Blockchain and its Applications in Medicine

Alicia Tran—McMaster Software and Biomedical Engineering, 2023

With the fast rate at which technology is developing during today’s day and age, many novel digital solutions are making their way to solve problems in new contexts. Blockchain is one such buzzword being thrown around in recent years.

A Surface-Level Look

The main characteristic of a blockchain system is the distribution of data in a peer-to-peer network rather than through a centralized server (1). Due to its numerous features and advantages, it is especially desirable for use in implementing cryptocurrency systems, its most well-known application, the process of which is shown below.

What’s the Big Deal?

As mentioned in the example above, data in the blockchain is immutable, meaning it cannot be changed, due to sheer amount of computational power that would be required to change data in all nodes of the network (2). This immutability leads to many advantages of the blockchain, namely, but not limited to, traceability, integrity, and security (3). As the data cannot be changed, transactions can be tracked through the system. In addition, the system verifies the authenticity of transactions against all data sources throughout the blockchain network, reducing likelihood of fraud (3). Lastly, the very nature of a decentralized system results in no single data source for malicious users to target (2).

Uses in Healthcare

There are many opportunities to implement blockchain the health sector. The main requirements of any health-related system being developed today are security and data sharing (3). Medical information is bound by Health Insurance Portability and Accountability Act of 1996 (HIPAA) and thus needs to be secure to ensure patient privacy (4). On the other hand, patients may wish to have access to their own data and physicians may need to share information with other doctors should a patient require expanded care, so it is imperative that information can be shared only with those permitted access (3). By leveraging the security and mobility of a decentralized blockchain system with many data sources, this general problem can be solved with the use of smart contracts, whereby records can only be accessed if users have the required signatures (or keys) (2).

Through this system, MedRec, developed as part of the digital currency initiative at MIT Media Lab, seizes on the opportunity for interoperability in healthcare systems by having a decentralized hub of medical records of which all healthcare providers would have access (5). Smart contracts are used to map patient-provider relationships, with a contract containing a list of references detailing the relationships between nodes (patients and healthcare providers) (5). This allows the patient to accept, reject, or modify relationships with healthcare providers, putting themselves in control of their own information (5).

Uses can also become more niche. In the case of clinical trials, it can be used to maintain a log of patient consent. Due to the immutability of data in the system, one can easily monitor trial standards and prevent falsification of consent forms, thereby reducing clinical fraud and preserving the integrity of the data (5). A smart contract system would prevent study investigators from accessing patient information unless they are provided with consent at each stage of the trial (5).

Drug tracking is another avenue of blockchain application. It prevents theft and fraud by making use of the immutability of the system to track the chain of custody of pharmaceuticals, from when it is manufactured to when it is in the possession of a patient (5). The Counterfeit Medicines Project, created by Hyperledger, the Open-Source Blockchain Working Group tackles the problem of counterfeit pharmaceuticals by tracing and removing counterfeit medicine from the supply chain (5).

It is clear to see how blockchain has many uses outside of cryptocurrency, with which it is commonly associated. As the technology is further developed, it will no doubt continue to become more widespread in the healthcare sector.

References

1. Oderkirk J, Slawomirski L. Opportunities and challenges of blockchain technologies in Healthcare [Internet]. Organisation for Economic Co-operation and Development. 2020 [cited 2021Dec12]. Available from: https://www.oecd.org/finance/Opportunities-and-Challenges-of-Blockchain-Technologies-in-Health-Care.pdf
2. Huang X. Blockchain in Healthcare: A patient-centered model. Biomedical Journal of Scientific & Technical Research [Internet]. 2019Sep27 [cited 2021Dec11];20(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764776/
3. McGhin T, Choo K-KR, Liu CZ, He D. Blockchain in healthcare applications: Research challenges and opportunities. Journal of Network and Computer Applications [Internet]. 2019Jun1 [cited 2021Dec11];135:62–75. Available from: https://www.sciencedirect.com/science/article/pii/S1084804519300864
4. (OCR) Office for Civil Rights. Summary of the HIPAA security rule [Internet]. HHS.gov. 2021 [cited 2022Jan11]. Available from: https://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/index.html
5. Bell L, Buchanan WJ, Cameron J, Lo O. Applications of blockchain within healthcare. Blockchain in Healthcare Today [Internet]. 2018 [cited 2021Dec11];1. Available from: https://blockchainhealthcaretoday.com/index.php/journal/article/download/8/29&hl=en&sa=X&ei=f7ehYZPYMIGEmgGSwISoAw&scisig=AAGBfm0Crm9y6UcKNWw50TQDjdIvrx-R4A&oi=scholarr