Patients’ and health care providers’ data are separated by a complex network of relationships between jurisdictions, professional services, specialists, and other providers. And this is before a global pandemic.
The COVID-19 pandemic revealed even bigger inefficiencies in the healthcare system. Health data is stored in institutional, siloed databases that can’t communicate with each other and are inaccessible to individuals and other stakeholders. Specifically, traditional healthcare systems do a poor job sharing patients’ health records across channels and have a slow response registry for medical professionals.
To better illustrate, here are some examples:
If a primary care doctor prescribes a medication for an allergy to a patient, that data will be stored in their database. But, when the same patient needs to go to the emergency room for surgery, the hospital will need to know the patient’s health record including any medication they are taking and allergic reactions. The patient typically needs to set up another paper trail to the hospital because their health records are siloed in the primary care database and lack an efficient way to share information. In reverse, when the patient returns to their doctor, they will need to explain the details of the surgery because they won’t have any records of it. This can be solved if the patient owns their own health data that can be verifiable, and be able to efficiently share their health data with both the doctor and hospital.
Another example of inefficiencies of the registry for medical professionals has to do with human resources. A hospital during the pandemic was in desperate need of epidemiologists. But the current process is too slow for recruiting and onboarding qualified professionals. This challenge is not due to a lack of availability or skillset; it is the inability to efficiently find those professionals when they are outside of your immediate network; ie, from different geographies, hospitals, private practices, and even departments.
This problem too, arises from siloed databases in different jurisdictions that can’t communicate with each other, making it a slow process to verifying a medical professional’s correct credentials and licensing. Glass Bead Consulting calls this the “talent management paradox”. If every professional had verifiable and trusted professional information then we could resolve this talent management paradox and get people to where we need them quicker and more efficiently.
The pandemic stressed the need for better technology to solve inefficiencies in sharing patient data, and, secondly, a faster registry to onboard and recruit medical professionals. One of the technologies that can solve these inefficiencies is blockchain.
Using the blockchain for health data
A blockchain is a distributed, immutable database that can be accessed by many different parties and is not controlled or manipulated by any single party. The information stored on the blockchain is called metadata. Metadata can be anything from identity, transaction details, credentials, etc. Using blockchain and metadata you can create a digital identity.
Digital identities allow patients and healthcare providers to add data from various sources such as health records and vaccines, to certificates and licenses. All the data stored on the blockchain is encrypted and digitally signed for security and authenticity. A healthcare provider can request access to the patient’s medical information and if the patient gives consent, the medical records become available.
Here are some of the top reasons blockchain can improve health data management:
- The blockchain allows health data and identity to be owned and controlled by the owner themselves. It also allows this data to be shared with third parties if the owner chooses to do so.
- Since the user is the owner of their data - rather than the health providers or insurance companies - the blockchain can offer a system that incentivizes the users to share their private data with clinicians and governments.
- This solution allows for a distributed skills and talent registry of medical professionals to be accessed by companies looking to hire qualified people.
Alright, so Blockchain increases the “fluidity” of data. Let’s take a look at how secure that more fluid data is.
How the blockchain is secure
When using a blockchain-based digital identity solution for health data in addition to making health data more accessible and efficient it must be secure and private. Here are five ways the blockchain is secure:
Decentralized: The benefit of a blockchain being decentralized is it’s not in control of a single entity. A single entity can sell personal information or prevent individuals from accessing their data, and even shut down their accounts without permission.
Instant Verification of Authenticity: Credentials are instantly verifiable from anywhere via the blockchain, removing the need for third-party verification services.
Secure record of information: Metadata attached to a transaction and confirmed on the blockchain is immutable. This means no one can change or tamper with it.
Timestamping: Details on when an action occurred, such as the last doctor’s appointment or vaccination date, are timestamped automatically and cannot be changed or adjusted.
Difficult to hack: Since the blockchain is a distributed database a hacker needs to hack into all the nodes and change the information simultaneously. Just to illustrate how difficult it is to hack the Cardano blockchain, a hacker would need to control 51% of the resources of a ~US$60 Billion network. It has never happened and as the Cardano network grows it becomes more difficult.
(If you’d like to know more on metadata on the Cardano blockchain, click here for a getting started article)
So: data becomes more fluid, and data is at least as secure on a blockchain as in siloed-off, proprietary solutions. But is it as private as current processes, or can it be privacy-enhancing?
Privacy using a digital identity
Digital identity can be pseudo-anonymous. Meaning you can share information without revealing your full identity. For example, think about showing your driver’s license to get into a bar. All they need to know is whether you’re old enough to enter. But, we give them our home address, weight, whether or not you’re an organ donor, etc. With a digital identity, users can choose to only provide the necessary information, in this case, age.
How Cardano can help
From sharing patients’ health records across channels and having a registry for medical professionals while enhancing privacy and being more elegant in what data you share: Cardano is building solutions.
Atala PRISM is a decentralized digital identity solution built on the Cardano blockchain. Using PRISM users can create their own digital identity. From patient health records and vaccinations to professional credentials and certificates. By leveraging blockchain technology, users have full control of their data but with their consent can share their data across different channels. Since users can build cohesive and current profiles, governments or clinicians can get the best dataset to tell who is vaccinated or which credentials they have. A dataset that is impossible to tamper with, nor is it corruptible.
Let’s look at how Atala PRISM can help in real-life situations. Due to the outbreak of COVID-19, places with a large gathering of people may require proof of vaccination. Using Cardano’s PRISM, a person can verify they’re vaccinated simply by using a smartphone. And since the information is stored on the blockchain we know it is secure and authentic. And going back to the original example, both the doctor and hospital will know that a patient is vaccinated simultaneously.
Using PRISM, we can also resolve the talent management paradox for medical professionals. The blockchain can be a distributed and transparent registry of medical professionals’ skills and credentials. It can be accessed by HR departments and allow faster processing. In addition, it will streamline coordination among different geographies more efficiently and transparently to get people where we need them.
Interested in reading more on verification? Check out more from Atala PRISM. Interested to build great things on Cardano? Check out the resources at docs.cardano.org, or enter our Plutus pioneer program