Healthcare blockchain development

The future is much closer than most people think. Current advances in the blockchain technology developments open the new horizons in different already existing areas of human activities and create the previously incredible opportunities.

The blockchain technology, which stands behind Bitcoin and many other existing cryptocurrencies, had attracted billions of investments from some of the world’s leading corporations for its security and immutability. It is known that nearly 150 million of secure Bitcoin transactions had been successfully performed since the digital currency launched in 2009. In the modern world of today, the Bitcoin and others can be used for various purposes that include hotel and flights booking, digital products purchase, paying in cafes in restaurants and even the healthcare.

The emerging blockchain technology has the much-needed potential to transform healthcare industry, placing the patient at the center of its complex ecosystem and increasing the security, privacy, and interoperability of health data overall. With the help of it, a new model of health information systems can be built.

The ambitious goal can be achieved by making electronic medical records more transparent, efficient, correct and secure.

So far, most of the blockchain tech success is supported by the fintech startups, but it does not end up just there. The healthcare industry is undoubtedly attractive as it has a high demand for innovations in different areas. In most of the world leading-tech countries, the healthcare authorities and even always cautious with the new movements governments are equally excited about the new possibilities presented by the blockchain technology.

Still, the top industry developers have to focus their efforts on establishing the blockchain community on forging the future ecosystem standards and frameworks options for the further implementation on a large scale level across healthcare implementation areas.

With the recent improvements in genetic research and the advancement of precision medicine, the healthcare industry is witnessing an innovative approach to disease prevention and treatment that incorporates an individual patient’s genetic makeup, lifestyle, and environment. Moreover, IT advancement has produced large databases of health information, provided tools to track health data and engaged individuals more into their own healthcare problems. Combining these advancements in healthcare and information technology would lead to a significant transformative change in the health IT-field.

Truth be told, the overall excitement emerges progressively as the blockchain tech marches all over the world. Nevertheless, specific points need to be taken into account for considering how the real implementation could look in future applications.

So, what qualities and application implementation features do the blockchain specified for healthcare industry has to offer to become truly useful and demanded? We need to define the primary cases where the blockchain can be at full fit and need for use in the nearest future.

1) Personalized Health Data Exchange systems advancement

Among many options needed for crafting the technology of the future, the very first thing comes to mind is a creation of the advanced systems of data exchange.
The thing is, currently existing IT-systems of the healthcare industry are in need of the fundamental upgrade and the blockchain can undoubtedly become that very stone on which the future of these systems will stand.

With it, the specific current challenges such as health data interoperability, overall integrity, security, portable user data, and processing speed could be tackled on an entirely new level.

Speaking about the areas that are more fundamental, the blockchain could enable data exchange systems that are cryptographically secured which will allow seamless access to historical and real-time patient data – with it the cost of data reconciliation will finally be out of the question.

It is also worth mentioning the recent collaboration between Guardtime, the data-centric security company, and the Estonian eHealth Foundation to secure the health records of one million Estonian citizens using its proprietary Keyless Signature Infrastructure (KSI) – a specific successful example of blockchain technology.

Anyway, that particular case is not likely to be global so far – specific complexities around the data origin, ownership and overall governance structure for health data exchange between public and private entities lead to the difficulties created in implementing the similar blockchain model for the health records worldwide.

When speaking about the patient care level, the standard clinical data integration would allow providers to seamlessly use the entirety of a patient’s health data to provide individualized care quickly and easily.
For example, blockchain technology could facilitate and streamline the use of tools like the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator, as the necessary clinical data inputs could be automatically gathered with access to a patient’s records.

In its entirety, data gathered across a range of personal health and wellness activities, diagnostic and therapeutic services, procedures, laboratory testing’s, radiology, smart devices, and genetic testing services could all be securely incorporated into a patient’s file, accessible to both patients and healthcare institutions. Patients control their own data, while institutions control institutional-level data. Each party involved could give encrypted access keys to providers, researchers, or any other parties they choose, providing a range of access—from minimal amounts of de-identified data to individual-level full-chain access—that can be revoked at any time. Every data interaction is appended to the chain in a time-stamped and stable manner, adding to the system’s intrinsic security.

2) Management systems for fraud & false claims elimination and Clinical trials resolution

For now, nearly 50% of all the clinical trials in the U.S. are known to go unreported, and investigators often fail to share their results (that makes almost 90% of trials on ClinicalTrials.gov results). All of it creates the troubles and safety issues for the patients and knowledge gaps between healthcare stakeholders and health policymakers.

The anarchy could be eliminated with the new system based on the blockchain, supporting the time-stamped permanent records of clinical trials, protocols and results could potentially address the issues of outcome switching, data snooping and selective reporting. This will help in reducing the overall level of fraud and time to time errors in clinical trial records.

Also, the blockchain-based management system could help drive unprecedented collaboration between participants and researchers around innovations in medical research in fields like precision medicine and population health management.
In the United States and many leading world countries of today, nearly up to 10% of healthcare costs are considered as fraudulent, which results in excessive billing or billing for non-performed services. In 2016, for example, the fraud in healthcare industry officially caused around $30 million of loss. The blockchain-based systems can provide realistic solutions for minimizing these medical billing-related frauds. By automating the majority of claim adjudication and payment processing activities, blockchain systems could help to eliminate the need for intermediaries and reduce the administrative costs and time for providers and payers. Blockchain could also have significant ramifications for improving some of the enormous logistical information tracking hurdles of reliability-centered maintenance (RCM) functions. For example, Gem Health, a provider of blockchain application platforms for enterprises, has collaborated with Capital One to develop blockchain-based healthcare claims management solutions.

3) Building the pharmaceutical products supply chain of the next level

Due to recent statistics, the pharmaceutical industry and companies annual loss worldwide are now close to $200 billion due to counterfeit drugs all over the world. Nowadays about 30% of drugs that are sold in developing and third-world countries are considered to be counterfeits. A blockchain system could ensure a chain-of-custody log, tracking each step of the supply chain at the individual drug/product level.

Moreover, the implemented new functionalities such as private keys and smart contracts could help build in proof of ownership of the pharma source at any point in the supply chain and manage the contracts between different parties. For example, a company called iSolve LCC is currently working with multiple pharma/biopharma companies to implement its Advanced Digital Ledger Technology (ADLT) blockchain solutions to help manage drug supply chain integrity.
Blockchain technology also stands to eliminate fraudulent clinics billing cost, for instance, are increasing every year. Crafting a tech-immutable severe blockchain with the help of which the patients are informed of all changes to their health care records and bills would eliminate the possibility of such abuse. The creation of such a system would also increase the safety of the drug and device supply chains. Counterfeit drugs are understood to pose both a public health threat and a significant cost to the pharmaceutical industry, costing the EU area nearly 10 billion Euros per year according to the official data.

4) Medical research implementations and data sharing

The future HC – data blockchains can surely help the next generation of scientific research as the Surgical and medical data of today is encumbered by the difficulty of building large datasets across existing silos of patient data. The cost, labor, and error associated with the problem of manual updating databases like ACS NSQIP, the National Trauma Data Bank, or the National Cancer Database can be avoided if clinical data are integrated into a standard, searchable blockchain records. Moreover, the power of these data will be amplified in coming years if the troves of genetic data from public online sources and phenotypic data from wearable devices can be effectively incorporated into the technology.
The data gathered across a range of personal health and wellness activity, diagnostic and therapeutic services, procedures, laboratory testing, radiology, smart devices, and genetic testing services could all be securely incorporated into a patient’s unique file, accessible to both patients and healthcare institutions.

Everyone can benefit from it – so the patients are in control of their own data, while the medical establishments control data on the institutional level. Each party involved could give encrypted access keys to providers, researchers, or any other parties they choose, providing a range of access—from minimal amounts of de-identified data to individual-level full-chain access—that can be revoked at any time. Every data interaction is appended to the chain in a time-stamped and stable manner, adding to the system’s advanced security measures.

5) Advanced network security

Speaking about the last, though not the least worth attention point of HC-blockchain development features, the security measures are needed to be executed on an entirely new level.

For example, the last reports by Protenus Breach Barometer, there were a total number of security breaches in the US exceeded 450 in 2016, and over 27 million patients had been affected. Moreover, about 43% of these breaches were insider-caused and 27% due to hacking and ransomware.
As the market of Internet of Medical Things evolves and grow every year, the existing computer system of health industry can face a lot of challenges in future due to the overall infrastructure weakness. It is estimated, that by 2020, no less than 20-30 billion of healthcare IoT-connected devices will be used on a global scale.

Blockchain-enabled solutions have the potential to bridge the gaps of device data interoperability while ensuring security, privacy and reliability around IoMT use cases. Companies such as Telstra, which specializes in user biometrics and smart homes, IBM (cognitive Internet of Things) and Tierion (industrial, medical device preventive maintenance) are actively working around these use cases.

Blockchain-based systems that aim to track each step of pharmaceutical procurement and delivery—with each intermediary contributing a cryptographic key to a final product hash are already being developed to eliminate this problem.

There are also security issues related to the centralized nature of these records in their current form, making them frequent targets of cyber attacks. More than one-third of the U.K. National Health Services’ (NHS) trusts report coming under cyber attack, and more than 110 million U.S. citizens had health care data stolen in 2015 alone. The next year the situation even got worse as the hackers targeted several hospitals in so-called “ransomware attacks,” where hackers locked systems until ransoms were paid, with at least one hospital in Los Angeles, CA, admitting to paying to meet hacker demands.

Blockchain-based systems that aim to track each step of pharmaceutical procurement and delivery—with each intermediary contributing a cryptographic key to a final product hash are already being developed to eliminate this problem.

In the nearest future, the health care providers would need encrypted keys to request information from patients, and patients could, in turn, select who has access to their medical records and when. Patients could potentially preauthorize information sharing with legitimate providers in unforeseen emergencies without actually pre-sharing that data, and choose to which, if any, research entities to lend their data.
Healthcare providers would need encrypted keys to request information from patients, and patients could, in turn, select who has access to their medical records and when. Patients could potentially preauthorize information sharing with legitimate providers in unforeseen emergencies without actually pre-sharing that data, and choose to which, if any, research entities to lend their data.

As blockchain technology continues to develop rapidly, it is essential that surgeons and other high-profile medical personnel understand both its capabilities and its limitations.

The more specific benefits of implementation and top existing problems
The HC-systems that currently exist are massively overrated regarding functionality and cost. The patients sometimes are treated without access to medical histories, current medications, and prior imaging studies that could influence patient care at large.

It can save up to $77.8 billion per year in U.S. market, mostly by avoiding redundant tests and imaging studies, and by decreasing administrative expenses as well.

Multiple reasons are standing behind the healthcare sector vulnerability to cyber attacks. The clinics budget shortages, IT-staff incompetence and overall systems insecurity, come to mind in the first place.

But there is always a place for human error which results in malware and ransomware infections due to the incompetence of clinic staff, and the software of unknown origin to be installed on healthcare systems.
Recent research made at Trapx Labs discovered the 63% increase in attacks in 2016. The most significant attacks revolve around the theft of patient records, including 3,6 million records stolen from Banner Health, and 3,4 million patient details leaked by Newkirk products. What drives all these cases? Patient record databases can fetch a decent price on the deep web these days, as long as they contain full information.
Medical device data hijacking remains one of the consistent trends throughout the recent years. A lot of medical devices are connected to the Internet, for some reason, making them prone to attacks from hackers looking to gain remote system access. Medical devices also contain backdoors, which can be accessed through targeted campaigns, malware attacks, and ransomware distribution. For now, addressing this problem is not easy, as the healthcare sector cannot afford downtime due to cyber attacks. In most cases, they will end up paying a ransom to make sure that their systems are left alone.

Conclusion

In healthcare, opportunities exist not only to revolutionize the electronic health information, supply chains, and data ownership, but also to assimilate expansive tranches of data for research purposes by creating technology that is transparent, digital, immutable, secure, and controlled by institutions and, more importantly, by the healthcare industry patients.
That represents another critical step at the beginning of the blockchain revolution at large, and significant obstacles to implementation remain. It is imperative that further research and advocacy efforts led by clinicians underscore potential advances in research and innovation as a result of blockchain technology.

Only time can tell if the blockchain can raise the healthcare field to the new level, but there is no doubt, that its fuel will ignite the overall process of long-needed advance in this industry and many others. The global technology areas covered by blockchain spread beyond the healthcare of course. That also implies the next level of healthcare chips development.
Another significant factor of the biotechnology progress is the biochips technology. Since the end of the 20th century, microchips of different design began to enter the arsenal of techniques used in scientific biomedical laboratories, and then came into diagnostic practice as well. Biochips are a sensitive, highly specific, reliable and fast method of research.

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