Can you imagine a patient getting a chemo treatment within hours and days instead of days and weeks? Would you prefer your medical records kept in one secure system throughout your lifetime? Is it valuable for you to be sure the meds you are taking are not counterfeit? How about being rewarded for sharing your medical data for research purposes with trusted institutions? Do you feel it’s time for healthcare to transform from top to bottom?
These are only a few of the promises of the emerging blockchain fuss in healthcare that make quite an impression. It has captured interest within various domains, such as healthcare records, medical research, data protection, improvement of contracts for insurance, medical staff credential verification, and many others.
According to the BIS research, this technology has the potential to save up to $100 billion per year in industry costs by 2025. The report predicts that the global healthcare market will face a 64% growth in 3 years. Moreover, after the pandemic, most activities have moved from offline to online, and we have the so-called “digital divide” when people suffer losses because they lack digital tools. It is crucially important to be able to record and store data effectively and exchange it securely among disjointed parties. But how exactly can blockchain enable this?
Blockchain in a Nutshell
First, let’s put the finger on the precise definition. Based on the cryptographic algorithms and hashing elements, blockchain is a way of synchronizing data among users and networks that makes it almost impossible to manipulate or falsify information. In short, it is a distributed digital ledger of interlinked data blocks stored in chronological order. Every block has a unique identifier called a hash and contains a direct reference to the previous block’s hash. Thus, they form a “chain,” and any data change will cause the succeeding block to define it.
On top of that, each record gets replicated on all the devices connected to the network creating a decentralized and fully transparent system. Since we face a decrease in trust towards traditional institutions like governments and banks and more often rely on services like Airbnb and Uber, which allow decentralized participation, it’s no surprise that technologies like blockchain have gained credibility. So, what are the low-hanging fruits in the industry?
Patient – Centeredness
Currently, the healthcare sector faces a challenge with illiquid low-integrity health records. Because of the data silos, patients and healthcare providers have a fragmented view of medical records. The John Hopkins study states that medical errors are the third leading cause of death in the USA. One of the reasons is poorly coordinated care which we can improve by creating a single blockchain-powered network with all the patient’s information recorded in one pool. Gordon and Catalini’s research shows how blockchain can provide the transition from institution-oriented to patient-centric for better data exchange interoperability through mechanisms like digital access rules, data aggregation and liquidity, patient identity, and a degree of immutability.
Beware that it’s not the actual medical information that is kept in the system but the encrypted version, which gets decoded if the patient wants to share it with a trusted party. Companies like Patientory are already developing applications with up-to-date patient history, tracking, reporting, and communication with verified healthcare specialists. Thus, chances grow that mistakes will be minimized if therapists see the complete picture of the patient’s health.
Counterfeit drugs are a huge problem worldwide. Alone in the USA, businesses lose $200 billion, and 1 million people die annually, according to WHO, because of piracy and counterfeiting. Using a blockchain-based application to track items from manufacturing to distribution can reduce time delays and human mistakes. It also empowers customers to have full transparency of the products they purchase. This approach has already proven to be necessary for the food market. Remember the 2018 Walmart scandal when dozens of people got sick from eating contaminated romaine lettuce? After that, retailer announced, it would switch to a blockchain-based tracking system to monitor contamination rapidly.
Pharmaceuticals and other healthcare domains, from breeders to dispensary shelves, also adopt the benefits of the technology. LucidID is one such company offering solutions for the cannabis industry. They collect and track such vital information as genetic data, lab results, cultivation process, supply chain details, location tracking, and customer feedback. Therefore, patients who meet the qualifying conditions to take CBD for their medical treatment avoid the risk of getting a pig in a poke.
Researchers foresee that around 2 billion human genomes will be sequenced by 2025. In genomics and Big Data research, the amount of information requires high-throughput sequencing processes and powerful computational capacity. Hence, affordability is a problem, as rough estimates show that the cost of sequencing exceeds $1000/genome. Consequently, there is a high demand for trustable, cost-effective, and user-level regulated infrastructure for data distribution in this healthcare domain.
Companies like EncrypGen and Nebula Genomics have already introduced distributed secure networks that allow people to safely discover, store and share their genomic data in a growing market. In doing so, they use blockchain to ensure high protection, enhance the processes’ efficiency, exclude go-betweens costs, and address the limitations of data management.
Health Trade in the NFT market
As we live in the digital health era, surrounded by personal sensors and apps, people tend to be more proactive in handling their health data. Presently, most of it is owned by companies providing medical services by default. But some start-ups have already introduced the pivot applications that allow patients to mint their medical information as NFTs (Non-Fungible Tokens) by creating a digital asset in their sole ownership and thus enable them to earn money whenever a transaction with the data occurs. The health monitoring app Go! creates Well-being NFTs, or W-NFTs, from personal activity data collected from well-known apps like Apple Health, Google Fit, and others. These tokens can further be traded on the open market.
Unfortunately, there are already cases when bad actors use such information without a person’s consent. A French surgeon tried to sell an X-ray of one of his patient’s injuries as digital artwork after the 2015 Bataclan attack in Paris. The technology and legacy issues are still in their infancy, but the potential is overwhelming.
Blockchain can solve many difficulties of the clinical trial ecosystem, such as replicating and sharing data, privacy issues, and patient enrollment. In theory, with blockchain, patients can keep their medical records anonymously, available only to trial recruiters. It may improve the patient’s enrollment efficiency, which is declared to be less than 40% for Phases 3 and 4 within the Clinical Trials Database.
What is also essential is that blockchain can ensure the honesty and integrity of all the flow of the research processes, as there is no backdoor access to avoid “after-the-fact” modifications. Bloqcube is a novel company that proposes a fully-integrated and decentralized remote trial management system that can track data flow in real-time. In addition, such an approach levels the playing field so that researchers from different parts of the world should be able to access the same data and achieve similar scientific results. As a result, it may encourage collaborative clinical trial decision-making.
The Roadblocks on the Way
Despite the temptation to follow the seductive charms of technology, we cannot look past specific concerns which may turn the carriage into a pumpkin if we dig a little deeper. The amount of electricity needed to drive “blockchain calculations” is outrageous and causes damage to the environment. Another weakness is the risk of a possible 51% attack by a “malicious” major group of miners as it brings into question the security guarantees which we cannot trade off in healthcare. There is currently a choice between using public or private networks to balance these issues, and the scales are tilting towards the hybrid ones.
Also, it may be hard to sway over the dominant players who gain profits from keeping a monopoly on the data they own. At the same time, those willing to get to the next level will have to deal with a lack of standards among various blockchain-based solutions. With all those mentioned above and many other obstacles, it may finally appear we are grasping at straws, relying on blockchain to improve medical care.
To Sum It Up
Though many talented technologists cooperate on projects of different scales to bring blockchain potential to fruition, most networks are experimental and early. The jury is still out on which ones will be remembered for only promises and which are the few that become the achievement we will applaud further afield.