Blockchain in Healthcare Today <p><strong>Blockchain in Healthcare Today (BHTY)</strong> is the world’s first international peer reviewed journal that amplifies and disseminates distributed ledger technology research and innovations in the healthcare sector. The preeminent open-access journal facilitates discussion and consensus building for a multi-disciplinary global community.</p> Partners in Digital Health, 241 Hamilton Avenue, Suite 21 Stamford, CT 06902 en-US Blockchain in Healthcare Today 2573-8240 <p><span style="color: #4b7d92;">Auth</span><span style="color: #4b7d92;">ors retain copyright of their work, with first publication rights granted to Blockchain in Healthcare Today (BHTY). Read the full <a href="">Copyright Statement</a>.</span></p> <p> </p> <p> </p> Critical Care Equipment Management Reimagined in an Emergency <p><strong>Summary</strong>: The COVID19 pandemic created a surge in demand for critical care equipment against a backdrop of fast-moving geographic virus hotspots. A team from IBM Europe was put together to prove that a devolved healthcare system can be rapidly bridged by a mix of advanced and legacy technologies to provide a federated view of critical care equipment deployment and use during an emergency. This was achieved with the deployment of predictive analytics and blockchain, integrated with conventional hospital management system. The corollary investigation determined the manner in which this system can be harnessed in a postemergency recovery to provide a national supply chain efficiency backbone.</p> <p><strong>Method</strong>: During a period of 2 weeks, a team of IBM consultants set up a technology sandbox environment to represent a network of an equipment manufacturer, a central national emergency monitoring center, and several hospitals managed by their respective trust organization. Within this environment, a hospital asset management system, Maximo, was configured to manage and track critical care equipment within a hospital; a blockchain traceability platform, IBM’s Blockchain Transparency System, was configured to ingest multiple hospital data reports; and a predictive analytic dashboard, Watson Analytics, would retrieve data from the blockchain platform to supplement other data sources to provide national views and support decision-making for the supply and movement of equipment. Three key principles in the design of this environment are speed, reuse, and minimal intrusion.</p> <p><strong>Results</strong>: The hypothesis was to test whether the chosen technologies can overcome the challenges of misaligned demand and supply of critical care equipment during a national emergency. The execution of the tests led to successful simulation of three scenarios: (1) the tracking of the location and usage history of any single equipment that has been placed into the network; (2) the movement of equipment between independent hospitals is recorded and reported; (3) a real-time interrogation of the current location and status of all registered equipment.</p> <p><strong>Conclusions</strong>: The successful completion of this proof of concept has demonstrated that emerging technology can be used to overcome poor macro level coordination and planning, which are the drawbacks of a devolved healthcare system. The corollary was that this proof also demonstrated that blockchain technology can be used to prolong the useful life of conventional technology.</p> Winston Yong Anya Kundakchian Copyright (c) 2020 Winston Yong, Anya Kundakchian 2020-12-17 2020-12-17 10.30953/bhty.v3.146 2020 Reflections: How a Pandemic Will Catalyze Innovation <p>This article reflects on key use cases that have received recent attention in the COVID-19 response as a result of the HIMSS Blockchain Task Force exploration of opportunities for futher blockchain adoption.&nbsp;</p> Katie Crenshaw Copyright (c) 2020 Katie Crenshaw 2020-11-07 2020-11-07 10.30953/bhty.v3.152 The Fourth Industrial Revolution of Healthcare Information Technology: Key Business Components to Unlock the Value of a Blockchain-Enabled Solution <p><em>Editor’s note: This article is one of an ongoing series covering topics published in conjunction with the Health Information Management and Systems Society (HIMSS) describing the development of blockchain technology and its applicability to healthcare.</em></p> <p>&nbsp;As described by the World Economic Forum (WEF),<sup><a href="#CIT0001_139">1</a></sup>&nbsp;the fourth industrial revolution is here and is changing business models across every industry vertical. This revolution includes digital technology, big data, artificial intelligence, distributed ledger technology (DLT, or blockchain), and analytics, and represents new ways in which technology is being integrated into societies.</p> <p>This changing interaction with technology will impact business models. Traditional business models are historically based on a centralized framework for delivery of goods and services to the consumer. The new business model is based on the decentralization of the creation and delivery of goods and services. At the core of the new model, organizations must demonstrate value-creation and value-delivery, while ensuring their solutions are secure, scalable, and interoperable to remain competitive. A decentralized business model built on a blockchain framework can provide the decentralization and security needed for this industry shift.&nbsp;</p> Ann Ingraham Jim St. Clair Copyright (c) 2020-06-08 2020-06-08 10.30953/bhty.v3.139 Blockchain, Interoperability, and Self-Sovereign Identity: Trust Me, It’s My Data <p>No abstract available.</p> <p>&nbsp;</p> Jim StClair Ann Ingraham Dominic King Michael B. Marchant Fletcher Cotesworth McCraw David Metcalf John Squeo Copyright (c) 2020-01-06 2020-01-06 10.30953/bhty.v3.122 Open Data: Implications on Privacy in Healthcare Research <p>The advent of open data in health care has increased healthcare innovation, with the publication of complete datasets aggregated by private and public entities that lead to efficiency through crowdsourcing working code, facilitating research into personalized medicine, and publishing reproducible data pipelines for experimental validation.</p> <p>However, there lacks an internationally recognized definition for health data governance at the scope of individual health data and open source big data, which bring about a discussion about the implications of open data on data privacy. First, healthcare data sourced directly from public healthcare systems: by whom and for what purpose is these data used for within the context of healthcare research. Second, health data from private research: the regulations needed for mutual disclosure. Third, personal user-generated health data: safeguards in a digital era needed to prevent misappropriation and abuse.</p> <p>This paper addresses the opportunities of open data in healthcare research in a digital age without transparent regulation. The consequence of open data on privacy leads to a framework of four safeguards for stakeholders: public education, operational transparency, regulation for accountability, and validation of research ethics. It also pioneers public policy direction for a balanced agenda between privacy and healthcare research.</p> David Chen Copyright (c) 2020-09-21 2020-09-21 10.30953/bhty.v3.144 Dawn of a New Decade: Looking Forward with BHTY <p>In 2020, Blockchain in Healthcare Today (BHTY) begins its third year of publication.&nbsp;We thank our global community of passionate leaders and early adopters for their support and diligence in making technology innovation in healthcare attainable for both the healthcare consumers who are the key stakeholders in patient-centered care and the broader healthcare system.</p> Tory Cenaj Copyright (c) 2020-01-13 2020-01-13 10.30953/bhty.v3.125 OpenPharma Blockchain on FHIR: An Interoperable Solution for Read-Only Health Records Exchange through Blockchain and Biometrics <p>The healthcare system in the United States is unique. From payor to provider, patients have the freedom of choice. This creates a complicated and profitable paradigm of care. Legislation defines government expectations of data exchange; however, the methods are left to the discretion of the stakeholders. Today, devices and programs are not built to unified standards, thus they do not share data easily. This communication between software is known as interoperability. We address the health data interoperability by leveraging Fast Health Interoperable Resource (FHIR) standard, a viewer of FHIR called OpenPharma, and Blockchain technology. Our proof of concept, called “OpenPharma Blockchain on FHIR” (OBF), is interoperable by design and grants clinicians access to patient records using a combination of data standards, distributed applications, patient-driven identity management, and the Ethereum blockchain. OBF is a trustless, secure, decentralized, and vendor-independent method for information exchange. It is easy to implement and places the control of records with the patients.</p> Gracie Carter Ben Chevellereau Hossain Shahriar Sweta Sneha Copyright (c) 2020-06-23 2020-06-23 10.30953/bhty.v3.120 The Last Mile: DSCSA Solution Through Blockchain Technology: Drug Tracking, Tracing, and Verification at the Last Mile of the Pharmaceutical Supply Chain with BRUINchain <p><strong>Purpose</strong>: As part of the FDA’s DSCSA Pilot Project Program, UCLA and its solution partner, LedgerDomain (collectively referred to as the team hereafter), focused on building a complete, working blockchain-based system, BRUINchain, which would meet all the key objectives of the Drug Supply Chain Security Act (DSCSA) for a dispenser operating solely on commercial off-the-shelf (COTS) technology.</p> <p><strong>Methods:</strong> The BRUINchain system requirements include scanning the drug package for a correctly formatted 2D barcode, flagging expired product, verifying the product with the manufacturer, and quarantining suspect and illegitimate products <em>at the last mile:</em> pharmacist to patient, the most complex area of the drug supply chain.</p> <p>The authors demonstrate a successful implementation where product-tracing notifications are sent automatically to key stakeholders, resulting in enhanced timeliness and reduction in paperwork burden. At the core of this effort was a blockchain-based solution to track and trace changes in custody of drug. As an immutable, time-stamped, near-real-time (50-millisecond latency), auditable record of transactions, BRUINchain makes it possible for supply chain communities to arrive at a single version of the truth. BRUINchain was tested with real data on real caregivers administering life-saving medications to real patients at one of the busiest pharmacies in the United States.</p> <p><strong>Results:</strong> In addition to communicating with the manufacturer directly for verification, BRUINchain also initiated suspect product notifications. During the study, a 100% success rate was observed across scanning, expiration detection, and counterfeit detection; and paperwork reduction from approximately 1 hour to less than a minute.</p> <p>The authors demonstrate a successful implementation where product-tracing notifications are sent automatically to key stakeholders, resulting in enhanced timeliness and reduction in paperwork burden. At the core of this effort was a blockchain-based solution to track and trace changes in custody of drug. As an immutable, time-stamped, near-real-time (50-millisecond latency), auditable record of transactions, BRUINchain makes it possible for supply chain communities to arrive at a single version of the truth. BRUINchain was tested with real data on real caregivers administering life-saving medications to real patients at one of the busiest pharmacies in the United States.</p> <h2>&nbsp;</h2> <p><strong>Conclusions:</strong> By automatically interrogating the manufacturer’s relational database with our blockchain-based system, our results indicate a projected DSCSA compliance cost of 17 cents per unit, and potentially much more depending on regulatory interpretation and speed of verification. We project that this cost could be reduced with manufacturers’ adoption of a highly performant, fully automated end-to-end system based on digital ledger technology (DLT). In an examination of the interoperability of such a system, we elaborate on its capacity to enable verification in real time without a human in the loop, the key feature driving lower compliance cost. With 4.2 billion prescriptions being dispensed each year in the United States, DLT would not only reduce the projected per-unit cost to 13 cents per unit (saving $183 million in annual labor costs), but also serve as a major bulwark against bad or fraudulent transactions, reduce the need for safety stock, and enhance the detection and removal of potentially dangerous drugs from the drug supply chain to protect U.S. consumers.</p> William Chien Josenor de Jesus Ben Taylor Victor Dods Leo Alekseyev Diane Shoda Perry B. Shieh Copyright (c) 2020-03-12 2020-03-12 10.30953/bhty.v3.134 Harnessing the Power of Blockchains and Machine Learning to End the COVID-19 Pandemic <p>The last catastrophic pandemic the world has seen was the 1918 H1N1 influenza pandemic, considering that it happened 102 years ago, one can perhaps leverage the technologic advancements over the past century to combat the current pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19), which has already infected more than 16 million people globally and shut down the majority of the daily activities of life. The danger and challenge of infectious diseases such as COVID-19 lies in their highly contagious nature, spreading like wildfire with the potential to infect the majority of the world’s population unless drastic measures are undertaken. In some countries, the social distancing and quarantine measures are either insufficient or ineffective as the number of cases is still on the rise. A major issue causing this rise is that most COVID-19 carriers appear asymptomatic. Identifying infected individuals as well as healthy/immune ones is the most crucial step in halting the disease spread. This is where the role of mass screening comes in.</p> Hanaa A. Fatoum Kat Kuzmeskas John D. Halamka Shahrukh K. Hashmi Copyright (c) 2020-11-06 2020-11-06 10.30953/bhty.v3.153 Predictions for Blockchain in 2020 <p>During our 2019 ConVerge2Xcelerate (ConV2X) conference in Boston, we focused on the theme "Proving Market Value with Pragmatic Innovation in Healthcare"&nbsp;(see&nbsp;<a href=""></a>). This year, along with BHTY editorial board members, conference speakers were invited to join with Tory Cenaj, Publisher of BHTY, to contribute their&nbsp;expertise and share insights for the near-term landscape of blockchain in healthcare.&nbsp;&nbsp;</p> George T. Mathew Dennis A Porto Ron Ribitzky Susan Ramonat Uli C Broedl Kevin A Clauson Frank Ricotta Tory Cenaj Anh L Ngo Copyright (c) 2020-01-27 2020-01-27 10.30953/bhty.v3.126 Trust-by-Design: Evaluating Issues and Perceptions within Clinical Passporting <p>A substantial administrative burden is placed on healthcare professionals as they manage and progress through their careers. Identity verification, pre-employment screening and appraisals: the bureaucracy associated with each of these processes takes precious time out of a healthcare professional's day. Time that could have been spent focused on patient care. In the midst of the COVID-19 crisis, it is more important than ever to optimize these professionals' time. This paper presents the synthesis of a design workshop held at the Royal College of Physicians of Edinburgh (RCPE) and subsequent interviews with healthcare professionals. The main research question posed is whether these processes can be re-imagined using digital technologies, specifically Self-Sovereign Identity? A key contribution in the paper is the development of a set of user-led requirements and design principles for identity systems used within healthcare. These are then contrasted with the design principles found in the literature. The results of this study confirm the need and potential of professionalising identity and credential management throughout a healthcare professional's career.</p> Will Abramson Nicole E van Deursen William J Buchanan Copyright (c) 2020-07-09 2020-07-09 10.30953/bhty.v3.140 The business case for blockchain in health care — part I <p>While an organization might want to focus on a specific emerging technology to solve a business probelm, strong organizations focus on an honest evaluation, internally and externally, to assure the timing and the business value for using the technology is in their best interest.&nbsp; This requires a solution set of knowledge, people, and methodologies coupled with products datas and tools.</p> Ali Loveys Chen Zur Copyright (c) 2020-03-13 2020-03-13