BLOCK CHAIN and its Applications in Healthcare

Block chain technology is probably the buzz word these days, almost everywhere. It is likely to have a mention about it, irrespective of the industry and the curiosity is increasing day by day. However, setting aside the massive scope of opportunities that Block chain brings in; its prominent use cases are still concealed under Bitcoin.

Undoubtedly, Bitcoin is one of the most prominent implementations of Blockchain. But, certainly, it’s not just the only use case of this disruptive technology that we have today. To make the most of Blockchain, it is imperative to understand what exactly it is. Before we move on to its use cases in the healthcare industry, let’s understand what Blockchain is and how it works?

Block Chain, a methodology for conducting transactions that relies on a decentralized approach to authorization and edits, is finding its way from its origins in the virtual Bitcoin ecosystem to more traditional industries, such as mainstream finance, manufacturing, and healthcare. 

In other words, Blockchain is a record of digital events, which is distributed and immutable, shared peer-to-peer between different parties (of a networked database).Ideally, the essence of Blockchain is in its ability to maintain data integrity and retain networked immutability. It has synonymslike“Chain of trust” / “Chain of digital signatures”/ “Hash chain”, which make it easy to understand.

The original motivation for Bitcoin to implement Block chain technology was to solve the peer-to-peer double-spending problem with distributed timestamp mechanism, and every node maintains a copy of the chain to store every transaction.

Problem solved using Block chain application:

How can we prevent electronic transactions/data (defined as “a chain of digital signatures”) such as bitcoins from being spent twice or more than twice without having a central intermediary (eg, bank or mint)?

How does the Block chain network works?

An example of simplified block chain (hash-chain by taking bitcoin as example)

Each transaction of coins is enclosed in a block. A block may contain multiple transactions and is a basic unit to be verified. Each block also contains a hash value of the previous block's header, and thus forms a hash-chain or blockchain. As all blocks are chained, the order of the blocks is deterministic; therefore, each block can serve as a timestamp of the enclosed transactions to solve the double-spending problem. Note that each node maintains a copy of the whole blockchain, thus every node can verify every transaction

Where does Blockchain Fits into the Healthcare Industry?

Blockchain has made a blissful contribution to the fintech industry and it has just started to inspire the health IT with some achievable and speculative applications. The healthcare stakeholders are equally excited about the set of possibilities that Blockchain has presented. However, to give more power to this new technology, developing new frameworks to implement use cases of Block chain in larger scale is important. Putting the hype around Blockchain aside, here we discuss few of the amazing use cases of this technology in healthcare industry.

1. Interoperability and Exchange of Clinical Data

With health IT solutions that are backed by Blockchain, we can expect technological solution to various challenges in healthcare application development like managing big data, data interoperability, data security and integrity, and more. Blockchain enables a data exchange system that’s cryptographically secured and cannot be revoked. This will give access to the historic and real-time patient data, consequently reducing the data reconciliation cost. 

2. Healthcare IoT and Cyber Security Handling

According to a report by Identity Threat Resource Centre (ITRC), healthcare comprises 30% of all U.S. data breaches, second to the business sector. 41% of the health data breaches were a result of insiders, wherein, 73 out of 96 incidents are known to have affected 1,166,674 patient records. And 53% of breached patient records were the result of hacking.

In the current system of healthcare devices, it is quite challenging for the Health IT infrastructure to accommodate or support the emerging IoMT (Internet of Medical Things) ecosystem. Studies suggest that there would be 20-30 billion IoMT devices used globally by 2020. In such scenario, Blockchain powered solutions can ensure security, reliability, and privacy around the use cases of Internet of Medical Things.

3. Provenance and Integrity of Drug Supply Chain

A report by WHO states that 30% of drugs sold in developing countries are counterfeits. With a pharmaceutical system powered by Blockchain, a chain-of-custody log can be created that makes it possible to track the supply chain at individual product level. In addition to this, functionalities like private keys and smart contracts can act as a proof of ownership to justify the drug source.

Such an approach is adopted by iSolve that help organizations to manage drug development cycle. They collaborate with biopharma companies; render their ADLT Blockchain solutions to manage drug supply chain integrity.

4. Clinical Trials and Research Result Management

50% of the clinical trial goes unreported. This as a result creates safety issues for patients and also generates information gaps for the healthcare stakeholders and the policymakers. If the clinical trials are supported by a Blockchain solution, the results, protocols, and other related information would be time-stamped and immutable, resulting in less data snooping and errors. 

Integrating Blockchain into Health IT Solutions

Blockchain offers some convincing opportunities for the healthcare industry. It can help in working around a number of challenges, from drug supply chain provenance to billing fraud issues to cybersecurity. Finding and implementing the best possible use case of blockchain in mobile and IoT applications can let the technology spread out its wings and offer the best inimitable advantages.

In nutshell, the following are the broad differences between Health Information Exchange and Block chain:

Let us conclude with: Block chain no doubt has certain benefitslike: -

·     decentralized management

·     immutable audit trail

·     data provenance

·     robustness and availability

·     improved security and privacy using cryptographic algorithms

Potential problems and challenges:

There are several potential challenges to be considered when adopting blockchain technology in the health care domain:

·     The first challenge is related to transparency and confidentiality. As “everyone can see everything” on a block chain network,heightened transparency and decreased confidentiality, such as open transparency of information during transfer, is usually considered a limitation of block chain and it drastically affects the patient privacy in healthcare domain.

·     The second challenge is related to speed and scalability. The transaction time of blockchain can be long, depending on the protocol, and such a speed constraint may limit the scalability of blockchain-based applications

·     The last challenge is the threat of a 51% attack. A blockchain network may suffer from the “51% attack, which happens when there are fewer honest nodes than malicious ones in the whole network, and thus the whole network is taken over by the malicious attackers. This issue is also critical for security-demanding health care/biomedical applications.

The organisations need to thoroughly check the pros and cons before investing in block chain applications.It is very important to have the right set of use cases so that its full 

power can be utilized. Without any support, most of the use cases listed above might not be able to drive block chain adoption organically.In order to make these use cases feasible, we would needthe right combination of appropriate regulations and support from the government.

Team Telehealth!