Much is said about blockchain technology, and how it will change how business operates. As with any new technology, a gap exists between understanding the theory and seeing the practical applications. But it should be no surprise that blockchain technology is already being used to secure the digital electronic health record (EHR) of large numbers of people in Europe.
EHR, augmented with data from self-monitoring devices, will change how health is managed. But this digital future comes with legal and ethical risks. Legitimate concerns include how sensitive personal data can be kept secure from theft or cyber-attacks. Without the assurance that blockchain technology promises, digital files can be corrupted, deleted and altered. Since much existing data protection legislation is purblind to digital data, the European Commission has acted to reform the rules across all EU member states. The General Data Protection Regulation (GDPR), aimed to strengthen data protection for those in the EU, puts clear legal obligations on controllers and processors of any personal data.
This move aligns with the concept of a “personal data economy” in which people take control of the scattered mass of digital data about themselves and share it with whomever they choose. Many individuals seeking life insurance want to share their medical data simply and promptly, so it’s important that rules protect that process without hampering it.
Beginning in May 2018, the GDPR will act to hand back control of personal data to individuals. It means their data will be portable between service providers, and people will have the right to be “forgotten” and to have their data deleted when there are no legitimate grounds for retaining it. It is hoped GDPR will simplify the regulatory environment for businesses across the EU, creating savings and increasing competition.
Estonia is on the front foot. The country’s e-government system, which uses a website and smartcard to provide residents instant access to hundreds of public services, has earned it a reputation as a digital pioneer. Notably too, the entire electronic patient records of its 1.3 million citizens are collated in one central database. The security of this store of highly-sensitive personal data is underpinned using blockchain.
Blockchain may be used in any form of asset registry, inventory and exchange. This includes transactions of finance, money, physical property and intangible assets, including health information.
In Estonia individuals’ EHRs are condensed as “blocks” and linked into “chains” by computer code in a bid to keep them safe. The blockchain registers every change, access and update to the records, including hacks or attacks from malware, using a series of computer code - tracks that can’t be modified without leaving a trail. This makes it impossible for the information to be tampered with, deleted or improperly changed in any way without it being spotted. Patients may log in to view who has accessed their data at any point in time or added information to their records. This means people can feel their data is more secure and their rights protected while the opportunities for medical or insurance fraud and other harmful misuse are mitigated.
Estonia stores complete patient histories in a national database to protect public health and create efficiencies and cost savings. The value in the combined medical data is used to drive improvements in the quality and effectiveness of care. The information can be exchanged between doctors so that interactions with clinical services are simpler and personalised.
Sharing data for the common good requires a high degree of trust. One way of ensuring accuracy is to allow people to agree on what represents the truth. Blockchain is a “trustless” system since the network of users act together to vouch for the accuracy of the record. The example of blockchain protecting patient records in Estonia demonstrates its potential to implement other trusted and secure transactions with less bureaucracy.
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