How can blockchain technology give impetus to healthcare 5.0 in 2023

By Abhinanda Sarkar

First, blockchain is much more than crypto and crypto is much more than blockchain. So, what is a blockchain if not crypto? IBM describes it this way: “Blockchain is a shared immutable ledger for recording transactions, tracking assets and building trust.” We’re going to take a look at what all these words and expressions mean.

To do that, let’s take the future of healthcare as our context.

A “shared … ledger” refers to a digital database that is visible to all parties who contribute to adding entries to it. When a new ‘block’ of information is added to the ‘chain’, the blockchain is updated. The updated blockchain is automatically shared with all parties, who can all be thought of as co-owners and

the co-creators of this distributed data. Consider electronic medical records (EMR) for a patient.

An EMR on a blockchain can be updated by doctors treating the patient, and the patient can access the update. In turn, the patient can update any third-party diagnostic test results for the doctor to review.

An “…immutable ledger” refers to the feature that a block in a blockchain cannot be changed once it is created. The data in a blockchain contains unique digital identifiers that are created by a process called “hashing”.

Any attempt to change data can be quickly identified. Also, the distributed nature of the blockchain makes it difficult to duplicate any unauthorized change on all the distributed versions. In our EMR example, this immutability makes an EMR on a blockchain reliable for hospital administrators assigning physicians, and for medical insurance companies that want transparent payment

details.

A digital mechanism to “record transactions” in shared and immutable ways is beneficial to a wide range of healthcare participants. Some examples:

(1) A medical school can award degrees through a blockchain. These can be accessed directly by the graduating student as well as by her hospital, thus creating automatically verified certificates.

(2) An entrepreneur building a clinic can verify land ownership via a land journal blockchain. Such a blockchain can contain records of all previous owners of the land, and note any problems with sales or conveyancing.

(3) A researcher conducting a clinical trial may ask participating hospitals to form a blockchain and thereby maintain the integrity of the collected data, as well as create a shared repository that can be assessed by reviewers.

In terms of “asset tracking” blockchain can contribute on a shorter time scale. The idea here is that a blockchain is built up as an item moves from location to location, each location adding its data.

Consider a pharmaceutical supply chain. This begins with a production site from which the goods are transported through possibly several warehouses using several transport vehicles. Finally, it reaches a pharmacy, either retail or within a clinical facility. From here it is made available to a patient

as medicine. Like any supply chain, tracking an item through its journey is useful for inventory management and valuable for processing planning.

Perhaps most important of all is “building trust”. Blockchains are designed to work in transparent and secure ways. This fits in very well with the requirements of the healthcare system, where a lot of trust is required and is often assumed. In the pharmaceutical supply chain scenario, it is assumed that the manufacturing site has the right registrations, for example with the US Food and Drug Administration (FDA), and that the medicines it makes have the right approvals, for example from the office of the Drug Controller General of India (DCGI) . There is also confidence that the medicine is not replaced by a counterfeit during transport or at the pharmacy.

A blockchain can help verify all of this and keep trust in the process. As Healthcare 5.0 expands, reliable data and secure digitization will be key. But there are challenges to overcome. The most important of these is scale. The hashing process is computationally intensive and consumes energy. For blockchain to spread beyond crypto, more efficient computation will be essential. Another aspect of scale is the size and nature of health data. Compliance requirements from, for example, HIPAA and GDPR increase the complexity of storing large amounts of data securely on a blockchain.

In the coming years, other distributed ledgers may emerge as alternatives to the blockchain. For example, the company Hedera uses an alternative called hashgraph to write smart contracts. SAFE is a digital health platform from the Mayo Clinic that has used the technology to verify Covid-19 testing and health

status. Several such digital health applications are emerging, based on smart contracts between providers and recipients of healthcare services. Blockchain and its descendants are poised to make healthcare better for everyone.

The author is the director, Academics at Great Learning

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