Blockchain in Healthcare

Blockchain in Healthcare

Introduction

The last decade has seen significant shifts towards digitization of health services. Hospital, pharmaceutical, government agencies, and regulators are increasingly pushing for increased digitalization of health records and practices. Stakeholders in the healthcare industry argue that increased digitization will help to cut down on the cost of health care, improve service delivery, and enhance patient outcomes. The push for increased digitization in the healthcare industry has not come without its share of challenges and opportunities.

The digitization shift has brought to the fore the need for increased security, interoperability, and sharing between the various existing systems. Over the last five years, industry practitioners and academics have been evaluating ways in which we can implement blockchain technology in the healthcare industry. Blockchain which is an immutable and decentralized ledger, has been instrumental in driving the development of cryptocurrencies and decentralized applications.Blockchain can also be applied in the healthcare industry through both vertical and horizontal innovations. This research paper evaluates some of the critical use cases for blockchain in the healthcare industry as well as the security and other strategic considerations.

Patient Identification

One of the primary functions that blockchain technologies can be used to solve in the healthcare industryis in patient identification. Current standards in digital patient identification do not have a universal metric of identifying patients. Organizations such as the HIMSS and CHIME have been continuously pushing for the development of a standard for recognizing and identifying patients. A comprehensive patient identifier will be integral in eliminating the challenge of inconsistent patient EHRS. Mismatched EHR records areone of the leading causes of medical error in Northern America(Zhang et al., 2018). A unique identifier will also help patients and physicians when transiting from one medical service to another or even when changing hospitals.

The adoption of a blockchain-based health system can help to resolve these issues. The blockchain ledger can be used to accord patients with unique identifiers within the blockchain ecosystems. Whenever a patient is enrolled in a healthcare system, they are accorded with a unique identifier which is used to identify them throughout their life cycle within the systems. The unique identifier will help to prevent records mismatch while also allowing physicians to track the patient throughout the system. A uniqueidentifier is also integral in setting the stage for interoperability and data sharing.

Sharing and Interoperability

Most of the existing healthcare system operates as silos that do not allow the sharing of information with other external entities. Blockchain technology can be used to facilitate the exchange of health records and data amongst its users(Khezr et al., 2019). Blockchain will also help in tracking what data has been exchanged and with whom. Blockchain can be used to offer incentives for patients, physicians, health institutions, and researchers to share data. Participants in these exchanges can freely participate in seamless information exchange with minimal costs. Unlike current centralized systems which are mostly expensive and tiresome when transferring large volumes of data, blockchainoffers a simple and inexpensive means for data transfer.

Application of blockchain in the transfer of medical information will not only help to reduce overhead costs but also enhance the data’s reliability and integrity. It is common knowledge that a lot of data corruptions occurs when information is on transit. The immutable and decentralized characteristics of the blockchain network can help to enhance data security and integrity during transit. Additionally, the uses of blockchain can alsohelp to eliminate the challenges of master-patient identities. Blockchain can leverage its cryptographic techniques to assist in validating patient identity and enhancing data probity during sharing. Overall, the implementation of blockchain technologies can allow the development of standardized methods and metrics of inputting data in health information systems.

Smart Contracts

One of the most significant developments of the blockchain is in its ability to implement smart contracts in the absences of intermediaries and third parties. Today, the healthcare system is fraught with bureaucracies, overhead costs, and brokers that have contributed to the spikes in the cost of healthcare services. Blockchain use of smart contracts can help to resolve this challenge by developing executable smart contracts that can be implemented seamlessly and in the absence of third parties (Daniel et al., 2018). Smart contracts will enable health stakeholders to perform or receive certain benefits automatically whenever certain conditions are met.

The use of smart contracts is integral in curbing issues insurance fraud and promote the concept of data monetization. The blockchain ecosystem can allow individual and health organizations to monitor service delivery and ensure accurate claims to medical claims. The ecosystem is also integral in promoting the monetization of intellectual property, data, and services through tokenization. Blockchain platforms can also facilitate digital payments for medical services. Overall, blockchain’s smart contracts can help to enhance transparency between health stakeholders and create a more equitable ecosystem for patients, insurers, health providers, and hospitals.

Drug Traceability

The healthcare system in the world today is faced with significant concerns about drug counterfeiting. It is estimated that approximately 20% of the drugs in the market today are counterfeit (Khezr et al., 2019).This is a worrying trend since it possesses significant health risks to the global population. Counterfeit drugs are usually different from theoriginalmedicines in terms of theirquantitative and qualitative composition.

Blockchain can be used to authenticate the correct drugs by assigning immutable timestamps for the drugs. The timestamps are then used to track and trace the drugs. Upon manufacturing drugs, the pharmaceutical companies should register their product either in a private or public blockchain network. Each drug is accompanied by a hash that contains information of the manufacturer, distributors, composition, among other critical requirements as specified by national and international regulations. The approach will allow manufacturers to create a system that is impermeable to counterfeits. It will also enable researchers and regulators to track and trace drugs to their sources in case of any problems.

Clinical Trials

In the recent past, there has been a significant increase in clinical trials and researches geared towards finding better medication for various emerging and existing diseases such as cancer, Ebola, and HIV/AIDS. Numerous clinical trials are being conducted across the world to ascertain the effectiveness of different medical products and services. These trials generally take up to several years of testing, retesting, validation, and counter validation. The trials produce a lot of data in terms of imagery, quality reports, statistics, and blood test.

Due to the vast amount of data involved in clinical trials, it is virtually impossible to establish control over the data (Zhang et al., 2018). It is also becoming quite difficult for researchers to collaborate in developing medicines. Although there is little documentation detailing the extent of fraud in clinical trials, it is quite evident that researchers fear to collaborate as a result of lack of trust. Blockchain can solve this problem by introducing proof of existence for any document. Since a majority of the nodes have to agree before validating a material, it is thus easier to verify the information. The public keys adopted by a blockchaincan also be used to authenticate information during clinical trials. In the blockchain network,researchers can compare private and private keys to ascertain the authenticity of all the information in the blockchain. Application of blockchain in clinical trials will not only help increase trust when sharing data on clinical trials but also allow the implementation of blockchain technologies in the healthcare industry.

Security

At the core of the blockchaintechnology is its assurance for increased security and data integrity. The application of blockchain technologies in the healthcare industry hasprimarily been driven by its increased guarantee of security and immutability. This is not meant to mean that blockchain isunhackable, with ownership of over 51% of the nodes in the blockchain network, one can easily alter information on the blockchain (Pilkington, 2016). Despite, that vulnerability blockchain remains one of the more secure technologies courtesy of its applications of methods such as cryptographic hash functions.

Cryptographic hash functions are particularly useful in the healthcare industry because of three significant properties. First, is that there are deterministic; hence no matter how many times one parses through, they will always get the same results. This is particularly important in keeping track with unique inputs. The cryptographic hash functions are also pre-image resistance; hence its quite difficult to trace an encrypted item to its original form. Finally, cryptographic hash functions have a snowball effect;therefore, a small change in the input will be reflected in the hash function generated.

Conclusion

In sum, blockchain technology offers numerous opportunities for innovation and development within the healthcare industry. Throughout this article, we have managed to review some of the probable concept ideas where blockchain can be implemented from patient identification to data sharing and clinical trials. Some of the concepts outlined in this paper are currently being practiced, while others are still under conceptualization. This notwithstandingblockchain should not be treated as the panacea for all issues in healthcare but instead as a tool for streamlining healthcare and service delivery in the health system.

References

Daniel, M., Cristian, C., & Shang, G. (2018). Smart contract applications within blockchain technology: a systematic mapping study. Telemat. Inform, 35(8), 2337-2354.

Khezr, S., Moniruzzaman, M., Yassine, A., &Benlamri, R. (2019). Blockchain Technology in Healthcare: A Comprehensive Review and Directions for Future Research. Applied Sciences, 9(9), 1736.

Pilkington, M. (2016). 11 Blockchain technology: principles and applications. Research handbook on digital transformations, 225.

Zhang, P., Schmidt, D. C., White, J., & Lenz, G. (2018). Blockchain technology use cases in healthcare. In Advances in Computers (Vol. 111, pp. 1-41).Elsevier.