'Blockchain' promises to end the lack of control and inefficiency of health data in the world

Different types of languages and medical records limit the benefits of mass health information. Decentralized databases have the potential to solve the problem, but depend on whether industry and governments are willing to cooperate

In the city of Boston (USA) there are 26 different electronic medical records systems, each with its own language for data representation and exchange. Critical information is often dispersed in multiple facilities, and sometimes it is not accessible when it is most needed; a situation that takes place every day, and that costs money and sometimes even lives. But it is also a problem that seems tailored for blockchain technology to  solve, according to information director at the Beth Israel Deaconess Medical Center in Boston, John Halamka .

Imagine that when a doctor treats a patient or prescribes a new prescription, the person agrees to add a reference to a blockchain, a decentralized digital record book like the one that Bitcoin holds. Instead of payments, this blockchain would record critical medical information in a cryptographic database virtually impossible to corrupt, maintained by a computer network accessible to anyone running the software (see The utility of Bitcoin in the future is independent of the currency). Each time a doctor wrote down a reference in the blockchain, it would become part of a patient's history, regardless of the electronic system used by the doctor. Thus, any other doctor could use it without worrying about incompatibility problems, Halamka explains.

Technologists and health professionals around the world see blockchain technology as an opportunity to modernize the exchange of medical records in a secure way , protect sensitive data from hackers  and give patients more control over their information. But before a revolution in the entire medical records industry is possible, a new technical infrastructure must be built: a  personalized health care blockchain .

The head of accounts of Gem, a start-up that helps other companies adopt blockchain technology , says that is beginning to be resolved. The expert details: "There may be specific rules that we want to include in the protocol to improve medical care." For example, the system should facilitate the exchange of complex health information between patients and providers , as well as between providers, and between providers and payers; all of that while maintaining protection against malicious attacks and complying with privacy regulations.

The best way to do it is still not clear. However, Halamka and the researchers at MIT Media Lab (USA) have developed a prototype system called MedRec (pdf), using a private blockchain based on Ethereum. The system automatically tracks to study who has permission to view and change the record of the medications a person is taking. MedRec also solves a key problem facing almost anyone who wants to use blockchainOutside the realm of digital currency: miners. With Bitcoin and other cryptocurrencies, miners use computers to perform calculations that verify blockchain data, a crucial service that keeps the system running. In turn, they are rewarded with part of that currency (see What is Bitcoin, and why is it important? ).

MedRec encourages miners (in general, medical researchers and health professionals) to do the same job by rewarding them with access to aggregated and anonymous data from patient records that can be used for epidemiological studies  (as long as patients authorize it) .

But this type of mining requires a lot of computing power, and the computers that do the work can consume a lot of energy. This process may not be necessary in an application for medical care, says Associate Director of the Media Laboratory and co-creator of MedRec, Andrew Lippman . He maintains that the following versions of MedRec can try to get rid of Bitcoin-style mining. For example, the blockchain of medical care could be based on the abundant computing resources available in some hospitals to verify information exchange.

Either way, the potential of the blockchain for the healthcare industry depends on whether hospitals, clinics and other organizations are willing to help create the required technical infrastructure . At this time, that means creating prototypes and testing fundamental concepts, says Vaughn. For example, the  health care blockchain will need a way to provide impregnable information about a patient's identity to anyone who needs it, anywhere.

To this end, Gem is working with clients on the prototype of a global patient identifier based on blocks that could be linked to hospital records, as well as including data from other sources, such as employee welfare programs and health monitors laptops It could be just the necessary link to join the maddening mosaic of digital systems that are now available.