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The storage and sharing of sensitive health data in Blockchain-based systems implicates data protection issues that must be addressed when designing such systems. Those issues can be traced back to the properties of decentralized systems. A blessing but also a curse in the context of health data is the transparency of the Blockchain, because it allows the stored data to be viewed by all participants of the network. In addition, the property of immutability is in contrast to the possibility to delete the personal data upon request according to the European General Data Protection Regulation (GDPR). Accordingly, approaches to tackle these issues have recently been discussed in research and industry, e.g. by storing sensitive data encrypted On-Chain or Off-Chain on own servers connected to a Blockchain. These approaches deal with how the confidentiality and integrity of stored data can be guaranteed and how data can be deleted. By reviewing the proposed approaches, we develop a taxonomy to summarize their specific technical characteristics and create a decision model that will allow the selection of a suitable approach for the design of future Blockchain-based systems for the storage of sensitive health data. Afterwards, we demonstrate the utility of the decision model based on a use case for storing test results from a digital dementia screening application. The paper concludes with a discussion of the results and suggestions for future research.



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