Blockchain Applications in Healthcare and Public Health: Increased Transparency (Preprint)
BACKGROUND While Big Data and smart technologies allow for the development of precision medicine and predictive models in healthcare, there are still several challenges that need to be addressed before the full potential of this data can be unleashed (e.g., data sharing and interoperability issues, lack of massive genomic datasets, data ownership, and security and privacy of health data). Health companies are exploring the use of Blockchain, a tamperproof and distributed digital ledger, to address some of these challenges. OBJECTIVE Obtain an overview of Blockchain solutions that aim to solve challenges in healthcare from an industry point of view, focusing on solutions being developed by health and technology companies. METHODS We conducted a literature review, following the protocol defined by Levac et al. to analyze the findings in a systematic manner. In addition to traditional databases such as IEEE, PubMed and Google Scholar, we included search and news outlets such as CoinDesk, CoinTelegraph, and Medium. RESULTS Healthcare companies are using Blockchain to improve challenges in 5 key areas: (i) electronic health records - Blockchain can address interoperability issues by creating an overarching mechanism to link disparate personal records, as well as stimulate data sharing by connecting owners and buyers directly; (ii) Drug (and Food) supply chain - Blockchain can provide an auditable log of a product’s provenance and transportation (including information on the conditions in which the product was transported), increasing transparency and eliminating counterfeit products in the supply chain; (iii) health insurance - Blockchain can facilitate the claims management process as well as help users to calculate medical and pharmaceutical benefits; (iv) genomics - by connecting data buyers and owners directly, Blockchain can increase sharing of genomic data, increasing its availability; and (v) consent management - since all participants in a Blockchain network view an immutable version of the truth, Blockchain can provide an immutable and timestamped log of consent, increasing transparency in the consent management process. CONCLUSIONS Blockchain technology can improve on several challenges faced by the healthcare industry today. However, companies must evaluate how Blockchain’s features can affect their systems (e.g., Blockchain being append-only limits the deletion of data stored in the network and distributed systems, although more secure, are less efficient). While these trade-offs need to be taken into account when considering Blockchain solutions, the technology has potential to optimize processes, minimize inefficiencies, and increase trust in all contexts covered in this review.