The Chain of Trust in Healthcare: Blockchain based cryptography system

Remember the famous 1993 cartoon by Peter Stein, published in The New Yorker , as it adequately sums up the inherent trust limitations with online commerce: “On the Internet, nobody knows you’re a dog.” What is needed is a blockchain based platform incorporating its immutable nature into Healthcare industry…

Commerce has for centuries relied primarily on two things, namely trust and verified identities. On a much more simple note, having complete trust on what is being exchanged, and who is it that’s participating and confirming it! Modern commerce and neo-classical economics have its roots in ‘mercantilism,’ or the trading activities professed by the Italian city-states fourteenth century and onwards. What was once a very direct and in-person transactional process is nowadays mostly conducted online and further necessitates commercial intermediaries. The simpleton requirement for entities such as governments, or banks, and other central authorities is in the verification of each transactional party’s identity, and for establishing requisite trust in-between them.

The basic theoretical concepts of commerce are still much the same, though the methods have grown exponentially complex and this need for intermediaries also translates into inefficiencies of decreased speed, increased costings and fraudulent activities. The privacy of transactional entities is also under threat, as the centralized storage systems of information are quite vulnerable to attacks and counterfeits.

Volatile to Transact Online

The Internet in the past two decades has revolutionized many aspects of business and society. Though the base mechanics of executing the transactional processes has not seen a relative upgradation as per modern scenario. The problem is not with doing transactions online, the problem with the conduction of seamless and reliable transactions online. Remember the famous 1993 cartoon by Peter Stein, published in The New Yorker , as it adequately sums up the inherent trust limitations with online commerce: “On the Internet, nobody knows you’re a dog.” What is needed is a blockchain based platform incorporating its immutable nature into Healthcare industry, as an effective means of countering the lack of trust, for validating the identity as well as with tracking capabilities that would eliminate the need for intermediaries in the medicare ecosystem. And as the volume of digital data proliferates in virtually every societal field, so do the associated risks with privacy and data security.

A Blockchain-enabled platform

Crossing the threshold here, Blockchain technology has been dubbed by technology experts and influential spokespersons as a Chain of Trust. The dynamic blockchain technology is capable of supporting next-generation transactional applications. It can lead to a much more streamlined business process by the establishment of trust, transparency and accountability, the essentials of modern day commerce. Blockchain can revolutionize the business processes by subjecting them to openness and utmost of efficiency, as would be expected from high-end technology in this Internet Era.

The healthcare ecosystem abounds multiple stakeholders tied together with intricate and sensitive interactions, leading to both data security as well as privacy challenges along-with massive operational inefficiencies. Blockchain has the potential to relegate both privacy and data access privileges back in the hands of citizens.

According to leading industry experts, the distributed and decentralized nature of blockchain facilitates a genuine, and a far more independent consensus than any other authority-based system. Take for instance: The bank or credit card could reject the transaction, thus leaving you at the mercy of a central authority that can go in and tinker with those numbers, making them appear or disappear magically. The Chain of Trust eliminates any and all such possibilities, due to the absence of a central database in blockchain technology.

Use Case: A Pre-Authorization Payment Infrastructure

The platform would assist in determining if a given medical expense or event is covered by the patient member’s insurance policy, as pre-authorization can be a slow process. Variables involved in here include the multiple stakeholders (consumer, care provider, care payer), the differing amounts covered also vary with the payer-provider relationship (in-network versus out-of-network). The timing of things is another critical component, and is based on the nature of medical issues the patient suffers from. In an ideal ecosystem, pre-authorization must persist through the full revenue cycle, ending with payment to the provider.

A healthcare provisioning platform based on blockchain technology would speed up the pre-authorization process. It will facilitate on-demand patient treatment, apart from ensuring accurate payments for the provider. Determining the healthcare benefits in real-time and networking are the major advantages here, as the blockchain ledger is shared among the stakeholders for timely accessibility.

Use Case: Counterfeit Drug Prevention and Detection

Globally, counterfeit medicines and fake drugs have a direct impact on the consumer’s health as well as the care provider’s liability. These “fake medicines” need to be eliminated from the marketplace, irrespective of their categorical impurity, namely contamination, lacking active salt bases or mislabelling.

The contemporary practice of storing all relevant information with a central authority is highly flawed as its liable for integrity compromises and corrupt malpractices such as fake documentation.

A cryptography based healthcare platform would ensure that all logistical movements are logged and duly certificated (signatory), establishing a complete life history of the shipped products as and when they entered into multiple business process systems. Further, due to blockchains’ anti-tampering capabilities in manufacturing, supply and allocation, would, theoretically eliminate any chances of drug counterfeiting.

Use Case: Clinical Trial Results

As a mandate, all publicly-funded clinical trial laboratories to submit complete research data including sample space of human subjects with the designated repositories. Presently very few research groups satisfy these criteria, and the rest simply ignore the accountability and furnish fake documentation. Further, storing exhaustive research data and medical records over long periods of time incurs considerable spending. In such cases where establishing the proof of existence and protecting the participant’s identity, the immutable data sets created via Blockchain technology can provide additional accountability and transparency for the clinical trial reporting processes. On an average, around 30,000 trials are published annually and the figure is expected to rise, thus rendering manual verification processes pretty much useless.

Generally a published study encompasses numerous clinical trials, and these can be curated within individual blocks and then published on the blockchain ledger. This imparts the much needed transparency and incentivizes research groups for uploading the links to negative data, in addition to the blockchain links that have the added advantage of being timestamped. Such an IT service can be extended to research institutions for maintaining dedicated project pages, listing all the past and current trials for future references. Promotional rewards program for publishing the latest and thorough updating of trial records via curated links and blocks shall further assist with synchronizing the dynamic platform and keeping it free of outdated records.

Next Generation Advances

The quick-paced developments in blockchain technologies are resulting in much speculation as to the exact strengths and capabilities of a blockchain enabled ecosystem. As the collaborative entities each using the blockchain do so in an independent manner, and the computer node verifies the accuracy of modifications, the copies, as well as all data transactions. The unique hashcodes associated with each transaction preserve the nature of every data and bit of information, upholding the trust of consumers, care providers, and care administrators.

Conclusion

Blockchain technology is poised to play an increasingly significant role in healthcare by ushering beneficial disruption and promoting efficacy for every stakeholder within the ecosystem. The next couple of years are instrumental for its success, as a widespread dissemination of the technology into all walks of life would result in a new generation of powerful, blockchain-based applications which would single-handedly shape the next era of commerce and healthcare.