Researchers Suggest Using Blockchain For Electronic Health Records (hbr.org)

The CIO at a Boston teaching hospital and two MIT researchers write in the Harvard Business Review that blockchain "has the potential to enable secure lifetime medical record sharing across providers," calling it "a different construct, providing a universal set of tools for cryptographic assurance of data integrity, standardized auditing, and formalized 'contracts' for data access." An anonymous reader quotes their report: A vexing problem facing health care systems throughout the world is how to share more medical data with more stakeholders for more purposes, all while ensuring data integrity and protecting patient privacy... Today humans manually attempt to reconcile medical data among clinics, hospitals, labs, pharmacies, and insurance companies. It does not work well because there is no single list of all the places data can be found or the order in which it was entered...

Imagine that every electronic health record (EHR) sent updates about medications, problems, and allergy lists to an open-source, community-wide trusted ledger, so additions and subtractions to the medical record were well understood and auditable across organizations. Instead of just displaying data from a single database, the EHR could display data from every database referenced in the ledger. The end result would be perfectly reconciled community-wide information about you, with guaranteed integrity from the point of data generation to the point of use, without manual human intervention.

Comments

How do you Store a 5gb MRI image

[hsmith]

In a 256 bit hash? I'd love to know. Block chain can verify data - that is it. Tired of dipshits selling the latest buzz word when they have no idea what it is. Block chain is ledger, not a fucking database.

Re:How do you Store a 5gb MRI image

[frank_adrian314159]

And what do you do when you need medical data expunged from the record? It's difficult enough as is today, but still doable in cases like wrong diagnoses or a doctor or nurse logging to the wrong journal. But you can't modify a signed chain without breaking it - that's the entire point.

Yes. It is the entire point. But you don't remove data from an EMR (Electronic Medical Record). Working with them on a daily basis, I can tell you the "removed" bits and "reason for removal" fields in their databases have a reason. You always add to the record, even if it is a removal. That is, you do if you and your customers value their legal skins.

Re:How do you Store a 5gb MRI image

[Kjella]

Yes. It is the entire point. But you don't remove data from an EMR (Electronic Medical Record). Working with them on a daily basis, I can tell you the "removed" bits and "reason for removal" fields in their databases have a reason. You always add to the record, even if it is a removal. That is, you do if you and your customers value their legal skins.

That's the default, yes. But at least here in Norway you have the right to have information that is found wrong or unnecessary and strongly burdensome not only corrected, but actually expunged. Usually it involves possible substance abuse, child abuse, psychiatric diagnoses or something like that and the burden of proof is on you, it happens very rarely but it does happen from time to time. This is more a legal process around the registration of personal information than a medical process and you can appeal beyond the institution that logged it. Generally though the duty to document is very strong, even if what they thought or did was incorrect that's their basis for action and review so for example if you want to sue for malpractice that should be done first. But even if this happens in only one in a million journal entries, it's pretty incompatible with a blockchain.

Re:HL7

[jbmartin6]

HL7 is just a messaging format, doesn't provide for audit, nor does it scale well across a large number of recipients. Unless you want every hospital and doctor to maintain records on every person, and maintain a VPN to every other hospital and doctor.

Re:Public?

[GLMDesigns]

The blockchain concept is perfect for YOU to store your medical information (or any other information). The issue is distributing the keys to doctors, insurance, gov't etc...

You can store (and add to,) your records easily; and nobody can see it without knowing your "VERY_SECRET_PASSWORD".

But now, here's the problem. How do you disseminate the information to others? And how do you do this if you're in a coma?

Then someone else needs access to this "VERY_SECRET_PASSWORD". And who is that? The government? Insurance companies? That is the problem. Not securely storing it on the blockchain.

Privacy? How quaint.

[Anonymous Coward]

As a physician for > 30 years, I can tell you that the ship has sailed on privacy of your medical records a loong time ago. In the 80s, my senior partner's office medical records still consisted of brief notes jotted on index cards. This basic situation of written or dictated notes, on paper, which were copied and mailed or faxed, really began to shift with the wider adoption of EMRs only in the last 5-8 years - prompted by government diktat and financial penalties. In the hospital, it was all hand-written charts until EHRs became commonplace over roughly the same period.

The driving force for EHR/EMRs is, of course, money. An electronic record can be audited more easily, screens applied, and payments denied. If you go into the hospital and sit in the nurse's station, you would see the medical record perused by doctors, nurses, pharmacists, LPNs, nurses' aides, PTs, OTs, lab techs, venipuncturists, and unlicensed employees of utilization review, quality assurance, billing and insurance preauthorization depts, etc. Not to mention remote access by doctors offices and all the apparatus of the out-patient utilization review, quality assurance, billing and insurance preauthorization, and govermental auditing (Medicare/Medicaid). There have been many many revealed instances of people viewing and distributing info from the charts of spouses, girlfriends, etc. And, this leaves aside the millions of medical records exposed by compromises and hacks of hospital and insurance co. databases. And, I'm sure the NSA or other TLAs have scooped all that data as well.

There really is no privacy to your medical info. But if you want to believe that, fine.