Answer to World’s Most Challenging Problem: “Autonomous” Healthcare
By Gagan Sachdeva on ALTCOIN MAGAZINE
In a September 2017 Lancet Global Health editorial, Tedros Adhanom Ghebreyesus, DirectorGeneral of the World Health Organization (WHO), called UHC an ethical question, asking: “Do we want our fellow citizens to die because they are poor?
At least half the world’s population still lacks access to essential health services, and two billion people cannot access the medicines they need. This is more than one in every four people worldwide. At the same time, the global cost of healthcare by 2013 had jumped to over USD 7.35 trillion. Almost 100 million people are pushed into extreme poverty each year because of out-of-pocket health expenses.
While the world is still focused on making efforts to make autonomous cars and staying forever young, we have somehow forgotten about solving the fundamental need of offering quality and cheap healthcare facilities to all humankind. Limited access to healthcare poses a significant barrier to long-term social and economic development around the world.
Healthcare problem is more of supply-side and access issues rather than demand. E.g., according to the Indian Journal of Public Health, India has a ratio of 5 doctors per 10,000 people. It will take ~600,000 doctors and 2.5 million nurses to reach the minimum level recommended by the World Health Organization.
To solve this problem, we need to build infrastructure around laying an ecosystem which is beyond barriers of a single nation or Medical Institute. Imagine a world where the world’s healthcare data (including medical reports, Imaging data, scans, diagnostic reports, medical prescriptions, etc.) are stored in a decentralized ledger. This database which I call “Heart of Health” or “HoH” would be the repository of all the captured information and will act as the Golden or Master storage platform.
With the advent of Blockchain technology and zeitgeist of cryptocurrency, this HoH storage platform can be autonomous, decentralized, financially self-sustainable and economically viable.
On user side, private institutions/governments or WHO can be place computer systems or smartphones (maybe along with IOT devices) which will be connected to the HoH platform, and the platforms can act as a guidance system to primary healthcare facilities (to begin with Phase 1) that lack good doctors or advance detection facilities.
The setup centers will be self-sustainable due to the enablement of “Ethereum” contracts and capabilities of cryptocurrencies which can tokenize the information. Example: Initially when the record is created, the encryption key is only available to the patient but the encryption key needs to be shared with a physician so that he/she may review the case. Hence we need to use “asymmetric” encryption where keys come in pairs. What one key encrypts (public), only the other can decrypt (private). Fortunately, every Ethereum user already has a set of public and private keys to interact with the blockchain. Ethereum uses elliptic curve cryptography with the secp256k1 curve. The same keys can be used for asymmetric encryption of patients’ healthcare data.
We have seen in the past how IBM and Google have leveraged Artificial Intelligence technology to unlock vast amounts of health data and power diagnosis. IBM Watson and Google’s DeepMind Health have shown the world the real potential of using technology and a vast amount of data. This solves two major issues 1) It offers superior and quality guidance to patients who have to travel miles to reach a decent hospital in developing countries 2) It helps to develop a peripheral ecosystem of drug suppliers, diagnostic center’s who can invest on facilities in these area bases the exact needs, saving them ton of time and money
Blockchain has the potential to offer this solution in healthcare because it is:
- Decentralized: Copies of the database are kept in multiple places and no third-party needs to exist as an administrator. This reduces overhead and the need for middlemen (which healthcare has in spades)
- Consistent: With Blockchain, data can’t differ across databases because there is one single record. This reduces issues with duplicate or tampered data and makes the data itself much more accessible, rather than trapping it in different organizations’ record-keeping systems.
- Append–only: Users can only add transactions to a database, making everything traceable and auditable
- Ownable: Patients can “own” data and choose who gets to access it. Instead of a company selling someone’s data to a third party, that person can control where their data goes
Some Challenges to implementing blockchain
- Lack of data standards means blockchain projects are being worked on in siloes. Interoperability will help solve this problem in a big way. A lot of companies like Cosmos or Polkadot are currently engaging to build these solutions
- New cryptography techniques — like zero-knowledge proofs, homomorphic encryption, and secure multi-party computation — allow computation to be performed on data that are encrypted. This means that sensitive information can still be used without actually being exposed.
- Better data access models can incentivize patients, hospitals, etc. to monetize their digital assets (e.g. patient data)
Blockchain technology and distributed ledgers have real potential for healthcare especially for people sustaining at the bottom of the pyramid.