Healthcare and Blockchain
Blockchain has been the subject of a lot of hype in recent times. Plenty of attention has been paid to cryptocurrencies and their extraordinary returns for early investors in certain coins (looking at you BTC). The core concepts that make up a blockchain can have wide-reaching effects on other industries and applications.
Let’s start by going over what makes up a blockchain. I urge anyone interested to read the bitcoin whitepaper by clicking here. It covers all the technologies used in bitcoin and how they are integrated. A blockchain is a distributed ledger shared amongst a network of nodes. It’s comprised of blocks which are packets of data, the hash of the previous block, and its own hash. The ledger is impossible (or at least very, very difficult) to alter because changing one block would alter each subsequent block due to these hash values. Different blockchains can have different consensus mechanisms to verify transactions. The bitcoin protocol uses proof of work, where miners expend energy to find these hashes at set intervals. This creates a system of nodes and miners that store a very secure database.
Since the data is decentralized and verified in this manner, there is no need for a single source of truth (eg an order book on a single server). Blockchain removes the middleman. Transactions placed on blockchain do not need middlemen like VISA or MasterCard, getting rid of high transaction fees. The data are stored on a decentralized network allowing every member to see the whole ledger.
A common misconception about blockchain is its anonymity. All transactions conducted by a wallet can be viewed on a chain. This wallet may not be tied directly to your name but once your identity is linked to your wallet all your transactions can be found. This differs from a centralized source of truth. For a credit card, your identity may be tied to every transaction but ideally the entire history of transactions is only visible to you and the central authority (barring any hacks or other mishaps).
Another feature some blockchains have are programmable smart contracts. These programs are executed once the condition of a smart contract is met. A smart contract can be used in lieu of purchase orders in a supply chain. Payment can be automatically executed once the buyer receives the goods instead of requiring extensive paperwork and communication between different departments of a large company. This can be repeated through multiple levels of the supply chain. If the smart contract removes 1% of the inefficiency at each level, the benefits can add up. Additionally, the transactions are visible to all members of the blockchain ensuring trust.
Let's take a look at how some of these benefits of blockchain can apply to healthcare. We’ve discussed security and immutability, visibility, and decentralization.
The pharmaceutical and drug manufacturing industry can use blockchain to keep an immutable and auditable trail of the materials in all its products. The source of a contaminant can be easily traced and remedied. Drugs that stem from the source could be removed from the market to prevent patient injury. Counterfeit drugs would be more difficult to distribute since it would be very difficult to add the supply chain of those products to a blockchain.
Clinical trials can use blockchain to store statistics and data from tests, allowing researchers to verify the data has not been tampered with. There are incentives in medical research to publish only positive studies or tamper with data to produce certain results. Public trust in these studies would increase as the research community can audit and reproduce trials.
Blockchains can store patient data on a decentralized network to allow patients to transfer their data easily from provider to provider. A single blockchain storing all patient data would allow any provider to view a patient’s medical history, current medications, prior surgeries, previous admissions, and a whole host of other data. The patient would be the owner of their own medical data and has authority over who can see their data and when they can see it. Anonymous patient data could be used to conduct very interesting population health research.
Smart contracts can be used by medical insurance companies. A contract can automatically be executed and payments provided once a medical chart is submitted to the insurance company. Evidence of payment is forever stored on the blockchain and viewable by all allowed parties, increasing trust between institutions.
