The incorporation of the Blockchain technology in healthcare by Melanie Swan.

Blockchain Health

In the future, there might be different kinds of blockchains (ledgers) for recording and tracking different kinds of processes, and exchanging and providing access to different kinds of assets, including digital health assets. Blockchain health is the idea of using blockchain technology for health-related applications. The key benefit behind blockchain health is that the blockchain provides a structure for storing health data on the blockchain such that it can be analyzed but remain private, with an embedded economic layer to compensate data contribution and use.

Healthcoin

Healthcoin could more broadly be the coin or token for health spending, forcing price discovery and rationalization across health services. Services in national health plans could be denominated and paid in Healthcoin. This could help to improve economic inefficiencies rife within the health-services industry. Price transparency and a universal price list—could result, such that every time a certain health service is performed, it costs 5 Healthcoin, for example, instead of the current system (in the United States) where each consumer might pay a different amount that is a complex calculation of the multipayor system connecting different insurers and plans.

EMRs on the Blockchain: Personal Health Record Storage

Personal health records could be stored and administered via blockchain like a vast electronic electronic medical record (EMR) system. Taking advantage of the pseudonymous (i.e., coded to a digital address, not a name) nature of blockchain technology and its privacy (private key access only), personal health records could be encoded as digital assets and put on the blockchain just like digital currency. Individuals could grant doctors, pharmacies, insurance companies, and other parties access to their health records as needed via their private key. In addition, services for putting EMRs onto the blockchain could promote a universal format, helping to resolve the Blockchain Health issue that even though most large health services providers have moved to an EMR system, they are widely divergent and not sharable or interoperable. The blockchain could provide a universal exchangeable format and storage repository for EMRs at a population-wide scale.

Blockchain Health Research Commons

One benefit of creating standardized EMR repositories is exactly that they are repositories: vast standardized databases of health information in a standardized format accessible to researchers. Thus far, nearly all health data stores have been in inaccessible private silos for example, data from one of the world’s largest longitudinal health studies, the Framingham Heart Study. The blockchain could provide a stand‐ardized secure mechanism for digitizing health data into health data commons, which could be made privately available to researchers. One example of this is DNA.bits, a startup that encodes patient DNA records to the blockchain, and makes them available to researchers by private key. However, it is not just that private health data research commons could be established with the blockchain, but also public health data commons. Blockchain technology could provide a model for establishing a cost-effective public-health data commons. Many individuals would like to contribute personal health data like personal genomic data from 23andMe, quantified-self tracking device data (FitBit), and health and fitness app data (MapMyRun)—to data research commons, in varying levels of openness/privacy, but there has not been a venue for this. This data could be aggregated in a public-health commons (like Wikipedia for health) that is open to anyone, citizen scientists and institutional researchers alike, to perform data analysis. The hypothesis is that integrating big health data streams (genomics, lifestyle, medical history, etc.) and running machine learning and other algorithms over them might yield correlations and data relationships that could be helpful for wellness maintenance and preventive medicine.152 In general, health research could be conducted more effectively through the aggregation of personal health record data stored on the blockchain (meaning stored off-chain with pointers on-chain). The economic feature of the blockchain could facilitate research, as well. Users might feel more comfortable contributing their personal health data to a public data commons like the blockchain, first because it is private (data is encrypted and pseudonymous), and second for remuneration in the form of Healthcoin or some other sort of digital token.

Blockchain Health Notary

Notary-type proof-of-existence services are a common need in the health industry. Proof of insurance, test results, prescriptions, status, condition, treatment, and physician referrals are just a few examples of health document–related services often required. The “notary function” as a standard blockchain application is equally well deployed in the context of blockchain health. Health documents can be encoded to the blockchain as digital assets, which could then be verified and confirmed in seconds with encryption technology as opposed to hours or days with traditional technology. The private-key functionality of the blockchain could also make certain health services and results delivery, such as STD screening, more efficient and secure.

Doctor Vendor RFP Services and Assurance Contracts

Blockchain health could create more of a two-way market for all health services. Doctors and health practices could bid to supply medical services needed by patientconsumers. Just as Uber drivers bid for driver assignments with customers, doctor practices could bid for hip replacements and other needed health services for exam‐ple, in Healthcoin at minimum bringing some degree of price transparency and improved efficiency to the health sector. This bidding could be automated via trade‐
nets for another level of autonomy, efficiency, and equality.

Virus Bank, Seed Vault Backup

The third step of blockchain health as a standardized repository and a data research commons is backup and archival, not just in the operational sense based on practitioner needs, but as a historical human data record. This is the use case of the blockchain as a public good. Blockchain backup could provide another security layer to the physical world practices of virus banks, gene banks, and seed vaults. The blockchain could be the digital instantiation of physical-world storage centers like the Svalbard Global Seed Vault (a secure seedbank containing duplicate samples of worldwide plant seeds), and World Health Organization–designated repositories like the CDC for pathogen storage such as the smallpox virus. A clear benefit is that in the case of disease outbreaks, response time can be hastened as worldwide researchers are private key–permissioned into the genetic sequencing files of pathogens of interest.

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Blockchain: Blueprint for a New Economy: Melanie Swan.