Blockchains

Blockchains

What is a blockchain? 

▪A growing list of records, called blocks, which are linked sing cryptography
▪Each block contains a cryptographic hash of the previous lock, timestamp, and transaction data
▪Invented by Satoshi Nakamoto in 2008 to serve as the public transaction ledger of the cryptocurrency bitcoin

▪Three main components: a distributed network, a shared ledger and digital transactions 

Characteristics of a blockchain

▪      An open, distributed ledger that can record transactions between two parties efficiently and in a verifiable and permanent way

▪      Is resistant to modification of the data

▪      Once recorded, the data in any given block cannot be altered retroactively without alteration of all subsequent blocks

Uses of blockchain

▪      Cryptocurrencies -  Eg: bitcoin network and Ethereum

▪      Smart contracts - proposed contracts that could be partially or fully executed or enforced without human interaction

▪      Banks

▪      Other uses -  insurance industry, Tezos (decentralized voting), Quorum (a permissionable private blockchain by JPMorgan Chase with private storage, used for contract applications), Proof of Existence (an online service that verifies the existence of computer files as of a specific time),  Facebook

A Blockchain Model For Health Care

▪      Any blockchain for health care would need to be public

▪      Need to include technological solutions for three key elements:

–   Scalability

–   access security

–   data privacy

Scalability

▪      A distributed blockchain that contains health records, documents or images would have data storage implications and data throughput limitations

▪      Because health data is dynamic and expansive, replicating all heath records to every member in the network would be bandwidth intensive, wasteful on network resources and pose data throughput concerns

▪      So all medical data would be stored off blockchain in a data repository called a data lake

▪      Data lakes are highly scalable and can store a wide variety of data, from images to documents to key value stores

▪      Data lakes are valuable tools for health research and would be used for a variety of analysis including mining for factors that impact outcomes, determining optimal treatment options based on genetic markers and identifying elements that influence preventative medicine

Access Security and Data Privacy

Technical Advantages of a Health Care Blockchain

•      Blockchain is based on opensource software, commodity hardware, and Open API’s. These components facilitate faster and easier interoperability between systems and can efficiently scale to handle larger volumes of data and more blockchain users

•      Allows patients, the health care community and researchers to access one shared data source to obtain timely, accurate and comprehensive patient health data

•      Blockchain works with standard algorithms and protocols for cryptography and data encryption - heavily analyzed and accepted as secure and are widely used

Health Care Advantages of a Health Care Blockchain

•      Delivers a broad diverse data set by including patients from different ethnic and socio-economic backgrounds and from various geographical environments

•      Collects health data across a patient’s lifetime, it offers data ideal for longitudinal studies

•      Easier to engage “hard-to-reach” populations and develop results more representative of the general public

•      Improves individualized care with specialized treatment plans based on outcomes/treatment efficacy

•      Ensure continuous availability and access to real-time data

•      Facilitates continuous, 24 hour-a-day monitoring of high risk patients and drive the innovation of “smart” applications that would notify care givers and health providers if a patient reached a critical threshold for action