How could health care benefit from blockchain technology? What needs to be done to bitcoin primer the health care blockchain? What will be the role of government? What is a shared, public ledger?
Go to the Features category archives. 2 billion of investment from some of the world’s leading corporations for its security and immutability. 1 More than 130 million secure Bitcoin transactions have occurred since the digital currency launched in 2009. As blockchain technology continues to develop, it is important that surgeons and other stakeholders understand both its capabilities and its limitations. In the wake of the 2007 financial crisis, an anonymous individual or group of individuals, using the pseudonym Satoshi Nakamoto, published a white paper proposing a peer-to-peer electronic payment system. 8 The proposed system eliminated trusted third parties, such as banks and credit card companies, from online financial transactions and replaced them with secure, peer-to-peer financial networks. Nakamoto proposed that these blockchains, rather than being stored in a single, central repository, should be distributed to multiple locations, thus making blockchain theft or alteration impossible.
Each node, or computer system involved in supporting the blockchain network, holds its own identical copy of the blockchain, in what is known as a shared ledger. Transparency: Centralized financial ledgers are subject to fraud and misuse, as evidenced by a range of recent financial scandals. Immutability: In the current paradigm, centralized ledgers offer rich targets for hackers, who regularly attack such IT systems, costing the global economy hundreds of billions of dollars each year. 11 With blockchain technology, an attack on a single node has little network-wide ramification. Because each member of the network, or node, holds an identical copy of the shared ledger, efforts to hack or change the ledger will be rejected by the broader network.
Anonymity: The data that exist in the blockchain are anonymous and encrypted, making the information of little value for coercion, extortion, or corporate espionage. While Bitcoin is among the most widely known examples of blockchain technology, there is an increased focus on the use of this platform beyond secure financial transactions, and investment in blockchain technology is rising. 450 million in 2016, up 79 percent from the previous year. Interoperability: EHRs lack interoperability and are exceedingly costly. Because EHRs are unable to effectively communicate with each other, physicians and surgeons often treat acutely ill patients without access to medical histories, current medications, and prior imaging studies that could influence patient care. 16 Achieving full interoperability has been projected to save the U.
In a truly interoperable network, data gathered over the course of a patient’s life through personal health and wellness activity, and diagnostic and therapeutic activities such as patient encounters, procedures, laboratory testing, radiology, smart devices, and even third-party genetic testing services, could all be securely incorporated into a patient’s unique EHC. Personalized medicine: At the patient care level, common clinical data integration would allow providers to seamlessly use the entirety of a patient’s health data to provide individualized care quickly and easily. Research: A health care data supply chain could revolutionize the next generation of scientific research. Surgical and medical research today is encumbered by the difficulty of building large datasets across existing silos of patient data. Security: Blockchain technology also stands to improve the security of health care delivery.
19 Establishing an immutable blockchain in which patients are informed of all changes to their health care records and bills would eliminate the possibility of such abuse. Establishing such a system would also increase the safety of drug and device supply chains. There are also security issues related to the centralized nature of these records in their current form, making them frequent targets of cyber attacks. More than one-third of the U. Health care providers would need encrypted keys to request information from patients, and patients could, in turn, select who has access to their medical records and when. Centers for Disease Control and Prevention, to track pandemics, or the U.
In its entirety, data gathered across a range of personal health and wellness activity, diagnostic and therapeutic services, procedures, laboratory testing, radiology, smart devices, and genetic testing services could all be securely incorporated into a patient’s unique EHC, accessible to both patients and health care institutions. Patients control their own data, while institutions control institutional-level data. Significant challenges and limitations to implementing health care blockchains remain. These challenges are most pronounced with regard to EHR.