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Is blochain the answer to Indian healthcare woes?

Posted on Monday, October 22, 2018

Ajoy Khandheria writes how blockchian can enhance the Indian healthcare

There is a hype around the term ‘blockchain’; considering its applications to IT systems around the globe have been projected to expand by 42.8% by 2020. Estimates show that blockchain technology was worth $600 billion at the end of 2017. Already, in 2018, organisational spending on the technology have reached $2.1 billion. Linkedin careers in this space have increased threefold since last year.

Conceptually, a blockchain is a record, marking a new transaction or validating a contract between parties in a manner that is immutable, encrypted and distributed across a network of computer systems instead of being stored in a centralised database. This means that, as far as electronic data records are concerned, the role of intermediaries, governments and interventionists such as hackers can virtually be eliminated.

What do Blockchain applications hold for the healthcare industry in India?

Around the world, healthcare industries are literally drowning in data – with patient records, drug prescriptions, insurance claims and clinical testing information – all crying for organization and systematization while dealing with concerns for safety and integrity at the same time. Virtually all information is exchanged via computer systems. Financial accounting systems, for example, often rely on a third party such as the SWIFT to ensure that financial institutions are able to send and receive data pertaining to financial transactions in a secure, interoperable and reliable environment. If a business can create a blockchain solution that encodes certain transactions as a block of software code that can be added to the tail of an electronic ledger, a copy of which is available to every peer in the computer network, and validated by a majority of users, then the complexities of the encryption algorithm involved would make it highly improbable (but not impossible) for someone to change a piece of this record on one computer, mainly because inbuilt safeguards would prevent inconsistency of information across different computers, without validation. It is not feasible to manually change data across a million nodes. In contrast, a centralized information repository will always be at risk of someone breaking through its firewalls.

Prevention of Fraud

Now, when an insurance claim is processed, it becomes relatively safe to retrieve genuine records of the medical procedures involved, patient history, undisclosed medical conditions, premiums paid and so on. This will help prevent fraudulent claims while making investigations swifter and disbursal of money more certain. Similarly, when a patient buys a drug at the pharmacy, a generated code could suffice as the identifier of the date of manufacturing, active pharmaceutical ingredients, events along entire life-cycle of its supply chain and so on and assist in confirming the veracity of the drug being sold.

Blockchain applications would help in managing this flow of information in real-time, distribute this information across servers minimising the fear of spurious entries without confirmation by multiple users and automatically updating records. This also provides oversight over actions taken to modify data by any one user because time stamps and user logs are a self-generated input in these technologies.

Limitations of Blockchain applications in Indian Healthcare

There are many clauses that give one reason to doubt the utilities of this technology. First, blockchains are still comparatively new to the IT space and its future applications have not yet been fully comprehended. There is the possibility of collusion among users. If 51% of users validate a contract, then it will be deemed to hold. This is a major structural flaw in blockchain architecture.

In a country such as India, where electricity connections and internet penetration (at 500 million of 1.31 billion or approximately 38%) are still below desired levels, healthcare centers fragmented and IT systems disaggregated with non-uniform interfaces, blockchain implementations can be problematic. Current platforms also are untested for huge volumes of data that will apply to a nation the size of India. It is hoped that our vibrant computer scientists, who have been at the helm of affairs in technology companies all over the world, will soon come up with versions of blockchain that can be put to practice here and enable healthcare to attain the dream of Universal Healthcare Access as early as possible.


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