Editor's note: This article comes from the eight-dimensional blockchain, author: eight-dimensional blockchain, published with authorization.

On September 13, Huashan Hospital Affiliated to Fudan University joined hands with Ant Financial to launch the country's first blockchain electronic prescription. Blockchain + medical care has entered a new stage again.

This technology can solve many problems such as accurate and unalterable prescriptions in hospitals, and the risk of re-prescribing patients with prescriptions outside the doctor's orders. In the future, patients only need to click on the Alipay Huashan Hospital Life account to see their illnesses. Doctors will prescribe prescriptions remotely, and patients will sit at home and wait for the medicines to be delivered to their door.

What kind of possibilities can blockchain + medical care collide with? Eight-Dimensional Capital compiled a Medium article on blockchain + medical care for readers.

In this article, my colleague Jorden Woods (co-founder of DoubleNova Group) and I discuss the benefits, opportunities, and challenges of applying blockchain and distributed ledger (DLT) technologies to the healthcare sector. We take a data-centric perspective, because data is at the heart of digital health—especially when it comes to data acquisition & storage, data security, and trust.

Today, digital health is largely based on electronic health records (EHRs). EHR promises that if we can better obtain patient data, the probability of medical accidents and medical costs will be greatly reduced, the safety of patients will be better guaranteed, and the treatment effect will be significantly improved. From a doctor's point of view, if a doctor can quickly obtain a complete record that includes the patient's specific conditions and medical history, he can provide a better and more cost-effective diagnosis and treatment. From the perspective of the patient, if the doctor has a more complete and comprehensive understanding of your condition and medical history, it will also virtually strengthen the bond of trust between the doctor and the patient.

However, at this point in time, it is still full of challenges to effectively obtain comprehensive patient data through the EHR system. In general, patient data remains fragmented for each healthcare stakeholder, as different stakeholders typically use different EHR systems. Interoperability issues often create data silos. In addition, the security protocols of many medical devices are very weak, so the centralized EHR system is often targeted by hackers. Hackers can steal millions of patient records or attack the system through ransomware, thereby Created a lot of chaos. Due to these security loopholes, many medical equipment companies are afraid of sharing or converting EHR systems. They are afraid that they will encounter more security loopholes, lead to negative media reports, and then lose public trust.

Because patient data is stored in the hands of diverse and fragmented stakeholders, it is difficult to share a comprehensive historical record. For example, cancer patients might store their CAT scan records in different labs, radiology notes in different radiologists, chemotherapy records in different hospitals, and other medical records and records in completely different Electronic forms of presentation (such as prescription files of pharmacies and medication compliance records provided by other companies, etc.). We must find a solution to enhance the trust of different stakeholders and increase interoperability by building a decentralized ecosystem.

Advantage

Advantage

Blockchain technology has three core advantages that can be directly applied in the medical field:

We describe these core strengths in detail below.

Super secure and immutable information storage

Ultra-secure information storage is what's needed in a healthcare world plagued by hackers and ransomware. When the potential of blockchain technology is fully realized, patients and doctors can freely share and exchange medical data without worrying about hacker attacks.

Putting medical data into a secure blockchain-based data warehouse has the added benefit of making the data more transparent. In the past, healthcare and billing fraud has cost tens of billions of dollars due to a lack of transparency in the healthcare sector. Since in the process of diagnosis and treatment, all medical expenditures and data of the diagnosis and treatment process can be encrypted and signed, the blockchain is expected to greatly reduce the probability of fraud and errors.

The blockchain-based system is expected to greatly enhance the trust among all stakeholders, because they will share a complete and identical medical history information. In the past, medical professionals had to make decisions based on relatively limited information, and patients had to rack their brains trying to remember their medical history, and they had to take the trouble to communicate the specific details of their medical history to doctors. Now, these are no longer necessary.

decentralized exchange

Since medical data can be distributed and synchronized to multiple subjects, from the perspective of data acquisition, expansion and security, the blockchain-based distributed ledger (DLT) infrastructure is better than the existing centralized system Much stronger. Moreover, the decentralized system can also simplify the cost structure, reduce the transaction time, and eliminate unnecessary middlemen and management fees, so that the cost performance is also higher.

Because of regulatory constraints, we may not be able to completely decentralize the healthcare system. However, some credible ecological players such as hospitals, insurance companies, clinics, laboratories, and healthcare information exchanges (HIEs) will still be important components to shape the new system, because they can all play the role of storing and processing patient data.

Embedded gamification

The tokenization of services and the application of tokens have created many new incentive mechanisms. We can use tokens to "pay" patients or other stakeholders in the ecosystem, thereby incentivizing them to do certain behaviors that are beneficial to the system . In a narrow sense, beneficial behaviors include ensuring system security or helping to process transactions, and these nodes will receive block rewards (consensus protocol rewards) for their contributions to the system. In addition, beneficial behavior in a broad sense can also be pursuing a healthier lifestyle (such as better eating habits, exercising, reducing bad habits) or sharing medical data with the medical community/pharmaceutical companies.

Chance

Chance

Above, we introduced the advantages of using blockchain in the medical ecosystem. In this chapter, we will highlight some specific application scenarios that have or are expected to generate huge benefits through the use of blockchain technology.

We believe that key data-centric application scenarios with great potential in the future include:

We describe these opportunities in detail below.

Personal Health Record (PHR)

For the blockchain ecology in the medical field, the most important element is PHR. It is a key part of the entire ecology, because PHR contains a complete record of each person's medical records, including diagnosis and treatment history and health data. If you make an overview of the patient's health information, it includes the following aspects:

• personal identification

• vital organs

• Family history

• medical condition

• drug

• Allergens

• immunity

• dietary restrictions

• genome data

The concept of PHR is not new, and many companies have tried to develop and promote their PHR products since 2000; however, due to the lack of security and interoperability issues, the actual implementation of the products has been hindered. And blockchain technology has the power to make secure PHR a reality. If users are willing to accept blockchain-based medical dApps and smart contracts on the mobile side, the large-scale global application of PHR products is expected to come true.

For compliance (such as HIPAA regulations), the ownership of each PHR is owned by the individual, because the personal data is their own. At the same time, most solutions propose that each individual has the right to decide whether others can obtain their data, and the extent to which they can obtain it, and can also charge for the behavior of obtaining data through smart contracts. In the blockchain community, there is a core idea that individuals have the right to control and sell all information related to their own digital identities. Some blockchain-based PHR solutions further propose that we can set a special digital address for each PHR, and the data in it is fully encrypted and signed by encryption, which can be applied to most EHR systems and has many advantages. Strong interoperability.

As long as you become an internal member of the blockchain ecology, all stakeholders with authority can easily obtain the latest version of personal PHR, although we also pointed out in the previous article that access to different levels of data may require authorization, and the purchase of data Fees apply. A typical application scenario of PHR is diagnosis and treatment. Doctors can quickly obtain complete medical information of patients to optimize diagnosis and treatment. Another typical scenario is pharmaceutical companies, which can use PHR in virtual clinical trials.

Overall, blockchain-based PHRs have the potential to reduce costs by optimizing the management of health data and achieve quality and efficiency improvements in healthcare.

population health

Population health data is a type of medical information for a specific population. As an example, it might be health risk data for overweight Hispanic women ages 65-80. This data is usually published anonymously (without revealing personal information) and is often used to analyze and compare risks between different kinds of population groups.

For population health management, the biggest challenges it faces are data security, sharing and interoperability. Patient information is isolated, insecure, stored in different EHR systems and cannot communicate with each other. The consequence of these problems is the shortage of data. Available population health datasets covering diverse populations are scarce.

safety

• safety

• sharing

• Interoperability (for on-chain data)

• data authenticity

• Real-time updates and access

Additionally, another advantage of using blockchain is that contributors to population health research can monetize their data.

By better collecting and sharing population health data, blockchain technology will improve healthcare for diverse population groups. When we have enough population data, we are expected to use more advanced technologies such as artificial intelligence (AI), machine learning (ML), etc. to discover and detect hidden and dispersed health risks among a large number of people. For example, by combining big data and algorithms, medical service providers can discover and give priority to serving those patient pools who are in urgent need of diagnosis and treatment but have not been served, thereby reducing social risks. (like the opioid epidemic)

Globalized medical services are shifting from a fee-for-service model to a value creation model.

This means that patients will pay for the results and efficacy of diagnosis and treatment, not just for services. Today, the model based on value creation motivates people to make fuller and more comprehensive use of population health data. In the United States, Medicare and Medicaid are giving financial subsidies to medical institutions to incentivize these institutions to make full use of population health data to reduce costs and improve service quality. Blockchain technology is at the right time to make this vision a reality.

personalized medicine

Blockchain promises to bring personalized medicine mainstream. Personalized medicine, by definition, refers to a privately customized treatment service based on personal health data (medical history and genes). Because the blockchain can well acquire and utilize personal medical records (PHR) and related population health data, medical service providers are expected to provide routine personalized diagnosis and treatment services for people soon.

Imagine in the not-too-distant future: a breathless African-American male patient suffering from palpitations and headaches provides his PHR when he visits a doctor at a clinic. The clinic can then take the PHR, then use the AI-based tool to select the appropriate population health data and provide a list of three potential diagnoses. The doctor selects the most likely diagnosis, and then goes to the system that contains population health data to inquire which treatment plan is the best for the patient's specific population. In the end, the doctor will choose a treatment plan that is the most cost-effective, curative and efficient for this individual patient.

The blockchain improves the attributes of data security, shareability and interoperability, and when combined with more sophisticated technologies such as big data, AI and ML, it will stimulate the next revolution in the medical field.

Other application scenarios

In the medical industry, blockchain has many other application scenarios. We cannot go into details one by one, but we still want to share with you. These scenarios include:

Applying blockchain and distributed ledger (DLT) technology in the medical field still faces some major challenges, and these challenges boil down to the fact that the technology is still in its infancy. These challenges include fewer successful implementation scenarios, slower transaction speeds, lack of scalability and limited storage capacity.

For the medical industry, there are some more fundamental challenges, including:

• Players in the industry are slow to adopt new technologies

• The transformation from paper to digital is still in progress

• The willingness of ecological players to share information is not high

• Data interoperability is still early in the industry

• Cautious regulatory environment slows development

• The existing blockchain storage capacity is low, and it is difficult to meet the needs of medical data (especially images)

Although the application of technology faces the above-mentioned severe challenges, early participants in the industry have seen the great opportunities of blockchain technology in the medical industry, and have carried out a series of related explorations and attempts. We believe that the challenges we are facing now will eventually be overcome, and blockchain technology will lay the cornerstone and foundation for future medical innovation projects.