Blockchain Technology in Health
Until the 90s, the only way to get information was encyclopedias. The verification source for the research conducted here could only be another encyclopedia. Also, since this information could not be updated constantly, their accuracy was highly questionable in this respect. In addition, the companies that printed these encyclopedias agreed with the authors of whatever point of view, in a sense, this was the point of view in this encyclopedia. So, it was difficult to get an objective perspective. However, with the public opening of the internet in the 90’s, a new flow of information started. Events and information were quickly uploaded to the Internet by multiple people who were not affiliated with an institution. Thus, information shifted from a centripetal structure to a decentralized system. In other words, intermediaries in the information have been removed. So how does getting rid of intermediaries on all systems sound?
Bitcoin: More than just an electronic coin
In 2009, a person or groups pseudonym Satoshi Nakamoto published an article called “Bitcoin: Peer-to-Peer Electronic Cash System” and introduced an electronic money system called Bitcoin. This system was talking about a completely global financial system without accepting any tool. Bitcoin has introduced a larger system than its target, perhaps a potential revolution. This revolution was called Blockchain.
A blockchain is basically a registry. It uses a scattered ledger system rather than a centripetal ledger. This distributed ledger system allows the relevant data to be securely stored and quickly transferred from one point to another when needed. For example, when health data belonging to an X person is transferred from one end to the other, it is first verified that this data belongs to the person in the blocks and is transferred to the person to be transferred. The verification here takes place through a process called the Consensus Protocol. According to this protocol, in order for the transaction to take place, at least 51% of the Blockchain nodes must verify that the data to be transferred belongs to X person and that this data is a transfer request. However, under these conditions, the process takes place. This transaction is algorithm-based, and stakeholders are ultimately rewarded with cryptocurrency.
Why is the Blockchain system necessary in healthcare?
The American healthcare system is the system where Blockchain necessity is felt the most. For example, an appendicitis surgery can be performed for 1500 dollars in a health institution and costs up to 182 thousand dollars elsewhere. When the reason for this difference is questioned, organizations respond as trade secrets. Another requirement is felt for technological devices. While the development of technology causes a decrease in prices in most areas, it has the opposite effect in the health sector. A security approach to the Blockchain can play a role in the removal of this impasse.
In addition, systems operating with a central system, such as insurance systems, are not reliable enough against external intervention and are very vulnerable to abuse. The frauds in the process of leaking the health data of the person and the insurance payment for health reveal that the system is in need of Blockchain technology in terms of security.
In this direction, the first companies emerging from Europe and America wanted to integrate electronic health records into the Blockchain system. Thus, both the security of the data would increase, and the sharing would take place faster when necessary. However, these initiatives have not yet attracted investor interest and have not grown enough in these years. Although the initiatives have not attracted attention, institutions such as the European Union and UNICEF continue to provide financial support to the Blockchain system for the future.
Potential Blockchain Applications in the Pharmaceutical Industry
Blockchain technology has enormous potentials in the field of health, especially in the pharmaceutical industry and clinical trials, compared to other fields. This can be examined in 5 different applications.
- Medicines returned to the manufacturer: Manufacturer companies can usually buy these drugs when the expiry dates of less used drugs approach and give the seller a new one at a low cost. However, fraudsters can counterfeit these drugs and try to leak money from the company. Such security vulnerabilities can be prevented by controlling data with Blockchain.
- Counterfeit medicines and medical devices: There may be frauds made by the manufacturer here. The consumer can also be prevented from being damaged by the secure system of the Blockchain.
- Monitoring compliance with regulations in the drug supply chain: Some drugs should be transported in the cold chain. This is critical for the prepaid drug effect and user health. Compliance with this cold chain can be controlled via Blockchain.
- Transparency of patient participation forms in clinical trials and establishment of retrospective compliance: When pharmaceutical companies begin to give drugs to patients after animal trials, patients must obtain a consent form. However, companies may not always do this fully in order to limit time and financial loss. Whether this system is functioning properly or not can be checked through the Blockchain, which cannot be manipulated since there is no intermediary.
- Improving the quality and safety of clinical trial data: Health data are generally very valuable. Purchases can be made for big money. Therefore, superior efforts are required to protect this data. Blockchain can be used for this.
Why is Health Data Protection So Important?
Health data must be protected with high protection technologies. Because these data are quite valuable. Institutions and companies that accumulate large amounts of specific health data can sell this data for high fees. Not all health data have the same material value. Confirmation of the accuracy of the data and the way it is obtained are the factors that determine the value of the data. The graphic in Figure 1 shows the items that increase the value of health data and average wages.
The data evaluation process can be exemplified as follows.
As a first step, this data has no value when hospital registration is made. Because no person or institution has verified that this data belongs to a patient. With the first verification by the hospital, the data gains a certain value. The value of the data increases even more when the number of confirmations increases, respectively, by the first doctor, and the second doctor makes the same diagnosis. Especially in diseases with a high risk of death, such as cancer, the patient may need to obtain a committee report for various procedures. This will increase the value of the data to the level of 1000 dollars.
Then, the determination by the insurance that this patient has a large risk worth paying and that the insurance payment terms are met further increases the security of the data and thus its value. The value of the data increases to $ 8000, when the drug intake is tailored to the patient, and the patient has an advanced disease and a secondary disease. If the patient has a tumor and the sequencing of this tumor has been performed and the treatment process is followed with devices covered by the Internet of Things, the data value is priced at $ 10000 levels.
While application-based initiatives see value and make money after the Internet revolution, initiatives at the protocol layer are more valuable in the blockchain area. Since applications that are successful in health are application-based, a blockchain technology-based application in health has not been fully successful for now. However, the continued support of funds for this technology, especially due to its security and fast data sharing opportunity, shows that Blockchain technology has a great potential.