How Blockchain is Transforming Health Care
WASHINGTON — A digital ledger of transactions known as blockchain, that can protect an individual’s identity and information, is evolving in the health care space into decentralized patient-centric platforms.
“Think of blockchain as an underlying technology that supports everything. It’s a ledger of knowing what happened, and when, and being able to prove that and have a history of auditable actions. That’s what blockchain does, it’s a full history that you can trace,” said Debbie Bucci, current chief data officer at Equideum Health during a phone call with The Well News.
“You have a ledger and you have data points, but you still need rules to make your decisions that things are based on. Smart contracts can be used to automate the logic behind those decision points,” continued Bucci.
Bucci said in her 27 years of experience working in the federal life sciences one of the main issues she’s seen is problems with patient matching, which can be solved by the capability of the blockchain to place the patient at the center of the process.
“It’s a way to identify the same patient across different systems, certain claims or identifiers that could come across the systems that are tied to a person, and identify the same person across multiple systems,” said Bucci.
“You would have improved audibility about who has accessed a record, who has seen it. Privacy is not always about non-disclosure, it’s also having insight to where data has been used,” continued Bucci.
In early 2020, Equideum Health, formerly ConsenSys Health, partnered with the Dixon Center for Military and Veteran Services to create the Veterans Incentivized Coordination and Integration initiative, also known as VICI.
“Twenty-two Veterans a day die by suicide on average, and despite countless efforts this horrific number has maintained for years at much higher levels than the rest of the population. We aim to help veteran-focused groups fill the gap in these critical needs for this population, to improve health, well-being, connectedness and help them thrive,” said Sean Manion, chief scientific officer and federated network orchestration coordination lead at Equideum Health, in an email to The Well News.
The VICI initiative will enable self-sovereign identity data and ability for veterans to preserve their privacy while accessing care that can be stigmatizing, such as for suicidality, substance use disorders, military sexual trauma, and post-traumatic stress.
On a broad scale, the initiative will allow patients to control their identity and their consent as part of sharing that information, especially when it comes to critical social, economic, demographic or other population health factors that are part of their clinical care.
Outside of the VICI initiative, blockchain is being used in a number of public and private partnerships for projects like the NASA Mars Rover Project, Army defense simulator projects and by the U.S. Department of Veteran Affairs for things like personal protective equipment training.
“During the height of COVID, for instance, the VA came to us and asked us if we would update all of the personal protective equipment training that’s done for hundreds of thousands of people, and they not only decided to do it for themselves, but they decided to open it up to all health care providers too,” said David Metcalf, general partner of Global Blockchain Ventures, during a recent webinar on how to open source benefits for veterans health care initiatives.
“So, we got a pretty wide berth of use to make sure that people are protected every day, and to also make sure that those training records were going to be kept in such a way that you had ongoing standards-based access … no matter what organization you’re in, whether you’re in the VA, within another part of the federal government, or outside of the government and health care organization,” said Metcalf.
“Those are the types of things that blockchain solutions help with because of the continuity, because you can put a smart contract in place that actually allows you to have just the information you need, no more, no less, no matter what your stakeholder value proposition is inside of there,” continued Metcalf.
Manion, of Equideum Health, said that the 21st Century Cures Act, along with the Trusted Exchange Framework and Common Agreement and other federal policies seem to point to the need for technologies like blockchain, along with appropriate privacy approaches, to be part of the next generation of digital health solutions.
Bucci said that the HHS continues to support implementing blockchain as an underlying technology to support AI and machine learning, as seen in the recent release by the agency of the HHS Trustworthy AI Playbook.
Although Bucci said there is no current federal or state level policy for blockchain use in the health care sector, the Uniform Electronic Transactions Act established a digital signature framework most states adopted in some form which might support blockchain efforts.
“A number of states either enacted specific laws or leveraged the existing framework to recognize blockchain signed records and associated smart contracts as legally valid. That may go a long way to supporting blockchain verifiable claims,” said Bucci.
Bucci said she will also be keeping an eye on pending updates to the National Institute of Standards and Technology guidance and drafts which might impact blockchain implementation.
“The pandemic made data available at a scale that I had never seen before, vastly expanded telehealth service and driven innovations in general that may or may not include blockchain. The pandemic has changed the federal and private appetite for emerging technologies as they have seen the cracks in the current system,” said Bucci.
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