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Bitcoin - Part of a Solution for Healthcare?

  • Feb 21st, 2017
  • Guy Paterson

Bitcoin - Part of a Solution in Healthcare?

Blockchain is the technology behind Bitcoin.  Rather than be concerned about its 'dark web' uses and reputation perhaps it’s time that the health industry take a closer look.  Blockchain is essentially a tool to keep secure data in a distributed, easily accessible encrypted ledger (Hmmm - almost like a medical record) with specific control of who has access to that ledger.  The ledger is a list of digital transactions (read health data) within one shared ledger that is spread across a network of synchronized and replicated databases visible to those with access.  Security improves as access is not controlled by one central administration giving full access to hackers - hacking one block of a chain is impossible without hacking every other block in the chain's chronology. 

When transactions take place data is grouped into an encrypted block with other transactions.  While major advances have been made in electronic health information, the critical problem is linking the data from many different sources with different standards.  Interoperability of the various collections has been a consistent and difficult problem.  Using Blockchain, the ledger becomes the standardization and institutional, privacy and regulatory roadblocks are reduced. The various elements of a health interaction (visits, lab results, prescription, x-rays, procedures, etc.) are recorded in the local electronic record.  As elements of the record are validate by the care giver with access to the Blockchain the software then adds the data to the correct part of the ledger in chronological order, using any of multiple standardized health integration tools such as FHIR, HL7 and CCD. The ledger shows every transaction made in the history of the ledger, and crucially, for patient privacy and security, users don’t have to send data back and forth to see it. They just all have to point to the same common ledger while using existing health systems functionality and storage.

Data captured on blockchains can be shared in real time across a scalable group of individuals and institutions. Every event or transaction is time-stamped and becomes part of a long chain, or permanent record, that can’t be tampered with after the fact. On permission-less blockchains, all parties can view all records. On permissioned blockchains, privacy can be maintained by agreement about which parties can view which transactions – and where desired, by masking the identity of the party. In this way, blockchains shift the lens from disparate bits of information held by a single owner, to the lifetime history of an asset. This holds true whether that asset is a set of financial transactions, a patient’s health record or a bottle of pills as it moves through the supply chain.

The technology is still in its infancy when it comes to healthcare applications but major players in the eHealth Industry including the Office of the National Coordinator for Health Information Technology (ONCHIT - part of HHS), Mayo Clinic, and Humana are participating in trials.  They found blockchains as a significant health opportunity.  An IBM study of 200 leading US health organizations found 16% expected some Blockchain applications in 2017; while 90% expected some investment in Blockchain health applications in 2018.  They stated:

"So much healthcare data is digitized but not yet shared, and there are extensive regulations and risks associated with sharing it. It isn’t surprising that Trailblazers see the greatest impact from blockchains on those frictions we classified as information frictions – imperfect information, information risks and inaccessible information."

Guy Paterson Feb 21, 2017

Excerpted from:

https://www.wired.com/2017/02/moving-patient-data-messy-blockchain-help/

https://www.pubpub.org/pub/medrec

https://www-01.ibm.com/common/ssi/cgi-bin/ssialias?htmlfid=GBE03790USEN&

Author

Guy Paterson Co-chair Saskatoon Chamber of Commerce - Health Opportunities Committee

Guy Paterson is owner of IRG Informatics. Saskatoon, SK and Co-chair of the Greater Saskatoon Chamber of Commerce Health Opportunities Committee. 

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