HIT Think How blockchain technology could aid key data challenges
Bitcoin. Ethereum. Cryptocurrency. Most people believe that these terms have absolutely no relevance to healthcare today. However, the technology behind cryptocurrency is slowly becoming relevant to healthcare in an unexpected way.
Blockchain technology is currently known for keeping cryptocurrency transactions secure. With adaptations, it may soon be used to keep personal health information more safe and secure, as its name suggests, than ever before.
The current model for storing data is by keeping said data stored in one place. For example, a Microsoft Word document is saved to a desktop. While access to that document may be made through the server, even remotely, it is still saved in a single, centralized location. Blockchain is, arguably, the exact opposite.
Data is stored as the “block” of the technology. The blockchain, in its entirety, is an encrypted ledger that is replicated throughout the database. The data (block) is decentralized through this replication. In other words, it is not saved to a single place, but instead exists across all blocks in the network. Even though the ledger exists in a public space, a private key is required to access a specific block—it enables data to be distributed, but not copied. This manner of data storage protects information from ransomware and hacking attacks by requiring a hacker to simultaneously breach and affect every block in order to render any damage, as opposed to corrupting or stealing just one document in the current centralized version of data storage.
Quite frankly, the current method of storing electronic medical records and private health information is inadequate in light of the onslaught of very capable ransomware hackers and technologically impaired hospitals. The nightmare of entire hospitals becoming locked out of their electronic records happens more often than we would like to admit. For private health information to remain, well, private, new technology, such as blockchain, will need to rapidly rise and spread in a cost-effective manner.
The HIPAA Security Rule establishes national standards to protect individuals’ electronic personal health information that is created, received, used, or maintained by a covered entity. The Security Rule requires appropriate administrative, physical and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health information. It is left up to the entities to create and implement their own security procedures and protection methods.
Out of the over $10 million paid last year in HIPAA violations, more than $8 million in fines were related to issues involving protected health information (PHI). Even without human error, hackers can find their way into electronic protected health information (ePHI) under the current laws, regulations and security methods.
Switching to a blockchain system could be the answer. While the current data model has multiple healthcare providers handling, transferring and storing copies of a patient’s health records, the blockchain data would enable a patient to simply provide access to a healthcare provider by giving the “key” to the block.
So when a family doctor updates information and refers a patient to a specialist, he or she would simply be able to log in and see the pertinent information based on the patient’s permission. Permissions also could be easily revoked, without the worry of destroying digital copies saved to individual computers.
No centralized version of information exists for a hacker to steal or corrupt. The increased speed and access to a person’s health data by approved medical professionals would improve healthcare and potentially reduce the number of medical malpractice cases that result from such inefficiencies in the current system.
Another advantage to the blockchain storage system is that an individual’s entire medical history could exist within the blockchain. There would no longer be a need for Doctor A to send records to Specialist 1 about Problem I. Specialist 1 could simply sign into the block and view records.
In June of this year, Walmart won a patent for a system that would maintain medical records on a blockchain. The abstract Walmart listed on the application to the U.S. Patent & Trademark Office states:
“A method for obtaining a medical record of a patient that is unable to communicate, wherein the medical record of the patient is stored on a blockchain, is provided, including receiving an encrypted private key and a public key associated with the patient stored on a wearable device of the patient, in response to a scanning of the wearable device of the patient at a scene of an emergency, wherein the encrypted private key is decrypted by a biometric signature of the patient, obtaining the biometric signature of the patient by scanning a bodily feature of the patient, decrypting the encrypted private key using the biometric signature of the patient to determine a private key associated with the patient, and accessing the medical records of the patient, using a combination of the public key and the private key associated with the patient, to access a local storage medium of the wearable device.”
Walmart certainly has some good ideas in mind regarding potential uses of blockchain. The abstract clearly illustrates a possible system for utilizing blockchain for emergency services.
Over the summer, UnitedHealthcare, Humana, Optum, Quest Diagnostics and MultiPlan launched a pilot program using blockchain technology to assist payers in tackling mandated provider directories. The program utilizes the technology to reduce costs associated with insurers updating demographic data from providers. It can also prevent claim rejections and fines from the Centers for Medicare and Medicaid Services by preventing tiny errors from cropping up from the influx of data, such as a wrong address. Once one member of the blockchain updates information, the other members do not have to update the same piece of information as it is already updated. This is clearly meant as more of a business use of the technology, but it is still a first step, and an experimental one, into the potential uses by major players in the healthcare field of the uses of blockchain technology.
Blockchain technology is complicated to use, fully comprehend and implement. There is still the question of governance over the blockchain. While it is intended to be run without a sole overseer, the technology itself is made up of machines and code developed by people. Resulting conflict resolution procedures are not solidified, and the entire system itself may not even technically be covered under HIPAA at this time. This could open up the possibility of fraudulent and unethical behavior if procedures and laws are not properly thought out prior to implementation.
However, it will be only a matter of time before updates and redesigns make this technology more intuitive to use and, more importantly, cheaper so that it can be made more widely available. Blockchain technology certainly has great potential in the healthcare world and may find its place in the near future.