1. Introduction To Healthcare
Healthcare is all about keeping yourself fit and active at all times. Healthcare processes mainly involve the following aspects:
- Treatment: Doctors or healthcare organizations take care of the treatment of a disease, illness, injury, etc.
- Diagnosis: Diagnosis a chronic illness or disease.
- Physical or mental impairments
2. Blockchain App Development In Healthcare
Many people may have heard about blockchain technology in terms of cryptocurrencies like Bitcoin, Ethereum, etc. It can also be widely used in other fields as well rather than using it for payment system only. So, how blockchain works for the healthcare industry?
3. Advantage of Blockchain App Development In Healthcare
Blockchain application development has gained traction over the recent years. It’s immutable and distributed data records nature makes it much popular among people or organizations. So, there are many pros to blockchain technology in the healthcare industry.
3.1 Data integrity
Many health care organizations maintain records of their patients. Maintaining data records may become complex when data volume increased every year.
Data managed by healthcare organizations may include:
- Personal Health Information(PHI)
- Electronic Health Record(EHR)
- Medical Insurance claims
To verify the correctness of the data is crucial for any medical service. This is where blockchain comes into the role, where information once recorded and encrypted, can not be changed after that at all.
3.2 Data Transparency
Public data regarding the user, healthcare organization and diagnosis reports can easily be available anywhere in the distributed network. Data transparency reduces fraud in the healthcare industry.
4. Use Cases of Blockchain Technology In Healthcare
4.1 Use case 1: Drug Traceability
4.1.1 What is the Problem?
Drug counterfeit is a major problem in the healthcare industry. Here are some of the metrics revealed by the Health Research Funding Organisation.
- 10-30 % of medicines sold are counterfeit.
- The counterfeit drug market is worth $200 billion yearly.
- Counterfeit drug sale on the internet is worth $75 billion.
- WHO estimates that 16 % of the counterfeit drugs contain wrongs ingredients and 17 % of counterfeit drugs contain the wrong level of necessary ingredients.
The main issue with counterfeit drugs is not the fact that they are fake but they are quite different from the original product. However, many of the counterfeit drugs do not contain an actual ingredient that they claim to. If we consume these drugs, obviously they can impose some side effects on our body.
4.1.2 How Blockchain Can Help?
The main characteristic of blockchain technology is the security which can be helpful in this scenario. Every new transaction which is added to the blockchain is immutable and a timestamp is added with the transactions which make it easy to track the drugs. Once information added to the blockchain, it can not be altered after that at all.
When a drug is produced, a unique hash is generated which contains relevant information about the drug and manufacturer. Each time the produced drug moves from one entity to another, hashed information is stored on the blockchain which makes it easy for everyone to track the drug’s origin and authenticity and integrity.
Blockchain technology helps in two main causes when it comes to drug traceability.
- We can prevent drug counterfeit to the extent level.
- Healthcare organization can track their product easily anywhere anytime.
4.1.3 Hyperledger Fabric(Blockchain as a solution)
Hyperledger Fabric is an open-source enterprise-grade permissioned distributed ledger technology (DLT) platform. It was established under Linux Foundation.
The distributed ledger nature of the blockchain differs from traditional databases because records are stored in a decentralized manner. There is no change of failure for the data storage and the ledger is synchronized across the network. In this use case(Drug Traceability), it comprises manufacturers, wholesalers, pharmacies, hospitals, authorities, and end-user. The process of keeping the ledger up to date with all parties in the agreement is through Hyperledger Fabric's process of consensus. This involves, ordering service(ordering of transactions) and the list of peers available on the network, to agree upon and commit changes to the ledger.
As we know Hyperledger Fabric is permissioned and private. It means that all the members have to enroll through the Membership Service Provider.
We will be using the Hyperledger Fabric framework to track each part of this process. Let’s go into details about how we will solve this problem using Hyperledger Fabric.
Hyperledger Fabric Elements:
Before going into the details of drug traceability problem, let’s discuss Hyperledger Fabric Elements one by one
- Channels: Channels in Hyperledger Fabric are the private subnet for communication between two or more specific network members. Channels are used for conducting private and confidential transactions between two or more specific network members. Each channel is a separate chain of transaction blocks that related to particular transactions for that channel only.
- Chaincode: Chaincode also known as smart contracts. Smart contracts are the key mechanism for encapsulating information(asset definition and business logic or transactions) keeping it simple across the network. In most of the cases, smart contracts interact with database components.
- Ledger: Ledger is the current world state of the Hyperledger network. Transactions are added to the ledger once they are approved by appropriate participants.
- Network: Network is a collection of peers. The network is responsible for the consistently replicated ledger.
- Ordering Service: Ordering service is a collection of nodes that are responsible for ordering transactions into a block-based on timestamp. It also eliminates faulty transactions.
- World State: World State represents the current data about all the assets in a network.
- Member Service Provider(MSP): MSP is responsible for identity management and permissioned access to clients and peers.
Participants or Organizations:
- Manufacturer - is a person or organization who produces a drug
- Wholesaler - is the next person or organization in the chain who gets the manufactured drugs in bulk from the manufacturer.
- Pharmacist - Who verifies the origin of the drug sells the medicines to the patients
- Patient - Who verifies the origin of the drug.
In our scenario, the approved manufacturer, the approved wholesaler, the approved pharmacist, and the approved patients should be the only ones allowed to join the network. Why do we use the word “approved”? Because Hyperledger Fabric is a permissioned ledger network in which members can register themselves through MSP(Member Service Provider).
In our scenario, we have two chaincode which will be running on all four channels.
- One for the price agreement between two participants.
- One for the transfer of drugs.
- One for the price agreement between manufacturer and wholesaler.
- One for the price agreement between wholesaler and pharmacist.
- One for the price agreement between pharmacist and patient.
- One for the transfer of drugs.
Transaction Flow in Hyperledger Fabric(common case path)
Summary of The Problem Architecture
Based on the above diagram, below is a summary of the drug traceability problem.
- The manufacturer who produces the drugs uses applications' user interface and record all information and form a transaction. This information goes to the ledger. Before it reaches to the ledger, the transaction is passed to the endorsing peers in the network. Endorsed peers will validate the transaction. The endorsed transaction is then sent to the ordering service. Ordering service will order this transaction into the block. This block will be sent to the committing peers where committing peers will commit this block after validation.
- As a drug is passed along the blockchain. Other participants may use their application to query the ledger for specific details about a drug.
- The manufacturer may agree with the wholesaler and agree on a price of 50$. They use the BLUE channel for the chain code contract specifying price i.e 50$. With this agreement, a new transaction is updated in the BLUE channel’s ledger.
- In the separate business agreement, the wholesaler may agree with the pharmacist and agree on a price of 80$. They use the GREEN channel for the chain code contract specifying price i.e 80$. With this agreement, a new transaction is updated in the GREEN channel’s ledger.
- In the same way, the pharmacist may enter an agreement with the patient and agree on a price of 1000$. They use the RED channel for the chain code contract specifying price i.e 100$. With this agreement, a new transaction is updated in the RED channel’s ledger.