Blockchain, drug fraud and the opioid epidemic


BRIAN BEHLENDORF: So there is a huge amount of fraud in the prescription drug market. And just as for detecting the provenance of diamonds or the food supply chain, it is possible to trace the provenance of pharmaceutical products. You can have a system whereby the drugs – from the moment they were made and the lot they were made to and the factory where they were made – were traced in a way that maybe some parts were public, maybe parts they were private, but were traced through the distribution process to the final recipient. Obviously, when we talk about individual patients and the prescriptions they receive, it is highly sensitive data. This is data that could never be stored directly in a chain: what is your prescription, what are my prescriptions, that kind of thing – but keeping track of these objects, tracking down the individual vials of a drug or bottles of a drug as they come down at the pharmacy level is something we can do to try to see: where are there pharmacies that seem to dispense much more than they should be based on the prescriptions they are receiving?

Also, finding ways to actually measure, then perhaps separate from the opioid crisis, but we actually have a challenge of adherence in the drug industry to understanding, for a given drug, which is actually taking it at times when it should take it and keep taking the whole regiment rather than stopping halfway because they felt good. And so you can see the IoT sensor data from the vendors' devices themselves, weaving an image that allows us to see from the batch where the drug was produced to the people being prescribed, and who took it if c & # 39; is there a problem out there, if there is a quality control problem where it comes from, and who could be responsible for it? And consequently, patients who adhere well benefit from the use of these drugs? Or those who are having little reaction are those who are only taking half of their prescription? This kind of thing.

Reporting to the opioid crisis, I think the monitoring prescriptions in a system like this, if we can find ways to do it while respecting the patient's confidentiality – because I am a big supporter of the importance of keeping the patient at the center of who their information is shared and on what basis – but if we are able to build a hermetic system to track all that and understand where these prescriptions are going, we will have a much better basis for discovering frauds, finding places where they could be fraud, and it's worth investigating more thoroughly, and trying to figure out how to get there – I tend not to blame those who use drugs because I think they're just meditating to satisfy their needs, they're really distributors and those who write fake recipes and others who are giving the way to much of this crisis and I think that the technology of the generalized register can help us to understand where there might be abuse in that system.

So we have a number of health organizations in our community. We have a company called Kaiser, really big on the west coast, and I think they are known here too. Change Healthcare, which is part of McKesson, and many startups. And they are examining a number of different use cases in the healthcare sector from the supply chain origination in pharmaceuticals to the suppliers' directories, which are basically these medical directories and certifications that have been rewarded and are keeping pace with their year ten hours of education, these types of things, the prescriptions and then the big type of Holy Grail is the medical records. Can we make the medical records more portable? Not publishing them in a distributed ledger because, once again, the whole point of a distributed ledger is "extending this data extensively", but instead creating portfolios of health information for individuals keeping track of their records, which somehow work like a Bitcoin Wallet where you know you have these resources and you can decide to share these records. You get them from a doctor, you can decide to share them with another doctor. If you have moved and had to change your doctor, change healthcare provider, you can bring that data with you. And what would be drawn on ledger is a pointer to your wallet and a signature for each of the records you have that attests your actual data. So if I get a prescription, I can not change that item from 10 pills to 100 pills because that would change the signature and the signature is what would be recorded in the ledger. So all these kinds of questions about trust, provenance and discovery, understanding of "where is all my data?" and being able to put it all together and see the patient as the center of health information exchange is a problem that we have not been able to solve when we have approached health as a challenge of integrating or we left the patient in the cart around the big boxes of paper documents or CD-ROMs, but I think we can really get in touch with the distributed ledger technology, and many of our companies are working on that same challenge.

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