Towards a decentralized e-prescription system using smart contracts.

Electronic prescription (e-Prescription) is a digital way to manage medical prescriptions and reduce inconsistencies in the communication between doctors, patients, and pharmacies. Smart contracts allow the automation of tasks and business rules in a decentralized architecture (i.e., without the need for an intermediary or central authority). Platforms such as Ethereum and Hyperledger Fabric support smart contracts development through a consensus mechanism such as Proof-of-Work or another criterion among the network's participating nodes. This paper explores Tendermint, a Byzantine Fault Tolerant (BFT) based consensus mechanism that has not yet been widely adopted for smart contracts platforms. We apply our devised model to the healthcare application domain, more precisely in the field of e-prescription, and our results demonstrate that smart contracts can be implemented on a BFT-based platform. To the best of our knowledge, this is the first study investigating the implementation of smart contracts in a BFT-based platform such as Tendermint. We exploit this domain as there can exist some conflicting interests of profit-taking. For example, pharmacists can increase the medication dosage above the one prescribed by doctors for profit-taking. Such a scenario can occur particularly in countries where healthcare is free of charge and offered as a public service (e.g., Brazil). We show that smart contracts in BFT-based blockchain can help in solving problems in these application scenarios. Finally, our two key contributions in this paper are two-fold: (i) exploit smart-contracts in BFT-based platforms where they (smart contracts) are not very established yet in the blockchain domain; (ii) provide a smart-contract-based e-prescription solution to reduce the costs (no need for a central authority) and scams particularly in countries where the medical service is free and public.