How can blockchain technology provide impetus to healthcare 5.0 in 2023

By Abhinanda Sarkar

First, blockchain is much more than crypto and crypto is much more than blockchain. So, what is blockchain if not crypto? IBM describes it this way: “Blockchain is a shared immutable ledger for recording transactions, tracking assets and building trust.” We will look at what all those words and phrases mean.

To do this, let’s take the future of healthcare as our context.

“Shared… ledger” refers to a digital database that is visible to all parties who contribute by adding entries to it. When a new “block” of information is added to the “chain”, the blockchain updates. The updated blockchain is automatically shared with all parties, all of whom can be considered co-owners and

co-creators of this distributed data. Consider Electronic Medical Records (EMR) for a patient.

EMR on blockchain can be updated by doctors treating the patient, and the patient can have access to the update. In turn, the patient can update any third-party diagnostic test results for the doctor to review.

“…immutable ledger” refers to the feature that a block in a blockchain cannot be modified once it is created. The data in a blockchain contains unique digital identifiers that are created through a process called ‘hashing’.

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Any attempt to change data can be quickly identified. In addition, the distributed nature of the blockchain makes it difficult to duplicate any unauthorized change in all distributed versions. In our EMR example, this immutable characteristic makes an EMR on blockchain reliable for hospital administrators assigning doctors, and for medical insurance companies that want transparent payment.

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A digital mechanism to “record transactions” in common and immutable ways is useful to a wide range of participants in healthcare. Some examples:

(1) Medical school can grant degrees through blockchain. These can be directly accessed by the graduating student as well as by her employing hospitals, thus creating automatically verified certificates.

(2) A contractor building a clinic can verify land ownership through a land record blockchain. Such a blockchain can contain records of all previous owners of the land, and note any problems in sale or transfer.

(3) A researcher conducting a clinical trial can ask participating hospitals to form a blockchain thus maintaining the integrity of the collected data, as well as creating a common repository that can be reviewed by reviewers.

When it comes to “asset tracking” blockchain can contribute on a shorter time scale. The idea here is that a blockchain is built as an object moves from place to place, each place adding its data.

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Consider a pharmaceutical supply chain. This starts with a manufacturing site from where the item is transported through potentially multiple warehouses using multiple transport vehicles. Then, it reaches a pharmacy, or retail or within a clinical facility. From here, it is available to a patient

like medicine. Like any supply chain, tracking an item through this journey is useful for inventory management and valuable for healthcare.

Perhaps most important of all is “building trust.” Blockchains are designed to operate in transparent and secure ways. This suits the demands of healthcare very well, where a great deal of trust is required and is indeed often assumed. In the pharmaceutical supply chain scenario, it is assumed that the manufacturing facility has the correct registrations, for example with the US Food and Drug Administration (FDA), and that the drugs it produces have the correct approvals, for example from the office of the Drug Controller General of India (DCGI). There is also confidence placed that the medicine is not replaced by a counterfeit while in transit or at the pharmacy.

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Blockchain can help control all of this and retain trust in the process. As healthcare 5.0 becomes more widespread, reliable data and secure digitization will be key. But there are challenges to overcome. The most important of these involves scale. The hashing process is computationally intensive and consumes energy. For blockchain to proliferate beyond crypto, more efficient computing will become imperative. Another aspect of scale is the size and nature of health data. Compliance requirements of, for example, HIPAA and GDPR add to the complexity of storing large amounts of data securely on a blockchain.

In the coming years, other distributed ledgers may emerge as alternatives to the blockchain. For example, the company Hedera uses an alternative called hashgraph to write smart contracts. SAFE is a Mayo Clinic digital health platform that has used the technology to monitor Covid-19 testing and health

status More such digital health applications are emerging, based on smart contracts between providers and recipients of treatment. Blockchain and its successors are poised to improve healthcare for all.

The author is the director, Academics at Great Learning

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