Secured and reliable sharing of
patient data on the blockchain - Sandeep Kanao
MedicDataX transforms patients medical history to insurance, clinical trial companies, pharma companies
through blockchain technology
Business case :
Patient shares data with unique
private key on secured Hyperledger-Fabric
block-chain.
Company (Pharma, clinical
trial, insurance etc.) pays patient using
MedicToken to access the data.
Patient dictates data access permissions (whom, which data and
compensation token amount etc.) using smart-contract.
Details:
Pharma, clinical trial, insurance
companies need real time health data from various people groups. The
lack of access to such data not only results in costlier, less efficient care;
it causes errors that can lead to serious adverse events, including patent
registration for a new drug, financial loss due to false insurance claims etc.
The current system often
prevents the timely access of this data across geographic locations and
systems. Interoperability has been dubbed by some as health IT’s Holy Grail.
It’s a cliché, but it’s true: It’s deeply desired yet seemingly unattainable.
Interoperability has long been a goal–and a Meaningful Use requirement–but it
has yet to be put into practice. Aside from the technological challenges to
interoperability, there are those posed by data blocking[1] and the practice of
charging patients for copies of their own electronic records.
Comprehensive patient
information should automatically–and securely–follow the
patient across the healthcare continuum, and patients should have
unrestricted access to their own complete medical records and should be fairly compensated
for sharing the data.
MedicDataX, a blockchain-based
solution for healthcare, changes the “should” to “will.” Launched in January
2018, MedicDataX is the antithesis of the siloed, centralized data stores that
dominate healthcare data today.
Understanding blockchain
Blockchain was designed as the
distributed accounting platform for cryptocurrencies (e.g., Bitcoin). But it’s
an industry-agnostic tool to keep data in an encrypted, distributed, ledger–and
to control access to that ledger. [2] It’s decentralized, spread across a
synchronized network; all the data are visible to anyone with proper
authorization. As a result, there’s no single repository for hackers to target.
[3]
We’re applying this approach to
electronic medical records. MedicDataX is decentralizing data while making it
more accessible.
Beyond push, pull and view
Medical data among institutions
is generally shared one of three ways: push, pull or view. But each approach
varies by vendor, institution and state law. MedicDataX offers a different
model altogether.
A patient’s data is stored
securely in the community-wide ledger, giving clinicians, hospitals and other
relevant organizations access to a patient’s complete health (not just medical)
history. Because the entire chain is updated in real time, any changes to
medication and allergy lists will be immediately available. That also means
there’s no need re-enter the same medical data at each encounter with a new
provider or institution. It dramatically reduces the likelihood of costly
duplicative –and therefore– wasteful screenings and services.
The MedicDataX model provides a
decentralized control mechanism. Everyone In the chain has a stake, but no one
owns it exclusively. A clear audit trail ensures accountability. This approach
allows for control of record access without the need to create custom
functionality for each vendor.
This approach also gives
patients control over their data, unlike most, if not all, current
approaches.
Patient-centered
Patients have full access to
their data as well as control over how it is shared.[4] In accomplishing this,
MedicDataX achieves the ONC’s call for individuals to “have access to
longitudinal electronic health information” to which they can add information
and “direct … to any electronic location.”
This record would include
patient-generated data. It would accept data from the patient’s Fitbit (or
other wearable), 23andMe profile, biometric data, etc. Patients can build a
holistic record of their medical data and authorize others for viewership, such
as pharma companies, clinical trial companies [5] This allows individuals to be
consumers of healthcare and to control their own data, insurance and care.
Secure and immutable
MedicDataX’s decentralization
is the key to its security. Once a record is submitted to the chain, it becomes
immutable–it can’t be updated or changed. The records are synced and stored on
all nodes worldwide. To hack one record, the hacker would have to hack the
entire system and change the information in every computer, simultaneously. Not
only would that put everyone on alert, but sheer computational power required
would be too much for even the most sophisticated hacker.
Credentialed users can add
to–but not delete or change–the records. Transactions must be verified by the
network.
The system also offers
protection against inaccurate information being entered. A consensus algorithm
newly entered information against the existing record. So, for instance, if a
hospital adds data indicating the patient has blood type A, but existing data
block indicates the type is O, then the information will not be recorded in a
blockchain.
What MedicDataX offers goes far
beyond electronic records, however.
Better insurance claims
MedChainX offers the potential
of automating claims adjudication and payment processing, eliminating the need
for intermediaries and reducing the administrative costs and time for providers
and payors (and thereby also reducing cost and frustration for patients). It
would also minimize, if not eliminate, the number of claims that are rejected
due to incomplete or inaccurate patient information.
A new healthcare economy
MedicDataX will eventually use Medictoken as value.
Medictokens are digital units
of value created and managed inside a closed ecosystem. They can be used for
network storage allocation, revenue payment cycles, provider incentives and
more. This will likely launch in 2018. Given that blockchain developed
primarily in the financial sector, it makes sense to apply that concept to the
healthcare marketplace.
A blockchain mobile wallet
system can allow participants to use Medictokens to purchase health insurance,
equipment, medication and other services–including storage space. For example,
patients will be given an allotted amount of space to store information for
free on the MedicDataX network. These Medictokens tokens would allow them
to purchase extra space from nodes set up in hospitals systems. Healthcare
organizations use tokens in a similar fashion.
We will be using ERC-20, an
open-source blockchain technology focused on real-world transactions. Patient blockchain will be built using IBM and
Linux backed blockchain technology – Hyperledger-Fabric. Hyperledger-Fabric binds digital assets, digital identity, smart
contracts and a secure communication protocol into its platform.
Building on success
We are not reinventing the
wheel. The financial services industry has already demonstrated the power of
blockchain. The technologies for data storage, security and encryption already
exist and are in use today. MedicDataX brings together the how and why, to
better assist patients, providers and health systems. We think electronic
medical records can be made more mobile, reliable, trusted, and secure, and we
intend to make it happen.
Ongoing development is underway
for Phase 2.
·
Scalability
·
Transparency
·
MPI (master patient index)
·
Data analytics
·
E-prescribing
ICO Development Phase 2 (Medicdatatokens)
********
[1] Report on Health
Information Blocking, ONC, April 2015
[2]“Moving Patient Data Is
Messy, But Blockchain Is Here to Help,” Wired, Feb. 2017 www.wired.com/2017/02/moving-patient-data-messy-blockchain-help/
[3] “What is Blockchain
Technology? A Step-by-Step Guide for Beginners”
blockgeeks.com/guides/what-is-blockchain-technology/
[4] Linn L, Koo M. Blockchain
for Health Data and Its Potential Use in Health IT and Health Care Related
Research. Posted by ONC April 2016
[5] Ekblaw A, Azaria A, Halamka
J, Lippman A. “Case Study for Blockchain in Healthcare: ‘MedRec’ Prototype for
Electronic Health Records and Medical Research Data.” posted by the ONC
April 2016