Decentralized-OpenHealth : Identidade Auto-Soberana e Interoperabilidade FHIR/HL7 no Ecossistema Brasileiro
Abstract
The fragmentation of clinical data in Brazil compromises interoperability and privacy in healthcare. To address this issue, this paper proposes Decentralized-OpenHealth (D-OH), an architecture combining Decentralized Digital Identity (DID) with the FHIR/HL7 semantic standard. Under the governance of the Ministry of Health and aligned with the National Health Data Network (RNDS), the model uses Verifiable Credentials with BBS+ signatures to enable Zero-Knowledge Proofs (ZKPs), ensuring citizens have exclusive custody and selective disclosure of their clinical history in compliance with the LGPD. Performance evaluation on a permissioned network (Hyperledger Besu), combined with hybrid IPFS storage for dense medical exams, demonstrated an over 99% reduction in credential payload, proving the solution’s high scalability and technical viability for adoption in the Unified Health System (SUS).
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