Hashing it Out: Blockchain Terms Explained Part 3.

#Hashing it Out: Blockchain Terms Explained aims to help demystify common terminology used in the PharmaLedger project.

Cryptocurrency is no longer the only sector using distributed ledger technology (DLT), as more and more industries are realising its potential. Blockchain isn’t anything new, but its application in healthcare is still early in its development. PharmaLedger is applying this technology to derive tangible solutions and its added value through eight use cases.

If you’re trying to make sense of all the technical jargon surrounding blockchain, follow along as we continue our mini-series: #Hashing it Out: Blockchain Terms Explained. Creating a more trusted healthcare ecosystem backed by DLT is only the beginning of how we can use this technology to build greater efficiency and a more trusted healthcare ecosystem. 

1. Governance

When it comes to blockchain, governance involves determining how the given blockchain will function and be structured. This can include the rules, management and architecture of the project. 

In order for a blockchain network to work efficiently, there has to be a structure of parameters and rules based on the participant’s goals. A company has certain rules and an organisational structure that clearly defines roles and responsibilities. Governance affects companies, partnerships, projects and organisations doing some sort of activity. Blockchain governance deals with the various processes and technologies that make up a blockchain system. 

Since this technology is constantly evolving, it is important to make sure that blockchain is working efficiently while still in development. What gets a bit complex is answering the questions: Who is making these decisions, and how can we be sure that the goals of the blockchain network are ethical? These are some of the issues that are being covered on legal and regulatory levels.

What it means for healthcare

Our PharmaLedger consortium is made up of 29 partners that are currently co-working to determine the structure and processes of the blockchain network being built. The partners are the ones in charge of deciding the project governance of the blockchain platform and any major changes. 

PharmaLedger is a three-year project that is actively working to determine exactly how the blockchain architecture will operate, since it has to have established and agreed upon guidelines in order for it to function properly. Once the project concludes in 2022, a new governance body/entity would ideally provide next-generation governance to the decentralised blockchain ecosystem. The 29 companies in the PharmaLedger project are helping to create a blockchain network now, but once the three-year project ends, ideally the progress made by PharmaLedger and blockchain will continue. Ideally, the PharmaLedger partners involved now will step in to govern the network. In order to provide stability to the next generation body/entity and the PharmaLedger project, the likelihood will be a continuation of the existing stakeholders and consortium members. They are likely to be key participants in establishing the required governance for the successful implementation of the ecosystem in the future. 

You can read more about the PharmaLedger project and its governance by reading about the recent Insureblocks podcast with invited PharmaLedger guests.

2. Provenance

Data provenance is the field of creating an audit trail of given information–the history of the information and how it is collected, stored and used. 

Blockchain itself creates a “digital trail” that cannot be changed or altered. This is useful in supply chain management, where tracking processes and finished goods using blockchain technology helps to trace the origin of a product, which is also important when checking the authenticity of products.

What it means for healthcare

One example of data provenance is authentic medical products being traced in the current COVID-19 pandemic. One can now purchase fake COVID-19 vaccine certificates and it is obvious how this poses a risk to the public, especially if unvaccinated individuals are using these fake certificates to travel without even taking a preventative test to see if they are testing positive. If these vaccine certificates were to be traced on a blockchain-enabled application, for example, it would be easy to check the origin and authenticity of these certificates. You can read more about these fake certificates in the recent article Inside the Paranoid, Highly Excitable Ecosystem of the Vaccine Card Black Market from the New Republic.

Data providence provides evidence of how the tracking and tracing occur so that the validation and verification process is simplified while also maintaining the right integrity of the data. Read more about the PharmaLedger Anti-Counterfeiting use case to find out how the project wishes to address this issue.

3. IoT Devices

Internet of Things (IoT) devices are physical items with sensors, software and other technologies that allow them to be connected to each other and share information through the internet. 

An example of this is fitness wearable devices or even smart home devices. Integrating low-powered and smaller chips called Radio-frequency identification (RFID) tags into physical items has made it possible to connect physical items that normally were not connected to the internet to emerge. 

An obvious IoT device is a smartwatch that helps record your workouts or sleep schedule. Another area on the rise is industrial IoT, where processes and supply chains would be revamped with interconnected structures and greater efficiency with all parts online. These devices allow greater monitoring, but there is yet a big challenge to how to manage the large amounts of data recorded by these devices and organise it systematically.

What it means for healthcare

In the healthcare industry, IoT and IoMT (Internet of Medical Things) devices are used to collect and monitor health data from patients. 

A smartwatch recording your heartbeat during a workout can be taken one step further by applying this in the medical field. What if there was a way to use IoMT devices for research purposes? This is the idea behind PharmaLedger’s IoT Medical Device Use Case, where patients with chronic heart failure are supported with various IoMT devices. Data collected through these IoT devices would allow patients and participants in clinical trials to remotely provide data to the trial. After collecting this information retrospectively, it then transmits onto the PharmaLedger blockchain-enabled platform where it is then stored and analysed. In the long run, the idea is that these IoT devices would allow for faster analysis to make quicker decision-making regarding a patient’s health. You can also learn more about how IoT devices can be used in clinical trials by reading about our second PharmaLedger Track track panel discussion from the European Blockchain Convention (EBC): Powering Clinical Trials with IoT and Blockchain.

4. Self-sovereign Identity 

Self-sovereign identity (SSI) is a way in which an individual or business can use a digital identity to control and own their accounts and personal data without the need for a central authority. This means that each user owns his or her data and can control what is shared and with whom. 

Users with SSIs on a blockchain can apply it for verification or transactions without needing an intermediary to verify it. SSIs grant users more empowerment since they can consent and control their data by knowing exactly who is accessing the data and in what way. This is also beneficial because third parties are prevented from selling or monetising a user’s data without their knowledge. It is interesting to note that many social media websites or credit card companies may be using our data without our knowledge. One area where SSIs are being introduced and helping to empower patients is in the medical field. Patients will finally be able to be in control of their own medical data.

What it means for healthcare

A good example of this in healthcare is that a user can through an SSI to share information with a doctor or a clinical trial. 

First, a patient creates an SSI via an app, and therefore establishes their personal digital identity on a healthcare blockchain network. When a doctor or clinical trial researcher wishes to access certain data, a patient is notified via the app and can grant or deny consent to share this health data. This system leaves a clear record of how and with whom the data is shared. 

This process empowers patients, gives better control and ownership over personal health data and has even led to discussions of possibly creating a rewards system where patients are rewarded for participating in clinical trials and sharing their data. PharmaLedger’s Clinical Trial eConsent Use Case explores how to more easily screen and connect patients’ access to research studies, and uses SSI to help patients grant access to health data.

5. Data silo

When data is siloed, it means that the information is “stuck” in one place, often due to the incompatibility of various systems or due to inefficient processes. 

Siloed data can happen in large companies where the management systems are far too large to communicate efficiently among each other due to legacy infrastructure. Data silo also relates to information technology. This is one of the main challenges of interoperability (explained in #Hashing it Out: Blockchain Terms Explained Part 2.) when systems and software aren’t compatible with the different technologies working together. All the new software and information is collected, yet it gets siloed in one place and doesn’t get analysed properly in a beneficial way. As more data is being collected, making use of it all is a new challenge of this day and age.

What it means for healthcare

There are so many different processes and softwares used in healthcare, so it’s understandable that a lot of information gets siloed throughout the healthcare ecosystem. Working to make these various systems and processes work together is where blockchain technology comes into play. 

Blockchain can help siloed information become interconnected by having current linear systems unite with common data sharing with patients at the centre- the PharmaLedger platform. This new way of sharing information can also lead to an innovative interconnected digital core. 

But, technology isn’t the only area where blockchain can distribute siloed information. By creating a more efficient medical supply chain with blockchain, problems are detected faster and information that has been siloed can be shared more quickly. 

If a factory producing a specific product suddenly makes a recall, it could take months to reach a patient that has purchased the faulty product. Through a blockchain-enabled interconnected supply chain, patients would be able to be notified of a specific product right away through an app, which is all interwoven through the healthcare ecosystem. These are just a few examples of how PharmaLedger is easing the burden of siloed information in the medical field.

This concludes part three of our Hashing it Out: Blockchain Terms Explained series. As a part of our educational series, we will also be releasing short videos on each of our eight use cases that will help you understand how we are creating a blockchain-enabled healthcare ecosystem.

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