obstetrics nursing and medical health system based on

Research ArticleObstetrics Nursing and Medical Health System Based onBlockchain Technology

Baolin Sun Zhihui Lv and Qin Li

Department of Obstetrics Affiliated Hospital of Qinghai University Xining 810000 Qinghai China

Correspondence should be addressed to Baolin Sun 2012990004qhueducn

Received 30 November 2020 Revised 29 December 2020 Accepted 29 January 2021 Published 5 March 2021

Academic Editor Yang Gao

Copyright copy 2021 Baolin Sun et al +is is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited

Blockchain as an emerging force transforming the Internet has applications in finance logistics public services and other fields It willalso have a huge impact on the medical and health industry +e salient features of blockchain technology include guaranteeing in-formation security and user privacy decentralization without the involvement of third-party trust institutions and being able to establisha high-value input and output two-way system which has a very important application space in obstetric care medical and health +etraditionalmedical and health system is far from being able tomeet the information exchange between doctors and individuals+ereforebuilding an interconnected obstetric care and health system based on blockchain technology is the direction of future obstetric care andmedical development+is paper has conducted an in-depth study of the obstetric caremedical health systemwith the help of the Internetof +ings blockchain and other technical means the purpose is to realize the sharing and security of medical data and to break thelimitations of traditional user information +is paper builds a medical electronic health record system model and a hybrid consensusmodel based on blockchain technology to realize the safety and transparency of patientsrsquo personal medical information data and achievetwo-way communication and interconnection of information between doctors and patients +is paper analyzes the current status ofdomestic and foreign medical and health systems and the blockchain-based medical electronic health record system It is concluded thatthe domestic investment in medical and health in 2018 was as high as 1132 billion yuan and the entire investment scale is continuouslyexpanding Pay attention to the health system In the future the obstetric care andmedical health system based on blockchain technologywill surely be realized and improved

1 Introduction

With the development of cities and the improvement of peoplersquosliving standards more and more people have begun to payattention to their personal health especially paying more at-tention to maternal health care My countryrsquos medical andhealth demand continues to grow With the promotion ofInternet technology ldquoInternet of+ings+Medicalrdquo has becomean inevitable trend in the pharmaceutical industry In additionthe establishment of a medical and health system based on theblockchain is also a general trend

As a kind of information technology blockchain can beused as a shared ledger distributed in scattered points using aconsensus mechanism to perform encryption algorithm cal-culation results and finally achieve point-to-point informationtransmission Its most prominent feature is as follows in thedata link it can track the data source and cannot modify any

data at will with high transparency and openness In summaryit achieves data security and transparency and provides trustguarantee for the use of blockchain +e combined use ofblockchain and obstetric care and medical care is well suited tothe characteristics of decentralization and promotes trust andcooperation between multiple subjects

Huang H designed a health care system (HES) frameworkthat collects medical data from WBAN transmits the medicaldata through a wide range of wireless sensor network infra-structure and finally publishes it to the wireless personal areanetwork through the gateway In addition HES involves agroup of transceiver model solutions to achieve key distributionand secure data transmission matrix-based homomorphicencryption to ensure privacy and an expert system that cananalyze scrambledmedical data and automatically feed back theresults +eoretical and experimental evaluations were con-ducted to prove the safety privacy and improved performance

HindawiJournal of Healthcare EngineeringVolume 2021 Article ID 6631457 11 pageshttpsdoiorg10115520216631457

of HES compared to current systems or solutions However thefurther prosperity of electronicmobile healthcare still facesmany challenges including information security and privacyprotection [1] In order to promote learning in health systemscience and add value to the health system Gonzalo et al triedto determine the true roles of students in a series of clinicalsettings and explored the value of the students who fulfilledthese roles From2013 to 2015 they conducted a series of on-sitevisits and leadership interviews at clinical sites (n 30) +e-matic analysis is used to determine the tasks and benefits ofincorporating students into the interprofessional nursing teamTypes of system roles include direct patient benefit activitiesincluding monitoring patient progress and facilitating access toresources through the care plan and clinical benefit activitiesincluding promoting coordination and improving clinicalprocesses+e perceived benefits include enhancing the value ofthe clinical mission and enhancing student education +eseresults clarify a framework for student roles that can enhancelearning and add value to the health system However theeducational plan that seeks to include students in the role of thesystem has not been well described [2] Lemieux aims to explorethe value of blockchain technology as a solution for creating andmaintaining trustworthy digital records and proposes thelimitations risks and opportunities of this approach Meth-odological approaches involve the use of requirements em-bedded in records management and digital preservationstandards in particular ISO 15489 ARMArsquos recognized record-keeping principles ISO 14721 and ISO 16363 as a commonassessment framework based on risk assessments for developingcountriesrsquo land registration systems of the specific proposedimplementation of blockchain technology +e analysis resultsshow that assuming appropriate security architecture and in-frastructure management control measures blockchain tech-nology can be used to solve current and short-term issuesrelated to information integrity However it cannot guaranteethe reliability of the information from the beginning and it willbe subject to some limitations as a long-term solution to providereliable information [3]

+e innovations of this paper are as follows (1) +ispaper uses a combination of quantitative and qualitativemethods which is well reflected in the third part of themixed consensus mechanism model (2) +is paper uses acombination of theoretical analysis and countermeasureresearch While establishing model analysis and givingcountermeasures and suggestions this method runs throughthis paper (3) +is paper uses the hash algorithm andMerkle tree data sharing and lattice algorithm which is formedical electronics based on blockchain +e health recordsystem EHRS has been fully analyzed

2 Method of Obstetric Care andMedical HealthSystem Based on Blockchain Technology

21 Overview of Blockchain Technology +e concept ofblockchain was proposed by Nakamoto in 2008 It wasinitially mainly used in economic fields such as finance andinsurance and then developed into logistics Internet of+ings public services and other fields [4] Its core tech-nology is the consensus mechanism and the application of

smart contracts By using smart contracts both parties donot need to use a third party for trust guarantee which solvesthe problem of trust transactions Generally speaking theblockchain system consists of six layers data layer networklayer consensus layer incentive layer contract layer andapplication layer which can be programmed at various levels[5]

+ere are three types of blockchains namely publicblockchains joint (industry) blockchains and privateblockchains +e scope and objects of application of thethree are different [6] First of all the public blockchain hasthe widest scope of application the least restrictive condi-tions and the lowest requirements and it can adapt to themost extensive blockchain needs With the characteristics ofdecentralization its transaction speed is also the slowestSecondly the joint blockchain mainly refers to the block-chain in a certain industry which has the characteristics ofmulticentralization and its data can realize multiparty in-tercommunication +e most typical one is the hyperledger+e third is a private blockchain +e typical representativeis Ant Financial Its transaction speed is very fast which canfully guarantee the companyrsquos internal information andprovide protection for the companyrsquos privacy [7 8] +efeature comparison between the three is shown in Table 1

+e main characteristics of the blockchain are as follows(1) Decentralization the application of blockchain does nothave unified central management and its distributed storagecan resist hacker intrusion and protect the privacy of dataAnd there is no need for unified software and hardwarefacilities and the requirements for equipment are average(2) Cannot be tampered with it is difficult to modify anddelete data because of the constraints of the consensusmechanism in the blockchain [9 10] (3) Independence eachsmart contract is signed independently by both parties to thetransaction without the blessing and guarantee of a thirdparty It can calculate the contract according to mathe-matical algorithms such as hash algorithm and automaticallycomplete the transaction and transaction data

In summary it has the characteristics of decentralizationnontampering whole process mark traceability collectivemaintenance openness and transparency If these character-istics of the blockchain can be used well the problem ofdecentralizedmanagement of medical equipment can be greatlysolved At the upstream end enterprises and hospitals uploadrelevant information through an encrypted system includingmedical equipment production information productionquantity and logistics information at the downstream endhospitals and manufacturers use blockchain technology tostrengthen communication and strictly control the complianceof medical equipment required standards and so on and in-crease the recognizability of products which will help hospitalsstrengthen the daily management calculation and inventory ofmedical equipment

22HashAlgorithmandMerkleTree +e hash algorithm is akind of mathematical algorithm but in fact it is more like athought algorithm It does not have a fixed formula forcalculation It only needs to input information to compress

2 Journal of Healthcare Engineering

messages of any length into fixed-length information Forany field it can improve the utilization of storage space so itis widely used [11] In addition another characteristic of thehash algorithm is irreversibility that is it is difficult to findthe reverse law which is a very important application for themedical and health field [12]

+eMerkle trusted tree is generated to verify the securityof information It is only based on the security of the hashalgorithm and can be verified without too many other as-sumptions It uses a traversal algorithm to reduce the cal-culation idea of redundant hash function values and finallyobtains a root hash value through layer-by-layer processingof small data blocks It has a wide range of applicationsmainly in information security so it is very useful to verifythe validity of data in the blockchain [13]

23 Data Sharing and Lattice Algorithm Obstetric nursingusers store all their personal medical information in adistributed database use the reencryption key in cryptog-raphy to encrypt the information [14] and use it for dataupload browsing and viewing In a decentralized block-chain technology there is no need for a third party to act asan agent for data access application and control To completethe reencryption operation you only need to add andmodify any node in AFS and MIFS [15]

For example when a doctor needs to view the patientrsquospast medical information the patient will perform normalencryption processing on the part that the doctor needs toview and at the same time generate a corresponding proxyreencryption key +en the patient selects one of the nodesin the list of competing agents and sends the reencryptionkey to this node and then the agent reencryption node willcomplete the reencryption operation and store the cipher-text in the distributed database Finally the doctor uses theprivate key to open the database and consult the relevantinformation

+e method of using proxy reencryption can effectivelyrealize data sharing and protect usersrsquo privacy rights +isprocess is called the entrustment of rights [16] +e

agreement is formulated in accordance with the results of thelattice algorithm

(1) Generate a random matrix A isin Znlowastnq and select a safe

integer q n(2) Generate a public-private key pair the public key

pk P P R minus A and S isin Znlowast1q where R and S are

Gaussian parameters and then the private keysk S

(3) Encryption algorithm

c c1 c2( 1113857 e1A + e2 e1P + e3 + m middotq

21113876 11138771113874 1113875 (1)

In formula (1) e1 e2 e3 are the error parameters(4) Decryption algorithm

m c1S + c2 (2)

Determine whether it is 0 or 1 based on the distancefrom 0

(5) Reencryption key generation algorithm

rka⟶b PB Q( 1113857

Q X minusXSB + E + SA

0 I1113890 1113891

(3)

Among them X is a random matrix and E is noise(6) Reencryption algorithm

c1prime c2prime( 1113857 h1 A PB( 1113857 + h2 h3( 1113857 + c1 c2( 1113857 middot Q (4)

Among them h1 h2 h3 are selected from the errordistribution

3 Blockchain-Based Obstetric Care MedicalHealth System Architecture Model

+is section is based on the basic architecture and functionalmodules of the obstetric care medical and health systembased on the blockchain It describes in detail how

Table 1 Comparison of characteristics of public chain alliance chain and private chain

Blockchaincharacteristics Public chain Alliance chain Private chain

Target the crowd Anyone Specific organization Individual person or entityDegree ofcentralization Decentralization Polycentric Centralization

Incentives Need Optional Not neededNode write Free to join Authorization required Internal controlTransaction speed 3ndash20 penssec 1000ndash10000 penssec 1000ndash10000 penssec+e Internet P2P network High-speed Internet High-speed InternetNode storage Personal computer Specific server Specific serverAccess threshold Low Higher Very highApplicationrepresentative

Bitcoin blockchain Ethereum smartcontract Hyperledger Ant Financial

Practical field Digital currency transactions financial assettransactions proof of existence and so on

Transaction within the organizationbank or country clearing and

settlement

Companies governmentshospitals

and other entities used asinternal information systems

Journal of Healthcare Engineering 3

blockchain technology improves the privacy security andintegrity of the medical and health system so as to realize theblockchain and obstetricsrsquo effective integration of nursingcare and health systems

31Medical andHealth Electronic File SystemModel Based onBlockchain

311 Basic Logical Structure +e architecture model ofobstetric care and medical health system based on block-chain is designed into three levels data storage layer dataconnection layer and data application layer [17] Take thepersonal electronic medical health file as a blockchain andall relevant data and information are stored in the distrib-uted ledger of the blockchain+e data is input updated andoutput through the data connection layer to realize dataviewing and review Finally the intelligent contract is usedfor data application and the implementation of the triggercontract completes the operation of the data [18 19] Fig-ure 1 shows the characteristics of the blockchain decen-tralized healthcare system

312 Data Storage Layer +e construction of the obstetriccare medical health system model based on blockchaintechnology is based on the way of blockchain for datastorage In a large database each personrsquos medical andhealth records are organized into a separate chain +isdata link can be updated and added in real time but cannotbe modified or deleted+is effectively guarantees the timecohesion authenticity and integrity of its health files [20]Electronic health records are a lifetime of data generatedby the physical health of different ages it mainly recordsinformation related to physical examination items andhealth activities +e time is not fixed +erefore theinformation is not stored at intervals but is updated in realtime [21]

For example when a mother needs obstetric care whichincludes prenatal care and postpartum care every physicalexamination data will be directly recorded in the motherrsquospersonal exclusive blockchain A complete blockchain iscomposed of two parts namely the initial source moduleand the additional module When creating a personalelectronic health file for the first time you need to record thebasic information of the individual After that each addi-tional physical examination will automatically generate ablock and automatically record it in the blockchain

+e blockchain deployment of the data storage layeradopts the private chain method and the public chainmethod in each case If a private chain is used the amount ofdata is too large but the number of nodes can be effectivelycontrolled it can be installed in major database centers andthe feasibility of implementation is enhanced If the lattermethod is used huge computing resources are required Nomatter which method is used a common technical feature ofthe blockchain is the consensus mechanism which canensure the safety and effectiveness of the entire operationprocess and limit the control and sharing of its data [22]

313 Data Connection Layer In the Bitcoin marketblockchain technology is used to test the authenticity se-curity and validity of the transaction process [23] +en inthe model of this paper the application of blockchain can beused to verify the authenticity of the information of bothparties in the transaction and the validity of data operationsduring the transaction +e function of the data connectionlayer is to integrate all the userrsquos distributed information intoa blockchain and select the appropriate node for storageparticipate in the real-time update process of data andensure that users can effectively access the blockchain [24]+e blockchain nature of the data that cannot be tamperedwith at will can ensure the integrity and authenticity of theentire data chain and can also see the traceability of all datagiving users certain rights and operability to ensure theauthenticity and validity of the data

In general all information operations at this level are safeand reliable Specifically the starting block of the blockchainin the data connection layer mainly includes the followingaspects first determine candidate nodes +e user needs toselect the applicable candidate node organization infor-mation generally speaking he will choose the health in-formation data center [25] second determine the user roleUsers who apply for the first time can choose among threeuser roles namely owner operator and manager [26]Ordinary users generally choose to be the owner and havefull operation authority for their own information and datawithout any restrictions but they still cannot modify ordelete data information +is is also true for the other tworoles +e operator role is generally selected as the healthmanager of the hospital After having this role permissionyou can apply to view and share the relevant information ofthe patient and increase the relevant case informationprovided that the owner is authorized to succeed Each nodein the initial module is a manager in addition to operatingfunctions you can also change user roles [27] To modify theuser role the following conditions should be met the op-eratorrsquos role modification requires the identification of theoperator and the operator here must belong to a staffmember registered by a health service department with arelevant certificate of practice

+e storage process of the blockchain and the transac-tion storage process of Bitcoin are essentially the same Bothcan record detailed operation records and update real-timestatus +erefore it is possible to increase the informationstorage in the blockchain at a fixed time interval

Smart contract is one of the important components of thedata connection layer Intelligent contract is a scripting lan-guage based on blockchain which can be triggered by the statechange of blockchain thus realizing the data operation onblockchain It is an operating system based on the blockchain toverify the identity and trust of both parties in the transaction Itconnects the data storage layer and the data application layer inthe entiremodel is the bridge of the entire process and is at thecore Smart contracts are also divided into two categories one isthe smart contract that comes with the system and the other isthe smart contract form that can be customized to fully meetthe transaction needs and personalized characteristics of thetransaction subject


314 Data Application Layer +e data application layerrefers to the data operation of health files according tospecific application requirements such as user authoritymanagement and doctorrsquos viewing information authority[28] In user authority management the account ownerneeds to respond to the current authority application of therelevant person and set the content of the personal infor-mation file disclosure authority +e specific process is asfollows First when the operator requests to access thepatientrsquos electronic file information the smart contract willbe triggered the smart contract is mainly used to verify theapplicantrsquos identity information by verifying the applicantrsquosdigital signature After the verification is passed the operatorcan check whether the permission of the information heneeds is open If it is open the data operation is successful Ifit is not open it needs to send an application to the owneragain and wait for its reply If you agree the next step will betaken Abandon the operation +e user owner can also setthe disclosure of some project permissions such thatnonprivate projects can be opened but for information-sensitive projects multiple encryption operations arerequired

+e two core functions of the data application layer areas follows the first is permission management the second is

data manipulation In order to realize the convenience ofquerying electronic medical health files you can considerdeveloping related applications such as permission appli-cation API or data manipulation API

32 Hybrid Consensus Mechanism Model Based onBlockchain +e hybrid consensus mechanism model HL1HL2 will be represented by a set Nlowast1 and a set Nlowast2 re-spectively +ere are

Nlowast1 ge 3f + 1 (5)

Among them f is the maximum number of error nodeswithin the acceptable range of HL1 For the sake of simplecalculation set as

Nlowast1 3f + 1 (6)

HL2 is the set of complements HL1 In the specific oper-ation move HL1 the limited number of authorized repre-sentatives at the bottom to the HL2 bottom and select HL2the limited number of authorized representatives at the topto be moved to the middle HL1 +e formula can beexpressed as

Cannot be tampered withTimestamp

TransparencyHigh redundancy

Multiple private keys

Decentralization of blockchain

Ensure the normaloperation of the system

Safetycertificate Data sharing

Informationprocessing

Figure 1 Blockchain decentralized healthcare system


Nlowast2 lfloor2frfloor n

12

f

1113868111386811138681113868111386811138681113868

1113868111386811138681113868111386811138681113868 (7)

First of all it is necessary to reorganize the positionalrelationship between HL1 HL2 the information of in-cluding the server information in the sum so that they canmatch each other +en sort these servers by number 1minusc+en according to the requirements of block height andserver number select the current node R which needs tomeet the following formula

R (H + c)modNlowast1 (8)

where H is the height of the current blockAgain the remaining nodes HL1 in the setting are all 0

and the number is expressed as 0 1 Nlowast1 minus 11113864 1113865 as long asthere is ldquoupgrade and downgraderdquo the random number canbe renumbered the check node HL2 in the command is C

+e formula of thismodel needs to be divided into two stepsinitiating consensus and confirming consensus As long as thereis a request from a user or hospital operator HL1 will auto-matically initiate a consensus on the duty node In the model inthis paper we set Φ the time interval required for a consensus+en the value node will upload the received data informationtogether with the digital signature then form a block afterencryption processing and finally store it in the blockchain

In the blockchain the trigger standard of the consensusmechanism is very high For example the original block mustmaintain a high degree of consistency in order to initiate aconsensus And in the process of confirming the consensus themedical data server information H and hash index of allnodes must be consistent which is quite high for hospitals

4 Obstetric Care and Medical Health SystemBased on Blockchain Technology

41 0e Current Situation of Domestic and Foreign Medicaland Health Systems

411 Scale of Domestic Medical and Health IndustryCompared with foreign countries my countryrsquos time toattach importance to the medical and health system is muchlater However following the national strategy and thesupport of national policies the development of the do-mestic obstetric care and medical health system is steadilyimproving From the data in Table 2 it can be seen that thescale of my countryrsquos medical and health industry in 2011was only 17 trillion yuan and the scale of development wasnot large enough however as can be seen from the line chartin Figure 2 the annual growth rate is very fast and thegrowth rate exceeds 10 even as high as 35 growth rate in2013 As of the end of 2018 the market size of the domesticmedical and health industry was 59 trillion yuan and itsscale has expanded several times It can be seen that mycountryrsquos medical and health industry has a bright future

412 0e Scale of Domestic Medical and Health InvestmentIt can be seen from Table 3 and Figure 3 that my countryrsquosdomestic healthcare investment and financing scale has

shown an upward trend from 2010 to 2018 In 2015 theinvestment amount was 623 trillion yuan with an increaseof 48 after 2015 my countryrsquos investment in the medicaland health field has increased rapidly and the total in-vestment has expanded several times which can wellrepresent the domestic medical and health field in mycountry

413 Global Healthcare Investment and Financing Asshown in Table 4 and Figure 4 the financing scale of theglobal healthcare industry has made a huge leap in 2015 and2017 and at the same time financing events have also in-creased significantly In 2018 the amount of financing was158 billion yuan with a year-on-year increase of 37 +e

Table 2 Scale and growth rate of domestic healthcare industryfrom 2011 to 2018

Industrial scale (trillion yuan) Growth rate ()2011 year 172012 year 2 252013 year 28 352014 year 35 262015 year 39 152016 year 47 182017 year 52 112018 year 59 17

17 228

3539

4752

59

25

35

26

1518

11

17

0

5

10

15

20

25

()

30

35

40

0

1

2

3

4

5

6

7

2011 2012 2013 2014 2015 2016 2017 2018

Industrial scale (trillion yuan)Growth rate

Figure 2 Scale and growth rate of domestic healthcare industryfrom 2011 to 2018

Table 3 Chinarsquos healthcare financing

Financing amount (100 million yuan)2010 652011 632012 752013 1202014 3482015 6232016 8522017 9672018 1132


financing event was 1030 and the increase in financingevents was not fluctuating +is shows that the amount offinancing in the early years is directly proportional to theoccurrence of financing events while the performance inrecent years has shown an irregular state In the case of asmall increase in the number of financing events the amountof global medical and health financing is still increasingsignificantly indicating that for most people the enthusiasmfor financing has not diminished and may hold a wait-and-see attitude or increase investment in the same project

414 Global and Domestic Financing Changes in the Medicaland Health Industry Segments It can be clearly seen fromTable 5 that in 2018 the investment and financing fields ofthe global healthcare industry were mainly concentrated inbiotechnology medicine medical informatization andmedical equipment with financing amounts of 511 trillionyuan 278 trillion yuan and 299 trillion yuan respectively+e total investment is 295 trillion yuan and the totalnumber of investment events exceeds 1000 accounting for73 of the total

It can be seen from Figure 5 that the amount of in-vestment in biotechnology far exceeds investment in otherfields and the latter are mainly innovative fields driven byconsumer demand More exploration has not been carriedout such as rehabilitation nursing bioengineering andmedical tools +e financing situation in these areas is notoptimistic

As can be seen from Table 6 and Figure 6 the domesticinvestment enthusiasm is still slightly different from theinternational investment field +e top ones with the highestenthusiasm for domestic healthcare investment are bio-technology medicine medical informatization and primarycare +e financing amount is much lower than the globalfinancing amount which is 119 trillion yuan 69 trillionyuan 73 trillion yuan and 609 billion yuan respectivelySecondly there is a general investment preference in severalareas such as drug sales medical equipment medicaltechnology and consumer medicine

In general in the direction of domestic and globalmedical and health investment and financing subdivisionsscience and technology are the main orientation andtechnological innovation has shown great advantages in thefields of biotechnology medical informatization medicineand so on +e amount of investment and financing is muchhigher than that in other fields in addition the enthusiasmfor investment in consumption or service-oriented fields isnot high

42 Ehrs Analysis of Medical Electronic Health Record SystemBased on Blockchain +e purpose of constructing ablockchain-based obstetric care medical health system isto use the advantages of blockchain to solve the short-comings of the traditional medical system especially thereading of personal health information data and the se-curity of information data Traditional medical and healthsystems have disadvantages such as difficulty in storinginformation and cumbersome procedures for reviewinginformation and data verification and the entire process isprone to data modification and data insecurity +ese arenot conducive to building a more complete and safe smartmedical care

It can be seen from Figure 7 that since 2011 mycountryrsquos nursing hospitals have begun to use standardizedEHR on a large scale By the end of 2017 almost 100coverage has been completed +is shows the developmentof the medical data information era and the relatively maturemedical data informatization these can partially solve the

65 63 75 120

348

623

852967

1132

2010 2011 2012 2013 2014 2015 2016 2017 2018

Financing amount (100 million yuan)Expon (financing amount (100 million yuan))

Figure 3 Chinarsquos healthcare financing

Table 4 Global healthcare financing

Financing amount (100 million yuan) Event (a)2011 52 2352012 73 2202013 122 3362014 179 4892015 392 8562016 587 13242017 985 12912018 1580 1030

1500

1000

500

01 2 3 4 5 6 7 8 1

2

Figure 4 Global healthcare financing


storage and access application problems of medicalinformation

From Table 7 and Figure 8 we can see that differenttypes of hospitals use the basic version of EHR to differentdegrees but there is a certain degree of growth every year+e growth rates of small hospitals and rural hospitals arealmost the same Large hospitals and emergency hospitalshave increased significantly from 2014 to 2018 +e data ofthe two hospitals in 2018 were 83 and 80 respectivelycompared with 28 and 20 in 2014 an increase of more than60 +is shows that more and more hospitals are also

aware of the importance of medical and health datasharing which brings great convenience to both doctorsand patients

In general the current application and research ofblockchain in the medical field have attracted much at-tention +e development of blockchain technology haschanged the traditional way of centralized storage of medicaldata eliminating the auditing role of intermediaries andblockchain technology It can help doctors patients andresearchers to authenticate permissions quickly and safelyand realize free data access and sharing

Table 5 Changes in financing of the global healthcare industry in 2018

Financing amount (100 million yuan) Number of events Event (a)Biotechnology 511 224Medicine 278 82Medical information 299 365Medical equipment 295 372Technology medical 119 301Primary care 119 60Drug sales 28 29Great health 21 89Medical finance 29 18Consumer medical 26 19Rehabilitation nursing 16 18Seek medical advice 12 12Medical tools 6 1Motherhood 5 17Medical support 5 12Seek a doctor 5 8Biological engineering 2 2Circulation channel 08 1

511278

299295

119

11928

212926

1612

6555208

22482

365372

30160

2989

181918

121

1712

82

1

0 100 200 300 400 500 600Biotechnology

MedicineMedical information

Medical equipmentTechnology medical

Primary careDrug sales

Great healthMedical finance

Consumer medicalRehabilitation nursing

Seek medical adviceMedical toolsMotherhood

Medical supportSeek a doctor

Biological engineeringCirculation channel

Financing amount (100 million yuan) number of eventsFinancing amount (100 million yuan) number of events

Figure 5 Changes in financing of the global health care industry in 2018


Table 6 2018 Chinarsquos medical and health industry sector financing situation

Financing amount (100 million yuan) number of events Event (a)Biotechnology 119 84Medicine 69 38Medical information 73 68Medical equipment 258 76Technology medical 213 37Primary care 609 33Drug sales 473 19Great health 188 44Medical finance 123 6Consumer medical 243 25Rehabilitation nursing 45 11Seek medical advice 38 7Medical tools 52 6Motherhood 33 15Medical support 23 8Circulation channel 06 1

0102030405060708090

0

20

40

60

80

100

120

140

Financing amount (100 million yuan) number of eventsEvent (a)

Biot

echn

olog

yM

edic

ine

Med

ical

info

rmat

ion

Med

ical

equi

pmen

tTe

chno

logy

med

ical

Prim

ary

care

Dru

g sa

les

Gre

at h

ealth

Med

ical

fina

nce

Con

sum

er m

edic

alRe

habi

litat

ion

nurs

ing

Seek

med

ical

advi

ceM

edic

al to

ols

Mot

herh

ood

Med

ical

supp

ort

Circ

ulat

ion

chan

nel

Figure 6 2018 Chinarsquos medical and health industry sector financing situation

1650

28604540

60407454843889529540

0

71908522

9331 9569 96 9780 98

000

5000

10000

15000()

20000

25000

2010 2011 2012 2013 2014 2015 2016 2017

Certified EHRBasic EHR

Figure 7 +e proportion of basic EHR and standard EHR adopted by nursing hospitals from 2010 to 2017


5 Conclusions

+e paper is mainly to study the construction of obstetricnursing medical health system based on blockchain tech-nology +rough in-depth research on blockchain it can beeffectively applied to the medical health system of obstetricnursing +is paper uses a combination of qualitative andquantitative research methods an in-depth understandingof the blockchain combined with the characteristics of theblockchainrsquos decentralization trustlessness informationsecurity and transparency and its role in obstetric care andhealth care It helps to build a complete medical and healthsystem based on blockchain +e combination of blockchaintechnology and medical health system forms a new modelfor the development of information data in the field of themedical word

In this paper the hash algorithm and Merkle tree datasharing and lattice algorithm are used to construct ablockchain-based medical and health electronic file systemmodel and a blockchain-based hybrid consensus mechanismmodel and analyze domestic and foreign medical +ecurrent health system and the EHRS analysis of theblockchain-based medical electronic health record systemshow that there are still information asymmetry and in-formation security issues in the domestic medical healthsystem +e obstetric care medical health system based onblockchain technology can solve these problems well

In the future the establishment of this system willstrengthen the relationship between doctors and patients andachieve multidirectional communication and information

exchange In the process of in-depth research on the com-bination of blockchain and the medical field we also realizedthat there are still some difficulties in the research topic of thispaper +e first is the contradiction between decentralizationand centralized management Although decentralization hasadvantages it also has disadvantages such as the lack of aunified management core and the system cannot be auto-matically adjusted or repaired +e second is that the stan-dards of blockchain technology have yet to be improved +ecomplexity of the blockchain itself coupled with numerousproblems in the medical and health field has a serious impacton it and restrict the development of the blockchain medicaland health system

Data Availability

No data were used to support this study

Conflicts of Interest

+e authors declare that they have no conflicts of interest

References

[1] H Huang T Gong N Ye et al ldquoPrivate and secured medicaldata transmission and analysis for wireless sensing Healthcaresystemrdquo IEEE Transactions on Industrial Informatics vol 13pp 1227ndash1237 2017

[2] J D Gonzalo D Graaf B Johannes et al ldquoAdding value tothe Health care system identifying value-added systems rolesfor medical studentsrdquo American Journal of Medical Qualityvol 32 pp 261ndash270 2016

[3] V L Lemieux ldquoTrusting records is Blockchain technologythe answerrdquo Records Management Journal vol 26 no 2pp 110ndash139 2016

[4] J J Sikorski J Haughton and M Kraft ldquoBlockchain tech-nology in the chemical industry machine-to-machine elec-tricity marketrdquo Applied Energy vol 195 no June 1pp 234ndash246 2017

[5] Y Zhang and J Wen ldquo+e IoT electric business model usingblockchain technology for the internet of thingsrdquo Peer-to-PeerNetworking and Applications vol 10 no 4 pp 983ndash994 2017

[6] M H Miraz and M Ali ldquoApplications of blockchain tech-nology beyond cryptocurrencyrdquo Annals of Emerging Tech-nologies in Computing vol 2 no 1 pp 1ndash6 2018

[7] J Wang W U Peng X Wang et al ldquo+e outlook ofblockchain technology for construction engineering man-agementrdquo Frontiers of Engineering Management vol 4 no 1pp 71ndash79 2017

[8] I Eyal ldquoBlockchain technology transforming libertariancryptocurrency dreams to finance and banking realitiesrdquoComputer vol 50 no 9 pp 38ndash49 2017

Table 7 +e percentage of different types of hospitals using basic EHR

All hospitals Small hospital Rural hospital Critical access hospital2014 28 21 21 202015 42 39 37 362016 59 51 51 522017 78 70 70 682018 83 81 80 80

0

10

20

30

40

50

60

70

80

90

2014 2015 2016 2017 2018

All hospitalSmall hospital

Rural hospitalCritical access hospital

Figure 8 +e percentage of different types of hospitals using basicEHR


[9] W Meng E Tischhauser Q Wang et al ldquoWhen intrusiondetection meets blockchain technology a reviewrdquo IEEE Ac-cess vol 6 pp 10179ndash10188 2018

[10] J Sun J Yan and K Z K Zhang ldquoBlockchain-based sharingservices what blockchain technology can contribute to smartcitiesrdquo Financial Innovation vol 2 no 1 pp 1ndash9 2016

[11] R Beck M Avital M Rossi et al ldquoBlockchain technology inbusiness and information systems researchrdquo Business amp In-formation Systems Engineering vol 59 no 6 pp 381ndash3842017

[12] P Yeoh ldquoRegulatory issues in blockchain technologyrdquoJournal of Financial Regulation amp Compliance vol 25 no 2pp 196ndash208 2017

[13] M A Engelhardt ldquoHitching Healthcare to the chain anintroduction to blockchain technology in the Healthcaresectorrdquo Technology Innovation Management Review vol 7no 10 pp 22ndash34 2017

[14] S Saberi M Kouhizadeh J Sarkis et al ldquoAn improvedauthentication scheme for internet of vehicles based onblockchain technologyrdquo International Journal of ProductionResearch vol 57 no 7-8 pp 2117ndash2135 2019

[15] A S Miltenburg R F Kiritta T B Bishanga et al ldquoAssessingemergency obstetric and newborn care can performanceindicators capture health system weaknessesrdquo BMC Preg-nancy and Childbirth vol 17 no 1 pp 1ndash9 2017

[16] J O Swanson D Plotner H L Franklin et al ldquoWeb-basedquality assurance process drives improvements in obstetricultrasound in 5 low- and middle-income countriesrdquo GlobalHealth Science and Practice vol 4 no 4 pp 675ndash683 2016

[17] S Topu ldquoCaesarean or vaginarean epidemics Techno-birthrisk and obstetric practice in Turkeyrdquo Health Risk amp Societyvol 21 no 3-4 pp 141ndash163 2019

[18] V Jithesh and T K S Ravindran ldquoSocial and health systemfactors contributing to maternal deaths in a less-developeddistrict of Kerala Indiardquo Journal of Reproductive Health ampMedicine vol 2 no 1 pp 26ndash32 2016

[19] T Baskaran L P Feld and J Schnellenbach ldquoFiscal feder-alism decentralization and economic growth a meta-analy-sisrdquo Economic Inquiry vol 54 no 3 pp 103ndash133 2016

[20] S Acorn P A Ratner and M Crawford ldquoDecentralization asa determinant of autonomy job satisfaction and organiza-tional commitment among nurse managersrdquo Nursing Re-search vol 46 no 1 pp 52ndash58 2016

[21] A Clayton J Noveck and M Levi ldquoWhen elites meet de-centralization power-sharing and public goods provision inpost-conflict Sierra Leonerdquo Policy Research Working Papersvol 18 no 11 pp 2252ndash2258 2016

[22] K Kis-Katos and B S Sjahrir ldquo+e impact of fiscal andpolitical decentralization on local public investments inIndonesiardquo Journal of Comparative Economics vol 45 no 2pp 344ndash365 2017

[23] B Panda and H P +akur ldquoDecentralization and healthsystem performancendasha focused review of dimensions diffi-culties and derivatives in Indiardquo BMC Health Services Re-search vol 16 no S6 pp 1ndash14 2016

[24] T J Bossert ldquoDecision space and capacities in the decen-tralization of Health services in FijiComment on ldquodecen-tralisation of Health services in Fiji a decision spaceanalysisrdquordquo International Journal of Health Policy and Man-agement (IJHPM) vol 5 no 7 pp 443-444 2016

[25] G D Wright K P Andersson C C Gibson et al ldquoDe-centralization can help reduce deforestation when user groupsengage with local governmentrdquo Proceedings of the NationalAcademy of Sciences vol 113 no 52 pp 14958ndash14963 2016

[26] M Espasa A Esteller-More and T Mora ldquoIs decentralizationreally welfare enhancing empirical evidence from survey data(1994-2011)rdquo Kyklos vol 70 no 2 pp 189ndash219 2017

[27] T Baskaran A Brender S Blesse et al ldquoRevenue decen-tralization central oversight and the political budget cycleevidence from Israelrdquo Center for European Governance andEconomic Development Research Discussion Papers vol 42no Mar pp 1ndash16 2016

[28] M R Farzanegan C Lessmann and G Markwardt ldquoNatural-resource rents and internal conflicts-can decentralization liftthe curserdquo Economic Systems vol 42 no 2 pp 186ndash2052018


of HES compared to current systems or solutions However thefurther prosperity of electronicmobile healthcare still facesmany challenges including information security and privacyprotection [1] In order to promote learning in health systemscience and add value to the health system Gonzalo et al triedto determine the true roles of students in a series of clinicalsettings and explored the value of the students who fulfilledthese roles From2013 to 2015 they conducted a series of on-sitevisits and leadership interviews at clinical sites (n 30) +e-matic analysis is used to determine the tasks and benefits ofincorporating students into the interprofessional nursing teamTypes of system roles include direct patient benefit activitiesincluding monitoring patient progress and facilitating access toresources through the care plan and clinical benefit activitiesincluding promoting coordination and improving clinicalprocesses+e perceived benefits include enhancing the value ofthe clinical mission and enhancing student education +eseresults clarify a framework for student roles that can enhancelearning and add value to the health system However theeducational plan that seeks to include students in the role of thesystem has not been well described [2] Lemieux aims to explorethe value of blockchain technology as a solution for creating andmaintaining trustworthy digital records and proposes thelimitations risks and opportunities of this approach Meth-odological approaches involve the use of requirements em-bedded in records management and digital preservationstandards in particular ISO 15489 ARMArsquos recognized record-keeping principles ISO 14721 and ISO 16363 as a commonassessment framework based on risk assessments for developingcountriesrsquo land registration systems of the specific proposedimplementation of blockchain technology +e analysis resultsshow that assuming appropriate security architecture and in-frastructure management control measures blockchain tech-nology can be used to solve current and short-term issuesrelated to information integrity However it cannot guaranteethe reliability of the information from the beginning and it willbe subject to some limitations as a long-term solution to providereliable information [3]

+e innovations of this paper are as follows (1) +ispaper uses a combination of quantitative and qualitativemethods which is well reflected in the third part of themixed consensus mechanism model (2) +is paper uses acombination of theoretical analysis and countermeasureresearch While establishing model analysis and givingcountermeasures and suggestions this method runs throughthis paper (3) +is paper uses the hash algorithm andMerkle tree data sharing and lattice algorithm which is formedical electronics based on blockchain +e health recordsystem EHRS has been fully analyzed

2 Method of Obstetric Care andMedical HealthSystem Based on Blockchain Technology

21 Overview of Blockchain Technology +e concept ofblockchain was proposed by Nakamoto in 2008 It wasinitially mainly used in economic fields such as finance andinsurance and then developed into logistics Internet of+ings public services and other fields [4] Its core tech-nology is the consensus mechanism and the application of

smart contracts By using smart contracts both parties donot need to use a third party for trust guarantee which solvesthe problem of trust transactions Generally speaking theblockchain system consists of six layers data layer networklayer consensus layer incentive layer contract layer andapplication layer which can be programmed at various levels[5]

+ere are three types of blockchains namely publicblockchains joint (industry) blockchains and privateblockchains +e scope and objects of application of thethree are different [6] First of all the public blockchain hasthe widest scope of application the least restrictive condi-tions and the lowest requirements and it can adapt to themost extensive blockchain needs With the characteristics ofdecentralization its transaction speed is also the slowestSecondly the joint blockchain mainly refers to the block-chain in a certain industry which has the characteristics ofmulticentralization and its data can realize multiparty in-tercommunication +e most typical one is the hyperledger+e third is a private blockchain +e typical representativeis Ant Financial Its transaction speed is very fast which canfully guarantee the companyrsquos internal information andprovide protection for the companyrsquos privacy [7 8] +efeature comparison between the three is shown in Table 1

+e main characteristics of the blockchain are as follows(1) Decentralization the application of blockchain does nothave unified central management and its distributed storagecan resist hacker intrusion and protect the privacy of dataAnd there is no need for unified software and hardwarefacilities and the requirements for equipment are average(2) Cannot be tampered with it is difficult to modify anddelete data because of the constraints of the consensusmechanism in the blockchain [9 10] (3) Independence eachsmart contract is signed independently by both parties to thetransaction without the blessing and guarantee of a thirdparty It can calculate the contract according to mathe-matical algorithms such as hash algorithm and automaticallycomplete the transaction and transaction data

In summary it has the characteristics of decentralizationnontampering whole process mark traceability collectivemaintenance openness and transparency If these character-istics of the blockchain can be used well the problem ofdecentralizedmanagement of medical equipment can be greatlysolved At the upstream end enterprises and hospitals uploadrelevant information through an encrypted system includingmedical equipment production information productionquantity and logistics information at the downstream endhospitals and manufacturers use blockchain technology tostrengthen communication and strictly control the complianceof medical equipment required standards and so on and in-crease the recognizability of products which will help hospitalsstrengthen the daily management calculation and inventory ofmedical equipment

22HashAlgorithmandMerkleTree +e hash algorithm is akind of mathematical algorithm but in fact it is more like athought algorithm It does not have a fixed formula forcalculation It only needs to input information to compress














21113876 11138771113874 1113875 (1)


m c1S + c2 (2)



rka⟶b PB Q( 1113857


0 I1113890 1113891

(3)













settlement





















Nlowast1 3f + 1 (6)












12

f

1113868111386811138681113868111386811138681113868

1113868111386811138681113868111386811138681113868 (7)















17 228

3539

4752

59

25

35

26

1518

11

17

0

5

10

15

20

25

()

30

35

40

0

1

2

3

4

5

6

7

2011 2012 2013 2014 2015 2016 2017 2018













65 63 75 120

348

623

852967

1132

2010 2011 2012 2013 2014 2015 2016 2017 2018





1500

1000

500

01 2 3 4 5 6 7 8 1

2









511278

299295

119

11928

212926

1612

6555208

22482

365372

30160

2989

181918

121

1712

82

1

0 100 200 300 400 500 600Biotechnology














0102030405060708090

0

20

40

60

80

100

120

140


Biot

echn

olog

yM

edic

ine

Med

ical

info

rmat

ion

Med

ical

equi

pmen

tTe

chno

logy

med

ical

Prim

ary

care

Dru

g sa

les

Gre

at h

ealth

Med

ical

fina

nce

Con

sum

er m

edic

alRe

habi

litat

ion

nurs

ing

Seek

med

ical

advi

ceM

edic

al to

ols

Mot

herh

ood

Med

ical

supp

ort

Circ

ulat

ion

chan

nel


1650

28604540

60407454843889529540

0

71908522

9331 9569 96 9780 98

000

5000

10000

15000()

20000

25000

2010 2011 2012 2013 2014 2015 2016 2017




5 Conclusions





Data Availability




References











0

10

20

30

40

50

60

70

80

90

2014 2015 2016 2017 2018






































21113876 11138771113874 1113875 (1)


m c1S + c2 (2)



rka⟶b PB Q( 1113857


0 I1113890 1113891

(3)













settlement





















Nlowast1 3f + 1 (6)












12

f

1113868111386811138681113868111386811138681113868

1113868111386811138681113868111386811138681113868 (7)















17 228

3539

4752

59

25

35

26

1518

11

17

0

5

10

15

20

25

()

30

35

40

0

1

2

3

4

5

6

7

2011 2012 2013 2014 2015 2016 2017 2018













65 63 75 120

348

623

852967

1132

2010 2011 2012 2013 2014 2015 2016 2017 2018





1500

1000

500

01 2 3 4 5 6 7 8 1

2









511278

299295

119

11928

212926

1612

6555208

22482

365372

30160

2989

181918

121

1712

82

1

0 100 200 300 400 500 600Biotechnology














0102030405060708090

0

20

40

60

80

100

120

140


Biot

echn

olog

yM

edic

ine

Med

ical

info

rmat

ion

Med

ical

equi

pmen

tTe

chno

logy

med

ical

Prim

ary

care

Dru

g sa

les

Gre

at h

ealth

Med

ical

fina

nce

Con

sum

er m

edic

alRe

habi

litat

ion

nurs

ing

Seek

med

ical

advi

ceM

edic

al to

ols

Mot

herh

ood

Med

ical

supp

ort

Circ

ulat

ion

chan

nel


1650

28604540

60407454843889529540

0

71908522

9331 9569 96 9780 98

000

5000

10000

15000()

20000

25000

2010 2011 2012 2013 2014 2015 2016 2017




5 Conclusions





Data Availability




References











0

10

20

30

40

50

60

70

80

90

2014 2015 2016 2017 2018











































Nlowast1 3f + 1 (6)












12

f

1113868111386811138681113868111386811138681113868

1113868111386811138681113868111386811138681113868 (7)















17 228

3539

4752

59

25

35

26

1518

11

17

0

5

10

15

20

25

()

30

35

40

0

1

2

3

4

5

6

7

2011 2012 2013 2014 2015 2016 2017 2018













65 63 75 120

348

623

852967

1132

2010 2011 2012 2013 2014 2015 2016 2017 2018





1500

1000

500

01 2 3 4 5 6 7 8 1

2









511278

299295

119

11928

212926

1612

6555208

22482

365372

30160

2989

181918

121

1712

82

1

0 100 200 300 400 500 600Biotechnology














0102030405060708090

0

20

40

60

80

100

120

140


Biot

echn

olog

yM

edic

ine

Med

ical

info

rmat

ion

Med

ical

equi

pmen

tTe

chno

logy

med

ical

Prim

ary

care

Dru

g sa

les

Gre

at h

ealth

Med

ical

fina

nce

Con

sum

er m

edic

alRe

habi

litat

ion

nurs

ing

Seek

med

ical

advi

ceM

edic

al to

ols

Mot

herh

ood

Med

ical

supp

ort

Circ

ulat

ion

chan

nel


1650

28604540

60407454843889529540

0

71908522

9331 9569 96 9780 98

000

5000

10000

15000()

20000

25000

2010 2011 2012 2013 2014 2015 2016 2017




5 Conclusions





Data Availability




References











0

10

20

30

40

50

60

70

80

90

2014 2015 2016 2017 2018



























12

f

1113868111386811138681113868111386811138681113868

1113868111386811138681113868111386811138681113868 (7)















17 228

3539

4752

59

25

35

26

1518

11

17

0

5

10

15

20

25

()

30

35

40

0

1

2

3

4

5

6

7

2011 2012 2013 2014 2015 2016 2017 2018













65 63 75 120

348

623

852967

1132

2010 2011 2012 2013 2014 2015 2016 2017 2018





1500

1000

500

01 2 3 4 5 6 7 8 1

2









511278

299295

119

11928

212926

1612

6555208

22482

365372

30160

2989

181918

121

1712

82

1

0 100 200 300 400 500 600Biotechnology














0102030405060708090

0

20

40

60

80

100

120

140


Biot

echn

olog

yM

edic

ine

Med

ical

info

rmat

ion

Med

ical

equi

pmen

tTe

chno

logy

med

ical

Prim

ary

care

Dru

g sa

les

Gre

at h

ealth

Med

ical

fina

nce

Con

sum

er m

edic

alRe

habi

litat

ion

nurs

ing

Seek

med

ical

advi

ceM

edic

al to

ols

Mot

herh

ood

Med

ical

supp

ort

Circ

ulat

ion

chan

nel


1650

28604540

60407454843889529540

0

71908522

9331 9569 96 9780 98

000

5000

10000

15000()

20000

25000

2010 2011 2012 2013 2014 2015 2016 2017




5 Conclusions





Data Availability




References











0

10

20

30

40

50

60

70

80

90

2014 2015 2016 2017 2018

































65 63 75 120

348

623

852967

1132

2010 2011 2012 2013 2014 2015 2016 2017 2018





1500

1000

500

01 2 3 4 5 6 7 8 1

2









511278

299295

119

11928

212926

1612

6555208

22482

365372

30160

2989

181918

121

1712

82

1

0 100 200 300 400 500 600Biotechnology














0102030405060708090

0

20

40

60

80

100

120

140


Biot

echn

olog

yM

edic

ine

Med

ical

info

rmat

ion

Med

ical

equi

pmen

tTe

chno

logy

med

ical

Prim

ary

care

Dru

g sa

les

Gre

at h

ealth

Med

ical

fina

nce

Con

sum

er m

edic

alRe

habi

litat

ion

nurs

ing

Seek

med

ical

advi

ceM

edic

al to

ols

Mot

herh

ood

Med

ical

supp

ort

Circ

ulat

ion

chan

nel


1650

28604540

60407454843889529540

0

71908522

9331 9569 96 9780 98

000

5000

10000

15000()

20000

25000

2010 2011 2012 2013 2014 2015 2016 2017




5 Conclusions





Data Availability




References











0

10

20

30

40

50

60

70

80

90

2014 2015 2016 2017 2018
































511278

299295

119

11928

212926

1612

6555208

22482

365372

30160

2989

181918

121

1712

82

1

0 100 200 300 400 500 600Biotechnology














0102030405060708090

0

20

40

60

80

100

120

140


Biot

echn

olog

yM

edic

ine

Med

ical

info

rmat

ion

Med

ical

equi

pmen

tTe

chno

logy

med

ical

Prim

ary

care

Dru

g sa

les

Gre

at h

ealth

Med

ical

fina

nce

Con

sum

er m

edic

alRe

habi

litat

ion

nurs

ing

Seek

med

ical

advi

ceM

edic

al to

ols

Mot

herh

ood

Med

ical

supp

ort

Circ

ulat

ion

chan

nel


1650

28604540

60407454843889529540

0

71908522

9331 9569 96 9780 98

000

5000

10000

15000()

20000

25000

2010 2011 2012 2013 2014 2015 2016 2017




5 Conclusions





Data Availability




References











0

10

20

30

40

50

60

70

80

90

2014 2015 2016 2017 2018




























0102030405060708090

0

20

40

60

80

100

120

140


Biot

echn

olog

yM

edic

ine

Med

ical

info

rmat

ion

Med

ical

equi

pmen

tTe

chno

logy

med

ical

Prim

ary

care

Dru

g sa

les

Gre

at h

ealth

Med

ical

fina

nce

Con

sum

er m

edic

alRe

habi

litat

ion

nurs

ing

Seek

med

ical

advi

ceM

edic

al to

ols

Mot

herh

ood

Med

ical

supp

ort

Circ

ulat

ion

chan

nel


1650

28604540

60407454843889529540

0

71908522

9331 9569 96 9780 98

000

5000

10000

15000()

20000

25000

2010 2011 2012 2013 2014 2015 2016 2017




5 Conclusions





Data Availability




References











0

10

20

30

40

50

60

70

80

90

2014 2015 2016 2017 2018


























5 Conclusions





Data Availability




References











0

10

20

30

40

50

60

70

80

90

2014 2015 2016 2017 2018


























obstetrics nursing and medical health system based on

Documents