Counterfeit Industry rescued by Blockchain?
Take a second to really internalize this: your child is suffering from some fatal disease, and you’re worried you might lose your child. But you feel somewhat relaxed because you bought medicine for your child that you are sure will help because it was prescribed by the topmost and trusted doctor in your city. Fast forward to a few weeks later, and you continue to pray that your child gains health again. In fact, the opposite occurs. Your child got sicker as weeks went by. How could this be? Turns out the “best doctor in the city” gave you “medicine” that was not authentic, and was fake. This results in your child passing away.
Chances are most of us living in developed countries didn’t feel as huge of a connection to this because we either thought that 1. it isn’t a big issue where we live, or 2. it isn’t even a reality. But the truth is that this is actually an issue in countries like Canada and the U.S. and is a constant reality especially for people living in India or Africa.
Before we move forward to solve some of the worlds most important issues like Cancer, we first need to make sure that there is transparency, equal care, and safety in terms of the medicine being produced and sold to everyone. So if you weren’t already aware, welcome to the world of Counterfeiting:
The World of Counterfeiting
According to the new research of the World Health Organization (WHO) “1 in 10 medical products circulating in low and middle-income countries is either low-grade or apocryphal. In specific areas in India, fake medicine results in 30–40% at most of their medicine. That’s ALMOST 50%.. I mean almost but still!!! Imagine going to the store, and thinking that the medicine you are about to purchase has a 1/2 chance of killing you or helping you.
In Canada and the U.S., 40% of our medicine comes from outside areas, and 80% contains some sort of ingredients and compounds from outside areas. Controlling the movement of these medicines from our borders is actually very hard to control.
The counterfeit medicine market is now responsible for around 1 million deaths per year, in an industry estimated to be worth $80bn annually. In fact, the counterfeit medicine industry is estimated to be growing at twice the rate of legitimate pharmaceuticals, making it up to 25 times more lucrative than the global narcotics trade.
So it’s obvious this is a huge issue and so you might be wondering why it hasn’t been resolved yet. Because we currently have a week regulatory system and it just sucks.
Why hasn’t the problem been addressed so far?
Until recently, tracking the manufacture and supply of legitimate goods versus counterfeit ones had been near impossible. Not to mention the lack of enforceability over cyber crime and theft of IP. We have a really week regulatory system in place, but it makes sense because tracking such a think is nearly impossible with our current approaches.
But think about this:
What if we could track, trace and authenticate the drugs at each stage of their journey from the pharma company all the way to patients, AND create an HL7 messaging system where patients and doctors can directly prescribe medicine online and follow along with the journey. A collaborative, safe and transparent app.
How could we do this?
Overview: The Supply Chain
The first, and most obvious solution provided by the blockchain is a redesign of the supply chain through it’s decentralized ledger, that is able to store a complete history of transactions on a shared database, means that we can trace a products movements across the world.
As well, with innovations, we can now track every link in the supply chain, from the manufacturer, to the distributor, to the customer, to a network that can prove the origin of the product, trace its ownership, and provide authentication.
The most unique attribute is that anyone can track information in this ledger from anywhere in the world using a smartphone which really ensures that the consumer at the end of the supply chain is receiving the product they expect to. This also places power back into the hands of the consumer, who can access the same information as retailers, transforming their understanding of the product, its origins, and the manufacturing process- allowing for more informed, and ethical, consumer choices.
For example, Walton Chain is a blockchain based company whose supply chain solution combines RFID tracking technology with the immutable and decentralized nature of the blockchain, to create real transparency and efficiencies in business for retail. They have chips which are embedded in such an item of clothing, and can constantly feed information and updates back into the blockchain- allowing for garments and products to be completely traceable, create an immutable record of all transactions.
On a high level:
- The manufacturer would produce the drug and mark it with a unique code (Unique Micro QR Codes?), which will be connecting to the Blockchain.
- The Wholesaler verifies the origin of the product, making sure the code on the code and Blockchain match up.
- Pharmacist and Consumer then also verify this, ensuring full transparency.
But first… what exactly are distributed ledgers?
Distributed ledgers use nodes to record, share and synchronize transactions in their respective electronic ledgers instead of keeping data centralized. Blockchain organizes data into blocks, which are chained together in an append-only mode.
The Main Components of Hyperledger Frameworks are:
- An append-only distributed ledger
- A consensus algorithm for agreeing to changes in the ledger
- Privacy of transactions through permissioned access
- Smart contracts to process transaction requests.
There are various different types of hyperledger frameworks that can be used for this purpose. Each one has its own unique abilities/benefits:
Hyperledger Framework 1: Iroha
Hyperledger Iroha is a simple and easy to incorporate into infrastructure projects requiring distributed ledger technology. Hyperledger Iroha emphasizes mobile application development with client libraries for Android and iOS, and complements Hyperledger Fabric and Hyperledger Sawtooth, while providing a development environment for C++ developers to contribute to Hyperledger.
Hyperledger Framework 2: Sawtooth
Contributed by Intel, it is a blockchain framework that utilizes a modular platform for building, deploying, and running distributed ledgers. Distributed ledger solutions built with Hyperledger Sawtooth can utilize various consensus algorithms based on the size of the network. For example by default, it uses the PoET consensus algorithm, which provides the scalability of the Bitcoin blockchain without the high energy consumption. PoET allows for a highly scalable network of validator nodes.
Hyperledger Framework 3: Fabric
Hyperledger Fabric provides a modular architecture, which allows components such as consensus and membership services to be plug-and-play. Hyperledger Fabric allows entities to conduct confidential transactions without passing information through a central authority through different channels. It is important to remember that, unlike Bitcoin, which is a public chain, Hyperledger Fabric supports permissioned deployments.
Hyperledger Framework 4: Indy
Hyperledger Indy is a distributed ledger purpose-built for decentralized identity. Hyperledger Indy’s goal is to achieve this by developing a set of decentralized identity specs and artifacts that are independent of any particular ledger and will enable interoperability across any DLT that supports them.
Hyperledger Framework 5: Burrow
Currently, under incubation, Hyperledger Burrow is a permissible smart contract machine that provides a modular blockchain client with a permission smart contract interpreter built- in part to the specification of the Ethereum Virtual Machine (EVM). It is the only available Apache-licensed (open-source EVM implementation.
The major components of Burrow:
- The Gateway: interfaces for systems integration and user interfaces
- The Smart contract application engine: the integration of complex business logic
- The Consensus Engine serves the purpose of:
a. Maintaining the networking stack between the nodes. Ordering transactions
- The Application Blockchain Interface (ABCI) provides interface specification for the consensus engine and smart contract application engine to connect.
HL7 Messaging Integration
HL7 messages transmit data between disparate systems. An HL7 message consists of a group of segments in a defined sequence, with these segments or groups of segments being optional, required, and/or repeatable.
There are various different types of HL7 message types which defines the purpose for the message being sent and is present in every HL7 message. Message types are identified by a three-character code, and are used in conjunction with a trigger event. An HL7 trigger event is a real-world event that initiates communication and the sending of a message, and is shown as part of the message type. Both the message type and trigger event are found in the MSH-9 field of the message.
A HUGE ISSUE IN THE HEALTHCARE INDUSTRY IS INTEROPERABILITY ... WHICH CAN BE SOLVED BY HL7 AND BLOCKCHAIN INTEGRATION.
How it could work
When you usually go to the doctor's office, you would fill in information about your name, birth, and insurance company. All this data would now be on the blockchain app. All your doctor checkups and data will be updated regularly on here. If your doctor prescribes you medicine to purchase, this would also be updated on here and would be shipped to you. The same supply chain process will be used and we can also ensure that you are getting the right medicine, from a safe supplier recommended by your doctor.
Through this, we will be able to connect different doctors, institutions, and patients together but in a secure way where all data is securer than it could have ever been.
Defining an HL7 Message
Most commonly used HL7 message types include:
- ACK — General acknowledgement
- ADT — Admit, Discharge, Tranfser
- BAR — Add/change billing account
- DFT — Detailed financial transaction
- MDM — Medical document management
- MFN — Master files notification
- ORM — Order (Pharmacy/treatment)
- ORU — Observation result (unsolicited)
- QRY — Query, original mode
- RAS — Pharmacy/treatment administration
- RDE — Pharmacy/treatment encoded order
- RGV — Pharmacy/treatment give
- SIU — Scheduling information unsolicited
In our app, this integration will help to create a more collaborate platform which is safe, and transparent.
This is able to help with the process from start to finish. Meaning from when the doctor asks the patient to order a drug, and the patient does, to the production, shipment and receiving of the product. Everything will be verified and run by a smart contact which will ensure no tampering has happened in between the process.
Can Blockchain do it?
In 2014, it was revealed that fake pharmaceutical products imitating those created by Pfizer- one of the largest drug manufacturing companies in the world- were being sold in 107 countries! In a black market that is growing by 20% a year, and responsible for an increasing amount of fatalities, using blockchain solutions as a means of counterfeit protection can save millions of lives every year.
Over the next few weeks, I will be working with Dr. Sukant from India, one of the top researchers in the area, and an international team of helpers to continue researching and deploying my own app which will help to track, and detect Counterfeit Medicine but also create more collaboration in the healthcare system through HL7 messages integration, and an interface with many different languages of communication.
In my eyes, a blockchain is a mechanism that can restore trust between manufacturers and consumers by empowering consumers with more transparency, knowledge, and choice- and that is where the true power lies. I look forward to bringing this to life, and seeing what it can really do.
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