NEWS / Blockchain

Blockchain in Healthcare

June 14, 2019

For centuries, medicine has been at the forefront of technological advancement, leading the way in clinical research, evidence-based practice, and the continuous development and refinement of tools and processes. However, when it comes to adopting IT, healthcare authorities can lag behind. A 2017 report found that the UK’s National Health Service was the world’s largest buyer of fax machines. There are several reasons for the health sector’s reluctance to make broad changes: a conservative approach to making large changes with no prior proof of benefit; concerns about cost-effectiveness in adopting technology which is changing and developing all the time continuously; difficulty in anticipating which systems will last and which will quickly become obsolete.
All this, in a sector which negotiates huge amounts of data of the most sensitive and private nature, and where any mistakes could have a catastrophic human impact. The adoption of blockchain in healthcare is, therefore, in its early stages. There are clear benefits, and reasonable barriers, to the use of blockchain for the storage of and access to medical records.

Where does Blockchain fit in healthcare?
  • Confidentiality and privacy: attention must be paid to the sensitive nature of health records, but the technology exists to encrypt even decentralized, public access data so that only the holder of a ‘key’ – the subject of the medical records – can grant full access to the data.
  • Decentralized storage and portability of information: this is particularly pertinent to personal health data, and could allow for greater individual ownership of data, enabling easy movement between healthcare providers, even worldwide, and instantly available information on medical history in an emergency.
  • Accessibility and transparency: personal health information needs to be findable, retrospective, and safe. Health records are treated as legal documents and should be unalterable. Blockchain by nature is immutable and therefore irrefutable.
  • Interoperability: this will be inbuilt; there are already thousands of systems in use for health records, pharmaceutical records, pathological records, social care records, and many more, which are stand-alone systems and do not necessarily integrate with each other, even within the same healthcare setting. Having one type of data repository which is accessible to any chosen agency should mean completely seamless and timely access to all records on the same chain.
  • The elements of each block (i.e. reference, chain reference, timestamp) means data is transparent and auditable, and reliable both for care provision and in the case of legal proceedings.
Where in the healthcare chain does blockchain help?
Blockchain in healthcare could revolutionize efficiency and quality of patient-centered care, by incorporating, on a single decentralized system:
  • Individual personal health records.
  • Clinical trials data, with findable, relevant, and up-to-date evidence.
  • Medical devices, particularly IoT-enabled health monitors.
  • Pharmaceuticals and dispensing information, both general and individualized.
… in fact, any relevant information can be linked to individual care records. This freely accessible individual data can mean a number of things. For the individual, it can mean ownership of health data, choice of healthcare provider, and instant access to records in case of emergencies. There are also implications for public health and research: decentralized interoperable information (even given individual privacy needs) could mean availability of HUGE demographic patterns, and fundamentally transform the way we approach national and international health trends and crises.
Blockchain and Beyond
It is impossible to separate blockchain in healthcare from the Internet of Medical Things, and having systems which are interoperable with wearable devices to monitor individuals’ health and lifestyle could have applications in diagnosis and management of disease. An immutable record of healthy living with IoT health monitors could even be used to inform insurance companies; like ‘black box’ insurance for drivers, proof that a person is adhering to their insurance company’s rules for healthy eating, smoking cessation and alcohol intake, to name a few, could have a positive effect on both insurance premiums and public health. There is a slightly disturbing aspect, however, to the idea of insurance companies’ continuous surveillance of people’s behavior and their ability to financially punish them for what they consider poor choices.
There are compelling reasons to adopt blockchain technology into healthcare, but with the sheer volume of personal health records and clinical data worldwide, the retrospective recording and ongoing use of blockchain for health data is logistically overwhelming. The same can be said of any major functional shift, however. Blockchain needs to be tried to be tested, and while still in its nascent stages of use in medicine, the potential is there.