**6. Conclusions**

In this chapter, we presented a scalable and interoperable BET-LPHR solution to solve a longstanding PHR problem. Patients get benefits of controlling the security and privacy of their own LPHR when sharing the information with trusted health care providers. The permission control autonomy is achieved via BeNGAC. The BET-LPHR is built on top of BeNGAC network with a FHIR interface so it is interoperable with other EHRs. Both BeNGAC and BET-LPHR are enterprise scalable. The BET-LPHR is distributed yet decentralized and tamper resistant with auditable changes. We discussed two limitations of the solution when owner lost the private key or cannot directly authorize the access to BET-LPHR. Also, the current HF version supports up to 100 organizations [27] on the same policy or data secure channel, which can present a limit when a patient wants to include more than 99 EHR organizations to BET-LPHR on the same secure policy channel. We leave this for future research.
