With increased specialization of healthcare services, accessing healthcare services across multiple hospitals has become very common for diagnosis and treatment. The doctors can make prompt decisions with the informed knowledge of a patient’s history for a smarter, safer, and more efficient care. Due to the privacy and high sensitivity of Electronic Health Records (EHR), many EHR data sharing still happens through fax or mail which in turn delays patient care. Thus the development of a system that facilitates secure, trustable management of EHR data became a necessity.
In 2009, Bitcoin introduced the first use of blockchain technology. Blockchain is digital information (the “block”) stored in a public database (the “chain”). A single block on the Bitcoin blockchain can actually store around 1MB of data. Depending on the size of the transaction a single block can house a few thousand transactions under one roof. The three broad areas of blockchain deployment within healthcare include; applications in drug development, supply chain management, clinical trial management and patient-centric usage.
Drug development and supply chain management
Starting from target identification to being available in the market for public use, a drug undergoes multiple complex, expensive and time consuming processes that require transparency and trust among the stakeholders involved in various steps. Blockchain can be applied to several aspects of drug discovery and development lifecycle, namely data management, clinical trials, intellectual property, royalties and licensing, ensuring drug authenticity and supply chain compliance.
After a new drug is developed, clinical trials are conducted to test its efficacy. Confidentiality and proprietary information must be maintained while collecting and sharing clinical trial data. However, it is challenging to accurately and efficiently manage clinical data from multiple sources of information. Blockchain can help improve the quality of clinical trial outcomes by offering a single sharing platform for all stakeholders.
Blockchain can provide the immetable and interoperable shared ledge using smart contracts, updated, and read by all participants in the drug supply chain, creating the ability to monitor the journey of the product through serialization from manufacturers, distributors, repackagers and wholesalers before reaching the public. The drugs use barcodes which are scanned and enter into secure digital blocks whenever they change hands.
This ongoing real -time record could be viewed anytime by authorized parties and even patients at the far end of the supply chain. At any given time, a quick scan of the product can pull up the full history of that product’s path along the supply chain. Any anomalies in the supply chain integrity would be easily detected.
Clinical trial management
Clinical trials require informed consent from participants about each step in the trial process. Blockchain can ensure transparency of informed consent documents, and tracking of the consent forms. Exochain is an example of a blockchain startup working on secure storage of patient data.
Due to a unique set of challenges, clinical trials are a perfect test case for blockchain technology, as it provides for immutability, scalability, and traceability of records with multiple data access permission levels. For example, deployment of a clinical trial on a blockchain could help manage patient consent, maintain trial protocols, track patient samples and ensure communication between trial sites.
Smart contract is a method that allows seamless and secure management of patient consent and health record ownership across data silos. Smart contracts are codes that are stored in a blockchain and automatically executed when predetermined terms and conditions are met. This idea could potentially remove the need for trusted third-party companies.
The contracts are self executed on a trusted network that is completely controlled by computers. Encryption is an application that uses smart contracts to transfer patient data in a secure way, allowing no access from third parties. This way the patients are in control of their own data. If researchers want to use patient data, they must pay for it. Not only that, but the patient has to choose whether or not they want to sell it to them.
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