The popularity of mobile health apps and other connected devices has created an opportunity to access previously unavailable personal health data.
Integrated pathways allowing researchers to access this data could advance proactive, personalised healthcare and preventive medicine.
Data that expands beyond traditional tests, which could alter clinical trial implementation by combining genomic and ‘internet of things’ sensor data, could provide new insights to develop effective disease prevention interventions. However, to create meaningful links between patient-generated data, healthcare services and research organisations, there is a need for innovative systems for data sharing and consent.
Current systems are disconnected and often incompatible, while patients need to be actively recruited and consented for studies, limiting opportunities for data sharing. The secure and decentralised structure of blockchain presents an opportunity to build novel pathways, for integrated mechanisms for data sharing.
A type of online ledger, blockchain provides a time-stamped record of ‘information transactions’. Each transaction – block of information – has a unique identification called a ‘hash’. When a new block is added, it stores the previous block’s hash as well as its own, linking the blocks to create a chain. This structure makes the ledger secure.
If one block is tampered with its hash will be changed, the new hash will no longer match and the interference can be spotted. Additionally, each member of the network receives and stores a copy of each new block. This allows all members to add new information and increases the security of the blockchain.
Greater connection of information means clinicians and researchers could use patient-generated data secured by blockchain to provide consented access to personalised data.
At a population level, insight from large and high quality dataset analysis could expedite preventive medicine and interventions that proactively protect health. For instance, insights for preventing obesity could reduce health consequences and economic burdens on the NHS as tailored behavioural interventions (e.g. nudges to be active) could be targeted for people based on their health, social and economic situations.
Blockchain also provides a means of improving interoperability of separate healthcare systems, improving the efficiency and quality of individual care by providing a means of consented access to large, inclusive and specific datasets.
Equally, patient datasets excluded from traditional studies and clinical trials because they are unfeasible due to location, or because they have comorbidities that make them ineligible, could be accessed.
The key challenges however for linking health data this way are ownership, privacy and security. Clear and simple patient consent processes are essential in developing a linked network of health data and preventing breaches of data protection laws. ‘Smart contracts’ could be set up on a blockchain system that would make it easier for patients to set conditions for, or deny access to, their data.
Around the world, blockchain is being implemented within healthcare by both governments and private companies, from Estonia to America. The system could be applied in the UK to link data from the NHS, private providers and patients to benefit population health through research.
In simplifying and personalising consent processes, blockchain can contribute towards the shift to a patient-centred healthcare system.
By enabling a secure network of patient-consented linked health data, blockchain creates opportunities for new research and analysis that could improve the impact of preventive medicine, health services and population health outcomes. Patients will benefit from blockchain systems by gaining more control over and engaging with the management of their health data.
Healthcare providers and research organisations will benefit from increased interoperability, greater efficiency, and more extensive and higher quality data that can uncover new insights to tailor interventions to prevent and treat health conditions before they can have significant negative consequences.
