The possibilities of blockchain and healthcare have been a focus of recent interest. But is such a combination feasible, or does it bring added risk?
What is Blockchain?
Blockchain is basically distributed computing that uses a large network of independent servers on the internet to store and secure information. This means that any attempt to steal data must attack and overcome the entire network, an unlikely and extremely difficult event. The servers are hosted not by any one organization, but by different volunteers who hope to earn (or “mine”) virtual currency such as bitcoin for their participation.
Blockchain and Healthcare
Like most new technologies, blockchain is said to be able to do it all. From financial transactions to stock trading, blockchain in theory can provide a de facto invulnerable method for storing sensitive data. By its distributed nature there is no single server or organization managing the entire system, so there is no single point of failure that is vulnerable to attack. Information is encrypted and duplicated throughout the network, so it is unlikely to be lost or destroyed. Any attempts to steal data will require compromising the entire network, which is considered almost impossible.
Applied to healthcare, this provides an extremely robust way to store and verify information. Providers and patients alike can rest assured that there data is stored at each of the network’s many storage points, or “nodes,” and as the chain grows and adds nodes, the whole system becomes even more secure. Compare that to the present state of affairs, where countless healthcare organizations are successfully attacked by hackers every year.
What are the Risks?
On the other hand, while the combination of blockchain and healthcare has obvious strengths, its shortcomings may appear only after sustained use. One issue is that transactions are not necessarily immediate but take some time to be adequately secure. Another challenge is the need to transition IT staff to the new technology, but given its newness, there is a shortage of programmers who can work with these systems beyond simple trouble-shooting. But the biggest problem could be the concept of blockchain itself. In blockchain, each node must maintain a copy of the entire network. As the network grows, so also the amount of data that can be stored, which then puts a demand on the node’s expensive server space. Eventually, smaller operators will drop out, leaving your data in the hands of just a few operators. Even now, one study found over 75% of all transactions are being performed by just five operators. This definitely raises the risk of collaboration or coercion by an outside force. There are other concerns related to blockchain and healthcare. Bitcoin mining uses a lot of electricity, and utilities could begin to impose restrictions and penalties. Global climate initiatives like carbon limits could also raise electricity rates. What’s worse, the notorious instability of cryptocurrencies like bitcoin could lead to wide fluctuations in value. This could drive smaller nodes out of business, and thus shrink the network.
And this points to the key issue for blockchain and healthcare: control. Under current technology, companies attempt to secure their single point of failure networks, or hire trusted vendors to do so. Blockchain in contrast has many independent machines being managed by unknown individuals or organizations who are trying to earn bitcoin. These bitcoin miners may or may not have good character, and their technical skills could also vary. Yet using blockchain means you are trusting them to secure your patients’ private financial and health data, instead of using well-known cybersecurity companies with professional staff.
As healthcare providers seek efficiencies to counter the ongoing uncertainty and strains in the industry, blockchain offers attractive potential for greater security and effectiveness. The question remains as to how exactly to use it, and how to control the risks that are inherent in the concept.