When it comes to technology, the healthcare sector faces several significant challenges. Cybersecurity is one – as medical devices become smarter and more connected, they generate more and more meaningful data for practitioners. However, more data and devices also create more incentives and attack vectors for cybercriminals.
The industry also has legacy issues with digital information systems, many of which are not interoperable and suffer from problems with data integrity, such as incomplete medical records or inconsistencies in clinical trial data. The strict requirements for patient data and record keeping in such an environment create additional time and administration burdens for professionals. There are further inefficiencies to be found in the insurance claims and payments process, which can lead to delays in provider payments and patient treatments.
The features of blockchain technology offer the opportunity to mitigate some of these challenges. Blockchain transaction data is highly secure and cannot easily be hacked, stolen, or manipulated, meaning blockchain could be a better solution for use cases such as medical supply chains or clinical trials, which suffer from problems with fraud and data integrity.
Furthermore, blockchain privacy solutions could offer a way to separate medical data from personally identifying data, helping to better secure patient privacy.
Taking privacy a step further, the potential for blockchain-based self-sovereign identities could ultimately allow patients to have more control over their health data. Using a private key as authorization, individuals could carry their medical records in a digital wallet and grant access to selected medical professionals for a time based on need.
Use Cases of Blockchain in Healthcare
Projects and companies working at the convergence of blockchain and healthcare are predominantly working in four key areas: patient data and records, clinical trials, supply chains, and medical insurance.
Patient records and data security
Blockchain solutions for patient record keeping and data security aim to give patients more control over their healthcare data while reducing the burden of data management and record keeping for professionals. Academic research into the potential of blockchain-based healthcare records acknowledges that they can strengthen interoperability and privacy protection of patients. However, the caveat is that there are gaps in other areas of research into such systems, including ethical considerations.
Nevertheless, several companies are pioneering such solutions, such as Guardtime, which has been used nationally to manage citizens’ electronic healthcare records in Estonia.
Data integrity is paramount in clinical trials, which must prove that rigorous testing regimes have been followed based on strict codes of ethics and patient consent. Any evidence of tampering or data mismanagement can invalidate trial results and delay drug development. Blockchain-based records for patient consent and drug trial results could help to increase the integrity of records, reducing the risk of breaches.
Furthermore, the opportunity for informed patient consent to give anonymized medical data could increase the availability of such data to researchers, making it easier to carry out drug research and obtain approval for new interventions.
In 2022, a blockchain-based platform called Triall confirmed a two-year collaboration with the Mayo Clinic to advance clinical trial data and study management.
Pharmaceutical supply chains
Blockchain has applications in supply chain management, where it can be used to enhance the traceability of products in supply chains. This has benefits for the pharmaceutical industry, which suffers from the challenge of counterfeit drugs entering the supply chain. Used in tandem with electronic tagging technologies such as RFID, blockchain could be used to authenticate goods as they move through the supply chain.
Chronicled is one example of a company offering blockchain solutions for medical supply chains. It was involved with the Mediledger product, an industry-wide effort to trial blockchain systems in pharmaceutical logistics.
Holding medical data on a blockchain also offers the potential to speed up and streamline the process of obtaining health insurance coverage and making claims. Rather than patients providing their medical history each time they take out a new policy, portable, self-sovereign medical identities on the blockchain could be portable between providers and give out only enough information to enable a quote for coverage.
Similarly, the claim process could be automated via smart contracts operating on rules that release payments automatically once updated medical records are verified via the blockchain.
Solve.Care works at the convergence of blockchain and healthcare, with a platform that offers healthcare providers the ability to set up networks. Among other benefits, these networks claim to streamline health insurance claims, speed up reimbursements, and reduce incidents of fraud.
Benefits and Challenges of Using Blockchain in Healthcare
Along with the opportunities within specific industries, there are broader benefits to using blockchain in healthcare. A blockchain-based medical identity moves the responsibility for record management from providers to patients, increasing privacy and transparency over data use for patients and reducing the costs of data management and compliance to firms. Such a system also allows individuals to own their full medical history, rather than having records fragmented among multiple providers or systems, which can help make individual diagnoses more robust.
Enabling selective access to mass patient data on a pseudonymized basis could help to improve research into diagnostics and support other areas of emerging healthcare technology, such as AI-based diagnostics.
However, the challenges of incorporating blockchain into the healthcare sector are significant. Typically, healthcare innovations require testing on a vast scale to prove their efficacy, and it can be difficult for blockchain projects to gain this level of buy-in or investment. The relatively long timeline involved in developing drugs or new medical testing hardware means that the industry is more predisposed to incremental innovation than disruptive technologies. Furthermore, shifting to a model of personal data sovereignty over provider data management requires a significant change from how healthcare data is managed today.
The decentralized and permissionless nature of public blockchains also creates a dilemma in developing healthcare DApps. Medical data is highly sensitive and personal, and the idea of delegating responsibility to a pseudonymous open network would act as a deterrent for many enterprise and individual users.
Privacy and Security Issues in Blockchain-Enabled Healthcare
Blockchain-based medical data could create several issues for privacy and security. For example, the EU General Data Protection Regulation conveys a “right to be forgotten” that allows patients to request the deletion of personal data from a system. However, this is incompatible with the permanent, untamperable nature of blockchain-based records.
The high prevalence of vulnerable people in healthcare could also create issues for data management and security if people are made responsible for sharing their own medical data – for instance, by making it easier to steal someone’s sensitive medical or personal data using tactics such as phishing.
Future Trends and Developments of Blockchain in Healthcare
Blockchain in healthcare appears to offer plenty of promise but is slow to deliver. However, healthcare is vastly different from many other segments of blockchain, such as DeFi, since the industry is far more heavily reliant on personal data, which introduces strict legal and regulatory requirements and offers little room for failure.
As such, any substantive changes resulting from the introduction of blockchain technology are likely to take place over a long timeline – in much the same way that the transition from paper to electronic healthcare records is still ongoing in many parts of the world.
However, even if the pace of development is slower than in other sectors, blockchain in healthcare is a growth market and is expected to continue to evolve over the coming years.
Blockchain in healthcare essentials
- Blockchain has potential use cases in healthcare in the areas of data, record-keeping, and identity, including patient medical history, clinical trial results and consent, and drug supply chain management.
- There are several opportunities to increase efficiencies, enhance privacy and ownership of medical records. However, there are substantial barriers to adoption due to the rigorous testing, safety, and compliance requirements.
- Any adoption of blockchain by the healthcare industry is likely to take place incrementally over many years.