Blockchain technology is a distributed digital ledger system that
enables frictionless data-sharing and prevents corrupting or
damaging data. In this system, information is placed into immutable
blocks and chained together. Once a block is created, you can’t
change that block. The system can detect whether unauthorized
changes have been made. Data integrity is also protected because a
blockchain is decentralized – multiple copies are distributed, so if
one is compromised, the others remain untouched. According to the
existing definition of the Blockchain in Healthcare Today project,
it is a shared digital record of patient health information that
securely authenticates each update and holds the complete history of
patient care. It could be the silver bullet for healthcare because
it prevents fraud. A blockchain system reveals changes on any one of
the copies of data.
It is no wonder that information security
has gained paramount importance in the healthcare sector, given the
high stakes involved. Whether it is keeping confidential details out
of the hands of those who are not privileged, preventing the
alteration and manipulation of records, or ensuring access to the
relevant information by the right stakeholders, the healthcare
industry is no stranger to information security threats made worse
by the fact that more data is being shared on increasingly
exploitable cyber systems. This article provides a glimpse of how a
blockchain can provide better information security by addressing
security-related challenges such as the centralization of data
storage, alteration of records or identities, and advanced
encryption it offers the healthcare industry.
Blockchain consists of a chain of blocks linked together storing
transaction records, creating a tamper-proof, automated
record-keeping system that can be transparent and decentralized. The
tamper-proof characteristic of a blockchain depends on a few
important features of the technology platform. These include
decentralization (the ledger is not held by any single entity but is
rather held by a network of computers that replicate the data and
validate each other by consensus), immutability (meaning that if a
record of a transaction was added to a block, that record could not
be subsequently altered within that block or retrospectively
deleted) and others.
A blockchain consists of three basic
elements: blocks, chains, and nodes. Each block contains transaction
records, a timestamp, and a link to a previous block, thereby
constituting a chain. Meanwhile, nodes are individual computers that
accept transactions, process them, and store them in a copy of a
blockchain ledger. Every node on the network maintains a copy of the
entire ledger and validates new transactions. Additional blocks are
appended to the chain in a process known as mining, where nodes
compete to solve a complex puzzle to add a block and validate new
transactions. It is worth noting that for the network to come to an
agreement on which transactions are valid and to avoid the embedding
of fraudulent information in the chain, protocols such as Proof of
Work, Proof of Stake, and other consensus mechanisms are normally
created. This way, the entire population of nodes in a blockchain
network can agree on the current state of the blockchain. Blockchain
is a distributed ledger that enhances the security and transparency
of recording data.
The risk of data security-related breaches has become a serious
issue in the provision of healthcare services, with the common
threats including hacking, unauthorized accesses, and breaches by
insiders. Attacks against healthcare organizations tend to become
more advanced in terms of complexity, leveraging malicious attacks
such as ransomware or phishing to capture confidential patient data
for criminal gain or to interrupt the delivery of services.
Likewise, intrusion by unauthorized individuals and unauthorized
access by disgruntled internal staff may pose serious risks to the
confidentiality and integrity of sensitive health information.
Traditional
static data storage and management infrastructure can’t give
patients the kind of diagnostics, access, and level of security they
require. Many healthcare organizations still operate their services
on centralized databases rather than decentralized networks, which
introduce single points of failure and can lead to large-scale
breaches. Legacy systems could also be outdated by current security
standards and technology, failing to provide the protection needed
to secure key data. Moreover, such legacy platforms will often be
unable to keep up with rapidly changing technological threat trends.
Regulations such as the US Health Insurance Portability and
Accountability Act (HIPAA) and the General Data Protection
Regulation (GDPR) in Europe exist precisely to mandate stringent
data security measures, including access controls and regular
auditing. Compliance with these regulations enables patient records
to be protected to an extent but also involves onerous,
bureaucratic, and costly burdens that become challenging to meet
when an institution is constrained by legacy systems that aren’t
designed with current threats in mind.
Because thousands of nodes work together to store all the data, there is no single point of failure, making blockchains virtually immune to cyberattacks. This also makes medical information on the blockchain virtually inaccessible for anyone who doesn’t not only have access to a blockchain on the same network but also has the account keys. This decentralization and security-by-design principle are two key characteristics of blockchain technology that the entire system leverages to secure healthcare data.
Another critical feature of blockchain is its immutability or disallowance of change once healthcare data is entered into a block. The data is placed on a blockchain and made tamper-proof by cryptographic hashing, in which each block gets inextricably linked to the next one. When further posts are made, the entire chain of ledger gets updated. This gives a mechanism to increase the network’s consensus about what a patient’s history is, and this chain of posts cannot be deleted or modified. Due to this feature of the blockchain, there is no possible way to go back and change a data record. If someone tries to modify a database entry in the chain, the whole system becomes aware of it and rejects the changes.
Crucially, encryption is central to any blockchain system, ensuring that all data directly passed between a system and a user is always protected. Encrypting data stored in a blockchain also means that any actor can’t unilaterally view it except an authorized user with the keys to unlock or decipher it – this is particularly important when handling sensitive information like health data, making patient information even more secure.
Access control is built into the platform via smart contracts (a self-executing contract in which the terms of the agreement are written into code and automatically executed) as well as cryptographic keys (a code chosen randomly by a computer to encrypt a message and decrypted only by a specific recipient using another randomly generated code). Smart contracts are used to regulate access to the data, and cryptographic keys make sure this access is strictly controlled – and controlled only by designated people. In this way, the blockchain offers numerous advantages over traditional databases because it caters specifically to the importance of data privacy without creating risks of private data being accessed by unauthorized people.
Empowering patients to independently own and control their records while preventing third-party manipulation could be game-changing for the healthcare industry. Blockchain’s technological design presents numerous benefits to this scenario. For instance, patient records could be directly uploaded into a consensus-driven, distributed, immutable ledger using a private blockchain: The idea of storing the records of the medical history of a patient in an immutable record ensures that all records are accurate and that once written into the chain they cannot be subsequently edited. Control over access to the blockchain ledger can be achieved through encryption via cryptographic keys, meaning that patients themselves could either grant or revoke access to their own records while ensuring confidentiality and no risk of hacking.
Today’s biggest challenges in sharing health information among organizations are related to security and interoperability. Blockchain can overcome those challenges, offering a secure and immutable channel for data sharing. Each information upload is recorded into a decentralized ledger, ensuring that everybody who needs to see the same relevant information sees the same unchanged information at all times. This further enhances the possibility for more effective and efficient data exchange, drastically reducing the occurrences of data breaches and data entry errors.
The transparency and integrity of data collected during the trial process are the keys to ensuring the integrity of trial results and maintaining the public’s trust in clinical trials. Blockchain can also improve clinical trial efficiency and prevent data manipulation. By providing a transparent record of all trial data (from consent to final results), it (1) deters manipulation of trial data and makes it easier to detect; (2) facilitates tracking changes to the data; and (3) more efficiently manages consent and data-sharing among researchers.
Counterfeiting of medicines is a serious global issue involving billions of dollars. Blockchain, with its ability to guarantee the authentic provenance of an item, can easily bring transparency between drug producers and pharmaceutical dealers throughout the supply chain. This is done by recording the entire process of a drug’s life on a distributed ledger – from the manufacturer and distributors to the pharmacies, ensuring that the drug that reaches a consumer – is safe and the same one that left the drug manufacturer.
A key benefit of using blockchain technology in healthcare is that it allows for enhanced security, mainly by reducing the risk of data breaches. Much of the value of blockchain stems from the fact that the data isn’t stored in one place on a central computer system; instead, it is distributed across multiple locations. This means that if a single computer is compromised, it shouldn’t be possible for the hacker to gain access to information stored elsewhere, thereby mitigating the risk of a single point of failure and making it harder to target more than one node in a coordinated attack. The incorruptible nature of the blockchain also means that data is immutable, in the sense that once it has been recorded, it’s impossible to delete or change it: this creates a secure and verifiable record of every patient’s information.
Its properties of greater transparency and trust in data management are also relevant. Every blockchain contains a permanent record of data transactions, which all authorized parties can view. With its 100 percent transparency, a blockchain registers all commands and actions with an indelible audit trail that can be inspected with data analytics tools, decompiled, and, if necessary, retraced. Furthermore, audit trails can be segmented to ensure that certain aspects of procedures are only visible to those in a need-to-know position. In effect, this brings greater trust and prevents fraud.
The use of blockchain will enhance efficiency as many health sector processes have heavy regulations and procedures, with many intermediaries and much paperwork involved. With blockchain, data verification and transactions can be automated through smart contracts, an algorithm that runs autonomously on the blockchain and can generate actions once certain conditions are met. This allows for a reduction in manual processes and costs and streamlines data processing, thereby helping to improve the efficiency of operations.
Patients are given fuller control over their health data by the ability to provide, share, and revoke information based on cryptographic keys using blockchain. The rise of self-sovereign identity allows patients full access to their data and enables them to determine who can view or use it, giving them greater control and improving the privacy of their health information. Such capabilities are more likely to foster patient trust regarding their health data and engagement in self-management.
However, the newest innovations on the blockchain are set to
radically reshape healthcare through its unique approach to data
security and management by tackling some of healthcare’s most
stubborn roadblocks. These new strategies include the ability to
develop improved consensus algorithms and more scalable blockchain
frameworks to enhance the speed and functionality of blockchain in a
healthcare context. Other new developments are also geared towards
improving interoperability between different blockchains, and
integrating blockchain with other technologies such as IoT, AI or
3D-printing, to elegantly bring all the promises of a decentralized
digital world to healthcare.
Moreover, blockchain isn’t just
having a health-specific moment. Still, it is also integrating with
other technologies, such as artificial intelligence (AI) and the
Internet of Things (IoT), with some exciting implications. AI can
use the immutable means of recording data on the blockchain as the
basis for predictive analytics and decision-making (the
technological future will rely heavily on an ‘intelligence’ built on
reliable information). IoT devices generate a host of health data,
and their real-time monitoring capabilities can be even more
beneficial when data from wearables and other connected devices is
recorded and tracked in a secure way and verified with a real-time,
decentralized network like the blockchain, ensuring its authenticity
and accessibility. This combination of technologies could lead to
more customized and proactive medicine, helping healthcare
professionals improve patient outcomes and efficiency.
With the
projections in the figure predicting a rise in the adoption of
blockchain, it can be predicted that blockchain will become more
mainstream and will become a part of many healthcare organizations.
Over time, we will notice more changes towards blockchain in daily
work in the healthcare system because the technology will get more
mature and show its value in protecting data, reducing fraud, and
easing work for operation from the very beginning. As more
healthcare staff see the purposes of blockchain and many countries
are paying more attention to protecting patients’ data and are more
stringent in terms of regulations, it is quite likely for more
organizations to use blockchain, too. Blockchain will also receive
more support, investment, and promotion from governments. Over the
next three years, blockchain will likely become a standard part of
healthcare IT infrastructure, changing how data is stored and
shared.
To summarize, blockchain technology has the potential to revolutionize how health data is secured. It can address several pertinent issues associated with the insufficient security of health data, such as data hacking, lack of authorized access, unauthorized sale of data, and fraud while promoting increased transparency and consumer trust. The integration of blockchain with existing health systems has the potential to improve the protection of health data around the globe while facilitating better exchanges of information. All in all, only time will tell how the technology advances and its inherent capacity to be integrated with the existing systems will be leveraged. For now, it’s safe to say that blockchain has the potential to alter the security of storage and exchange of health data shortly, leading to a more secure and efficient healthcare ecosystem.