The healthcare industry, like many others, has benefited immensely from technological advances in the recent decade. Wearables and smartphones have enabled the collection of precious health data that was previously unavailable to doctors and researchers. And thanks to ubiquitous internet connectivity, the availability of nearly limitless cloud resources and advances in artificial intelligence and deep learning, we have the possibility to process and leverage our health data in ways that were previously impossible.
However, the advantages of tech-enhanced health services have not been without tradeoffs.
Presently, the industry suffers from a “centralized and decentralized” data problem, which is the source of confusion, security and privacy challenges and a serious barrier toward making full use of the opportunities that exist.
One possible solution to these challenges is the use of blockchain, the distributed ledger technology that brought us bitcoin and is now being widely used in other domains as well. To be fair, in recent years, blockchain has been used in dishonest and meaningless ways to make quick money and run scams. But in this case, it seems that we’re looking at a promising and functional solution.
The centralized problem
Health device manufacturers, services and organizations currently store all the health data they handle in their centralized servers. This burdens them with the responsibility to secure all that information.
Obviously, not all of them fulfill that responsibility properly. Centralized data stores give cybercriminals attractive targets to attack. By breaking into a single system, they’ll find access to the sensitive information of millions of users. Healthcare organizations (and their customers) have suffered some of the worst data breaches in recent years. This is a problem that not only healthcare providers but all companies that handle sensitive consumer information are facing. Last year’s data breach of credit rating agency Equifax was a reminder of how vulnerable centralized services are.
Centralized data storage also poses a privacy challenge. Users have little visibility on their data and even less control on how service providers use it. They’ll have to trust the company that stores them to use it with honesty and not share it with other parties without their consent.
Since users don’t have ownership of their data, if they want to switch devices or services, they won’t be able to take their data with them, unless their current service has tools for exporting their data. And they’ll still be responsible for taking care of compatibility issues. The entire process can be so frustrating and difficult that most users will abandon it altogether, losing precious data in the process.
The decentralized problem
In parallel to the centralized problem, the current health tech landscape suffers from a fragmentation of data. The health data of each user is scattered across the servers of dozens of services, which means no user has a consolidated picture of their data.
This results in a lot of data redundancy. Users must replicate much of their personal information across several services and keep them in sync, which sometimes requires a lot of manual effort and at other times becomes impossible.
Meanwhile, physicians also don’t have access to a comprehensive picture of their patients’ data and must manually reenter a lot of data that already exists elsewhere into the electronic health records (EHRs) that they maintain at their own organizations. A patient might have several different health records with separate health organizations.
This fragmentation also impedes the work of researchers, who will have to struggle to find consolidated data for their efforts.
Centralizing data around users
While many blockchain enthusiasts will just say that decentralization is the answer to all the problems of the internet, in this specific case, I’ll beg to differ. The healthcare industry’s problem isn’t that it’s centralized, but rather that it’s centralized in the wrong way. Everything revolves around services, companies and applications, which is the reason why there’s so much data redundancy and confusion, and why there are stores of data that can prove valuable to malicious actors.
The solution would be to move the epicenter of user health data from companies and organizations to the users themselves. If every user had a store of data which they authentically owned without relying on a third-party service, they would have full visibility and access to its contents and decide who to share it with. This store could contain their EHR and any data generated by their health devices and wearables.
This way, patients could give their doctor access to their health data store and enable the doctor to update their data. Likewise, if a user decides to switch to a new device or health application, they can take their data with them and without leaving anything behind.
While the idea of personal health data stores sounds simple, implementing it isn’t so straightforward. Users would have to set up a personal server for their personal health data store. This would burden them with all the installation, maintenance, connectivity and security tasks that come with having a server. While hackers would no longer have targets with large stores of data, they would still be able to find plenty of negligent users to attack.
An alternative would be to create a cloud service where users can store all their health data and share accessibility with other services and devices. But this too wouldn’t solve the problem because it would re-centralize user data in a single store, giving the service provider too much power over user data while also giving hackers a juicy, data-rich target.
Where blockchain enters the picture
Blockchain is a decentralized method of storing data. It enables storing and exchanging information online without the need for third-party services and brokers. Every record stored on the blockchain is encrypted and replicated across thousands of computers. None of those computers can access the content of that record because the decryption key is in the hands of its true owner. Meanwhile, tampering with the data would require hacking and manipulating a considerable number of computers that store the blockchain, which is virtually impossible.
Blockchain provides users with the tools to claim exclusive ownership of their data. By storing their health data on the blockchain, users will be able to access it from anywhere without the need to rely on any centralized service. Meanwhile, the encryption will prevent anyone but the real owner of the data from specifying who can access and update the data.
Healthcare companies would also benefit from a blockchain-based model, since they would be relieved of the burden of securing user data. This is especially critical as upcoming regulations such as the European Union’s General Data Protection Regulation (GDPR) will raise the penalties for companies that fail to secure their customers’ data.
Blockchain is still a nascent technology and we have yet to see the extents and limits of its possibilities. But it clearly shows promise to be the infrastructure needed to protect and leverage the reams of health data that we’re generating.