Blockchain and healthcare: The new industrial revolution?

28 Sep 2018

Image: John Panella/Shutterstock

Blockchain could help healthcare organisations become more efficient and give patients more control over their health data.

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While many people would only be familiar with blockchain as a framework for the world of cryptocurrency trading, blockchain-based systems are increasingly compelling in the healthcare space to improve data integrity, decentralise trust and reduce costs.

Healthcare is one of the most complex and demanding sectors on the planet. Consider the numerous aspects that need to run smoothly and concurrently, such as drug supply chain management, regulatory compliance and the growing swathes of digital patient data. spoke to experts in the field about the opportunities blockchain represents, particularly as healthcare turns towards a more technologically advanced, patient-centred era.

While the principles certainly should not be seen as a panacea for data standardisation or system integration issues encountered in healthcare and medicine, blockchain still addresses some key issues that could make every step more efficient, from primary care centres to pharmaceutical trials.

Auditing and consent

Dr John Halamka is CIO of Beth Israel Deaconess Medical Center in Boston and is also the editor in chief of the academic journal Blockchain in Healthcare Today. He said that public ledger methods will make a big difference for two main areas in healthcare: auditing and consent.

“When a plaintiff attorney requests a medical record, a hash written to a blockchain will guarantee that the medical record is complete and unedited. When patients consent for data sharing among payers, providers, researchers, other patients and companies providing care navigation services, the blockchain can serve as a perfect repository for consent,” explained Halamka.

CTO of Deloitte’s EMEA blockchain lab, Antonio Senatore, said that fully integrating such systems will take a while yet. “In a broader sense, we are still at the very beginning of the journey.”

Individual control

One particularly powerful use case is giving the patient more control over their own health data. The interoperability that a distributed ledger brings could allow for medical professionals to verify a patient’s digital identity across numerous healthcare centres. This would minimise friction, creating efficiency that was not there previously.

Halamka added: “It [blockchain] might store a map of where your records are located and the consent for accessing them, but it will not store the records or billing data.” Senatore noted that the use of blockchain for patient data indexing is something of an extension of the wider push for digital identity solutions implemented by many governments across the globe.

The public/private key encryption scheme creates identity permission layers, which allow people to share distinct identity attributes with specific healthcare organisations on a need-only basis. This could reduce the inherent vulnerability of personal data storage for organisations, and better protect patient privacy.

Senatore added that there are ways in which blockchain could prop up more efficient medical studies. “Let’s say I authorise to share my data for clinical trials every time I’m in a certain hospital – that enables better data for clinical trials.” Progress for precision medicine is also a possibility here.

Furthermore, blockchain would be useful to view patient consents and authorisations. Halamka said: “Privacy is all about respecting patient consent preferences. If consents are stored on the blockchain, then all stakeholders can reference those consents before sharing data.” This would make organ donation status and other medical queries simpler to access by medical professionals with the correct permissions.

Supply chain management

Drug supply chain integrity in pharmaceuticals is another area where blockchain can help things run smoothly. The decentralised ledger model could help identify and validate drugs at various points using smart contracts along the development path. Recall management and other drug safety protocols could also benefit from the tracking opportunities blockchain offers.

The foundation of trust that blockchain offers makes for better information management and a clearer view of what is happening, in real time, with serialised tracking and tracing on an interoperable system. “Lot numbers of pharmaceuticals could be tracked in a blockchain, providing a chain of trust from the point of manufacture to the point of use,” Halamka added.

Senatore noted that drug counterfeiting is a major issue of our time and “supply chain and blockchain fit together” in a way that could reduce its impact. He continued: “We want to see the data running where you can match against the supplier, logistical operator and the hospital.”

What does the future hold?

While technologists and healthcare stakeholders are still exploring the possibilities blockchain holds, there are still some obstacles to full integration, much like any other technological advance. Senatore points to the issue of legacy systems in place across hospitals and other health-adjacent organisations.

He added that a lot of work is going into the privacy aspect of blockchain, which is crucial when it comes people trusting the methodology.  Cryptographic advances and the evolution of the different types of distributed ledgers are paving the way for general adoption.

According to Halamka, some firms are making things simpler. “Some companies are creating cloud-hosted ‘blockchain as a service’, making its use much easier.”

Challenges in the implementation are numerous, but so too are the potential benefits of blockchain in healthcare. Continued investment, experimentation and the creation of guidelines may see a transformation in health and medical data management. Senatore said: “We are really seeing the next industrial revolution.”

Ellen Tannam was a journalist with Silicon Republic, covering all manner of business and tech subjects