Understanding Blockchain Distributed Ledger Tech (Part 2)

As explained earlier in the first part of this series, the Blockchain is also similar to a database which stores information. However, the main difference is that the data is located in a network of personal computers called nodes where there is no central entity such as a government or organization controlling the data. Instead, all data is shared publicly.

Interactions within the Blockchain become known to all participants and require verification by the network before the information is added, enabling trustless collaboration between network participants while recording an immutable audit trail of all interactions. Each participant connected to the Blockchain network has a secret private key and a public key that acts as an openly visible identifier. The pair is cryptographically linked such that identification is possible in only one direction using the private key.

The emergence of the smart contracts has brought a great benefit to the Blockchain. Smart contracts help you share anything of value in a transparent, conflict-free way while avoiding the services of a middleman. Blockchain opportunities are changing healthcare globally. The exponential growth of Blockchain applications accompanied by the introduction of these smart contracts can benefit population health, medical records, and patient-generated data.

Healthcare has been lagging to adopt newer technologies with a large part of the medical industry still running on fax machines and on paper. As stated by Jackson (from Canada’s Institute on Governance), “The most interesting feature of Blockchain in the health sector is the ability of patients to own and control their own health information”.

Just as there has not been a good model with the appropriate privacy and reward systems that the Blockchain offers for the public sharing of health data and quantified self-tracking data, likewise there has not been a model or means of sharing mental performance data. If all this information can be linked to an identity, patients control could decide who gets to see what information. Perhaps a dentist doesn’t need an access to your sexual health history.

With the intensity of efforts on developing efficient health systems using the Blockchain, we hope to see the likes of new generational Fitbit or Apple’s iHealth on the iPhones, which automatically captures over 200 health metrics and sends them to the cloud for data aggregation and imputation into actionable recommendations.

Also, intelligent Blockchain solutions could easily be developed and used in capturing mental performance recommendations made to individuals through services such as the Microsoft’s Cortana, Apple’s Siri, Amazon’s Alexa, or the Google assistant, perhaps piped seamlessly through personal computer interfaces and delivered as both conscious and unconscious suggestions.

Following Issues, Blockchain Technology Can Solve

Below, are some of the most popular problems that could be solved using the Blockchain technology:

Multiple Data Backup And Security

Looking at the current software architecture of most healthcare organizations operating as of today, a majority of health organizations have one central database, with one team managing the database. This implies, there is only one point of failure, with that one database. Assuming there is an intrusion by a hacker into the system, he gets access and manipulates the database. The hacker either choose to encrypt/decrypt the database to his satisfaction, leaving the organization with a corrupt data. Hackers can even launch phishing attacks targeted at some of the hospitals’ professionals to get unauthorized access to their data.

The Blockchain helps solve this problem when applied, protecting the internal infrastructure within the organization. Having many copies of the Blockchain ledger within a healthcare organization with independent parties having access to the separate copies under lock and key creates redundancy like we have never seen before. If implemented correctly, Blockchain would protect against these types of cyber-attacks.

Data Verification And Validation

Another major problem in the healthcare industry is the verification and validation of medical data. Medical test reports for a particular patient can be made easily accessible to the appropriate owners without any fear of alteration. Suppose a patient conducted a medical test from hospital A, and as a result of a particular need for transfer, he was transferred to hospital B. If the medical report can be made available on the Blockchain, there won’t be the need to reconduct the test in hospital B since the result can be trusted by all.

By eliminating unnecessary repetition of processes, expenses go down and the patient is exposed to less stress. Two-way advantages! Meaning, both providers in different organizations can easily look-up the patient’s data on the Blockchain, to see when the last particular test was conducted.

Using Blockchain systems, healthcare centers could direct a regulated set of information, which could be then stored in a nationwide distributed ledger. This information would be then made available universally through the Blockchain private key, enabling patients to easily share their information with those organizations. This would eventually allow smooth access to real-time patient health data and discard the burden and expenses of data reconciliation. It will also eradicate inconsistency data standards and a dearth of compatibility across health data exchange systems.

Detecting Payment Frauds

Unlike the common payment practices with the use of fiat currencies, the medical systems can adopt the use of cryptocurrency as payment from patients. This can be efficiently used to curb corrupt practices in billing and payments. According to the National Health Care Anti-Fraud Association in 2017, health care fraud costs around $68 billion every year. Blockchain applications when used with systems tracking tests, results, billing, and payments by patients, it could reduce fraud to a significant extent. The change could be initiated by the healthcare insurance company industry.

Generally, most United States’ insurers follow Medicare. Medicare would have to back some implementation of Cryptocurrency, and if Medicare were to change, it would go a long way in saving the nation a lot of money by wiping out middlemen who are responsible to track the flow of information through various channels.

Also, on the part of patients, the Blockchain systems could also make insurance agreements and payments clearer and tamper-proof, thereby reducing the threat of being exploited.

Securing Pharmaceutical Supply Chain

In 2010, the World Health Organization pegged global fake drug sales at $75bn, a 90% increase over five years. Some other reports show that in many developing countries in Asia, Africa, and South America, counterfeit drugs comprise between 10% and 30% of the total medicines on sale. As such, governments around the world are tightening up their supply chain integrity requirements in hopes of slowing the global flow of fake medicines. An example is one of the outstanding efforts made by the United States government. The US introduced the Drug Supply Chain Security Act in 2013, giving the industry until 2023 to institute full, unit-level track-and-trace systems for products as they move through the supply chain.

Pharma supply chain is one of the most common use-cases of the Blockchain. In Pharma, drugs are first developed and manufactured at manufacturing centers and transferred to wholesale distributors before being distributed to retail companies and pharmacies. Only then, they are delivered to patients. In such a scenario, Blockchain technology can validate the integrity of the drug supply chain and fuel new drug development by allowing the Blockchain system to manage and support the drug development process.

As part of the efforts in bringing this to reality, in April 2017, IBM announced a partnership with Chinese supply chain management firm Sichuan Hejia, to introduce the Yijian Blockchain Technology Application System, a new Blockchain platform based on the Hyperledger Fabric open-source Blockchain framework.

With the help of Blockchain technology, some of the currently implemented processes in the supply chain can be drastically improved by utilizing smart contracts, distributed ledgers, proof of work and transfer of assets.

Patient Generated Health Data (PGHD)

With the advent of the cloud computing and internet of things (IOT), Patient Generated Health Date could leverage the Blockchain for security and sharing. The Blockchain technology can authenticate access to medical information, quickly and securely.

No doubt, the tremendous potential of Patient Generated Health (PGHD) is currently underutilized, simply because the majority of the data never makes it to the patient. One of the advantages of using PGHD is that patients could actually make profits from their health and demographic data, with the option to sell it to health research studies or drug discovery. That data would then be kept on the Blockchain, with permission for its transfer given by the patient to a provider via the system. Once patient-generated data is owned by the patient from wearables to physician and clinical visits a dramatic shift will occur.

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