Blockchain in healthcare: Is it really a “perfect fit”?

Earlier this year, I shared my top five digital predictions for 2019, one of which was the rise of Blockchain in healthcare. I’m happy to say the technology has finally made its debut, with the 2019 Global Blockchain in Healthcare Report making its way onto the scene, but what exactly is this software and how can healthcare embrace it?

What is a Blockchain?

A software originally developed for use in the running of cryptocurrency Bitcoin, Blockchain is a technology that stores data chronologically in a series of “blocks” that are then copied and distributed across a network of numerous computers linked together in what is described as the “chain”. Put simply, it’s a type of database that stores information in a way that makes changing that information a really difficult thing to do.

So, why is everyone in healthcare so excited about a fancy database? Many institutions are in need of an IT infrastructure upgrade, healthcare among them, which has undeniably fuelled the hype around Blockchain’s implementation. 

But – how does Blockchain actually “protect” data, and will this type of technology work for healthcare?

In the simplest of terms, a Blockchain is a decentralized database, where data is not stored in a single location as with a traditional database, but replicated across a network of computers. This in turn, makes the data distributed, meaning everyone has access to the same database and no single entity owns or controls all the data.

This, theoretically, makes the data immutable (unchangeable), and that means different parties don’t have to trust each other’s data when dealing within a Blockchain. Every party involved in the database has a copy of all the data, so no single entity can simply change a piece of data in the system as could happen in a centralized system. The only way this could happen, is if the majority of everyone who holds a copy of the data agreed to change the same piece of data too, meaning if someone wanted to hack into the system and fraudulently change a historic piece of data, they would require the computing power of over half that securing the Blockchain network.

At first glance, this may seem like a great thing, but what happens when there’s been a genuine error in data input which needs correcting? The reason Blockchain has worked relatively well in finance is because typically having the ability to amend historic data is not desirable in this field, but in healthcare, it can be a different story. For example, unlike financial transactions, which are for the most part electronically recorded, healthcare involves a much stronger human presence. From simply linking an electronic transaction to a physical object like medications, to the involvement of patients, HCPs, scientists and other players who will be recording the data, more human input will mean more room for human error, which makes the immutability of Blockchain difficult to deal with, if historic data cannot be changed. 

So, where can a Blockchain actually fit into healthcare?

Pharma supply chain: According to Interpol and the World Health Organization, over 1 million people die each year from counterfeit medications, with global profits on counterfeit medicines amounting to €150–200 billion a year, making it one of the most lucrative counterfeit businesses in existence. This is a massive issue, and it’s one that Blockchain can potentially influence for the better.

Currently the patient has no ability to identify where their drugs originate from beyond the supplier they purchased them from, while distributors, payers and manufacturers themselves also have limited transparency. Imagine if we were able to put the entire supply chain of a drug from raw materials to the patients themselves into a functioning Blockchain. All along the drug’s journey, each player would be required to authenticate the transaction, allowing everyone to obtain total transparency of the drug’s history right back to its raw materials, thereby drastically increasing the assurance in the product at hand. The potential for Blockchain could target the growing issue of counterfeit medication; however, in cases like this, issues still arise when the electronic data entry is linked to physical objects. What’s stopping the electronic representation of the physical object being flawed from the very start? This is a fairly significant challenge with Blockchain-based supply chains for which experts are still working to find a solution, but the gears are moving in the right direction, and that’s promising to say the least.

Health record accessibility and distribution: In an ideal world, we’d all have a single healthcare provider from birth until death who stores all our health records in one singular location throughout our life; however, in reality this is a completely impractical approach.

Throughout our lives, snippets of our healthcare data are collected and stored across numerous different databases, which in turn are controlled by numerous different institutions. The main drawback here is that all our health data is dissociated, difficult to access, and virtually lost to us in the practicality of things. Now, imagine having access to your health records in the same way you had access to your bank account. With a decentralized database like Blockchain, secured by its features and its technologies, improved accessibility is a given, as you don’t require permission from a third-party supplier to access your own data. It will be at your fingertips all the time, and sharing that data with new healthcare providers would be a simple and secure task.

As you can anticipate however, a reform like this is quite dramatic, so it will take time to come to fruition; but the benefits are certainly intriguing, and I’d be interested to see where the future of health records will land. 

Smart contracts: As Blockchain has the potential to take trust in counterparties out of the equation, smart contracts have become one of the most talked about uses of Blockchain in recent times. One of the benefits of this is that, by placing a contractual agreement on a decentralized Blockchain, control over the execution of that agreement is no longer in the hands of a single party but rather automatically managed through a string of code that governs the Blockchain. When the initial part of the contract is fulfilled, the final part will be initiated. For healthcare, this opens a world of benefit, including optimized processes for pharma companies and hospitals, increased transparency between patient-hospital transactions and more reliable physician credential verifications, to name a few. While we’re not quite there yet, as a Blockchain with sufficient interconnections between parties, assets and their relevant institutions is yet to exist, headway is certainly being made across industries with the dawn of the smart contract, and it is certainly an interesting new concept.

Blockchain: the future or just a fad?

Blockchain is undeniably an exciting new prospect; however, it’s easy to assume amid the mass of buzzwords and enthusiasm that Blockchain technology will solve all our IT issues, but this is unlikely the case. While there may be a place for Blockchain in healthcare, it’s important we don’t get carried away.

That said, I can confidently say 2019 will not be the last we hear of Blockchain in healthcare. What exactly will that future look like? Well, only time will tell. 

What do you think Blockchain’s role in healthcare will be?