Reimagining the Possible: Blockchain For Connected Health Ecosystem (IoMT)

The two mega trends IoT and Blockchain are causing a great deal of hype and excitement in the wider business world. Experts claim that these technological trends are geared up to revolutionize all aspects of our daily lives, however, others stipulate that there is a huge amount of hot air around both domains, and a plenty more is yet to be proved.

If we combine these global trends together and in theory, as a result, we will get an immutable, verifiable, secure and a permanent method of recording healthcare data. A lot of remarkable concepts have been created around blockchain and IoT devices that are already disrupting the existing systems.

The data transactions that occur between different healthcare institutions, service providers, and HIE platforms, the data custodianship gets passed between different parties. In contrary, the transactions made in a blockchain network are nature transparent because every event and activity can be tracked and analyzed by the authorities connected to the blockchain.

Between $.30 and $.40 of every dollar spent on health care are spent on the costs of poor quality. This extraordinary number represents slightly more than a half-trillion dollars a year. A vast amount of money is wasted on overuse, underuse, misuse, duplication, system failures, unnecessary repetition, poor communication, and inefficiency.” Information Source

Current Industry Challenges:

  • As the number of connected devices keeps increasing, the hacking threat surrounding medical devices keep increasing which must be taken on a serious note by OEMs (Original Equipment Manufacturer)
  • FDA in the States have already emphasized on several issues related to OEMs and published a new guidance documenting which focuses on post-market management of cybersecurity in medical devices
  • Keeping cyber-attacks and patient data theft in consideration, providers must choose a cutting-edge technology to combat such threats
  • Because of such privacy and security issues surrounding medical devices, the manufacturers have only been able to connect with appx. 30% with the IoT devices
  • Majority of the global health authorities have already appealed for serialization requirement mandates, which means everyone will have to ensure drug supply chain provenance shortly

Examples of failure with existing Healthcare based systems:

A medical device for medication administration must ensure complete traceability so as to monitor accurate data for Health Information Exchange.

At present, the healthcare data management systems are inefficient and unreliable when it comes to tracking point of failures and accountability. If we talk about medical devices such as infusion pumps, they often operate on 3rd party software or IT systems and in case of any error in medication administration or in warning systems, the regulatory agencies will find out who is responsible. As a result, the providers are charged with hefty fines and in the worst case, they are asked to discontinue the future commercialization.

In scenarios when an OEM (Original Equipment Manufacturer) or any other party involved wants to prove that they don’t stand responsible for their equipment failure, there is no such significant method to prove their claims.

Blockchain & IoT: An ecosystem that no malignant actor can bypass

At present, the healthcare data management systems are inefficient and unreliable when it comes to tracking point of failures and accountability. Employing blockchain technology for IoT devices can detect the countless security vulnerabilities that can expose sensitive patient data and confidential reports which might lead to cyber-attacks.

This unique combination of AI and Digital Ledger Technology, healthcare organizations, vendors, doctors as well as patients can keep an audit trail of all the actions taking place. Since the big data analytics make use of predictive modeling, then when combined with blockchain can drastically reduce healthcare costs and enhance the overall patient experience. As a result, blockchain-based IoMT (Internet of Medical Things) will the existing connected health ecosystem and everything else based on the similar concept more reliable and secure.

The IoMT might be the panacea for communities to address this existing overburdened healthcare system which is most likely to be under more stress as the human population continues to grow and new diseases keep surfacing.

To discover more on IoMT and blockchain you can download this Aranca report on the Internet of Medical Things and read our previous blogs on healthcare.

Part 2: How to improve efficacy of clinical trials using blockchain?

Clinical research is a big deal as it is saddled with almost a $100 million price tag per trial. Despite such massive costs, clinical trials continue to be one of the most expensive aspects of the modern-day healthcare panorama. Randomized clinical trials (RCTs) are believed to be the gold standard of the healthcare research and development. They represent the foremost procedures by which new techniques are evaluated for effectiveness and risks before making them available to for public welfare.

Healthcare experts claim that as much as 30% of the drug development timeline gets devoured by clinical research, which is perhaps the main reason for it being exorbitant. With the development timeline at stake, what is more unsettling here is that over 10% of clinical investigation sites taskedhealthcare research and development. with patient recruitment are usually unsuccessful to enroll a single participant.  

Anyway, let us answer few questions before we move ahead with the blockchain solution.

What is the harvest of a clinical trial?

A safe and effective drug or medical equipment that can be used for prevention or treatment of a disease in order to enhance the quality of life. Along with saving lives and creating a trustworthy healthcare future, DATA is the most important value generated out of successful a clinical trial.

Blockchain comes into play at the pre-trial activities

Before clinical trial kick-starts and patients get the recommended treatment, there is a huge amount of patient information and documentation which needs to be in safe hands.

clinical trial (1)

At Clinical Trial Level

Patient Collaboration: Firstly, getting the patient on board for a trial is a half battle won. During a trial, blockchain would rationalize the process of getting consent from each patient. It will address various issues (unapproved forms, invalid consent forms/failure to gain consent for a protocol) in a decentralized network where every activity will be approved and time-stamped.

By adding a blockchain layer in existing clinical settings, data can be automatically shared and easily accessed by anyone having the access to the chain. In blockchain clinical trials, it is possible to create a collaborative environment that can track all versions of a patient’s health-related data.

By introducing Blockchain technology, managing, monitoring, and tracking of data related to patient’s information can be tracked at each stage. Changes in a blockchain network need approval from each user or node in order to maintain the chain.

 

Smart Provenance

Blockchain clinical Trials

Image Source

The Role of Smart Contracts

The idea of having uninformed patients is the bygone era. Having the patients on board and having their fully informed consent for a clinical trial is perhaps a major challenge. At present, there is no such provision where patients can view the necessary documents and move ahead to provide their consent.

Here Smart Contracts come into play,

According to Wikipedia, “Smart Contracts are computer protocols that facilitate, verify, or enforce the negotiation of a contract”, and their execution can be implemented by using cryptographic hash chains.

By creating Smart Contracts, consent between the patient and provider becomes completely transparent and upfront as it is truly a patient-driven. With patients’ aware of the information sharing and monitoring at all times, they are able to accept each piece of new information as it gets finalized and recognized by others in the private blockchain network.

This image explains how Smart Contracts work for Public and Private chains

Blockchain Clinical trial

Image Credits

At Patient level

At present, there is an enormous room for human error as a single patient visit consists of numerous data points that are spread across multiple avenues. The blockchain provides utmost impenetrable security, it can impact the way clinical trials are being conducted inefficiently by managing the sensitive health-related data. The blockchain is built on an encrypted platform, which means that the patients can expect secured reports, transactions and documents that are verified and they do not need to undergo the same procedure again and again.

A Secured Data Infrastructure

Researchers and healthcare experts are confident that the Blockchain technology would allow trial and patient information to synchronize. This will likewise connect the patients directly to the trials and the patient will be notified at each step regarding his/her personal data.  Additionally, the ability blockchain technology brings would improve the communication in clinical trial results.

To understand blockchain clinical trials and blockchain for healthcare better, refer our previous blogs.

How to Improve Efficacy of Clinical Trials Using Blockchain

What are Clinical Trials?

According to World Health OrganizBlockchain-powered Clinical Trialsation (WHO)

Any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes’.

Clinical trials revolve around the following areas of healthcare for diagnostic or screening tests in order to find new ways to detect and treat disease:

  • Experimental drugs
  • Other biological products
  • Vaccines
  • Medical devices
  • Surgical and other medical treatments and procedures
  • Psychotherapeutic and behavioral therapies
  • Health service changes
  • Preventive care strategies and
  • Educational interventions

The need for Clinical Trials

Clinical trials are carried out for the development of new interventions, without which, it is crucial for us understand if a healthcare model is suitable for safe and effective use, or whether a diagnostic test works in alignment with a specific clinical setting. This gives us insight on how new treatments might work and if there are new substitutes for testing available.

Technological Advancements in Healthcare

Along with ML, AI and IoT, blockchain technology have rapidly emerged to become one of the healthcare industry’s most talked-about technologies.

“When considering the US healthcare economy, it is estimated that by 2026, the key clinical health AI applications have the potential to create $150 billion markets in annual savings.”

Blockchain addresses the improper treatments which arise as a result of lack of access to critical health data.  It facilitates the development of the patient-owned, centralized longitudinal healthcare.

Legacy healthcare model: Lack of Patient Centricity

Legacy healthcare model has a bare minimum role for the patient, it is inclined towards providers and stakeholders more. The relationship between healthcare providers and patients is considered to be paternalistic, as it lacks patient centricity. However, we have witnessed a significant shift of authority in recent times with the arrival of IoT and AI in the healthcare marketplace.

Fragmented Health data contained in legacy systems is siloed as it varies in formats and standards altogether making it extremely difficult to share. In short, the legacy healthcare data sharing model is ill-suited to the instantaneous needs of modern-day patients. As a result, stakeholders and healthcare providers in the network are incentivized to maintain their own records, and no single version of the truth exists.

“Blockchain technology is the biggest achievement in cryptography of the past decade. Source Data Verification (SDV), which consumes about 20–30% of the clinical trial budget nowadays, will become redundant when blockchain technology disrupts the pharma industry.”— Author, Cyntegrity

Blockchain-powered Clinical Trials: Democratized Medicine and Empowered Patients

Patients now control their own data and are expected to contribute to decisions related to their preferred treatment choices. With blockchain, clinical communication brings increased access to emergency information, allowing clinicians to intercommunicate. If an unauthorized person tries to update a patient health record, the system will prohibit to alter that record on the blockchain. Only the authorized users can make the update in real-time basis as there is no need for patient data to be manually transferred from system to system.

The blockchain for healthcare system will help in:

  • Evaluating and monitoring one or more treatment interventions for a condition along with decentralized approaches to surgery or therapies
  • Assessing different ways to prevent a disease or condition, for example, through precision medicines, vaccines, and closely monitored lifestyle changes in the decentralized network
  • Evaluating one or more diagnosis interventions by consulting third-party doctors and healthcare experts which is helpful in identifying or diagnosing a particular condition through evidence-based research.
  • Examining suggested and recommended identification methods for recognizing a condition across the clinical trial phases that are guided by smart contracts and timestamps.

Current Developments

The Digital Ledger Technology (DLT) is poised to disrupt the stagnant trial timelines, looking at which it can be presumed that the ability of legacy data management platforms will address the competing needs of patient privacy and clinical data integrity.

Blockchain in healthcare Use Cases for Clinical Settings


GENETIC TESTING

The blockchain model for genetic testing will likewise eliminate personal genomics companies such as middlemen between data owners and data buyers. However, data owners can acquire their personal genomic data from the blockchain platform and join the network in order to directly connect with data buyers. This will also satisfy the needs of data buyers in regards to genomic data availability, data acquisition logistics, along with the resources required for genomic big data.

PRECISION MEDICINE

At present, digital health workflows are functioning without acute data and silos among different hospitals and healthcare departments within a health system. As we witness the healthcare industry struggling to find the trade-off between risk and reward of technological advancements. The potential application of blockchain technology will provide a timely answer to unprecedented levels of data breaches. Blockchain technology here provides an additional layer of trust by inviting health data interoperability, cybersecurity, health data ownership, along with value-based care.

SUPPLY CHAIN MANAGEMENT

Major pharmaceutical companies are very optimistic about leveraging blockchain technology in order to track the drug supply chain for an enhanced customer journey. With blockchain, they are able to create a reliable and tamper-proof audit trail for medicines and equipment as they move through the healthcare ecosystem.

MEDICATION MONITORING

Blockchain technology offers an innovative way to ensure that keeping a vigil on abuse-prone medications are better controlled. The prescription can be tracked and monitored in the network which will likewise be helpful in medico-legal cases, tracking patients’ medical history and medical malpractices.

PUBLIC HEALTH SURVEILLANCE

Migrating the healthcare data securely from one peer to another in a complaint yet a transparent manner is possible with blockchain technology. Blockchain in healthcare use cases plays a major role in managing population health management situations by reducing the barriers involved in complex data sharing agreements between physicians, hospitals, healthcare providers and different government departments.

Other areas where blockchain for healthcare has a great potential are:

  • Clinical Data Exchange and Interoperability
  • Claims Adjudication
  • Billing Management
  • Pharma Supply Chain Integrity and Provenance
  • Pharma Clinical Trials
  • Cyber Security and Healthcare IoT
  • Robot-Assisted Surgeries
  • Monitoring Virtual Nursing
  • Dosage Error Reduction
  • Interconnection of Machines
  • Cybersecurity
  • Preliminary Diagnosis

EndNote

Healthcare users expect the instantaneous flow of data where they can trust the service provider when it comes to data transparency and security. Many industries like finance, real estate, and e-commerce have adopted the much-needed technological change to guarantee secured flow of information. However, the healthcare industry has lagged behind. So far, we have witnessed the healthcare industry as a lucrative target for hackers.

The blockchain technology will facilitate the clinical trials by interconnecting different systems that are not readily communicating with each other and rather create data provenance that satisfies regulatory and clinical requirements. As the blockchain technology adoption grow, it will increasingly provide a foundation that enables Artificial Intelligence and Machine Learning to fully realize their importance to healthcare.

The blockchain will likewise improve the quality of patient care whilst bringing major reductions in the healthcare cost. In a nutshell, it almost took us a decade to offer low-cost care delivery options to the patients rather than the traditional high-cost ones. Blockchain technology took the center stage where care coordination became the mantra for successful healthcare institutions.

Can Blockchain prevent Health data Hacks?

At present, the biggest issue that makes the use of blockchain revolutionary in the healthcare sector is the lack of a central administration. The private data being stored is vulnerable consisting of bits and bytes. As the industry evolves alongside emerging technologies, effective patient care has become supreme importance for everyone in the network right from pharma companies, to vendors all the way to the doctors.

DATA VULNERABILITY IN EXISTING EHR SYSTEM

Medical Data not only contains insurance details which can be misused for fraudulent billing and falsified prescriptions but also complete health histories, social security numbers, medications, credit card details and more. Such type of data holds huge incentives for hackers upon selling in black markets.
Adding to it, Breaches, Malware and Ransomware are making frontpage news for targeting and attacking health industry. Still, the industry is resistant to adopting emerging technologies and implementing security protocol as compared to finance, banking and retail industries.

KEY TAKES

  • In 2017, the former CEO of Cerner Neal Patterson passed away. His wife had to bring printed copies of her medical records to every specialist she saw because this information couldn’t be shared electronically. Neal had spent his career building an electronic medical record company to solve these very problems. Cerner is now valued at more than $20 billion
  • In HIMSS 2018, Medicare chief Seema Verma, who shared that her husband couldn’t access his own records after a cardiac arrest, everyone will be patients or at least caregivers. That means even the wealthiest and most powerful among people’s will need to grapple with healthcare system

In 2009, the Affordable Care Act required electronic health records to be incorporated into medical practices. However, even in today’s healthcare system, where 86.9% of office-based physicians have an EHR system in place, access to health care data is still a significant problems.

RISKS INVOLVED

We have established safeguards and regulations like HIPPA to “protect individuals medical records and other personal health information and applied to health plans and those health care providers that conduct certain health care transactions electronically”. The survey shares the statistics about millions of data breaches in 2018.

  • Many people are still not aware of insecure networks which are prone to the risk of fraudulent usage of data and get into contact with such networks unknowingly
  • In some cases, employees intentionally steal data with petty reasons like having grudges against the employer
  • The year 2017 witnessed several Cyber attacks examples include WannaCry and NotPetya ransomware attacks, Equifax data breach, MongoDB database leak, Elasticsearch server hack, Cloudbleed security bug, Zomato hack, HBO hack / Game of thrones leaks, Uber data breach, and Ethereum hack

EHRs and other sensitive health data are sold in the dark market and the immutable personal information that can be utilized for many forms of fraud. Such data breached in healthcare industry field costs $6.2 billion annually (Health IT & CIO Report) in a form of forensics, lost revenue, data theft etc.

BLOCKCHAIN IMPACT

Healthcare information is extremely valuable on the black market because it contains sufficient detail to hack health savings accounts, or commit identity theft. There is no provision for data safety, hence adopting a more secure yet cost-effective way to protect his data would be a very welcoming development.

Blockchain, the term which is getting massive popularity in security services, healthcare organizations now started exploring it. The blockchain is a shared, immutable record of peer-to-peer transactions built from linked transactions blocks stored in a digital ledger.  It’s decentralized and unique approach where the data is stored in a distributed network without any centralized authority. This trait can be effectively utilized to prevent attacks.

Most of the buzz around Blockchain in Healthcare is focused on EHRs, interoperability, and security. Consumers are demanding control over their medical information and remain updated with their own patient-reported data and status. The blockchain is a digital ledger of transactions that anyone on the network can see and no one on the network can alter the information. The main areas of the interest in healthcare blockchain industries are EHRs/EMRs, Pharmaceutical companies, Hospitals/clinics/doctors/care services etc.

Around 67% of healthcare organization have inefficient EHR systems that do not communicate efficiently and thus, the traditional method of sharing or transferring health records through fax machines and emails is still being followed. Blockchain supports healthcare data security processes by centralizing the data across the care perpetuity.

Health information stored on a Blockchain cannot be modified once it has been recorded. Each member in a Blockchain value chain has a secret private key and a public key. In order to uncover the patient’s information, one must need a private key in the blockchain network. The decentralized approach of the blockchain means that there is no single point of failure that can result in data loss or risk data security.

HOW CAN BLOCKCHAIN ADD VALUE TO EHR/SUPPLY CHAIN?

  • The blockchain is a technology which helps to keep data secure in a distributed ledger and provide control only to those who have access to that ledger.
  • Here, the patients have full control of their records and information.
  • Blockchain allows patients to access and control their entire medical history. Patients can approve members in their private secure EHR community. Also, they can approve changes and can track the data shared by different parties.
  • With Blockchain, providers can create a smart contract- a rule-based contract for accessing patient data which can be permissioned to selected health organizations.
  • In a pharma supply chain, drugs can be scanned and entered into secure digital blocks
  • In a Blockchain enabled the system, real-time records could be viewed anytime by authorized parties and even all the authorized members in the supply chain

EHR Blockchain

HIE and interoperability are other strong aspects playing a crucial role in the healthcare industry. Rather than relying on intermediaries for exchanging of data such as public/private networks, members can join the network without building specific interfaced between them.

The blockchain is becoming the backbone of digital health. It not only provides transparency between the members but also security while transferring the data and access to the patient’s records/history.

END NOTE
When considering the bigger picture, the potential of blockchain technology depends on how willing healthcare organizations are to embrace the much-needed technical infrastructure. However, one thing is for sure- blockchain has taken healthcare industry by storm over the past few years, and we have witnessed significant investments in its adoption. Patient centricity in conjunction with blockchain technology will open new doors for innovation and inject the much-needed trust whilst improving the quality of care in all aspects.

How Blockchain Contributes to Drug Supply-Chain Management?

The pharmaceutical industry has been wrestling with the challenges related to counterfeit drugs and ineffective supply chain management.  Naturally, it is the most important task for all the pharmaceutical companies to prevent fake drugs and gain confidence among the consumers. This blog intends to orbit the blockchain healthcare supply chain and how it is effective in fixing information asymmetry and combating counterfeit drugs.

A lot of pharmaceutical companies have developed drug tracking solutions using bar-codes or radio-frequency identification tags. However, but to sync the data across different suppliers and individuals in the network doesn’t suffice the need. Here, the data remains unavailable in real-time and the entire supply chain ecosystem is susceptible to manipulation. Regulatory issues along with data privacy are perceived as the two top hurdles in the pharma supply chain.

At present, there is no real-time management between legitimate drug inventories and the trading partners in the pharma supply chain. As per a survey conducted by Premier Healthcare Alliance in 2014, the estimated drug shortages cost U.S. hospitals about $230 million annually. Hence, it is easy to say that there are loopholes in the existing pharma supply chain model which must be redressed.

How can Blockchain revolutionize pharma supply chain management?
The blockchain is capable to bind together a complex team-based healthcare, finance management and payment structure with the care provided along with it. It helps in creating a new level of integrity for pharma supply chain management by making use of the inherent wealth of cryptographic public and private keys.

“Our vision is a system where everyone would register a serial number, and you could develop technology so that every time a drug changes hands, the technology automatically verifies the authenticity of the drug,”

Susanne Somerville, co-founder of the Link Lab, a life sciences consulting firm

Blockchain in Medicine being a game-changer has the potential to impact several industries. It has disrupted the pharma supply chain management and redesigned the complete business with its unique offerings. Blockchain technology also makes it effortless to track a particular drug as it makes it journey from manufacturer to the patient. This upgrades the traceability of a drug and helps to intercept drug counterfeiting.

The principal concept of effortlessly managing the data and maintaining the data security are the reasons why it is being adopted by a majority of pharmaceutical companies.  The improved information sharing among healthcare providers and patients means accurate diagnosis along with a cost-effective care. In the healthcare value-chain, the data security is maintained at all stages and it is possible to track data provenance.

ENSURING INTEGRITY OF BLOCKCHAIN HEALTHCARE SUPPLY CHAIN
Today, the counterfeit drugs add to a loss of more than $200 bn to the pharma industry. To add to the misery, this has also resulted in losing credibility and trust among the patients worldwide. Providing medication is very complex, and in most of the cases, supply chains are mixed up, thereby inviting counterfeiting. These inappropriate levels of supply chain management result in putting users at risk.

However, a Blockchain healthcare supply chain is capable to track drug route at every step. Here, the private keys and smart contracts help in building the proof of drug ownership. With blockchain integration, Pharma companies can reinvent the way of auditing and consult services by streamlining the entire process.

The entire Blockchain architecture supports in-built fault tolerance and data encryption. These features add to the benefits and the entire supply chain will become easy to work with. Moreover, this will likewise eradicate the need for complex point-to-point data integration systems.

A simplified, trust-based pharma supply chain:

 

TECHNICAL ADVANTAGES OF BLOCKCHAIN IN SAFER MEDICATION PRACTICES
Since the Blockchain technology has gained a cockpit position in the health IT systems, as a pharmaceutical supplier one should start re-basing their interoperability strategy in order to gain market leadership.

Recent efforts from pharmaceutical giants like Pfizer and Genentech have sought to introduce blockchain supply chain systems that are capable to track the drug supply chain of medications right from pre-manufacture stage to the patients.  Such a concrete ecosystem provides a significant way to establish rapid immutability & transparency and compliance with drug-related laws and regulations.

The Need for Drug Supply Chain Facelift
The pharmaceutical value chain kick-starts from the drug development phase which is a lengthy process. Hence, there is no room for simplicity of auditing and gaining regulatory approvals. Here are different stages:

  1. Discovery Phase
  2. Test Phase
    • Safety
    • Effectiveness
    • Efficacy
  3. Patent Protection
  4. Approval from authorities
  5. Final Stage

During these phases when a particular drug is up-scaled to enter the markets, the biggest battle is to fight the quality issues and consumers’ safety. Therefore, ensuring supply chain security is something that every pharmaceutical company must consider something of supreme importance. In many cases, Pharmaceutical manufacturers fail to maintain transparency and lose on disincentivizing future innovation.

The blockchain healthcare supply chain can enable pharmaceutical manufacturers to identify defective drugs before they enter supply chains, all credits to cryptographic timestamps. The entire system promises to keep counterfeit drugs out of medical supply chains and smooth the entire process.

How blockchain takes care of counterfeit drug problem pharmaceutical supply chain?
Two specific use cases in blockchain healthcare supply chain mentioned below make sense. First is securing the supply chain and the other is to optimize the supply chain, which brings visibility and accuracy in the event of a drug recall.

Use Case 1: Combating Counterfeit Drugs
Over 1,00,000 lives are lost annually due to the odd-effects of counterfeit drugs. Surprisingly, they account for 10% of the pharmaceutical market share, further resulting in an annual loss of over $200 billion. The 2010 findings of World Health Organization estimate in more than 50% of cases, medicines that were being purchased over the Internet were counterfeit drugs.  However, the overall death toll caused by counterfeit medicines is uncertain, but the costs to public health are enormous.

The blockchain solution
The blockchain is viewed as an opportunity platform which is developing the much-needed trust and transparency. The customers will be able to track pharmaceutical supplies throughout the supply chain. The blockchain grant access only the trusted parties who can scan and verify the drug source using barcode. Optimally, the blockchain powered platform ensures drug identification, detection, verification and altering in case dishonest practices are observed.

This is how the blockchain system works:

 

With the support of the blockchain technology, pharmaceutical supply chain stakeholders gain the power to maximize their efficiency while distributing the drugs to a bigger consumer-base. Patients, on the other hand, stand to profit by being enabled to independently verify the drugs at every stage.

Use Case 2: Fixing Data Asymmetry and Irregular Returns in Pharmaceutical R&D
The blockchain technology intends to add value to the pharmaceutical value chain. Since R&D is the primary source of data asymmetry between organizations and financers. This data asymmetry makes it difficult for investors to derive correct information. In a pharma supply chain network, the absence of reliable information is most likely to create uncertainty.

The blockchain solution
Blockchain can inherit trust and credibility among the stakeholders by increasing effectiveness and transparency in the early research phase. The blockchain safeguard information exchange and flow across different processes of the drug production stage.
The real-time information in a blockchain network is visible to the investors, which helps in reducing data asymmetry and therefore address the irregular returns in pharmaceutical R&D. Hence, the funding party gains belief as they see a value-added asset, which is most likely to be added to their valuation.

EndNote
The blockchain is perhaps a potential solution that can effectively keep a vigil on every activity performed in the supply chain. It provides the much-needed visibility.
Healthcare blockchain companies get you a robust cyber defense strategy to monitor the ongoing activities in the supply chain, which is possible only with underlying capabilities of this revolutionary technology.

 

How Health Information Exchange and Tokens Work in Blockchain For Healthcare?

The term Health Information Exchange (HIE) is used to describe the fluid movement of patient health data across various platforms. The first and foremost function of an HIE is to grant permission to a patient’s clinical information on demand. “

According to an American Health Information Management Association report.

“A successful HIE depends on trust between the patient, the healthcare provider and the HIE. In order to build trust, HIEs must develop and implement policies and procedures guiding their operations, including how they will maintain and secure protected health information.”

Current Scenario of Information sharing in the Healthcare Sector

Electronic health information exchange (HIE) make room for doctors, pharmacists and other healthcare providers along with the patients to appropriately access vital information and securely share critical details. This will likewise improve the speed and costs associated with patient care.

However, HIO model of the commercial space does not have the provision for the patients to make a profit from sharing the information. Hence, HIE is not seen as an entity but rather a simple data sharing activity.

In most of the frameworks, the typical Health Information Exchange activity falls into both HIO and HIE definitions. Here, the data link sold to the purchases (internal or outside organizations) is not patient-driven as the model does not benefit the patients.

The types of HIE and Development Stages:

 

Public Health Reporting Using HIE Here, we utilize the HIE to transfer data to public health entities, which depends upon the HIE model being employed.
EHR-Based Information Exchange Reporting in an EHR-based exchange is a direct electronic connection which is usually done manually unless a direct connection is established between the EHR-based exchange and the public health department.
Here, any modification in the data is by considering human and monetary resources.
HIO Model Exchange Here, all the information transfer takes places electronically where each provider builds a link to the HIO and where all the data is redirected. The existing model is entirely centralized.

HIE experts consider a three-stage development in planning the commercial health information exchange:

  • “Record and Playback” stage
  • “Local Limited HIE” stage
  • “Full Station” stage

However, to best serve the community it is vital to include stakeholders early in the process where everyone gets to know each other. As a result, a transparent design system is established alongside the policies, procedures, and agreements.  However, to do so there is a need for blockchain integration.

Working of the HIEs

The sharing of medical data is usually done using email or fax between different providers, this is further carried by the patients for appointments. The HIE cannot replace the traditional provider-patient communication, however, it can improve the completeness of patients’ records. The past medical history and other critical information are jointly be reviewed by everyone in the loop.

Cross-institutional sharing of this critical information allows the providers to avoid readmissions and medication errors thereby decreasing duplicate testing.

Cross-institutional sharing of this critical information allows the providers to avoid readmissions and medication errors thereby decreasing duplicate testing.

However, there are concerns surrounding the entire ecosystem, here are few insignificant barriers:

[1] The institutions often are reluctant to share data because of malware and privacy concerns as they fear that the information being shared might give others a competitive edge

[2] Even if the privacy concerns are addressed, the broad consensus around the technical infrastructure that supports it is usually missing

[3] Sharing of this information requires a mutual understanding between all the parties involved so as to share it efficiently and securely. These interoperability issues when left unchecked are most likely to limit the utility of data as expected.

[4] The most critical issue arises when a party fails to secure the patient data, it leads to financial and legal consequences as information misconduct might impact patient care.

As said by Farzad Mostashari, the former national health IT coordinator for the Department of Health and Human Services (HHS),

“Health information exchange will not become a reality as a single vision or system but instead include many models and business plans. The evolving HIE vision must be built around standards, directories, participation agreements, governance models, and a clear understanding of different ways that information can be shared and understood.”

The major concerns surrounding privacy and security in existing HIE model include:

  • Hacking attacks
  • Data availability
  • Trust and access control
  • Confidentiality of PHI and PII
  • Privacy regulations

How blockchain addresses these concerns:

Blockchain for healthcare guarantees to ensure cost-efficiency and accountability in managing sensitive health-related data transactions.

Here, the Bit-string cryptography maintains the data integrity without violating HIPAA (the Health Insurance Portability and Accountability Act), thereby limiting the real-time use and misuse of health information.

  • The chain nodes which are in majority corroborates transaction validity through consensus
  • Smart contracts notarize each transaction in the healthcare network
  • Those providing services can track and update their patient’s health data, that includes prescriptions, clinical notes, the care plan along with lab results, etc. whilst maintaining the data security.

The need for Blockchain in Health Information Exchange

What needs to be focused here is privacy and anonymity and how it is being applied to data sharing. Data privacy in true sense must ensure that only the authorized parties must have the access to the critical information as the patient is not just the sole ethical responsibility but also a legal mandate.

Blockchain for healthcare brings a democratized health and wellness ecosystem in the entire exchange process and the patients can self-govern data to gain access to better healthcare.

The decentralize medical health data will only grant access through smart contracts making the entire ecosystem secure and fair. The blockchain for healthcare data is directed towards a meaningful use of thought healthcare. With this, the patients get therapy focused conversational engagement layers that are supported by IOT devices and various medical pharma thumbprints.

pharma thumbprints.

The Transaction Process for Health Exchange in Blockchain

The blockchain for healthcare and EHR systems offers a holistic solution that enables the safe and secure exchange of to get over the usual incompatibilities at the provider level. Here, every health record, every medical device, and every wearable is a part of the blockchain network. As a matter of fact, it is self-explanatory that no one can alter the EHR blockchain record.

Firstly, the entire blockchain network focuses on user-patient satisfaction by incentivizing the platform making the offerings lively and dynamic. Also, tokenization ensures that every patient has the opportunity to earn and be rewarded for sharing health-related information. The blockchain ecosystem revolves around the use of tokens

Using Tokens in a Blockchain Network

In a blockchain for healthcare network, Tokens are used by the patients to pay for hosting and storage of their records. Everyone gets paid into this network right from pharmacists to the doctors for remotely reviewing patients’ medical information and providing consultation. Patients, on the other hand, also have the upper hand and gets paid in terms of token for sharing their healthcare data. Here, content is the King and distribution is the queen.

A unique digital signature will allow all the stakeholders to access the data and transact. The blockchain for healthcare streamlines the entire process when certain criteria are met for the Smart contracts to proceed further.

This is the usual transaction process:

 transaction process

Once the data is generated by the patient’s wearable device (watch, shoes etc.), the doctor writes a note to the blockchain. Soon after, the pharmacist dispenses the medicine as per the subscription.

  • The data encrypted is sent to cloud storage
  • As soon as the data is fetched, the blockchain ID retrieves the encrypted data.
  • The decrypted data is finally displayed on the device

Blockchain technology is capable to track and timestamp each activity related to the patients’ critical data. It provides a permanent audit trail whilst ensuring the updated version of the record is put to use.

Finally, healthcare providers reward the patients with the token in exchange for accessing critical health information. Eventually, this change will allow stakeholders to see how the HIO can transform health care quality along with the overall efficiency of healthcare. Moreover, the blockchain for healthcare makes it possible for the providers to create a positive belief that the procedures and technical infrastructure they are providing are backed by security and limited interruptions.

Storing Medical Records Gets Easier With Blockchain in Healthcare

Other than keeping cryptocurrency transactions secure, where can Blockchain technology utilize its underlying potential? Blockchain has found itself useful in many industries and out of these one of the most promising name is blockchain in healthcare. With applications evolving in healthcare IT, researchers are curious with questions such as can blockchain make the storage of medical records any easier with blockchain medical records? Is it possible to improve data security with blockchain in healthcare?

Present day Issues with healthcare data
The current way of storing health records is acceptable yet it has many issues which need to be addressed. The system is inefficient and allows too many roadblocks in the way of sharing patients’ health data. Patient data is scattered all around the healthcare system as there is no single healthcare provider who stores this information instead fragments of data are stored in different places. This not only makes it extremely difficult for the data to be collected in the time of need, but also raises different issues such as follows:

  • Patients’ data becomes vulnerable to theft
  • When splitting data between providers and associates, probability of breach increases
  • While HIPAA requires healthcare entities to implement safeguards to ensure health information, different healthcare entity apply their own security controls

Increase in the number of entities accessing healthcare data increases the potential of probable due to exposure of data. According to the Department of Health and Human Services’ Office for Civil Rights Breach portal, HIPAA-covered healthcare organizations and their business partners aren’t always aware where and how their data is being stored, transferred and used, and even when they are, it is quite impossible to prevent data breaches. This brings blockchain into the main picture as it can be used with blockchain medical records thus, improving data security.

What is Blockchain?
In the simplest of its form, a blockchain is a record of information that stores data in the form of limited sized blocks that are linked to each other. A blockchain distributed system has the following properties that makes it unique for applying in a wide variety of industries:

  • Distributed
  • Immutable
  • Secure
  • Trustable

A blockchain is based on the usage of cryptographic techniques that allow the processing of peer-to-peer transactions while facilitating the store, exchange and visibility of the information by the users. In order to store any information to be stored on the ledger, it needs to be verified first. The process of verification and validation of transactions is accomplished by entities known as miners. Once a transaction is successfully verified, it is added to the digital ledger.

As seen in the massive Anthem and Equifax data breaches, individual entities aren’t reliable and should not be  trusted for holding large amounts of data and keep it secure in a centralized system. Accumulating data in a decentralized system is a better option rather than using a centralized network.

Blockchain for Healthcare Data

  • With the aid of blockchain, every block of data on the blockchain is encrypted and secured by using cryptography. A block can be encrypted using public key cryptography and the information stored in it can be decrypted by using a private key or password.
  • Blockchain in healthcare will enable organizations to access patients’ data as blockchain medical records with the help of cryptographic key rather than multiple healthcare providers storing their own copies of a patient’s data.
  • Blockchain medical records would be inaccessible without the key associated with it. Moreover, it is impossible to get control of a single block of data as all the blocks are interconnected to each other in the chain’s chronology. This property also prevents any modifications to the blocks of data on the blockchain.
  • Blockchain can be used for transactions with the help of cryptocurrencies. With blockchain in healthcare, these transactions could take place between consultants, physicians, X-ray, test results, prescriptions, or surgical procedures.
  • Any new data which needs to be added would first undergo validation process which upon completion will allow it to be added to the chain with the blockchain comprising patient’s entire medical history.
  • Blockchain medical records will prove highly beneficial on both ends i.e. providers and patients by keeping the data secure as well as available to anyone at any given time
  • For patients, the current process of accessing records is tedious, costly and time-consuming, and potentially costly for the patient, since providers are permitted under HIPAA to charge a money for issuing copies of data. Rather than submitting requests for their data, patients will be able to get the data instantly with blockchain in healthcare

Though blockchain is a comparatively newer technology for healthcare, the recent trials of using it for medical data show very promising outputs. A trial by MIT Media Lab and Beth Israel Deaconess Medical Center shows that blockchain works extremely well in terms of tracking test results, treatments, and prescriptions for inpatients and outpatients over 6 months.

 

In order for healthcare organizations to fully adopt the blockchain technology, it is necessary to extensively test it along with the healthcare data. According to a survey by IBM, out of 200 healthcare organizations, 16% are expected to have a commercial blockchain solution in place this year. Encouragingly, with the adoption of blockchain increasingly and successfully in other industries, the healthcare segment seems to go ahead with blockchain medical records at an increasing pace too.

7 Things to Know About Blockchain In Healthcare

 

In healthcare, interoperability is defined as the ability of different computer and technology systems to communicate and exchange data across a reliable network. But when it comes to scaling of such systems on big levels, the ‘reliability’ factor often gets compromised. Reason being, the failure of effectiveness and increased fraudulent activities in the overall data sharing system. But there’s no stopping to increasing data in the days to come anyway, so what’s the solution here? Probably, Blockchain in healthcare.

Blockchain brief
A revolutionary technology behind the working of the leading cryptocurrency Bitcoin is what we call blockchain today. To keep things simpler, let’s say that a blockchain is an immutable and distributed record of transactions based on a peer-to-peer network model.

What makes blockchain so unique is its quality of being immutable while keeping the data integrated. This allows us to build applications and systems called smart contracts based which contribute in making the overall functioning of the system smooth and easy.

Blockchain Heathcare

Blockchain technology in Healthcare
Effortless sharing of data between healthcare providers results in higher chances of accurate diagnosis, fruitful treatments and cost-effective healthcare systems. Increasing patient data demands proper utilization in order to make the best effective use of the insights discovered from it.

Blockchain technology for healthcare can enable multiple participants of the healthcare system to share their data and keep a track of transactions without compromising its integrity and security. There are two types of blockchains that can be used in a system based on their permissions:

  • Permissioned Blockchains- Permissioned blockchains allow the data inside them to be shared in real-time. Each transaction when time-stamped, becomes tamper proof and is stored as a permanent record.
  • Permissionless Blockchains- Such blockchains enable every participant to view the records. As opposed to permissioned blockchains, identities of parties are not masked in this one.

Out of these two, permissioned or private blockchains can be effectively used in healthcare in order to make right decisions within the healthcare ecosystem. Blockchain in healthcare holds many possibilities and probabilities for the future as the field is constantly being explored. Here are seven things that you must know about Blockchain in healthcare:

  1. According to IBM, in a survey of 200 healthcare executives, 16% are expecting Blockchain rise in terms of adoption of a commercial blockchain solution probably this year.
  2. Using the application of Blockchain in healthcare, the donors in the network will be able to gain control of the data sharing process and get rewarded
  3. Members of the Blockchain in healthcare network can be benefited from being claimless and contribute as a shared economy for researches
  4. Using the technology of Blockchain in healthcare, work duplication and fraudulent activities can be minimized as the trust is based on consensus of the network parties
  5. With the aid of smart contracts, logic can be enforced on the top of the transaction occurring within the blockchain system. This allows the execution of rules to be based on how the transactions are carried out as per the contract.
  6. It is projected that 55 percent of healthcare applications will have adopted blockchain for commercial deployment by 2025 reports Statista.
  7. Potential healthcare application such as population health can be hugely benefited with Blockchain in healthcare. The need of health information exchanges as a middleman can be eliminated as blockchain for healthcare offers access to patient data as a decentralised and trustable system

Blockchain use-cases in Healthcare
To understand the scope of Blockchain in healthcare better, let’s consider few use cases here. According to studies, the drug counterfeiting market is worth $200 billion annually.

Drug counterfeiting & traceability
Drug counterfeiting refers to a system where authentic drugs are replaced with fake ones thus, increasing the profit margins for dealers while decreasing actual effect of drugs on patients. A drug company that uses a blockchain based product for selling the drugs can be assured when it comes to delivery of the right drugs to the right people. Here’s how-

Firstly, a private blockchain can be used in the system to ensure trust.

Secondly, the pharmaceutical companies can decide the miners in the system depending upon their position and role in the supply chain system.

As per the blockchain process, the manufacturer can start the transaction with a unique hash which then is verified by the wholesaler, pharmacist and the patient as the transaction proceeds. This information is kept in a secure ledger which cannot be altered by anyone else.

This way, unnecessary elements will be prohibited from accessing the system and changing things at any stage.

Patient Data Management

Another useful scenario of Blockchain in healthcare is the patient data management. There’s no argument to the fact that each person varies with the other one on the basis of certain factors. Whether it is a genetic disorder or a newly spreading disease, we cannot be sure of any one specific way in which it’ll affect people.

The possibilities are innumerable and this fact brings us to the need of storing patient data separately and securely. While there are methods of storing patient data, the centralized control over this data makes it vulnerable and exposed to unreliable sources.

Moreover, patients do not have access to their own medical records as there’s a chance that they can change them as per their choice. But thanks to the blockchain, these issues can be addressed in the following manner:

-Patient’s data can be collected and stored on databases. A hash is then generated from each data source to be redirected to the blockchain.

-Smart contracts can be used to enable access to patient’s data.

-The patient can decide to share his data with identifiable as well as non-identifiable resources. Upon access, the data can further be used by researchers or the medical community.

With all the new cases being explored and even newer ones getting discovered, we can be certain about one thing for sure: Healthcare has utilized the potential of blockchain technology in the past year and further plans to invest in it. New innovations and plans of blockchain in healthcare are expected to make some noise in the coming days.

 

Healthcare Innovation with Blockchain Powered Internet of things

The Internet of Things (IoT) is making a serious positive effect on almost each and every industry, and wherever. After the “Invention” of the Internet, IoT has been aggressively implemented in all the businesses in the world and in healthcare also which nobody can deny. However, the entire ecosystem of the IoT is questionable as it does not assure data security and integrity. The competition of IOT is day by day increasing and those who underestimate blockchain technology will be long left behind as the competition is going to become already stronger.

We explore IoT which has made lots of changes in the in the healthcare industry and how it is improving the lives of so many people worldwide.

Seeing all this we can surely predict that IoT has taken the reins and people are enjoying personalized attention for their major health requirements Such as: –

Key trends that are pushing IoT adoption include: –

  1. They can easily tune their devices and to set the reminder for them of their appointments, calorie count, exercises, blood pressure variations, regular checkup and much more.
  2. Through IoT, now it is easy that doctors can use the real-time location & services and track the devices used for treating their patients. Even the Medical staff might keep the devices in out-of-sight areas which makes them difficult to find when another medical staff comes on the scene.
  3. Monitoring equipment can be tagged easily and with the unique sensors and it is easy to locate with IoT. Apart from real-time location services, there are IoT devices that can help in environmental monitoring as well such room temperature.
  4. With the invention of the Internet of Things, it is easy for clinicians to predict the arrival of patients who are recovering from an illness such as for instance in the Post Anesthesia Care Unit (PACU). They can also monitor the status of patients in real time.
  5. These devices will be capable of applying difficult algorithms and analyzing them so the sufferer or victim will receive proper attention and medical care. Through remote monitoring, patients can reduce the readmission in hospital

Challenges for secured IoT deployments

Existing web-based security technologies play quite a role in mitigating IoT risks; however, it is not enough to control the threats. Here, it is easier said than done for many reasons, and here are some of the challenges with IoT Deployments:

  • Many IoT Systems are incompetently designed and implemented, the diversity of technology sometimes leads to conflicting configurations
  • Limited guidance for management of IoT devices
  • The privacy concerns with IoT are not always readily evident
  • There is a lack of belief for authentication and authorization for most of the IoT devices

Let’s consider an example, suppose your X-ray machine is digitally connected via Wi-Fi and its internal wiring gets baked. The IoT platform will recognize this issue and automatically place an order, and you will get the replacements shipped to your address without even placing an order.

This is a supreme reason why IoT is furiously being considered worldwide. However, having a secure and functional IoT platform is the goal of every business. The current technical scope for the security of the IoT is limited and the devices are vulnerable to malware, the data security is limited to just an account name and a password.

How can blockchain address these challenges?

Blockchain technology carries the possibility of disrupting different industries and enabling trust-based new business models. Since blockchain technology is young and is being adopted very rapidly because of the trust and transparency it brings to the table.

When it comes to a secure IoT environment, the Blockchain healthcare innovation is the silver bullet which acts as the missing link to settle the much-needed privacy and reliability concerns. With blockchain, it is easier to track billions of IoT devices and effectively eliminate single points of failure thereby, establishing a more resilient IoT ecosystem. Making the data more private is possible with the cryptographic algorithms and prevents the entire network from the man-in-the-middle attacks.

Sharing Secured Information

The decentralized and autonomous attributes of the blockchain make it an ideal component of secure IoT solutions. In an IoT network, the blockchain solutions can keep an immutable record of the history of smart devices. The immutable blockchain health records are perhaps one of the key highlights of blockchain for IoT.

Blockchain powered IoT devices can leverage secure and trustless interaction between different devices in the network. The treatment of message exchange between different devices is similar to that of financial transactions in the blockchain.

Web security should be the foundation of all the IoT systems where all the data needs to be encrypted. At the development stage of IoT applications, an agreed interoperability must be encouraged in the system in order to meet the development standards. The healthcare blockchain solutions, therefore, provides unmatched collaboration, coordination, and connectivity for each element in the IoT ecosystem, making it the most disruptive technology in addressing the various flaws and shortcomings.