- Benefits of the technology
- The downsides
- Conclusion
- Sources
In a decentralized blockchain network, no one has to know or trust anyone else. Each member in the network has a copy of the exact same data in the form of a distributed ledger. If a member’s ledger is altered or corrupted in any way, it will be rejected by the majority of the members in the network.
Companies often exchange data with their partners. This data, in turn, is typically transformed and stored in each party’s data silos, only to resurface when it needs to be passed downstream. Each time the data is transformed, it opens up opportunities for data loss or incorrect data to enter the workstream. By having a decentralized data store, every entity has access to a real-time, shared view of the data.
Decentralization can reduce points of weakness in systems where there may be too much reliance on specific actors. These weak points could lead to systemic failures, including failure to provide promised services or inefficient service due to the exhaustion of resources, periodic outages, bottlenecks, lack of sufficient incentives for good service, or corruption.
Decentralization can also help optimize the distribution of resources so that promised services are provided with better performance and consistency, as well as a reduced likelihood of catastrophic failure.
(Source: here)
Enables the owner of medical data to maintain its privacy while also providing a vehicle for patients, doctors, and healthcare providers to share the same information rapidly and securely In addition, can reduce patient documentation errors and issues resulting from conflicting data among medical practitioners. Moreover, blockchain technology, in combination with smart contracts, can set parameters that only allow access to patient data in compliance with a patient’s consent policy.
There are no third-party payment vendor services with blockchain as it relates to fees, meaning once a service is provided, the healthcare provider can receive a direct transfer of the agreed-upon cryptocurrency directly to their wallet, which provides a secure, transparent, fast, and traceable method of payment.
Current recordkeeping systems can be vulnerable to cyberattacks as data breaches result in significant financial losses to healthcare practitioners and organizations, reduce trust, and damage brand integrity. Blockchain, however, can be used to create standard security protocols, provide end-to-end encryption, prevent unauthorized access to data while in transit, and verify the integrity of software downloads. In addition, decentralizing sensitive data makes it harder, if not impossible, for hackers to penetrate data storage systems.
Rather than storing data in a single location, blockchain is stored across a network. That means if a healthcare organization suffers a massive data breach, the entire chain isn't compromised.
Blockchain technology requires a private key to grant access. Patients could allow access to trusted parties like physicians, but it would make unauthorized access nearly impossible.
The mathematical equations that compose blockchain help preserve the integrity and quality of data across the network.
Difficulty of Implementation and Development (Source)
Creating a provably consistent system is not an easy task. A small bug could corrupt the entire database or cause some databases to be different than other ones. Of course, a corrupted or split database no longer has any consistency guarantees. Furthermore, all such systems have to be designed from the outset to be consistent. There is no “move fast and break things” in a blockchain. If you break things, you lose consistency and the blockchain becomes corrupted and worthless.
Fixing or starting over and moving on a database would be easy enough to do in a centralized system, but this is very difficult in a decentralized one. You need consensus, or the agreement of all players in the system, in order to change the database. The blockchain has to be a public resource that’s not under the control of a single entity (decentralized), or the entire effort is a very expensive way to create a slow, centralized database.
A traditional centralized database only needs to be written to once. A blockchain needs to be written to thousands of times. A traditional centralized database needs to only checks the data once. A blockchain needs to check the data thousands of times. A traditional centralized database needs to transmit the data for storage only once. A blockchain needs to transmit the data thousands of times.
The costs of maintaining a blockchain are orders of magnitude higher and the cost needs to be justified by utility. Most applications looking for some of the properties like consistency and reliability can get such things for a whole lot cheaper utilizing integrity checks, receipts and backups.
Scaling is at least several orders of magnitude harder than in a traditional centralized system. The reason is obvious. The same data has to live in hundreds or thousands of places than in a single place. The overhead of transmission, verification and storage is enormous as every single copy of the database must pay them instead of those costs being paid just once in a traditional, centralized database. You can, of course, reduce the burden by reducing the number of nodes. But then at that point, why do you need a decentralized system at all? Why not just make a centralized database if scaling costs are the main concern?
Large Amounts of Data (Source)
Private healthcare data tends to be highly voluminous, which could impact the functionality of the blockchain. Blockchains suffering from network slowdown due to large storage could prevent an obstacle to mass adoption in the healthcare industry.
The Inherent Nature of Blockchains (Source)
Blockchains are not databases. Their role is to disseminate data, not store it. The structure of a blockchain actually makes it very expensive to keep information on-chain—a reason use cases so far have mostly used blockchains for provenance data, which are quite small.
EHRs, meanwhile, aren't exactly light on data. It's conceivable the health information of even a single individual would be too much to store on-chain, especially if it includes multiple large files like high-resolution images. There's no way any blockchain developed so far would be able to contain the data housed in a titanic EHR system.
"It's just too expensive, I mean that's a showstopper right there," Smolenski said."You know, if you take a photo from a standard camera today, that's 8 MB. If you were going to store 1 MB on a shared network it would cost you about $7,000, so it's not even practical."
Storing Patient Data on a Decentralized Network (Source)
HIPAA compliance may be an issue when storing private patient data on a decentralized network designed to be transparent. Storage of private patient data on a public ledger presents a risk of sensitive data being exposed. There is an argument that use of blockchain technology alone is not enough to ensure the requisite level of privacy.
The Encryption Method of Blockchain (Source) (Source 2)
Blockchain is premised on mathematically derived pseudonyms for distributed ledger verification and the HIPAA Privacy Rule prohibits use of mathematically-derived pseudonyms because of potential re-identification of de-identified protected health information (PHI). This limitation on the use of mathematically-derived pseudonyms as re-identification codes for de-identified information effectively makes blockchain non-HIPAA compliant (Page 53233).
There are, of course, many ways to counteract the downsides such as using blockchain together with alternate database. However, I firmly believe the downsides, even with the possible solutions, still outweigh the potential benefits the technology may bring.
- https://jimmysong.medium.com/why-blockchain-is-hard-60416ea4c5c
- https://aws.amazon.com/blockchain/decentralization-in-blockchain/
- https://www.jdsupra.com/legalnews/3-ways-that-blockchain-can-help-the-1711780/
- https://www.hipaajournal.com/blockchain-medical-records/
- https://www.anonos.com/blockchain-and-big-data-privacy-in-healthcare
- https://masur.com/lawtalk/is-blockchain-hipaa-compliant/
- https://www.fiercehealthcare.com/privacy-security/3-reasons-blockchain-answer-to-ehr-interoperability-and-security
- https://www.fiercehealthcare.com/tech/private-blockchain-explained-what-it-what-it-isn-t-and-how-to-manage-your-hipaa-expectations
- https://www.hipaavault.com/resources/blockchain-technology-and-the-future-of-healthcare/?amp