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Basics of the blockchain in healthcare

Kirsten Peremore July 24, 2023

Innovation

The blockchain offers a decentralized platform for the recording and verification of transactions. Within healthcare organizations, this can streamline processes and reduce time spent on simple tasks.

Understanding the basics of the blockchain

The blockchain is a decentralized and distributed digital ledger technology that records and stores information across a network of computers. It was initially introduced as the underlying technology for cryptocurrencies like Bitcoin. However, it has since found applications in various industries beyond finance, including healthcare, supply chain management, and more.

At its core, a blockchain is a chain of blocks, each containing a collection of data. This data can represent transactions, records, contracts, or any other form of information. Each block in the chain is linked to the previous block using cryptographic hashes, forming an immutable and transparent record of all transactions or data entries.

Related: What is cryptojacking?

Characteristics of blockchain

Decentralization: A blockchain operates on a peer-to-peer network, where multiple participants (or nodes) maintain and validate the blockchain. This decentralized nature eliminates the need for a central authority or intermediary, providing transparency and reducing the risk of single points of failure.
Security: A blockchain uses cryptographic algorithms to secure the data stored within blocks. The immutability of each block and the cryptographic links between them make it difficult for malicious actors to alter past transactions or records without consensus from the network.
Transparency: All participants in a blockchain network have access to the same version of the distributed ledger, ensuring transparency and accountability. Any changes or additions to the blockchain are visible to all participants, enhancing trust and traceability.
Consensus mechanism: Blockchain networks rely on consensus mechanisms to ensure agreement on the validity of transactions and the order in which they are added to the blockchain. Popular consensus mechanisms include Proof of Work (PoW), Proof of Stake (PoS), and variations.
Smart contracts: Blockchain technology often supports programmable and self-executing contracts, known as smart contracts. These contracts contain predefined rules and conditions that automatically execute transactions or trigger actions when specific conditions are met, providing automation and efficiency in business processes.

Using the blockchain in healthcare

Public blockchain

Public blockchains are open and decentralized networks where anyone can participate as a validator or miner. These blockchains are permissionless and allow anyone to read, write, and validate transactions. Public blockchains rely on consensus mechanisms to reach an agreement on the validity of transactions and maintain the integrity of the blockchain.

Uses in healthcare include:

Research institutions: Public blockchains can be utilized by research institutions for transparent and secure sharing of research data, facilitating collaboration among researchers globally.
Patient advocacy groups: Public blockchains can empower them to securely collect and share patient data, enabling them to advocate for improved healthcare policies and research funding.

Private blockchain

Private blockchains, also known as permissioned blockchains, are restricted networks where only selected participants have access to read, write, and validate transactions. Private blockchains are typically used within organizations and provide more control over data access and governance compared to public blockchains.

Uses in healthcare include:

Hospitals and healthcare systems: Private blockchains can be employed by hospitals and healthcare systems for efficient management of patient records, ensuring data integrity, and streamlining internal processes such as billing, supply chain management, and quality control.
Pharmaceutical companies: Private blockchains can enable pharmaceutical companies to track and authenticate the supply chain of medications, ensuring patient safety, reducing counterfeit drugs, and optimizing inventory management.

Consortium blockchain

Consortium blockchains are a hybrid form that combines elements of both public and private blockchains. They are governed by a consortium or a group of organizations that collectively manage the blockchain network.

Uses of health care include:

Health information exchanges (HIEs): Consortium blockchains can be utilized by HIEs to securely and efficiently share patient health information among healthcare providers within a specific region or network, promoting interoperability and coordinated care.
Insurance networks: Consortium blockchains can be employed by insurance networks to streamline claims processing, improve fraud detection, and enhance data sharing between insurers, healthcare providers, and policyholders.
Clinical research networks: Consortium blockchains can facilitate secure and auditable sharing of clinical trial data among participating institutions, ensuring data integrity, enhancing collaboration, and accelerating medical research.

Examples of blockchain systems for healthcare

MedRec: MedRec is a blockchain-based electronic medical record (EMR) system developed by MIT researchers. It focuses on patient-centric medical record sharing, allowing patients to have control over their health data while enabling secure and auditable access for healthcare providers.

Medicalchain: Medicalchain is a blockchain platform that aims to secure and facilitate sharing of electronic health records (EHRs). It enables patients to grant access to their health data, facilitates telemedicine consultations, and ensures the integrity and privacy of medical records.

Gem Health: Gem Health is a blockchain platform that provides solutions for healthcare data management, interoperability, and supply chain tracking. It focuses on improving data sharing, collaboration, and transparency among healthcare organizations.

Patientory: Patientory is a blockchain-based platform that allows patients to securely store and manage their health data. It provides a decentralized and encrypted storage system, facilitating secure sharing and access to health information between patients and healthcare providers.

Ethical implications of leveraging the blockchain in healthcare

While blockchain provides vital security measures, it is necessary to consider the privacy implications when handling sensitive health data. HIPAA regulations mandate strict safeguards for protected health information (PHI). Healthcare organizations leveraging blockchain must ensure that the technology and associated processes adhere to HIPAA privacy and security requirements, including data anonymization, encryption, access controls, and secure key management.

Blockchain also introduces the concept of decentralized data storage and control. While this can enhance data security and reduce reliance on centralized authorities, it also raises questions about data ownership. Healthcare organizations must carefully consider what data is stored on the blockchain to avoid unnecessary exposure to sensitive patient information.