Healthcare Blockchain: Securing Medical Data & Improving Trust
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Blockchain technology in the healthcare sector is also being considered in India as an attempt to safeguard health information and overcome issues related to lack of trust associated with centralised databases. In terms of large-scale health database breaches, the following scenario is often typical: one central database with millions of medical records, and one attack that reveals all information at once; this becomes more likely in light of further expansion of India's healthcare into the digital sphere. Blockchain technology provides a totally new method for the storage of such information based on the notion that there shouldn't be one central institution or server that holds the whole record of a patient's health information. The article describes how blockchain technology works in healthcare, where and how it is tested in India, and what its limitations are.
What is Healthcare Blockchain?
The technology of blockchain in healthcare is a system based not on one database but rather on multiple distributed nodes whose changes in the data stored there are cryptographically authenticated. The nature of the system is such that changing the information on one node without all other nodes recognising this change as a violation is almost impossible.
The use of the system for storage of the patient's data means that instead of the traditional practice of storing it at one place in a hospital server, the information will be stored on a network of distributed nodes with a chain of all changes to the information.
Moreover, blockchain technology allows creating so-called smart contracts that are programs performing their tasks once the predetermined conditions are fulfilled. For example, a patient's consent can grant a specialist 24-hour access to the patient's scans, after which it is automatically revoked without any need for manual control of the process by the hospital personnel.
Current Scenario in India
Research on healthcare blockchain in India has been driven by the ongoing digitisation initiatives in the country’s health care system. Studies on blockchain implementation in health data sharing have considered the integration of the technology with the country’s national digital health system architecture to enhance interoperability with patient-controlled access.
In another separate study that has considered adoption in hospitals in several Indian states, increasing awareness about the technology has been reported among doctors, patients, and administrative authorities even though implementation at a large scale is not yet possible.
Certain academic research papers have taken this one step further by suggesting lightweight cryptographic schemes for body area or wearable sensor-based health monitoring systems.
Key Use Cases
Decentralised electronic health records are among the most debated applications. Rather than storing a patient’s medical records within a single hospital’s closed system, it enables a patient to take along a validated copy of his/her records without having to depend on a single entity for storing and verifying those records.
Another domain of application is insurance claims automation, where smart contracts enable an automatic payout of claims once the pre-defined criteria, such as diagnosis or completion of a procedure, are satisfied. This is expected to minimise fraud and also make claim payments faster.
Another area in which blockchain applications have been proposed and piloted is telehealth data sharing and clinical trial/supply chain tracking. In the growing telehealth sector of India, it is being tried to see how it can help in transferring patient data between different healthcare providers who might not be on the same hospital system and also the clinical trials/pharmaceuticals supply chain tracking sector.
Advantages
The main advantage of using blockchain in the healthcare industry is reducing single points of failure. The data in blockchain is not stored in a single location; therefore, even when a breach occurs in one of the nodes, it will not automatically result in an exposure of the entire data, which is contrary to a traditional centralised database of a hospital.
The second advantage is the ability to control access to one's data. The system allows one to have more control over who accesses the data and the period during which the access is granted.
The last advantage is related to the process of filing insurance claims. This process can be automated through smart contracts to shorten the time of processing the claim and avoid the filing of fake claims.
Constraints
The problem with endpoint security persists. Even if it is impossible to tamper with the ledger itself, the endpoints, whether they be a device of the patient, a storage solution in the hospital not based on the chain, or a buggy smart contract, are still as vulnerable as any digital system despite the inherent security of the blockchain.
Key management is another practical issue to consider. Being locked out of your private key means being locked out of your health information, but while there are attempts to integrate recovery solutions through a contact person or healthcare proxy into such systems, it is still an unsolved problem in the whole industry.
Finally, there are various estimates regarding market sizing for blockchain technology in healthcare, all of which differ greatly depending on the research company. However, what is known for sure is that the underlying trend fueling the growth is the increase of data volumes and their trustworthiness, along with regulatory pressure.
Future Prospects
If blockchain is going to be used for scaling healthcare in India, then there is a possibility that it is going to be used together with the already-existing digital health infrastructure that the country possesses, rather than creating a separate parallel system for the storage of information about the records of the patients and the hospitals.
The continuous academic and pilot-stage research shows the growing interest in the technology among various use cases like claims automation and wearable device security, although the implementation of blockchain technology in hospitals is not that advanced yet compared to the market forecasts.
It will be seen whether blockchain technology will become one of the layers of the digital health ecosystem of India, or it is going to be used only in some particular use cases like claims processing and supply chain management.
Stay tuned for more such updates on Digital Health News
