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7USE CASES FOR BLOCKCHAIN IN THE DEVELOPMENT OF DIGITAL HEALTH
CEFEROV CEFER XOSROV
Azerbaijan State Oil and Industry University, Baku, Azerbaijan
Abstract - Blockchain technology has emerged in the last decade, sparked the attention of several industries, including banking, government, energy, and health. This article gives an in-depth look at blockchain applications in digital healthcare. In actuality, ongoing research in this sector is moving at a breakneck rate. As a consequence, we have found a number of cutting-edge use cases for blockchain technology, including electronic medical data exchange, remote patient monitoring, drug supply chain, and so on. We also concentrated on identifying the limitations of explored approaches, and we concluded by highlighting some open research problems and future study areas.
Keywords: Blockchain, Healthcare, Digital Health
Introduction
Blockchain is a sophisticated technology that allows many parties to securely share and access data. This is a big difficulty in digital health, where patient data privacy and security are crucial, but enhancing quality of care requires increased coordination in patient data management across the healthcare system and the ability to apply analytics to population level medical data. In brief, blockchain can help digital health by making it easier to securely communicate data across widely fragmented healthcare systems with patient agreement.
Before delving into the use cases, it's crucial to understand what blockchain is for and what business benefits it now provides to organizations.
What is blockchain for?
One of the most difficult aspects of blockchain is discerning between true blockchain-based applications and hype. This is difficult to do since, aside from Bitcoin, there are just a few large-scale, real-world blockchain implementations.
Blockchain's most revolutionary proposition, delivered through a carefully balanced mix of very advanced cryptography and built-in incentives (in the form of Bitcoin or other crypto-tokens), is that it eliminates the need for a centrally controlling authority and instead distributes power across all participants within the blockchain ecosystem. Hence, in principle, it can eliminate the need for a third party to manage transactions between two entities that don't know or trust one other digitally, securely, and impartially. This works well in the Bitcoin ecosystem but has to be tested in other typical corporate situations.
One of the primary advantages of a decentralized system is that end users - particularly consumers, but also businesses - would have far greater transparency and control over how their data is utilized. One of the long-term goals of disruptive blockchain-enabled companies is to decentralize the data economy, reclaiming power from Google, Facebook, Amazon, and other companies that centralize large datasets for competitive advantage, and instead giving individuals and organizations control over how personal and proprietary data is used.
In addition to providing end users with greater access and control over their data, blockchain's built-in payment mechanisms may allow them to sell it in return for crypto-tokens. To make all of this function quickly and autonomously, AI is used to select useful data sets and link merchants with buyers on top of the blockchain monitoring ledger.
This concept is still more theoretical than actual, and it may take a decade or more to materialize, if at all. However, over the last few years, blockchain has worked through its early growing pains, such as poor user interfaces, scalability issues, and the need for greater privacy to protect enterprise IP, and has proven to solve real but far more specific issues related to data reliability and accessibility.
What does blockchain do well?
• Tracking / registry: Capturing information and data in an immutable and transparent manner, so that no party has unequal authority over the data.
• Data access / transfer: Facilitating data transfer across numerous parties in order to create a shared source of "truth."
• Identification / authentication: Handling identities and permissions for authentication or verification, including the ability to validate identity attributes without revealing sensitive information.
• Settlements: Recording the movement of goods/revenues or the usage of services/assets to settle revenue.
• Transactions: Allowing (real-time) payments and transactions.
• Token exchange: The trading of virtual currency/tokens with intrinsic value between different parties. Virtual currencies can also be tied to fiat currencies, with escrow accounts holding similar values.
Supply chain transparency
Ensure the provenance of medical supplies to validate their validity is a key problem in the healthcare industry, as it is in many others. Utilizing a blockchain-based system to monitor commodities from the point of manufacture and at each level of the supply chain provides customers with complete visibility and transparency of the goods they are purchasing.
This is a critical goal for the business, particularly in emerging economies where counterfeit prescription drugs kill tens of thousands of people each year. It is also becoming increasingly critical for medical equipment, which are growing rapidly with the introduction of more remote health monitoring and, as a result, drawing the attention of bad actors.
MediLedger is a notable example of a blockchain system that allows organizations along the prescription medication supply chain to validate the legitimacy of medicines, as well as expiration dates and other critical information.
Major advantages of blockchain (when used with AI):
Consumer trust: The ability to trace each package's end-to-end origin, including integration with manufacturers, wholesale, shipping, and so on.
Compliance: Medical device and pharmaceutical businesses incur significant reporting obligations to maintain patient safety, therefore collecting supply chain data into a single system helps ease compliance - For example, FarmaTrust's blockchain-based technology notifies law enforcement when an issue is detected.
Optimisation of the supply chain: Companies use AI to better estimate demand and optimize supply once all of the data is in one place.
Outside of financial markets, one of the most advanced use cases for blockchain is supply chain management and transparency, such as the high-profile collaboration between IBM and Walmart to assure food safety in the supply chain. We anticipate that, because the technology and ROI have already been shown, this will be the most important short-term impact of blockchain on the healthcare business.
Patient-centric electronic health records
Every country and region's healthcare systems are dealing with the problem of data silos, which means that patients and their healthcare professionals have an incomplete perspective of their medical history. In 2016, Johns Hopkins University presented data indicating that medical mistakes originating from poorly coordinated treatment, such as planned activities not executed as intended or errors of omission in patient records, were the third largest cause of mortality in the United States.
One potential answer to this challenge is to develop a blockchain-based medical record system that can be integrated into existing electronic medical record software and serve as a centralized, unified version of a patient's information. It is critical to highlight that real patient data is not stored on the blockchain, but that each new item added to the blockchain, whether it is a physician's note, a prescription, or a test result, is transformed into a unique hash function - a tiny string of letters and
numbers. Every hash function is unique and can only be deciphered with the approval of the person who owns the data - in this example, the patient.
A complete single source of truth for a patient's medical records, resulting in a superior patient and healthcare provider experience.
They allow people to know when their medical records are updated and to grant explicit authorization when they are shared with healthcare professionals or others. Patients can also opt to share their medical data (or portions of them) with researchers and establish time limitations on how long any third party can access their medical information.
Medical insurers may obtain rapid, confirmed confirmation of healthcare services directly from patients, saving time and money.
The advent of considerably more comprehensive, digitized, and shared patient health records will have a significant influence on the healthcare business by fueling more complex analytics. Personalised medicine, for example, is a promising topic, but its progress is hampered by a scarcity of high-quality data. Access to more reliable and widely available population level data would allow for far more robust segmentation and analysis of targeted treatment results.
Smart contracts for insurance and supply chain settlements
Pharmaceutical companies, medical device OEMs, wholesalers, insurers, and healthcare providers, for example, can authenticate their identities as organizations, log contract details, and track transaction of goods and services, as well as payment settlement details for those goods and services, using blockchain-based systems provided by companies such as Chronicled and Curisium. This environment extends beyond supply chain management to allow trading partners and insurance providers in the healthcare sector to work on entirely digital and, in some circumstances, automated contract terms.
They can significantly reduce disputes over payment chargeback claims for prescription medicines and other goods by having shared digital contracts between manufacturers, distributors, and healthcare organizations logged on a blockchain ledger, rather than each player having their own version of contracts. According to Chronicled, approximately one million chargeback claims are filed between these players each year, with more than 5% of them being challenged and needing long human adjudication.
Similarly, shared smart contracts may be used to manage medical insurance contracts for patients, where 10% of claims are challenged, according to Curisium. Insurance providers, as in other use cases, may utilize more advanced analytics to optimize health outcomes and costs if this data is digitized and freely available.
Medical staff credential verification
Similar to tracking the provenance of a medical good, blockchain technology can be used to track the experience of medical professionals, where trusted medical institutions and healthcare organizations can log the credentials of their staff, thereby assisting healthcare organizations in streamlining the hiring process. ProCredEx, located in the United States, has created a medical credential verification system based on the R3 Corda blockchain technology.
The following are the primary advantages of the blockchain system: Faster credentialing throughout the employment process for healthcare organizations A chance for medical institutions, insurers, and healthcare providers to monetize their existing credential data on previous and current employees.
Transparency and assurance for partners, such as organizations that subcontract locum tenens or in new virtual health care models to tell patients about medical staff experience IoT security for remote monitoring
One of the most significant developments in digital health is the usage of remote monitoring systems, in which various sensors tracking patients' vital signs are utilized to provide healthcare practitioners with more insight into patients' health, allowing for more proactive and preventative care. Many intriguing remote monitoring use cases have previously been discussed in our articles on 5G and edge computing in digital health.
Nevertheless, security is a major concern in health IoT, both in terms of ensuring that patient data is private and safe, and that it is not manipulated with in order to provide misleading data. In some scenarios, when a connected device may be relied on in an emergency situation, such as informing an elderly person's caregiver that they have had a fall or a heart attack, it is also critical that the supporting systems are highly resistant to DDoS or other service disruption attacks.
How blockchain technology may aid in the security of remote monitoring IoT devices: Blockchain cryptography guarantees that only authorized parties have access to personal data, which is saved as a unique hash function on the blockchain (any change in the source data will create a different hash function, and a user must have a specific set of cryptographic keys to decode the hash function into the source data)
Once patient data is recorded on the blockchain ledger (as a hash function), it is almost hard to tamper with since access to all stored copies is required.
While blockchain might improve IoT security in healthcare, many use cases are still in the early phases of research, and it is unclear if blockchain will be the appropriate tool to deploy. Blockchain is worth investigating for digital health organizations looking into how to secure the security of remote monitoring devices, but only as part of a far more complete end-to-end security plan.
Conclusion
The current study provided an overview of Blockchain application cases in digital healthcare. Moreover, due to the exponential expansion of this technology, blockchain has been used in a variety of use cases to improve the automation of medical services.
According to our findings, the bulk of blockchain-related studies in healthcare are focused on exchanging Electronic Health Records. Blockchain researchers should do further study in areas such as biomedical research, pharmaceutical supply chain, and insurance. Additionally, we discovered that articles seldom address implementation specifics.
Although though blockchain technology has potential aspects, more study is needed to properly comprehend, develop, and assess this technology in an efficient and safe manner. Continuing efforts are being made to tackle scalability, security, and privacy issues in order to raise stakeholder trust in utilizing this technology and expand its adoption in healthcare.
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