What Does Blockchain Mean for Health IT Infrastructure?

October 27, 2016 - The healthcare industry continues to explore the value of blockchain technology for improving its approach to security and interoperability. Blockchain could be the future of electronic health information exchange, but how does it work?

Bitcoin has turned blockchain into a technology buzzword over the past several years. The digital currency site uses blockchain technology that allows users to exchange funds safely and publically without a centralized party documenting or approving the transactions. Bitcoin transactions take place over the public internet, which on principle makes it an undesirable solution for enterprise deployment at first glance, especially in the healthcare industry.

However, the healthcare industry is interested in blockchain. According to HealthITAnalytics.com, the Office of National Coordinator for Health Information Technology (ONC) has admitted that they knew little about healthcare applications of blockchain beyond the opinions of tech experts. In an effort to gain more valuable insight, ONC issued a challenge for researchers to submit documents suggesting how blockchain technology can benefit the healthcare industry.

Blockchain technology has the potential to positively impact the exchange of secure data, but only if an organization’s infrastructure is prepared. Because blockchain functions much differently than legacy infrastructure technology, several major components of  IT infrastructure including security, networking, and storage will be influenced by the implementation of blockchain technology.

What is blockchain?

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Blockchain is the exchange of information between nodes (e.g., users, organizations) via a shared database without the regulation of a third party controlling the data through a single silo and leads to the creation of a trusted history of transactions between organizations sharing data.

Each transaction between organizations consists of a block which holds the data from the current transaction along with a hash linking back to the previous transaction, thus creating a chain. Every transaction is documented and users cannot go back and alter past data.

Organizations in the network all have a copy of the data shared via the blockchain and can see who is accessing the data and why. If the data is accessed by an unauthorized user, the network can instantly detect it and take action to protect the data.

Every organization is required to sign off and approve each transaction acting as witnesses that the transaction was completed as stated. The number of witnesses needed to approve any transaction or update eliminates the need for pre-existing trust between organizations.

Here’s an example.

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Organization A agreed to send Organization B 1,000 units of their product. Using blockchain, Organization A sends the order of 1,000 units to their factory. The factory signs off that they received the order and that they are producing 1,000 units for Organization B. Because Organization B is part of the network, they are able to see each transaction in the block.

The factory updates the blockchain again indicating that they have shipped 1,000 units. The shipping company signs off that they received 1,000 units which are on their way to Organization B.

Most likey, Organization B will receive 1,000 units as the blockchain indicated. If Organization B only receives 900 units, they indicate on the ledger that the transaction was not fulfilled and they can trace the transaction history to find out if the error was made by Organization A, the factory or the shipping company.

For Bitcoin, this shared database is public with the blockchain providing a ledger documenting all transactions. While personal information such as account numbers and personal details are hidden, the blockchain makes each user’s transaction history visible, to any number of witnesses, eliminating fraud.

Enterprise blockchain technology does not give the public general access to the ledger; it’s only visible to other organizations contributing to the blockchain. Each organization in the network has equal access and control over the data, keeping each other honest.

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Storage and network

Organizations implementing blockchain through a network of affiliated organizations or within their organization have to lay the foundation before blockchain can be used successfully. Organizations need at least a hybrid cloud solution to connect to the blockchain.

Wireless networks also play a large part in a successful blockchain. Ledgers are sent out instantly and all parties have constant access. For IT infrastructure, this means that a reliable wireless network is needed. Virtual private networks (VPNs) are also used to form secure connections with the blockchain network. Organizations in the network need to securely reach out to each other.

Security

The biggest security benefit of blockchain is the elimination of a central log database. Traditionally, organizations give up control of their transaction data to a central point of monitoring and administration. Central databases give hackers a single point of access because all the data is stored in one place.

In healthcare, blockchain can improve security because of multiple checkpoints are required for any party to access the data.  According to HITSecurity.com, the validation aspect of blockchain is what sets it apart from other solutions that do not store data centrally.

Blockchain in healthcare

Blockchain has several uses in the healthcare industry including the provenance of medical goods and health information exchange.

Tracking products such as prescription drugs through the supply chain using blockchain eliminates the chance of counterfeit drugs or product theft during the transaction.

Blockchain could prove most useful to the healthcare industry for exchanging electronic health data. According to HealthITAnalytics.com, “when it comes to healthcare data, the blockchain has many promising applications. The strategy may be useful for reconciling changes in an electronic health record, ensuring that patient privacy is upheld, and fostering a trusted environment of health information exchange across party lines.”

Blockchain also has the potential for patients to monitor their own health. Patients can potentially be granted access to their own medical records and refer to them personally. They will be able to get a better overview of their own health and have a more active role in improving their quality of care.

The security blockchain provides by design could improve security, interoperability, and patient engagement. Organizations interested in embracing blockchain technology are advised to be sure their IT infrastructure is able to support it.

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