A ‘blockchain’ is a form of distributed database (or decentralised ledger) made up of unchangeable, digitally recorded data, packaged as ‘blocks’. Each block of data is stored in a linear chain, and each chain is cryptographically hashed. Every modification to the data generates a new block, while the old is preserved. Each new block of data is linked back to the previous block in the chain, to ensure that the overall blockchain is tamper-proof, and that the data history of each record is completely traceable. So why does the healthcare industry need blockchain? And what might stand in its way? What could be the impact of blockchain on healthcare?
I want to discuss the issues hampering the development and deployment of blockchain technology in healthcare, and how such technology can help build a global precision-medicine ecosystem that optimally connects patients, clinicians, researchers, insurers and clinical laboratories to one another.
Disruptors in the industry
Large companies like IBM, Accenture, Hashed Health and Kaiser Permanente are part of the Hyperledger Healthcare (HLHC) Working Group, to facilitate the adoption and evolution of blockchain technology in healthcare. As with any new technology, the opportunities for agile, innovative start-ups to harness blockchain for healthcare are huge. Many are combining blockchain technology expertise with healthcare industry experience to develop platforms and solutions. For example, the start-up company Gem(another member of the HLHC Working Group) developed the Gem Health Network to provide shared and secure data infrastructure to healthcare providers. Such companies have the ability to shake up how the industry approaches Healthtech.
New opportunities for healthcare
Blockchain represents tremendous value for the healthcare space, because it essentially moves away from the mistake-prone, documentation-centred approach to a flexible process where the transaction is key.
Blockchain has the ability to radically improve data security, data sharing, interoperability, patient engagement, Big Data analytics, health information exchange (HIE), fighting counterfeit drugs, R&D diagnostics, artificial intelligence (AI)-based diagnostics, and fostering vertical business models. The above image shows how AI-centred blockchain technology could link all healthcare stakeholders. In population health management, providers can use blockchain to progress in clinical research patient safety event reporting, adverse event identification, public health reporting and precision medicine. Cognitive computing and machine learning can be used to analyse non-patient identifiable data sets.
As with any emergent technology, blockchain’s use for healthcare data is a work in progress, but it’s predicted that within five years, healthcare blockchain will be the new norm for the sector. Thomas Goetz describes his feelings towards the Healthtech innovation: “In healthcare, decision-making isn’t a science problem, it’s an information problem.”
Benefits and challenges of blockchain
The current challenges facing the Healthtech industry’s implementation of blockchain include data security and privacy, operational inefficiencies, and a lack of uniform architectures and standards to ensure trusted access to Protected Health Information (PHI) and Personally Identifiable Information (PII), and safe data exchange. Implementation costs and regulations also prevent the healthcare industry’s use of interoperable data. Naturally, the shift in infrastructure, that incorporating blockchain would require, could be outside the capabilities of many organisations. Blockchain needs to fit in the regulatory framework and workflow of healthcare data ecosystems, and this is no mean feat. It’s thought that interoperability will be the main hurdle to overcome before blockchain can be widely used.
The Health Insurance Portability and Accountability Act (HIPAA) governs how healthcare handles sensitive patient data, and healthcare organisations will need to adhere to the numerous compliance regulations before adopting blockchain. As it stands, there are a few obstacles before full compliance is achieved, but it is thought that combining blockchain with Dynamic Data Obscurity could assist movement in the right direction. But realistically, blockchain implementation might have to take more of a ‘baby steps’ approach, to solve the regulatory issues bit by bit.
Another challenge facing the adoption of blockchain is the analysis of encrypted data. People are also asking what the monetary benefits of such a technology are. If blockchain is going to be used in the long term, the costs of updating or replacing existing IT systems must be balanced with the potential savings.
The overarching advantage of blockchain is its potential to resolve historical challenges associated with health IT, like interoperability and data security. By preventing tampering, blockchain makes health data more secure, and makes the currently cumbersome HIE more efficient. The investment opportunities in this innovative technology are vast, and many companies will be quick to capitalise on this new wave of HealthTech data solutions.
Patientory, a leading provider of blockchain solutions for healthcare, has managed to raise and impressive $7.2m using crowdfunding via crypto-currency. It’s blockchain-based distributed electronic medical record (EMR) storage computing platform comprises an innovative step towards more secure, interoperable HIE.
Security and compliance
While the prospects of blockchain applications are exciting, and the efforts to solidify its potential for data security and interoperability are strong, it’s fair to say that we’re probably still a good way off from seeing it widely deployed.
Blockchain ensures data integrity without violating HIPAA by using bit-string cryptography, but concerns over privacy and security are prevalent. Trust and access control, as well as confidentiality of PHI and PII are among the apprehensions, but each blockchain network participant has a private key and a public key, which are cryptographically linked, to ensure one-way identification. This way, potential hackers would need to have each participant’s private key to access any valuable information.
Compliance with HIPAA and other privacy regulations is assisted by the need for 51% of providers in one blockchain to approve any changes to the block, which is then distributed within the network and improves security.
The future of blockchain in healthcare
Almost all healthcare stakeholders would agree that change is needed if healthcare data is to strengthen. Even though blockchain in this industry is still in its infancy, its potential to improve data security and interoperability, as well as its ability to empower patients, is tangible. Healthcare systems are increasingly open to progressive technology to solve long-standing issues, and continue to break down silos and embrace integration.
Galen Growth Asia‘ mission is to create an integrated network of HealthTech innovators and is keen to encourage blockchain technology startups to engage in developing solutions to improve the Asia healthcare systems.