Monday 23 April 2018

Blockchain - Healthcare Implementation Use Case - Part 1

It's been a long time I am following Blockchain and my interest continued to increase and increased enough to dive into it.

This article is not intended to be a Blockchain introduction. There are many good articles available on it. This is first in a series of articles and my focus would be to make healthcare developers understand it independently of Cryptocurrency and relate it with healthcare use cases.

This article assumes that you know at least following terms related to Blockchain Technology

  • Blockchain
  • Peer to Peer Network
  • Distributed Ledger
  • Digital Transaction
  • Digital Asset
  • Digest SHA256
  • Public vs Private Blockchain
  • Public - Private Key

People usually relate Blockchain to Cryptocurrency and then develop a personal discomfort because of legal or other issues around them. It’s a most common myth  around Blockchain.

Blockchain is not Bitcoin or any other Cryptocurrency.

Blockchain is a distributed ledger that tracks digital assets on a Peer to Peer Network. Bitcoin was  first to implement Blockchain technology.

As an area of Interest, I was excited to see discussions around Blockchain implementations in Healthcare.
There are many articles on the topic ranging from patient health records to HIE and how Blockchain can solve security and privacy issues in various Healthcare use cases.

Most of the articles and tutorials around Blockchain are usually targeted towards Cryptocurrency and there are plenty of Hello-World Blockchain examples that tell you how Bob can transfer 10 bitcoins to Alice securely with Blockchain.

Usually you will see a blockchain explanation with something like this diagram

It was bit confusing initially when I started to relate these bitcoin examples with healthcare use cases.

When you read an article of healthcare use cases like Blockchain of a patient medical record and you see an example of Blockchain implementation saying Bob can transfer 10 bitcoins to Alice. How do you relate it?

So when we talk about a Blockchain, transactions inside a Block can be anything. It need not be a financial transaction. So Bob transferred 10 Bitcons to Alice can very well be seen as patient Alice booked an appointment with Dr Bob or Dr Bob prescribed Amoxicillin to patient Alice.

So doctor prescribing medications to patients is a valid Blockchain Transaction that can be recorded in a healthcare Blockchain without involving any digital currency.
Similarly doctor administrating a vaccination to patient is a valid Blockchain Transaction.

Transactions inside a block depends on the business model that you want to implement in Blockchain. It has no dependency on financial transactions.

Blockchain Technology doesn't restrict you to the transaction type or model that you must follow. It's all up to you or business network involved in designing Blockchain.

We can put these healthcare transactions as following in a diagram to better understand in terms of Blockchain.

If some one tries to remove the transaction that “Dr. Alice discontinued Aspirin for Patient Bob”, it can be easily identified because any change in data inside block will change the Hash of that Block.

While it would be design decision to keep all the different kind of healthcare transactions in same block/blockchain, it would be easy to implement and maintain a blockchain that serves a single purpose i.e. a Prescription Blockchain, an Immunization Blockchain etc.

Now, this Blockchain looks good to start with but it doesn’t cover patient Privacy and other security features. Like anyone can see that Patient Bob was prescribed Lipitor.

More on securing Patient identity with public keys in next article with more valid and specific use cases.

Sample Immunization Records Blockchain using Hyperledger Composer

This is basic and sample Blockchain implementation of Immunization Records using Hyperledger Composer.  Source Code available at:  https...