The immediate and obvious link between blockchain and healthcare is in the management and maintenance of sensitive data. Properly implemented, blockchain technology may be used in health and health IT to protect, manage, and exchange electronic health information.
Introduction to Blockchain in Healthcare
Blockchain uses proven cryptographic techniques to allow each participant in a network to store, exchange, and view information, without trust having to be previously established between the parties. Blockchain data is decentralized, and with no central authority, transaction records are stored and distributed across all network participants. Interactions with the blockchain are made known to all participants and require verification by the network before any information is added, which provides an audit trail of all transactions, and allows trustless collaboration between network participants.
In the context of longstanding industry issues, the use of blockchain in healthcare today has the potential to eliminate the historical problems of interoperability between health platforms and stakeholders.
Blockchain technology could facilitate a new model for health information exchanges (HIE) by making electronic medical records more efficient and secure and reducing or eliminating the friction and costs of the current intermediaries involved in these information exchange processes.
At the institutional and customer-facing levels, establishing blockchain networks for electronic medical records may improve healthcare providers’ efficiencies and support better health outcomes for patients.
To this end, the US Office of the National Coordinator for Health Information Technology has issued a shared roadmap, defining critical policy and technical components required for nationwide interoperability, which includes:
- An everywhere available, secure network infrastructure.
- Identity verification and authentication for all network participants.
- Secure mechanisms for authorization to access electronic health information.
Private, permissioned blockchain implementations can solve all of these problems. Unlike the public blockchains typically associated with cryptocurrency platforms, people and organizations who want to participate in a private blockchain must first gain permission from its central administrators to join the network. In the context of healthcare, these central administrators might be existing participants in the ecosystem, a regulated authority, or a consortium.
Private blockchains are also known as enterprise blockchains and have been designed to give commercial organizations access to quick transactions, enhanced privacy, and high security. This makes them especially suitable for healthcare applications and the particular problems associated with interoperability and data governance in the health sector.
Blockchain in Healthcare – Addressing Healthcare Data Handling Issues
Besides interoperability and a lack of standardization hampering the seamless interplay of medical data between various platforms, two major areas of concern are problems with identifying individual patients and issues with information blocking.
Despite some of the healthcare administration sector’s best efforts, there is still no universally recognized patient identifier. Having such a standard identifier would enable health providers to easily solve the problem of mismatched patient Electronic Health Records (EHRs), which has historically led to several errors in patient care and increased the likelihood of harm to patients and subsequent litigation.
Anecdotal evidence and statistics suggest that up to one in five patient records are not accurately matched, even within the same health care system, and up to 50% of patient records are mismatched when data is transferred between healthcare systems.
With cryptographic hash functions on a blockchain, an input string of any length will give an output of a fixed length — and no matter how many times you parse a particular input through a hash function, you will always get the same result. So in a healthcare blockchain, patients can be identified via their hash ID, which will be their unique identifier.
In the healthcare industry, information blocking is described as the result of “an unreasonable constraint imposed on the exchange of patient data or electronic health information.” Blocking may occur through a deliberate attempt to obfuscate or mislead because of policies that prevent sharing information or through practices that make information sharing extremely impractical. Whatever the reason, it’s a widespread practice, and the various methods that have been used to keep it in check are still highly ineffective.
Research suggests that one way to effectively combat blocking is by increasing transparency so that each and every action taken by the participants on an information network can be accounted for. Building a collaborative relationship between health IT companies, hospitals, and Health Information Exchanges could further curb information blocking. And introducing some form of financial incentive so that network participants will want to share information could also help.
By acting as a transparent medium, a healthcare blockchain can guarantee that participants in the network could study each transaction that takes place and establish whether all the relevant information is getting passed through or not. Protections inherent within the blockchain architecture would safeguard the information from tampering and misuse. And through the tokenization of digital assets, the blockchain could assist in creating a patient information sharing marketplace. This could provide incentives for information sharing between the different institutes, to prevent any information blocking, and give patients a greater degree of control over their own data.
Blockchain in Healthcare Companies
A number of promising startup companies are using blockchain technologies to make healthcare more efficient and secure. Among the leading healthcare blockchain companies in this regard are:
Akiri is the world’s first Network-as-a-Service (NaaS) optimized for the healthcare industry. The company offers Akiri Switch, a software-defined network (SDN) and a secure routing protocol for healthcare data. The platform supports security, identification, authentication, compliance, analytics, and applications for data spanning the entire spectrum of health, wellness, and medical information.
Based in San Francisco, Blockchain Health Co. is a software company that uses blockchain technology to create a direct connection between medical research and end-users. The platform enables users to share information directly with researchers.
The Gem Healthcare Network was developed on the Ethereum blockchain, and Gem develops blockchain applications specifically for healthcare. Security implementation occurs via permissioned blockchains in which patients control access to their own data, and there is a shared ledger system in which every new change is recorded.
With its headquarters in the UK, Medicalchain uses blockchain technology to securely store health records and maintain a single version of the truth. The Medicalchain distributed ledger enables doctors, hospitals, laboratories, pharmacists, and health insurers to request permission for access to patient records or to record transactions.
PokitDok provides a Platform-as-a-Service (PaaS) offering that enables healthcare organizations to quickly build modern commerce experiences across the entire healthcare value chain. A network of 650 trading partners provides access to real-time transactional data at scale.