Glad to gradually learn new things in cryptoacademy. We have reached week 3 of season 4 . Today i am writing homework task for professor @yohan2on which is about Blockchain in healthcare. Let's begin.

Research and Discuss the potential applications of Blockchain in the Health care industry

Blockchain is a decentralized public ledger system that has revolutionised diverse fileds of day to day utility through its inherent features like transparency, security, anonymity, non-repudiablity, accountability, auditablity , data integrity etc. We are concerned about use of blockchain in healthcare. It still seems a bookish concept in majority of the countries across the globe but we have real life example of the countries who adopted blockchain in healthcare and have met promising result. Estonia is a northern European country where 95% of health information is ledger-based. We will discuss this topic under following hearings :

• Blockchain for patient care.

• Blockchain for health professionals.

• Blockchain in healthcare supply chain.

• Challenges of blockchain adoption.

• Conclusion

Blockchain for patient care

Healthcare is much more than doctor patient relationship, although patient care lies at heart of healthcare. With the diversifying reach of blockchain to healthcare, patient care would be improved in following perspectives :

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• There is no substitute of blockchain as for record keeping is concerned. In India about 75 million people above 60 years suffer from chronic diseases. And in chronic diseases treatment of patients is carried out while looking at the previous records of the patient and patients live with these disease for decades and maintaining written records manually so long is very tedious and majority of the patient are not able to do so. With the incorporation of blockchain , patient records will become available online as electronic medical reports (EMR) and the burden of carrying out the bags of records will be solved forever.

• Electronic medical records (EMR) will help to identify the trend of diseases. Trend of diseases refer to the type of disease prevalent in a particular society or globally. With the recent change in the lifestyle of the people from manual workers to sedentary workers, trend in disease and deaths thereof has changed from infectious diseases to chronic diseases related to lifestyle like obesity , hypertension, diabetes etc. These lifestyle related disease came to be known as modern epidemic. With the incorporation of the blockchain in the healthcare trend of disease globally as well as locally would be evident in real time and foster action in time. Same holds true for epidemic outbreaks in which a particular type of symptom complex manifest in the people at an unusually higher rates and would therefore trigger alarm and an real time action. We can correlat it with the recent covid-19 outbreak which took about months for nations to bring into the notice of the healthcare authorities and the consequences are evident.

• Clinical trials carried out to study the efficacy of new drugs and vaccines are carried out confidentially without revealing the nature of drug given to the participants of trial. Moreover , those administering the drugs also do not know the nature of the drugs. This process is known as blinding and there is some third party that holds the codes of drugs administered. Selection of the participants to whom drugs are given and those to whom placebo is given is carried out on the basis of randomisation . Despite all these precautions there are chances of bias of various types. With blockchain, blinding and randomisation would be carried out in an ideal manner and therefore the results of the trial would be fair and transparent, that would in turn improve the healthcare .

• With manual record keeping, those in charge of record keeping have access to all the details of patients including diseases and addresses. This is in a way breech of privacy. With adoption of blockchain, privacy would be ensured by keeping private key bound records. More worrisome fact than above is that, some miscreants have stolen credit card and banking details from the health related records. Akiri, BURSTIQ, FACTOM, MEDICALCHAIN, GUARDTIME , HECOD are some of the companies that run blockchains dedicated for healthcare record keeping.

• Patients can share their records globally with the health professionals of their choice and avail best possible health care at minimum possibile cost. This would therefore remove the burden of healthcare expenses and ensure best possible treatment.

• Notifications generated in case of prophylactic, promotive and preventive treatment regimens would ensure 100% complaince. Patients can get medicine timing /schedule notifications just like we recieve text messages for cellphone recharges before exhaustion of packs. For example, all pregnant women are given folic acid tablets daily for first three months. Adoption of blockchain would allow generation of messages or notification to each pregnant mother on time and would therefore ensure 100% compliance.

• Benefits of health insurance would reach the deserving candidates as non editable and immutable nature of blockchain won't allow tempering of data that is usually seen in case of manual record provision for availing such benefits. Moreover, on time delivery of funds would be promoted. In india, one such company goes by the name of Vitraya Technologies and has shown good results as for service delivery is concerned.

• Use of smart contracts and internet of things has led to development of smart medical equipments that are programmed to detect signals about vital parameters like heart rate, blood pressure, temperature etc and communicate the same to the other IOT based devices for real time action. For example, a smart therap wriat band is able to detect any abnormality in working of patient's heart like heart attack and notify same to nearest possible health centre with location of patient for timely action.

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Blockchain for health professionals.

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• Blockchain would revolutionise the field of research. With the integration of datadata and being a public ledger, tons of data would become accessible for researchers and organisations in well structured manner and would therefore promote the field of research and that too in cost effective manner. Research in field of genetics would definitely touch new heights as global gentic information would be compacted in one place for researchers to dig deep and come up with miracles. Moreover, the genomic thefts that are common traditionally would be avoided.

• Well integrated system would allow registered health professionals throughout the globe to interact with each other in real time and discuss cases with professionals of super specialties and therefore increase their knowledge and skill.

Blockchain in supply chain

• Drug Tracking is one of the major advantages that would be provided by the adoption of blockchain in the healthcare system. In USA about 10% of the drugs supplied are counterfeit and in other countries the percentage is even higher. Through blockchain, radiofrequency identification (RFID) standards would be adopted in tracking drugs from source to patient. Authenticity of the drugs would be verified by using a small simple RFID scanner. Moreover, RFID labels containing information about storage conditions and expiry of drugs programmed to generate signals on compromise of any parametre, would promote delivery and dispensing of ideal standard drugs. It would also promote transparency by avoiding dumping of drugs and other logistics carried out by stockists to later sell at higer rates as demand increases. It can be correlated with the dumping of masks and drugs like Ramdesavir and Fempiravir by most of the distributors,
  wholesalers etc during covid-19 pandemic and later selling them at higher rates.

• Tracking of medical equipments: Loss of equipments in hospitals cause them to bear a huge loss every year. With blockchain RFID , tracking of devices would save huge bucks. Moreover , it was shown in one study conducted in US that, on an average during a shift of nursing staff, about 21 minutes are wasted in searching for equipments which collectively accounts for wastage of huge time and resources. Secondly, it would also promote transapeemcy as illegal stocking carried out by some miscreants during the time of anticipated need would be eliminated. It can be correlated with the illegal stocking of oxygen concentrators and cylinders carried out by some miscreants during the covid-19 and later selling them at higher rates. With the use of RFID, tracking of medical devices or equipments to the extent of time of stocking and place of stalking is possible.

• Tracking of equipments and drugs would also promote timely notification about the shortage of drugs and equipments, so that same can be made available before complete consumption and would therefore promote quality service delivery.

Challenges to Blockchain Adoption.

We know that nothing is absolute. Although adoption of blockchain in healthcare system would solve majority of the issues faced by the system currently, but it is not free of challenges . Some of the hindrances that lingers adoption of blockchain are given below :

• One of the major problem that would come under way is that of storage of data. As tons of data is generated every second catering to healthcare , storage of data would pose a biggest challenge and than the scalability of blockchain would add fuel to fire.

• Blockchain being a decentralized public ledger accesible to everyone. Denying access to sensitive information (Personally identifiable Information) would be a challenge too.

• Keeping our current standards of technology and technical literacy in view, it would still sound an alien concept to vast strata of population. Moreover, in countries like that of mine (India) , in 2020 survey showed that only half of population has access to internet but at the same time, no one is immune to all the diseases. So half of our population cannot take advantage from this technology yet.

• Resistance from traditional health care functionaries to change their style of working at organizational, structural, technological level.

Conclusion

Blockchain technology is booming as it is enriched with features that we have been yearning for. As it is gradually diversifying its horizons , its application in healthcare would tackle some of major ensuing problems and bring improvements in other. However, its adoption is not free of limitations. But pros definitely outnumber the cons and is therefore need of hour with some modifications.