A transformational new way to secure and ensure the integrity of data has come to healthcare, and it has the potential to impact almost every corner of the industry. Players including Humana, Optum, UnitedHealthcare and Quest Diagnostics have started to explore blockchain near its roots in cryptocurrency, but others are pushing the technological envelope and using the intrinsic qualities of blockchain to meet the security and privacy demands of today’s world.
We’ve seen the remarkable results of this innovation up close. Recently FRTYL adopted the ALTR platform, a scalable high-performance blockchain data-security system, to protect something so personal as the health records involved in fertility treatment and IVF. What’s most striking is that this represents an industry-specific approach for securing health data in assisted reproduction, and is a milestone in the commercial rollout of the technology within the larger healthcare sector.
However, transforming healthcare into a more secure data management environment is no small task. Regardless of the industry or organisation, data breaches have emerged as one of the most serious threats as cybercriminals erode our trust in institutions and people. Their inventive and insidious assaults are in the headlines each day.
Last year alone the cost of these attacks reached more than $1trl with the US spending more on cybersecurity than it does on natural disasters. The expanding attack surface represents a mixture of economic incentives that reward bad actors who are always one step ahead of us, our defenses against them less and less adequate.
What’s more concerning is the scope of the problem within healthcare itself. A recent study by Verizon indicated that 58% of breach attempts in healthcare were instigated by a credentialed individual, making it the leading industry for insider threats. Another report by Accenture revealed that healthcare employees are willing to sell confidential data to unauthorised outside parties for as little as $500, and 24% of healthcare workers know of someone who has done so.
Assisted reproduction, a $14bn slice of the much larger healthcare space, has itself been rocked by the “mix up” of gametes and repeated data breaches that have fundamentally undermined the systems that support our work, diminishing the trust and dreams of thousands of people along the way.
Restoring trust in digital health
An encrypted system of data exchange that relies on a distributed ledger, blockchain makes data more administratively friendly and restores trust to the patient-provider relationship. Trust is essential where the health and medical information held by providers and intermediaries includes highly sensitive details.
As FRTYL considered the options, this was the cardinal concern. The platform serves egg donor, surrogacy agencies and fertility clinics with a database and workflow CRM, enabling more efficient matching with intended parents. The donor profiles contain records such as extended family health history, sexual health history, drug and alcohol use, previous egg donation cycle history, and personal genetic carrier information.
Blockchain, by virtue of its cryptocurrency beginnings, was designed to provide digital trust through the decentralised nature of the technology itself. Decentralisation means these records cannot be changed because there is no single authority that alone can alter information. Operating on a distributed principle is important in healthcare because blockchain can resolve the issues around lack of a central “data keeper”, organising health information so that it can be verified and recorded through the consensus of all parties. This has the potential to build a truly patient-centered system.
It does not, however, mean that blockchain is only used in a decentralised setting. It is used when trust between parties, internal and external, patient and provider, is necessary with or without intermediaries. Its potential to overcome healthcare’s most serious challenges, from identity and privacy to data integrity and access, as well as interoperability, is too great to be ignored by our industry. In fact, it is the desire to stem the erosion of trust in health and medical data that has led us to blockchain and not the other way around.
Safeguarding identity of all parties
Especially critical to healthcare, where there are an enormous number of intermediaries and potential risk vectors, blockchain security can protect the identity and authentication of all participants in the process. The distributed nature of blockchain-based systems also means there is no single target point for failure, making it more difficult for unauthorised individuals to steal or corrupt records.
Information is shielded from deliberate or inadvertent unauthorised access, while also ensuring those who are using the data know that it is true and accurate. This forward-thinking approach to keeping the personal data of all parties safe not only increases efficiency of care, but provides both professionals and patients with peace of mind and a better experience.
One way to think of blockchain, in terms of sensitive health data, is having multiple control points rather than one single gateway to the information. This is significant in that it also provides patients with the ability to validate or reject any changes or access to their data, potentially giving them control over how it is seen and by whom.
Some health information exchanges (HIEs) have started using a distributed approach to their data security, but the difference is that blockchain provides this crucial characteristic of validation. Rather than simply placing blind trust in the accuracy of health records that move with ease between providers, insurance companies and any number of other players, parties to blockchain-enabled systems can know conclusively that the information is true and correct.
Healthcare service delivery, no matter the caregiver or medical specialty, is very often emotionally and financially challenging. Since deploying the ALTR data-security system, we have seen first-hand the privacy and confidence blockchain brings to the equation. This helps alleviate some of the stress that a diagnosis of infertility brings to couples and singles hoping to start a family by giving them repose that their most precious personal information is protected.
Solving multiple healthcare pain points
Blockchain provides a means for solving other pain points in healthcare and health information. As an interoperable network, blockchain facilitates the exchange of data across incongruous systems with inconsistent rules and permissions. Healthcare has long been hampered by the challenge of transferring and sharing data across silos. ALTR, by way of a blockchain example, provides a framework for health information to be pulled from multiple databases and sources to complete the data picture based on a single source of truth.
Blockchain can also assist with compliance, as with HIPAA where the goal is to maintain the privacy and security of personally identifiable information and health records, particularly when mandates limit the circumstances under which data can be used without authorisation from the data subject. We see our blockchain implementation as a way of “future proofing” access to ensure only those authorised to see the data are allowed into the system, and providing discrete windows and locks for segregating the information within each record according to preset permissions.
Furthermore, blockchain systems are ideal for responding to requests by regulators for details on how and when data has been accessed and utilised, and by whom, because it provides an auditable, verifiable record. For this same reason, it is a deterrent to fraud. As an enforcement mechanism, it can be used across the entire healthcare provider team to create trust and ensure that stakeholders, no matter their level of technical expertise, can be involved in setting appropriate data governance directives and rules.
Blockchain’s prescription for healthcare
While blockchain-based data security is new to the healthcare industry, it is conceivable (even inevitable) that it will displace current approaches as the preferred mode of safeguarding health and patient information.
Our recent rollout of the technology has addressed concerns regarding the privacy, security and the scalability of health records, and the underlying fundamentals of blockchain technology have given us a great deal of optimism about improving patient outcomes, provision of care, and effecting an essentially more personalised approach toward assisted reproduction.
We see the partnership between ALTR and FRTYL as an important indication of blockchain’s potential for the larger healthcare sector. Our experience shows that this technology is not only fit for purpose, but offers the vital and requisite physical, technical, or administrative protections for renewing trust in healthcare delivery.
Dave Sikora is CEO of ALTR. A technology industry veteran, he is the former executive chairman at Stratfor and has served as the CEO of two public and five private, venture-backed companies including Digby, Motive and Pervasive Software. Sikora holds an M.B.A. from Harvard Business School. Gail Sexton Anderson is the founder of Donor Concierge, the company that started FRTYL, the world’s largest fertility network. Known as one of the fertility industry’s leading innovators and creative thinkers, she holds an Ed.M. from the Harvard University Graduate School of Education.