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. 2020 May 2;27(5):747–756. doi: 10.1093/jamia/ocaa023

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© The Author(s) 2020. Published by Oxford University Press on behalf of the American Medical Informatics Association.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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Figure 2. — A simplified example of ExplorerChain. Only the aggregated data (ie, the machine learning model) and the meta information are stored on-chain, while the protected health information (PHI, the observation-level patient data) are stored off-chain. This design ensures that the institutions can share information to improve the predictive model without transmitting PHI. It should be noted that the amount of transactions is set to be zero, indicating that the blockchain serves purely as a nonfinancial distributed ledger.