Blockchain Healthcare Pilot

by Grapevine World, Microsoft, University of Southampton and Tiani Spirit

The main goal: To verify the effectiveness of the Grapevine World decentralized architecture for the worldwide exchange of Electronic Health Records using blockchain technology.

Grapevine World has established a partnership with Microsoft to conduct a pilot trial demonstrating the value of combining market-proven interoperability standards in health data exchange (IHE) and blockchain technology (Hyperledger Fabric) for monitoring and assessing health data provenance. We believe by joint efforts we can move the whole healthcare industry to a qualitatively new level, overcoming the crucial issues of lack of privacy, security, performance, and scalability. Collaboration with Microsoft is a further step to the achievement of this global mission. We continue looking for partner corporations striving to validate the benefits of blockchain for making secure and interoperable clinical data exchange. Let us know if you are keen for partnerships with Grapevine to help regulators and the software community achieve the common goal of secure and interoperable healthcare exchange by releasing the potential of the Grapevine architecture.

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About the pilot

From the 1980’s, innovators have been trying to come up with a highly effective standard of using IT systems in the healthcare sector. The result is the development of two universal healthcare standards called DICOM1 and Health Level 7. Considering DICOM1 and HL7 created technologically isolated spots with data caged in silos hindering the possibility for the patient to move between hospitals in the same region and, sometimes between different departments in the same hospital, these early initiatives suffer from the lack of interoperability. In accordance with ISO 27000, systems lacking interoperability violate other significant parameters of an effective IT system: availability and safety. DICOM1 and HL7 are still the major standards in the healthcare. Therefore, our key aim is to bring cardinal upgrades to these concepts.

The idea of the Blockchain Healthcare Pilot is to exploit and innovate existing healthcare IT deployments by enabling data provenance queries for all kind of clinical information from anywhere.


We build our roots on existing initiatives such as:

  • epSOS - the first large scale pilot (connecting almost all the EU member states) providing the first interoperability specifications based on IHE for Patient Summary and e-Prescriptions cross-border exchange.
  • e-SENS - the cross-vertical pilot project using the IHE process to further enhance and secure cross-border healthcare exchange.
  • eHealth Digital Service Infrastructure - the body of the EU commission operating under the "New EIF," the Cross-Border e-Health Information Services (CBeHIS).
  • The Trillium Bridge - the EU-US initiative for trans-Atlantic healthcare exchange.
  • NwHIN - the backbone of interoperability in the USA.

The Grapevine ecosystem interconnects these healthcare enterprises through the IHE standards (and provides a SDK for those who are not using IHE) enabling a healthcare data exchange at a global scale. Since IHE is not limited to the projects above and is available worldwide, the technology and standards are available and active all over the world.

Realization of the Blockchain Healthcare Pilot pilot idea can be achieved through the use of the peer-to-peer function of blockchain technology and smart contracts with the development of a provenance system resistant to frauds. This technical solution is the foundation of the Grapevine architecture.

IT Architecture

* The full pilot architecture can be found at

First, in our architecture, there are the following actors:

  • The Patient, who is the owner of the healthcare data;
  • The Healthcare Provider Organization, HPO, which provides infrastructure to safely store data;
  • The vendor facade, which provides the IHE-based entry point for access to this data from anywhere and sits in the security zone of the HPO;
  • The Grapevine Orchestration Engine, the GOE, which is a central component facilitating the exchange of data by creating secure and anonymous communication channels;
  • The Data Requestor, e.g., a Pharmaceutical Institute or Government for Population Health queries;
  • The provenance, a private blockchain running on Microsoft Azure which enforces the creation of provenance documents according to W3C.
Figure 2.1 depicts the architectural approach from a high level perspective.

Using the app, a patient signs up in the Grapevine Orchestration Engine to take part in the pilot ecosystem. During the registration process, he provides this info:

  • a user email (to notify him about events);
  • a user location (for clinical trials requesting this information);
  • a user’s ethereum address.


After signing up, the patient is authenticated by a hospital and by the ecosystem with a unique patient UUID. The previously enrolled Healthcare Provider Organizations (HPOs) provide the patient with QR Code to authenticate the patient belonging to the given UUID. In this way, the patient’s UUID is stored as a local patient (in the worldwide defined Grapevine World patient domain).Thus, at each query, the GOE always uses the UUID as the patient’s identifier in remote locations.

After registration, when a clinical trial or any other data request is available and the user decides to participate, the flow sequence begins. The patient is asked to provide a consent and a release of professional secrecy, and the GOE starts to fetch documents to check whether the patient is eligible for the specific request (e.g., by matching inclusion/exclusion criteria of the clinical trial). If the user matches the eligibility criteria, the GOE starts querying various hospitals where the patient has data and writes each event in the timeline. For each document, GVINEs are evaluated, requested as by the Pharmaceutical institute, and transacted to the stakeholders (patients, and HPO). The guarantor of security and interoperability of this IT architecture is the ability of HPO facade to evaluate the clinical data provenance in each document.

The main caution when launching a pilot is to prevent the disruption of the structure and equilibrium of the whole healthcare system. Grapevine IT architecture seamlessly integrates with existing legacy systems, preserving the instruments healthcare users (medical workers, patients) have in production at the moment. The viability of the Grapevine solution has been assessed through the implementation based on a Hyperledger Fabric private blockchain fully integrated in the IHE-XDS affinity domain. The chain code (aka smart contract) is an open source and can be found online on our GitHub profile. The overall system is available for a remote demonstration on demand at any time.


The pilot is based on existing international standards and innovates them using blockchain technology, the de-facto reference for security and immutability of medical records. This a flexible and secure-by-design approach can be scaled up to billions of records and citizens, as proven by the existing standards (e.g., the Sequoia project, the NwHIN), and well-established blockchain applications.

By building trust relationships focused on long-term mutually beneficial cooperation, Grapevine World acts as the interface and coordinator for stakeholders involved in this pilot: healthcare provider organizations acting as data owners, the data center provider (Microsoft Azure) leveraging Hardware-enforced security, interoperability technology (Tiani Spirit, Soton), blockchain technology (Grapevine World) and potentially pharmaceutical corporations acting as data requestors.

The ultimate goal of the pilot is to determine the peak of the Grapevine World decentralized architecture efficiency for the worldwide exchange of Electronic Health Records, thereby deepening the understanding of blockchain technology potential. We’ll compose a case study demonstrating the results of the pilot to position Intel, Microsoft and Grapevine as industry thought leaders as well as establishing an aligned Go-to-Market approach for scaling the solution across the global healthcare industry and catalyzing a pull for this collaborative solution. Strategically, the pilot can establish a network of healthcare organizations transacting on blockchain, on which we can implement other use cases, grow the community, and expand worldwide. Join our movement of healthcare innovators right now!

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