Distributed Storage Healthcare — The Basis of a Planet-Wide Public Health Care Network

Nikolaos Kakouros*
Johns Hopkins University, Baltimore, MD, USA

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© Nikolaos Kakouros; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Johns Hopkins University, Baltimore, MD, USA; Tel: 774-442-5043; Fax 774-441-6303; E-mail:



As health providers move towards higher levels of information technology (IT) integration, they become increasingly dependent on the availability of the electronic health record (EHR). Current solutions of individually managed storage by each healthcare provider focus on efforts to ensure data security, availability and redundancy. Such models, however, scale poorly to a future of a planet-wide public health-care network (PWPHN). Our aim was to review the research literature on distributed storage systems and propose methods that may aid the implementation of a PWPHN.


A systematic review was carried out of the research dealing with distributed storage systems and EHR. A literature search was conducted on five electronic databases: Pubmed/Medline, Cinalh, EMBASE, Web of Science (ISI) and Google Scholar and then expanded to include non-authoritative sources.


The English National Health Service Spine represents the most established country-wide PHN but is limited in deployment and remains underused. Other, literature identified and established distributed EHR attempts are more limited in scope. We discuss the currently available distributed file storage solutions and propose a schema of how one of these technologies can be used to deploy a distributed storage of EHR with benefits in terms of enhanced fault tolerance and global availability within the PWPHN.

We conclude that a PWPHN distributed health care record storage system is technically feasible over current Internet infrastructure. Nonetheless, the socioeconomic viability of PWPHN implementations remains to be determined.

Keywords: Electronic health record, distributed storage healthcare, public health care network, peer-to-peer networking.