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Health 3.0 enables decision-making to be based on longitudinal data from multiple institutions spanning the patient's healthcare journey. Blockchain smart contracts can act as neutral and trustworthy intermediaries to implement such decision-making. In this distributed healthcare setting, transmitted data are structured using standards, such as Health Level Seven Fast Healthcare Interoperability Resources (HL7 FHIR), for semantic interoperability. Hence, the smart contract will require interoperability with the domain standard. However, it will also have to implement a complex communication setup to work in a distributed environment (e.g., using oracles), and be developed using special-purpose blockchain languages (e.g., Solidity). To support these requirements, we propose the encoding of smart contract logic using a high-level semantic Knowledge Graph (KG), which uses concepts and relations from a domain standard and additionally lists distributed data requirements. We subsequently deploy this semantic KG on blockchain via a hybrid on-/off-chain code-generation approach. We applied our approach to generate smart contracts for three health insurance cases from Medicare. We evaluated the generated contracts in terms of correctness and execution cost (i.e., gas) on blockchain. Finally, we discuss the suitability of blockchain—and by extension, our approach—for a number of healthcare use cases.
Woensel et al. (Wed,) studied this question.