I had the pleasure to talk about the blockchain technology in healthcare at ICEEFest 2017 in Bucharest, Romania. Find more information about the event here: http://www.iceefest.com
Full transcript of the talk:
Trust is the key to our economic and financial system. It is the single most important element that allows individuals to interact and trade.
Eleven thousand years ago with the emergence of a system of bartering, the first men and women started exchanging goods. Back then, people would trade with other people within their tribe who they knew and trusted. But, as the population grew, it became harder and harder to know personally and trust everyone. Moreover, humans went from trading objects to exchanging all types of assets. Therefore, people eventually started calling on middleman like banks or governments to protect their interests.
But what happens when such third parties shatter the trust we placed in them?
Issues of trust started a long time ago but the 2008 financial crisis was the last straw. Trust not only in banks and other financial institution, but also in government third parties and big corporations hit rock bottom. It was at this very moment that an anonymous person or group of people known as Satoshi Nakamoto published a whitepaper describing a peer-to-peer electronic cash system using the new cryptocurrency Bitcoin. While you may already be familiar with Bitcoin, you may not be familiar with the technology required for it to work: blockchain.
Blockchain is a technology that stores information in a network of personal computers called nodes. For this technology, there is no central entity like a bank or the government controlling it. The system is distributed which means that all the computers in the network store the same information
Imagine the blockchain as a big public ledger that lists all transactions that have been executed between two parties. Each transaction is timestamped and immutable. Once you record a transaction, you cannot go back and change it or cancel it.
The people in the network, called miners, verify and add the transactions to the ledger. To do so, the miners enter the transaction information as a “secure hash algorithm”. This algorithm creates a unique output, or “hash”. What is important is that only the hash appears on the public ledger and not the transaction information, insuring privacy. Each new hash added to the ledger is stored in a block and each new block created is linked to the previous one, creating a chain.
Of course, Blockchain can store more than just a list of transactions. It can also provide proof of existence for any document such as audio files or images. As any change in the content of the document results in a completely different hash, this technology helps proving that no alterations have been made.
In short, the power of blockchain lies in the fact that it can prove that an unique event occurred at a certain time. This event can be a financial transaction or the creation of a certain document with a specific content.
Now, this characteristic makes it a valuable tool in several industries like health care.
There are many use cases for blockchain in healthcare for one main reason: insuring trust in the medical community, in researchers or in the pharmaceutical industry is essential to leverage scientific progress and improve the quality of care.
As we have a short time, I will only describe to you one of the use cases. I will more than happy to discuss other use cases afterwards with those of you who are interested.
Let me introduce this use case by presenting you a problem I believe you have all faced:
When you arrive at a new hospital, even in a critical state, most doctors have to run all the tests again, even if their colleagues from other hospitals have already done so previously. There is no way for them to retrieve the information. This results in a loss of time and money.
When it comes to medical data, there is one main issue in the healthcare sector: the lack of interoperability.
Whether it is the medical or scientific communities, they both lack access to information. What is more, when they finally find it, it is difficult for them to find the patient and obtain consent to use said data.
But what if each time medical information is produced we could register it on a ledger? And what if the ledger was public and accessible to doctors, researchers, pharmacists, and nurses? Finally, what if we would create a system that would only deliver access to the information if the patient gives his or her consent? Well all this is possible with blockchain.
This is how it could work, step by step:
- Healthcare providers collect information from the patient such as name, date of birth, procedures performed, prescriptions, etc.
- The data is stored in the organization’s existing secured databases.
- A hash is created from each source of data and is redirected to the blockchain along with the precise location of the original files.
- The patient decides who has access to his medical records.
- Healthcare stakeholders can query the blockchain that provides them with the location of the information.
You are probably wondering how exactly we can create and manage access to medical records. This answer is simple: through smart contracts.
Smart contracts are contracts written as code into the blockchain. When a triggering event it hit, the contract executes itself according to the codes terms.
The first advantage of this technology is that it allows the patient to control the access he gives to his medical records. In fact, all this will be done through an app or a website and the patient will just set the conditions on his profile. This can solve the trust issue in the healthcare industry.
The second advantage is that the blockchain can act like a catalogue which lists a patient’s entire medical history. This means that if a patient arrives at a new hospital, the doctors could immediately know what test he or she has already done and, with their consent, access the results.
As you can see, blockchain technology can radically change the way we envision our health care system. It can bring trust, interoperability and security. In fact, many big corporations such as Philips are already working on projects around blockchain.
However, I see too many people, myself included in the beginning, trying to use blockchain for anything and everything. Don’t forget that you don’t shape a problem to fit a technology. You start from the problem and then you analyze which technology is better suited to solve it.
We have a big advantage in this country, in Romania. Unlike in France, the country in which I currently live, and where the same health system has been running for years, here we have the opportunity to start everything from scratch and build a modern, efficient and patient-centered system. It is a unique opportunity that cannot wait.