There is robust evidence that blockchain will enhance data security
and facilitate healthcare. Blockchain is a distributed digital ledger
that tracks and records online activity among distinct participants,
eliminating the risk of data manipulation and theft through internal
corruption and external threats. This inherent digital security
feature makes it a logical solution for protecting the confidentiality
of patient information and guarding against illegal data attacks.
Additionally, the potential of blockchain isn’t limited to data
security but extends to game-changing novel opportunities for
enhancing operational transparency in healthcare software systems.
Transparency within healthcare is important for building trust between
patients, providers, and stakeholders by making the associated
processes of data management, decision-making, and the value of
patient information visible. Software transparency is necessary to
mitigate the risk of fraud and recording errors. Additionally,
patients must have control over their health information to achieve
equal trust and care. Therefore, developing more transparent software
will be essential for future operations within healthcare
organizations.
Another advantage of blockchain is its potential to bring greater
transparency to the healthcare system. Immutable, verifiable records
of transactions mean that data can be traced from its origin point to
its end use, holding everyone involved in the chain accountable.
Transparency has been shown to build consumer trust around patient
care, improving regulation compliance and ushering in process
efficiencies such as clinical trials and supply chain management. In
this series, we will explore specific blockchain applications in
healthcare to see how this innovative solution can transform
healthcare software through greater transparency and trust.
Understanding blockchain in healthcare
The blockchain is a decentralized digital ledger, a series of transactions recorded to multiple computers and then replicated across the network in an immutable ledger. Simply put, the recorded information can only be tampered with or changed after the fact with the network's consensus. Adhering to the concepts of ‘trust but verify’, blockchain is transparent, with everything recorded in the same data simultaneously, and each participant in the network has access to the same information. The hallmarks of blockchain include decentralization, immutability, and transparency. Decentralization means no central group, individual, or entity is in charge of logistics. Immutability means data is entered into the blockchain and is no longer ‘able to be changed.’ Transparency means all the data is available only to the allowed or permitted parties. In the healthcare setting, where access to health data must be secure, the characteristics of blockchain confer additional benefits to data integrity and security.
Blockchain is already being applied in several healthcare contexts
and, armed with some understanding of this platform, it is not hard to
anticipate how it might be deployed to better operations: Electronic
health record (EHR) management: blockchain can enable explicit and
implicit information stored in an EHR to be physically and
cryptographically shared with multiple healthcare providers while
providing detailed and provable evidence of the appropriateness and
trustworthiness of exchange using a secure, interoperable ledger.
Supply chain tracking: blockchain enables goods – in this case,
pharmaceuticals – to be tracked in real time over the supply chain
from manufacturers to distributors to patients.; to ensure drug safety
and access to medicine in a timely fashion. This application gives
consumers confidence in their safety and prevents the sale and
consumption of counterfeit drugs.
Several organizations have gotten into action, using blockchain for
healthcare. The MedRec project at MIT is working on using blockchain
to manage electronic health records for patients, granting them the
right to control access to their health data while also providing
healthcare providers with greater reassurance of a secure,
decentralized system. Another example is the MediLedger Project, which
is focused on the pharmaceutical supply chain, making the drugs supply
chain more visible and traceable, helping to reduce the incidence of
counterfeit drugs entering the supply chain.
Frontline healthcare presents various challenges for managing patient data – access to records and the collaboration of care providers are critical. Traditional medical systems often struggle to overcome these barriers. Blockchain foregoes this by extending a record of every event related to the patient onto the blockchain itself. Because entries in the blockchain are immutable after recorded transactions, they cannot be tampered with or deleted without the network's consensus, which then has to validate the highest number of records. Every patient record will have a completely transparent, permanent, and irreversible chain of evidence. Blockchain also allows for patient sovereignty and the sharing of data with permission. Patients can grant permission levels that give access to remote parties in the network. This can be done on a patient-to-patient level or even patient-to-provider level, according to preferences. This capability transforms the patient-provider relationship – as individuals begin to have a say in who has access to their health information, some agencies might experience a decline, forming a consent economy for healthcare.
Blockchain also plays a key role in the functioning of the pharma industry. In virtually every sector where goods pass through multiple points between manufacturers and end-users, counterfeit products become a problem. There are now numerous reports of fake drugs being sold, and although careful physicians can spot them, fake drugs are still a hazard to public health. Blockchain adds another check: by making it possible to track drugs from manufacturers to end-consumers, pharma companies can ensure that every pill along the way gets there fairly. Counterfeiters won’t be able to cheat these systems either since adding a fake product to the chain – for instance, injecting a pill at a point along the pipeline – immediately renders the fallacious product unwanted and unusable. Moreover, blockchain can help pharma companies ensure that their goods adhere to local and international regulations by keeping an irrefutable ledger of every object across the length of the journey. This would help not just pharma companies with their distribution game but could potentially save the lives of numerous patients by helping ensure that they receive genuine products.
By immutably recording all trial-related transactions on the blockchain, researchers can enable an auditable record of trial data and results, making them accessible to stakeholders such as regulatory bodies and the public. This should increase the ability of interested parties to trust in the research process and enable faster transparency in disseminating and validating the results. Patient consent-tracking can also be recorded on the blockchain, maintaining patient safeguards to ensure their right to give informed consent on how their data is utilized in research, thus encouraging participation.
The adoption of blockchain in healthcare faces several barriers. The first challenge, technical integration with existing systems, stands out. Many healthcare organizations run on legacy information management systems that might not be ready to use blockchain. Companies must invest in new infrastructure or refit the existing legacy systems. Another critical barrier to adopting blockchain is the market stakeholders' resistance. Those stakeholders are used to interacting with existing data management methods and do not always trust the new blockchain solutions. The ‘brainwashing’ of these stakeholders needs an enormous effort of educating and training them to see the benefits of the new way of using blockchain technology to improve healthcare operations.
Absorbing the regulatory framework surrounding blockchain in healthcare is another considerable hurdle. Health organizations must ensure their blockchain platforms comply with existing regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and other laws that provide data security and protect patients' privacy. Blockchain technology is inherently more challenging to comply with because it is decentralized, and it can be hard to pinpoint where the data is stored and handled. For that reason, widely accepted standards and guidelines must be implemented to ensure a smooth process for implementing blockchain technology in healthcare, which will require collaboration between technology developers, regulators, and health providers to establish compliant frameworks.
A blockchain network needs to scale to stand the test of time and respond to increasing users and transactions. High speeds and volumes of data must be able to handle these transactions efficiently and timely without compromising quality. Most existing blockchain networks have limited transaction speeds and capacity and would be unable to service the size of current and future large healthcare organizations. Scalability challenges will need to be addressed in the next stage of blockchain growth if we continue to see growth in the healthcare sector.
The potential for blockchain in healthcare is gigantic – especially if we combine it with other innovations such as artificial intelligence (AI) and the Internet of Things (IoT). These technologies would provide healthcare with more robust solutions to secure and process data in real-time. As AI would help in decision-making by analyzing large volumes of healthcare data archived on a blockchain, IoT devices, whose data could be constantly fed into the blockchain, would help collect patient data and keep records up to date. In the long term, this could result in better patient outcomes, more individualized patient care, and faster and more efficient back-office operations.
To demonstrate the full potential of blockchain in healthcare, peers and stakeholders must become active advocates and proponents of this innovative technology. Healthcare organizations can begin this process by educating staff, patients, and the broader community about it, showcasing the potential benefits of the technology to evoke interest and overcome current blockchain aversions. Collaborative efforts between tech companies and the healthcare community can also be integral to blockchain adoption. Partnerships that develop new valuable applications of blockchain, such as creating new shared platforms for data meant to be ‘read-only’ for most users, with pre-approved permissions for accessing and modifying the data, can foster innovation, expedite the development and deployment of new blockchain solutions, and serve as valuable feedback when the technology doesn’t quite work as planned. Such active collaboration can ensure that blockchain technology is well adapted to the unique needs of the healthcare sector and prioritize the advancement of transparency, the efficiency of operations, patient care, and many other critical aspects of healthcare.
To conclude, blockchain has the potential to be a game-changer for improving the transparency of health software systems beyond its initial focus on securing the underlying data. Its immutable and verifiable record might help to build confidence among patients and providers, with opportunities to streamline the handling of patient data, improve the integrity of healthcare supply chains, and raise the transparency of how clinical research is conducted. Whether the healthcare industry will finally adopt these technologies remains in question. Collaborations among industry stakeholders will also be instrumental in helping remove blockchain barriers. However, when that happens, it will usher in a healthcare system that is more transparent, fair, and trustworthy for everyone – which we all deserve.