Blockchain and medical data: how it works

    Today we will tell you how the Exonum TM blockchain can speed up the processing of medical data and protect this data from theft.



    Confidentiality


    Digitalization of medicine today enables all participants in the healthcare system, from patients to pharmaceutical companies, to exchange data electronically.

    For example, electronic medical records (EMRs) have made it easier for doctors and patients to access medical records. Similar solutions are successfully used in Taiwan and Estonia . EMRs open up new perspectives in healthcare, but they also require new approaches to personal data security.

    Human health data is very attractive to cybercriminals. According to  researchPonemon Institute in 2016, 89% of the interviewed heads of medical organizations admitted that they have encountered at least one leak in the last couple of years. Government agencies such as the U.S. Department of Health and Human Services ( HHS ) and laws like the 1996 Health Insurance Mobility and Accountability Act ( HIPAA ) provide recommendations on how to protect health information, but leaks often occur .

    Blockchain is able to help with solving the problem of personal data security in medicine. Distributed registries can formalize the process of sharing medical records, as well as give patients more control over their health outcomes. We at Bitfury, together with colleagues from the biotechnological company Insilico Medicine and the University of Oxford, developed the concept of the medical ecosystem on the Exonum blockchain. We will tell you how it is arranged.

    Exonum medical ecosystem on blockchain


    Our medical ecosystem consists of blockchain and cloud storage. The blockchain stores small files with medical data, and large files are stored in the cloud. The blockchain records information about data uploaded to the cloud, rights to read it, and information about key keepers.

    Any company can act as a cloud storage provider (the main thing is that the service meets HIPAA requirements). It is planned to store voluminous medical data in it, for example, CT or MRI images, which can take tens of megabytes. All data uploaded to the cloud is encrypted.

    Our medical ecosystem has four user groups:

    • Users (patients) - patients themselves or authorized third parties (medical centers, for example) who upload medical data to the system.
    • Validators - verify the quality and authenticity of data uploaded by users.
    • Clients (doctors) - study patient data, compile health reports.
    • Pharmaceutical and research companies - may gain access to anonymized user data.

    For the exchange of data, special LifePound utility tokens are used. Their number depends on the value of medical data on the blockchain. An individual record is considered as a system of three elements (triad) - type, time and quality.

    The data type can be dynamic (for example, a blood test or an epigen) or static (genome, fingerprints). The time element is the date that this data was received. As for quality, the “expiration date” of information or analyzes is taken into account - the higher it is, the more valuable the information. For example, a test result for cholesterol is valid for six months, and a genetic test - for life.

    In general, the model for calculating the value of a medical record for one person can look like this:



    Here k is the number of medical records, fk is the cost function for a combination of these records, and R is the triad.

    Other formulas are offered to calculate the cost of data for a group of people or entire families. You can find them in the report posted on our website, on page 11 .

    How data is handled


    The work begins with the fact that users upload data to the cloud storage, where they are checked and anonymized - the patient identifier is deleted - and then encrypted using symmetric encryption . Then, using the Shamir algorithm , the keys are sent to the custodians (this is one of the types of complete blockchain nodes) via direct authenticated communication channels so that they can decrypt user data if necessary.

    At the same time, a service transaction is generated that informs other participants in the ecosystem about the data upload to the cloud. This transaction contains the public key, data type information and a link to it in the cloud storage. After electronic signature, information can be recorded on the blockchain.

    To the decision whether to add a transaction to the blockchain or not, network participants come by consensus algorithm . Validator nodes verify the information and generate a service transaction that contains the data hashes and the validation result. If the data has been verified, then they are written to the blockchain, and their owner receives LifePound tokens, the amount of which is determined by the smart contract. After that, patient information is made available to other participants.

    Then, if the doctor needs these data for research or diagnosis, he forms a request and sends it to the validators. They add the request to the blockchain and inform the custodians that they need to send cryptographic keys to the doctor to decrypt the data from the cloud. Likewise, the process looks like for pharmaceutical companies, research institutes, public health facilities, and regulatory authorities.



    Prospects


    The Exonum blockchain can become a unified (but decentralized) medical information database. In the future, it will be possible to fill it not only with the forces of doctors who enter electronic card data, but also with the help of medical IoT gadgets. Also on the blockchain, you can record the results of group examinations from diagnostic centers and information about clinical trials of drugs.

    Authorized access to patient data will be obtained by any hospital in the country. This will enable doctors to quickly share the results of clinical trials, which will accelerate the development of drugs for serious diseases.



    Some of the components of our ecosystem have already been successfully tested in practice. Together with partners from Longenesis and Medical Diagnostics Web, we createdThe first private blockchain based on Exonum for the exchange of medical data in the field of radiology. The solution simplifies the work of radiologists - reduces the analysis time of images and provides access to a single database for research.

    We hope that in the future, with the help of our medical ecosystem, clinic patients will monitor their visits to the doctor, medical services, monitor the dynamics of their health status and evaluate the effects of the drugs prescribed by the doctor. In the future, a single ecosystem based on blockchain will help to speed up the diagnosis of diseases, reduce the number of errors in diagnosing and make the treatment process more transparent.

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