[ad_1]
The excitement surrounding the possibilities of blockchain for corporate IT has focused mainly on financial services. However, the health blockchain could also provide solutions to the IT challenges faced by healthcare organizations and consumers.
There are several challenges in the health sector that blockchain could help, including barriers to data exchange, supply chain problems, and patient data use obstacles in clinical research. Blockchain's unique structure offers decentralized and secure data exchange and monitoring technology to help address these challenges.
So, what is the blockchain, what is its potential in the health sector and how will it affect the infrastructure development plans of an organization?
Source: Thinkstock
What is blockchain technology?
According to the National Institute of Standards and Technology (NIST), blockchain is a decentralized ledger that keeps records of transactions on multiple computers simultaneously.
For a transaction, such as a purchase or a request for access to information, to be approved, each member of the decentralized network must accept that the transaction is valid.
Once a transaction is approved and entered in the ledger, it becomes a "block". Block information is linked to other blocks, forming a chain of records that are timestamps. The timestamp ensures that transactions do not overlap and that the most recent change – an addition to an EHR record, for example – always serves as a source of truth for future transactions.
As a result, blockchain produces a reliable ledger without the record controllers having to recheck, on an ad hoc basis, whether a transaction is allowed. By distributing data in secure blocks, the data security risks posed by storing sensitive data in a central location with a single administrator are reduced.
Blockchain can allow people to collect data from different sources and share only what they want.
According to a Deloitte and Pfizer white paper, blockchain provides:
- Transparency: the data stored on the blockchain are transparent for all approved users, creating a unique source of truth.
- Confidence: the data are linked through protected blocks distributed to multiple users, allowing trust among users who do not need to know each other.
- Disintermediation: Blockchain plays the role of existing intermediaries creating an ecosystem of trust.
- Auditability: data on the blockchain are difficult to modify, creating a complete audit trail.
"With the advent of these new blockchain features, the healthcare industry has started taking technology seriously," notes the white paper.
The main goal of the blockchain is to support all the digital aspects of a healthcare organization because every digital tool requires a safe and effective way to exchange data or control access through permissions.
"Blockchain systems may seem complex, but they can easily be understood by examining each component technology individually," NIST explained in his report on Blockchain technology.
For example, a component of a blockchain is an intelligent contract. Smart contracts are computer programs that automatically apply agreements without the need for manual human intervention.
This can automate time-consuming tasks, such as verifying that a healthcare professional has the right, based on HIPAA, to view a person's data. The fact that the entity has had access to the information is then recorded on the blockchain, creating a reliable audit trail for that person's digital record.
"An intelligent contract is a collection of code and data (sometimes referred to as functions and status) that are distributed on a blockchain, and future transactions sent to the blockchain can then send data to public methods offered by the smart contract. appropriate with the data provided by the user for the execution of a service, "explained the NIST report.
Blockchains can be authorized or public. Cryptocurrencies like Bitcoin are based on public blockchains. Anyone with a computer can join the community to exchange currency.
In an authorized blockchain, however, a participant must have the appropriate permissions to join the blockchain network and conduct transactions with other participants in the network. In implementing the blockchain, health IT managers should ask who should access the ledger and what data should be made available.
Blockchain participants can validate transactions and verify identity and ownership without the need for third-party intermediaries. All relevant information can be shared with others based on their roles and access privileges.
Encryption is often used to ensure network security and data privacy, which helps prevent unauthorized access to transaction details and discourage fraudulent activity.
Source: Thinkstock
What are the components of the Blockchain infrastructure?
As noted above, blockchain is based on a distributed ledger that replicates, shares and synchronizes the dissemination of digital data across multiple sites, countries or institutions.
Healthcare organizations need the storage and computing infrastructure to support blockchain along with the network capacity for data exchange.
Blockchain can put a strain on the network because every time a node is created on the blockchain, it must download the blockchain data. This activity uses a lot of bandwidth, the NIST report explained.
In addition, there is no central place for managing user keys, so users must manage their private keys. If a private key is lost, anything related to that key is lost, such as digital assets. "There is no function & # 39; forgot my password & # 39; o & # 39; recover my account & # 39; for blockchain systems," noted NIST.
Blockchain is not a data storage solution. It has limits on the amount of data that can be stored on the chain. As a result, large amounts of data must be stored elsewhere to ensure accessibility and security.
The infrastructure requirements for blockchain will depend on many factors that depend on what the organization wants to achieve. It is about finding the right balance between network speed, processor, disk and CPU.
Source: Thinkstock
What are the cases of use of health care for Blockchain?
While blockchain has not yet achieved widespread adoption in the health sector, many experts believe that it is only a matter of time before the methodology starts to make its mark. There are numerous use cases for blockchain in an industry that has historically struggled to manage its large data resources appropriately.
Clinical research
A case of health use that is receiving a lot of attention is using blockchain in clinical research.
Health organizations continually struggle to exchange data between heterogeneous systems. Healthcare workers, payers, sellers and regulators have struggled with interoperability for years.
"A patient's medical information can be spread across medical centers, doctors, health plans, and others," Deloitte-Pfizer's white paper explained.
"Health organizations often store these data in different digital formats and EHR systems, which can make it very difficult to aggregate and analyze patient data under common conditions and can generate inconsistent formats in the way data owners can make available health data to patients.The lack of continuity surrounding medical data and electronic medical records is a major concern for patients, "notes the paper.
Clinical research, which forms the basis of medical innovation, is burdened by barriers to accessing patient data. The Deloitte-Pfizer study identified the following obstacles:
- Limited accessibility and knowledge of clinical trial opportunities
- Few incentives for patients to share their medical information
- Lack of confidence in the fact that sensitive medical information will be kept secure
- Lack of interoperability records of digital health and ease of aggregation of data
The clinical research community has attempted to address many of these problems, but its efforts have not been achieved so far.
Heather Leigh Flannery, Health Circle Global Lead at ConsenSys and Co-Founder and Board Chair of Blockchain in Healthcare Global, believes that blockchain can help in clinical research.
"We have an incredible short-term opportunity to tackle a serious crisis in the health sector, which is the reproducibility of scientific evidence," he said HITInfrastructure.com.
"Unfortunately, from 60 to 80 percent of clinical trials it turned out that they are not reproducible, which means we are taking clinical decisions, we are approving drugs and devices, we are doing many, many things where the data itself is substantially distorted , largely because of the challenges with working with clinical trial data on multiple sites, more years and more stakeholders, "Flannery said.
A blockchain network can connect patients, pharmaceutical companies, research institutions, healthcare providers and regulatory authorities. Using the blockchain, patients can present their medical information and look for clinical research opportunities that meet their medical profile, explained Deloitte-Pfizer's white paper.
Researchers could provide incentives to patients by giving them access to search results and rewarding them with cryptograms for their participation.
Blockchain can protect the privacy of patients by disidentifying data so that only trusted users can access it and associate it with blockchain records. This allows researchers to analyze anonymous data and then gain access to donor information for use in their studies.
interoperability
Blockchain could help solve interoperability challenges, added the Deloitte-Pfizer report.
"Blockchain platforms are uniquely positioned to facilitate interoperability by creating a level playing field between data providers where there is no single owner of information, where all participants can keep their copies of data and where underlying patient can maintain his identity "the stated summary.
"Although this blockchain would require standards and agreements from various stakeholders, its nature and its distributed capabilities (for example, smart contracts that execute rules in an autonomous and coherent manner) can facilitate large-scale adoption among groups that do not intrinsically share information with each other compared to other traditional technologies, "he added.
Supply chain management
Blockchain can also be used to "track drugs, drugs, from production to distribution, to be used in dispensaries, to be able to eradicate counterfeit drugs, to be able to achieve better transparency and efficiency on the sides of use, or the point of use in dispensaries, like a pharmacy, "said David Houlding, chief health officer at Microsoft Azure and president of HIMSS Blockchain in the Healthcare Task Force HITInfrastructure.com.
Blockchain offers "new ways to collaborate that improve efficiency and transparency, add security, avoid a single point of failure and strengthen data integrity," he added.
Aditya Kudumala, a principal of Deloitte Consulting who worked on the blockchain report, said that blockchain improves the visibility of information flowing through the supply network, facilitates collaboration and improves traceability of drugs across the network, helping to remove fraud and waste in the system.
"The blockchain is helping us to create the entire chain of custody in a much better way than we had before. We can have an almost real-time exchange of information from the drug manufacturer to distributors, logistics providers, sites and, ultimately, to the patient, "he said.
Organizations can also monitor the movement of physical resources, such as medical devices, laptops or other portable technologies, added Houlding.
"The traceability of the medical device is similar to the case of the use of the drug supply chain, except that you are monitoring medical devices, so anything from a pacemaker to an MRI machine, taking it from the production point through the supply chain, through its use, even through multiple life cycles, "he said. "If there's a call, you can go to the blockchain and very quickly determine exactly which devices are affected and shorten the recall cycle from a year to hours."
Directory of providers and credentials
Blockchain could be used to reduce the costs and administrative burdens associated with maintaining accurate provider directory data.
"There's a lot of inefficiency, a lot of redundant work, and operational costs in maintaining directory providers," said Houlding.
"And if we could just keep track of that information in a decentralized ledger shared on blockchain and have consistent copies of provider directory information between suppliers, buyers and cut operating costs, avoid rebounded transactions, etc.," he said.
Synaptic Health Alliance is an organization that works on this use case. The alliance, which includes Aetna, Ascension, Humana, MultiPlan, Quest Diagnostics, Optum and UnitedHealthcare, is investigating how to use blockchain technology to keep health care provider providers' directories up-to-date.
In the longer term, the Alliance wants to examine how data sharing among healthcare organizations using blockchain technology can improve data accuracy, simplify administration, reduce costs and improve 39; access to care.
The credentials of the supplier are another use case. The exchange of professional credentials recently launched an effort to use the blockchain to alleviate the administrative burden of health personnel credentials. The exchange includes national government services, spectrum health, WellCare health plans, Accenture and the Hardenbergh group.
"If those credentials were on blockchain and the validation and verification of those credentials were also on blockchain, you could eliminate many inefficiencies – it could be a real advantage for physicians in terms of their ability to practice faster," said Houlding.
Blockchain is an exciting innovation that promises well for the healthcare industry. While significant advantages derive from this technology, doing it successfully will not be easy.
Considering carefully how technology could meet their needs, organizations could significantly increase the likelihood that their blockchain initiative will succeed.
