology in
healthcare [17]. The main task is to improve the transfer Need for cooperation with health care providers leads to the
of medical data between states [7]. increasing use of digital technologies. In this case an electronic
environment providing a convenient and effective interaction
- Development of a registry of medical data on the basis between all health facilities and consumers of medical services
of blockchain is conducted by a subsidiary of Google in is needed. Development of such an environment leads to the
the UK [19]. First users of the system called Verifiable creation of medical information storages based on the use of
Data Audit, will be hospitals, the British National the integrated electronic medical record (IEMC). To build an
Health Service (NHS), then patients will join it. The effective health management system, it is advisable to use a
system will be regulated by medical institutions and service model, where the central place is taken by IEMC. An
data operators. approximate scheme for organizing such a model is shown in
- In Germany SAP company uses blockchain-based the Figure 1.
software to establish interaction between patients and
physicians [17]. The SAP Health Engagement system
allows patients to maintain direct communication with
doctors and health facility managers, and medical
institutions.
- To develop better treatment of chronic diseases.
- The MedRec project in Israel is working on a system of
smart contracts for the exchange of medical cards
between different clinics [14].
- In Russia, the idea of transferring medical cards to
blockchain was also proposed. On Sept. 6, 2017, during
the Health Forum at the Eastern Economic Forum
(EEF), Health Minister Veronika Skvortsova said that
the blockchain technology could be used to store the Fig 1. E-health system model based on IEMC

699
 The main task of the IEMC is to provide collection of the In this case, a distributed ledger based on the blockchain
largest possible amount of medical information about a specific technology is ideally suited for storing electronic medical
patient in an electronic form. Technically, this information is a record data. The consistency of the data entered in such a
block of electronic personal medical records (EPMR) relating register is one of the main advantages of using the blockchain
to one person, collected and used by several medical technology.
organizations. The IEMC can be established by a group of
medical organizations or a health management authority. The In addition, the creation of such a system will allow the
management way of the IEMC, information storage, access main providers of health services to actively communicate and
rights and information exchange standards should be cooperate with other specialists and auxiliary medical
determined by the organizations creating the IEMC. General organizations, such as laboratories and pharmacies. In addition,
requirements for the IEMC must be formulated in a separate on the basis of the decentralized data storage system of the
national standard. IEMC, an effective communication between a health care
provider and a patient can be organized. Given that many
Thus, the IEMC is a properly organized electronic archive doctors do not want patients to have access to electronic
that provides reliable storage and operative regulated medical records, patients play a passive role in monitoring their
information exchange, as well as the fastest and the most health. Implementing the blockchain infrastructure of the
convenient way to delivery information about a patient to an healthcare system, health care providers receive new channels
authorized physician wherever and whenever it is detected. for simplified coordination of patient’s care and overall
improvement of health interventions results.
When designing the IEMC, various information tasks will
arise: organization and standardization of information flows Blockchain technology allows you to accumulate
and formats of the information exchange, strict delineation of information for the entire patient's life while ensuring a high
access rights, creation of a patient identification system, etc. level of safety. In this case, patients will completely dispose of
The concept of creating a unified information environment in their data and will be able to easily search for their records,
the healthcare sector is not feasible until they are solved. which are encrypted and stored in a blockchain. Thanks to
encryption with several keys a blockchain-based system will
Filling the IEMC is a separate task. In addition to grant access to data only if the person concerned signs the
information about the services provided and the medical corresponding permission [4].
history, the IEMC should contain the results of laboratory
studies and other medical documents. In accordance with a new In order to optimize relationships between health care
law it is planned to introduce electronic medical certificates of providers, insurance companies and patients, it is advisable to
incapacity for work, which will be transferred from polyclinics use smart contracts in conjunction with blockchain technology.
and hospitals. Exchange of the information about electronic Such an opportunity is provided, for example, by the universal
medical certificates can be arranged through the IEMC, that blockchain-platform Ethereum.
will combine information on the disability of citizens and
further to analyze the loss of economic potential due to Ethereum is the second most popular blockchain project in
morbidity. the world after Bitcoin [13]. In our opinion, this project is most
convenient since it allows to solve a wider class of tasks,
Thus, the main advantages of using the IEMC are: providing conditions for performing transactions based on
technology of smart contracts.
1. Keeping medical history in an electronic form, for
example, if the original is lost. At the same time this project:
2. Chance to quickly exchange information between • Allows you to maintain an optimal level of security due
doctors from different health facilities within a single to a large deployment and its irreversibility;
information system.
• Ensures transparency of the public blockchain,
In Russia, the work on creation of the electronic medical especially through open source franchising contracts;
cards within the framework of the EGIS is conducted for a long
time. More often in commercial medical organizations the tests • Has many improvements, especially with regard to
are delivered to a doctor electronically. Issues of connecting scalability.
the information systems of commercial laboratories and private Thus, the blockchain-platform Ethereum provides an
medical institutions to the regional segment of the integration opportunity not only to create a secure and transparent publicly
bus of the UGISZ are actively discussed, and a patient is given accessible IEMC register, but also to ensure efficient exchange.
full access to his data. However, the question arises - how to Below there is a schematic description of the blockchain of the
guarantee the unchanged data in such electronic cards? There health system infrastructure based on the IEMC (Figure 2)
are situations when an incorrect diagnosis is made, the course
of treatment is incorrectly assigned and a patient dies. In this The proposed scheme of the blockchain of the health
case, there is a possibility of fraud related to the correction of infrastructure assumes effective interaction of the patient with
the data in the IEMC in order to avoid claims from relatives of all participants of the healthcare system.
the deceased. To prevent such a scenario, it is necessary to The algorithm of the proposed system in case a patient
ensure security of personal medical data and their visits of a medical institution is as follows:
"transparency" for all participants in the digital healthcare
system. 1. A patient gives a temporary access to his/her data.

700
 2. A smart contract will temporarily unlock the patient's 1. The patient provides access to the records of his IEMC
IEMC for making changes, while the medical institution for other participants of the system.
uses its identifier to access the required data.
2. A smart contract defines the mechanism of interaction
3. Patient’s IEMC records are updated. Smart contract with unlocked patient data.
automatically informs the patient and the doctor about
it: 3. The patient can at any time get an access to his IEMC
through a single portal of public services.
- the patient is informed of changes in the IEMC records.
4. The independent commission monitors the current
-the physician receives information about the services processes in the blockchain and provides access to the
received by the patient during his visit to the medical data in case of emergency.
institution.
The use of blockchain technology to store IEMC will
4. The patient confirms changes of the IEMC, and the allow a patient to view and to provide his medical record to
doctor - the services rendered to the patient. state and commercial medical organizations for recording the
results of analyzes and treatment without being tied to a
Other participants of the system and a personal IEMC specific medical institution.
cooperate with a direct participation of the patient:

Patient
Pharmacies
Healthcare BLOCKCHAIN
Services

Public Service IEMC

Delivery Systems Research organizations

Insurance Supervisory bodies

companies
Doctor

Fig 2. Blockchain of the healthcare system infrastructure based on the IEMC

IV.DISCUSSION OF RESEARCH FINDINGS developed at Oxford University is positioned as a system that

Within the study, the possibility of successful use of the allows patients to safely store their data and provide access to
blockchain technologes and smart contracts in the healthcare specialists anywhere in the world, regardless of the medical
sphere was proved. The suggested hypothesis that this network or the electronic medical record used. Created in the
technology will solve the issues of reliability and laboratory of the Massachusetts Institute of Technology on the
"transparency" of the storage of the information concerning the Etherium platform, MedRec provides an ability to view and to
relationships between subjects of socio-economic systems in edit information about the medications that a patient receives
public networks has been confirmed by the system analysis of and to combine data from medical records in different medical
the blockchain technology and by the study of the practice of institutions.
its usage. Despite the fact that blockchain technology has a number of
A single approach based on the blockchain will allow undeniable advantages over other technologies, a number of
personal medical information to be always with a patient when issues remain unresolved:
visiting a new doctor or a new medical institution, which is 1. Information quality. The technology does not allow to
safe and reliable. In this case information can be instantly determine if the diagnosis is accurate and a suitable list of
updated after visiting a medical institution and will be services was provided to a patient.
immediately available to all the doctors who has a right to view 2. Information unification and standardization of medical
it upon patient’s permission. records. You will need the tools to manage data quality and to
Thus, blockchain technology provides trust, which is very create so-called "gold" records about patients: you will need to
important in medicine. For example, the Medichain platform

701
identify everyone, remove duplicate records. Without the tools Insurance) or by VHI (Voluntary Health Insurance) because
that automate this process it can take years. an insurance company will not need to make written inquiries
to a medical institution to check the patient's medical history.
3. Change of work processes inside the medical institution. The insurance company that will have access to viewing
A new principle of collecting and using information will entail patients' medical cards can directly see what medical services
changes in the order of work of doctors and administration. In have been provided and what medications have been
particular, a system of medical cards will need to be integrated prescribed for a particular patient. As a result, insurance
with a settlement system. Here, qualitatively formed smart companies will always be aware of the appropriateness of
contracts and technologies for crypto-currency settlements can using the funds allocated to the medical institution.
come to the rescue. It is also necessary to establish an
exchange of the information between institutions, to create and Thus, the use of blockchain technology to store IEMC will
to implement a process of providing and accessing the improve safety and security of patient data and will help to link
patient's card. Additional costs will be required for training disparate bases into a single one making the interaction
medical personnel to work with electronic platforms, as well between patients, doctors, medical institutions and insurance
as equipping with necessary equipment. companies more transparent. The use of blockchain makes it
possible to switch to personalized medicine since all the
V. CONCLUSIONS episodes of patient interaction with medical institutions,
analyzes, physiotherapeutic procedures, chronicle, heredity,
Within the framework of this research, the expediency of
reaction to various drugs, etc. will be stored in the database. It
using blockchain technology in the healthcare sphere has been
will be much easier to audit the quality of care provided and to
proved. System analysis showed that solutions based on this
rank medical institutions, as well as to monitor their work.
technology form a safe and naturally decentralized framework
for effective digital interaction. One of the main advantages of The main difficulty in using the blockchain technology in
blockchain in comparison with other models of distributed healthcare is to achieve a balance between protecting interests
databases is the integration of data processing, ensuring of participants in the system and to satisfy broader interests and
correctness and security in a single protocol, implemented needs of the society.
algorithmically and minimizing the human factor. Thus, the
main characteristics of the blockchain technology is REFERENCES
availability and stability of the information that allow it to be [1] R.T. Aune, A. Krellenstein, M. O’Hara & О. Slama (2017). Footprints
introduced into the healthcare sphere. on a Blockchain: Trading and Information Leakage in Distributed
Ledgers. The Journal of Trading, 12(3), 5-13.
We highlight the main advantages of the blockchain [2] N.Yu. Azarenko and O.V. Mikheenko. Readiness assessment of the regional
platform as a key element of the health information system: infrastructure to formation and development of the digital economy. Bulletin
of the Samara State Economic University. 2018. No. 6., 23-30
1. Entered in the blockchain data remains unchanged. A [3] S. Davidson, P. De Filippi and J. Potts, (2016). Disrupting Governance:
doctor making any new entries in the medical history will not The New Institutional Economics of Distributed Ledger Technology.
be able to remove already available information about a SSRN Electronic Journal.
patient, as it will always remain in the system and will be [4] Decentralized Information // Blockchain Research Lab [Online].
http://www.blockchainresearchlab.org/ projects/decentralized-
identified and tied to the particular person who entered it. information.pdf (accessed: May 6, 2018)
2. The blockchain technology will not allow you to [5] Distributed Ledger Technology: beyond block chain / Government
Office for Science (2016). [Online]. Available:
manipulate data about the patient's medical history for https://www.gov.uk/government/uploads/system/uploads/attachment_dat
obtaining positive medical conclusions. Data on the diseases a/file/492972/gs-16-1-distributed-ledger-technology.pdf.
cannot be deleted or unauthorizedly made without letting [6] D. Drescher (2017) Blockchain basis: a non-technical introduction in 25
know someone who has the right to adjust or to enter such steps. Frankfurt am Main: Apress.
data. Thus, the system reduces corruption risks associated with [7] A. Ekblaw et al. A Case Study for Blockchain in Healthcare: «MedRec»
issuing medical certificates. Prototype for Electronic Health Records and Medical Research Data //
Proceedings of IEEE Open & Big Data Conference. – 2016. – 13 p.
[Online]. Available: https://www. healthit.gov/sites/default/files/5-56-
3. Blockchain will help to avoid fraud with prescriptions onc_blockchainchallenge_ mitwhitepaper.pdf (accessed: May 5, 2018).
by implementing the following scheme. A patient visits a
[8] Google's DeepMind plans bitcoin-style health record tracking for
doctor and he establishes a definite diagnosis that requires hospitals // The Guardian. – 2017. – URL:
prescribed medicines. The doctor opens a system and makes https://www.theguardian.com/technology/2017/mar/09/google-
necessary preparation for making a record into the patient's deepmind-health-records-tracking-blockchain-nhshospitals (accessed:
medical history. The patient can immediately go to the May 13, 2018).
pharmacy where the pharmacist when opening the patient’s [9] R. Grinberg Bitcoin: An Innovative Alternative Digital Currency. (2011,
December 9). Hastings Science & Technology Law Journal, Vol. 4,
electronic card has an opportunity to make sure what medicine p.160.
was prescribed or if was prescribed or not. Based of this, the [10] C.R. Harvey (2014). Cryptofinance. SSRN Electronic Journal.
pharmacist gives prescribed medicine to the patient and [11] S. Nakamoto (2008). A Peer-to-Peer Electronic Cash System // Bitcoin.
immediately makes a note that the patient has received the Retrieved from https://bitcoin.org/bitcoin.pdf.
necessary medicines. [12] J. Prpić (2017). Unpacking Blockchains. Collective Intelligence 2017.
NYU, Tandon School of Engineering. June 15-16, 2017.
4. Blockchain will help to avoid misappropriation of [13] A. Tapscott, D. Tapscott, M. Yunus et al. (2016). Blockchain
budget funds and funds paid by CHI (Compulsory Health Revolution: How the Technology Behind Bitcoin Is Changing Money,

702
 Business and the World. Blockchain Revolution by Alex Tapscott & [18] In Dubai, extensive plans for the use of blockade technology // Coinfox.
Don Tapscott. Boffins Books. Retrieved from – 2016. – URL: http://www.coinfox.ru/novosti/5601-v-dubae-
https://www.boffinsbooks.com.au/books/9780241237854/blockchain- ozvucheny-obshirnye-plany-primeneniya-blokchejn-tekhnologii
revolution. (accessed: May 12, 2018). [19] The head of the Ministry of Health told about the use of blockade in
[14] US Government Issues Call for Blockchain Healthcare Research // Russian medicine. – URL:
CoinDesk. – 2016. – URL: http://www.coindesk.com/health-human- http://www.rbc.ru/rbcfreenews/59af5f759a7947050f6af37c (accessed:
service-department-seeks-blockchain-papers/ (accessed: May 3, 2018). May 12, 2018).
[15] Werbach, K.D., Cornell, N. (2017). Contracts Ex Machina. SSRN [20] How Estonia applies block-system on the scale of the whole state //
Electronic Journal. Geektimes. – 2016. – URL:
[16] Blochein may become the standard for the storage of medical records in https://geektimes.ru/company/wirex/blog/278618/ (accessed: May 12,
the US // Hightech. – 2017. – URL: 2018).
https://hightech.fm/2017/02/02/patient-data (accessed: May 12, 2018). [21] Medcarts in Russia will be transferred to the blockade [Электронный
[17] Blochein on the "service" of the world: Review of the digital agenda in ресурс]. – URL: https://www.if24.ru/medkartyperevedut-na-blokchejn/
the world // The Eurasian Economic Commission..№7. 2016. P. 6. URL: [22] Swan, M. Blockchain: Scheme of the New Economy. - Moscow: Olimp-
http://www.eurasiancommission.org/ru/act/dmi/workgroup/Documents/d business, 2017. p.240
igest/7%20%D0%A1%D0%BF%D0%B5%D1%86%D0%B2%D1%8B [23] The Digital Economy of the Russian Federation. Program. Order of the
%D0%BF%D1%83%D1%81%D0%BA_%D0%91%D0%BB%D0%BE Government of the Russian Federation of July 28 2017 . № 1632 -o. –
(accessed: May 12, 2018). URL http: // www.tadviser.ru/images/a/a/9gFM4FHj4P
sB79I5v7yLVuPgu4bvR7M0.pdf.

703