One of the key roles of public health organizations is to detect emerging threats to vulnerable population segments as part of their disease prevention and control efforts.
The current system requires healthcare providers to share information about such cases with their respective state health department via paper-based reports or online forms. Based on these reports, the state department alerts the CDC (Centers for Disease Control) in order to identify the onset of a potential epidemic.
However, as simple as this routine public health data sharing process may appear, it is a highly complex data management challenge, when it is addressed on a national scale.
Data from multiple sources must be funnelled, validated, managed, and analyzed, while maintaining patient privacy at all times. Many of the processes involved are currently carried out manually, which cause delays in disaster response.
This is a sensitive area where blockchain technology offers tremendous promise to cut down the communication time required to identify a developing epidemic and issue an appropriate response in a reliable manner.
CDC Supports Blockchain
Jim Nasr, former chief software architect at the CDC’s Center for Surveillance, Epidemiology, and Laboratory Services, says that public health and blockchain technology definitely belong together. The key to success in utilizing blockchain for epidemic alerts lies in the capability of the peer organizations (including the clinics and hospitals, local and state health agencies, and the CDC) to effectively collaborate and share data.
Moving the data among peers in a secure, compliant, and transparent manner – in the shortest time possible – is a vital part of this business model.
Blockchains, such as the ones that underline cryptocurrencies, are maintained with the help of multiple computer networks rather than a single central authority. These networks verify every transaction and record it in an encrypted ledger that is virtual incorruptible and can be shared by all computers within a network.
According to the CDC, blockchain technology is a particularly good fit for public health applications. Although organizations within a public health network are part of a common mission, the complicated mix of data usage agreements and data privacy rules demarcate which members may access the data and which ones may modify it.
These issues create a slowdown in the flow of information. Several additional processes, some of which are manual, are required to ensure that the right organization or individual sent or received the appropriate data, and that it was appropriately used. All these steps can be automated with a blockchain.
Advantages of Blockchain over Current Solutions
To begin with, blockchain offers an advanced level of security because this distributed ledger technology makes use of public key cryptography. Pre-programming of smart contracts can analyze incoming data and issue health alerts based on a number of triggers. This can eliminate much of the time lag that exists in the current systems.
Some of the key advantages of blockchain over current solutions include:
Reduced Transaction Time
Transactions based on blockchain can be processed 24/7 throughout the year. Unlike manual processing of data, no time lag is involved because new data additions, updates, and transactions occur in real time.
Enhanced Security
In a blockchain, privacy is maintained because the data is encrypted and accessible only to those who have the key. The distributed network lowers the risk of tampering and fraud. The blocks that comprise the blockchain are virtually impossible to alter, thus providing topmost levels of security against the threat of cyber attacks.
Decentralized Flow of Information
The blockchain is resilient and does not involve a central authority as the networks are distributed. Vital and actionable information can be quickly disseminated and published without the need of a single database.
Transparency, Immutability, and Process Integrity
As blockchain is an open source technology, it ensures that nobody can make changes to the logged data within the blockchain without all others seeing the change. Process integrity is ensured as all transactions are executed precisely according to the specified protocol.
Transmitting Alerts via a Secure Network
Blockchain technology is useful for large agencies such as the CDC and WHO because it creates distributed ledgers that professionals in any part of the world can easily update.
The data can then be utilized by healthcare providers to offer better care to the affected population. In a situation like an epidemic, the shared data can be updated hundreds of times per day with blockchain.
In the situation of epidemic outbreak, blockchain can alert the healthcare experts of emergencies and sudden spikes in reported cases of infection using a secure network. This limits the scope for rumors and false information. Doctors can isolate infected patients and streamline diagnoses more effectively.
Epidemics may sometimes originate in remote regions of the world, and accessibility to real time disease information via blockchain can completely change the nature and speed of international response to the epidemic at its source.
Distributing Medications and Supplies using Smart Contracts
Timely delivery of medications and supplies is critical in controlling and managing an epidemic. Healthcare agencies can use smart contracts to swiftly send and receive life saving medications and supplies.
Blockchain can create a transparent distribution network for healthcare agencies to distribute medications and supplies to far corners of the world where an epidemic may be spreading and causing disruption to life.
Blockchain can be the most reliable way to ensure that all medications and supplies reach the right organization, and each delivery can be tracked. Record maintenance and payments can also be done via the blockchain platform.
Data Storage and Distribution without Compromising Privacy
Using blockchain technology, all patient centric data can be stored in a completely secure data tier, while all diagnosis centric data gets stored in the public blockchain. Privacy and authenticity of the data is ensured as all the stored information is encrypted and can have digital signatures.
The distributed ledger with open participation of players such as the local and state healthcare agencies, medical providers and the CDC as well as customized access control mechanism enables a system that ensures patient privacy.
Real-Time Medical Alerts
As health data is expansive and dynamic, it need not be replicated to every member within the network.
Instead, the blockchain can store an indexed history of the entire medical data in a hashed format and further store all diagnosis centric data in an open, un-hashed format. Every block can include a unique key (a link to the medical record), time stamp as well as meta data about the healthcare information.
A unique pointer to the data can be registered in the blockchain together with the user’s unique identifier. As a result, each time a medical record gets added, a smart monitoring app would check whether any infection disease event threshold has been crossed. If a threshold is crossed, the system would immediately alert the CDC and other local and state healthcare agencies.
Challenges Exist
According to a report published by the MIT Media Lab, the potential of blockchain in the healthcare sector and with regard to epidemic alert in particular depends on whether clinics, hospitals, and other healthcare providers are willing to support the creation of the required technical infrastructure.
The current complicated patchwork of healthcare digital systems needs to be seamlessly integrated, which requires a collaborative approach among various stakeholders nationally and globally.
Blockchain technology is still new, and it requires healthcare providers and organizations to adopt a new way of thinking about information control. It is important to resolve complex questions such as: Who monitors the blockchain? Who receives access to data? Where are the servers located, and what types of digital and physical controls exist?
Public healthcare organization such as the CDC and WHO must work with various stakeholders to help build a robust epidemic alert system based on blockchain technology.