Blockchain as an Electronic Medical Record Lifesaver?


This post comes to us from Premier Developer consultant Crystal Tenn.


As of January 2014, The American Recovery and Reinvestment Act required all public/private health care providers to use electronic medical records (EMR). That opened so much potential for technological advancements and better health care for all of us! Yet, the current state of medical records can be alarming. If you visit one doctor’s office or hospital, your records are most likely kept only in that office’s record system or in a very small united system. There are currently no universal health records to easily transfer lab tests, imaging, or your medications between visits. Many small private electronic medical records companies are getting bought out, costing offices money and patients their health as accuracy falls in the data conversion process.

  • Wouldn’t it be nice if your medical records were instantly available for any future visits? No more dragging CDs and films from office to office or digging up records from 10 years ago.
  • What if diagnosis was made simpler by having your entire medical history at the click of a button?
  • What if no one was injured by a counter-indicated medication or known allergic reaction because it was on record?

Enter blockchain technology.

Blockchain Basics

A blockchain is a shared digital ledger that is distributed to an entire shared network. The most well-known and originator of the technology is BitCoin, the innovative payment network and digital currency. If you would like to see a 5-minute basic introduction video on Blockchain, please see here: https://www.youtube.com/watch?v=4sm5LNqL5j0

Usage of cryptography and digital signatures help keep the data’s identity, authenticity and read/write access secure. The records are sequential and protected by the existing ledgers—to try to change the data one person would have to out-compute everyone else in the system and this is statistically improbable.

Blockchain implements the proof-of-work (POW) system which means that to get your block in the chain, it requires processing time by a computer to solve a problem first (this process is known as mining). These problems have an interesting asymmetry: While these problems take time to solve, they must be easy to verify since the entire network will verify the new block as it is added to the chain. The result is a consensus of one true string of records in an environment where no one requires any trust of the other members of the system.

Each block is protected by a digital signature and cryptographic encryption with both a public and private encryption key. Specific customization can be set by the blockchain technology used and the system created to add more layers of security. There are public and private blockchains. Public blockchains allow every user to see all transactions, but they are so encrypted that the data remains anonymous. Private blockchains have user rights for access to read and write to the chain.

The Potential of Blockchain on Medical Records

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The potential to revolutionize medical technology for both healthcare providers and patients is endless. Blockchain technology provides a secure technology that I hope can be adapted for patient records (to be viewed between healthcare facilities with permission of the patient, and by the patient at home), healthcare payment (to streamline a faster way to integrate with insurance/Medicare and know how much a visit will cost) and within IoT devices (to connect to your patient records and get reactive healthcare from your providers).

Comments (3)

  1. Prince says:

    Blockchain is distributed ledger accessible to the general public to access and append information to it. How can health records be kept in it what about the privacy of the patient?
    Even if it a private blockchain all the participating entities will have access to the information which the individual might not be willing to share.

    1. Crystal Tenn says:

      Hi Prince,

      Thanks for leaving the question!

      Option 1: Remove all personal and identifiable information such as name, birthdate, gender, height/weight, etc and link each user to a “key” (patient should not need to know these, only diagnostic information). Patient will take the “key” and access their records online through a portal; ideally should add two factor authentication to record to make sure it is the correct patient. Could add an additional “key” to link to the doctor’s patient history report on an internal system that is non-client facing (internal history reports typically are not seen by patient). It would not be terrible to allow general information such as diagnoses, tests, and medications to be public information anonymously and this may even be an aid to medical studies with so much large data—with the consent of the patients.

      Option 2: Have one centralized application “own” the full blockchain (along with all medical offices/hospitals/caregivers) and distribute information back to the user if they are able to authenticate and identify as the correct person. Essentially as an technology to help make the to the universal medical electronic records system happen. In this case you do not require anonymity, you just require that only a trained medical staff can access your records and that some online portal has strong two factor authentication for you to access it at home.
      *I very seriously doubt with HIPAA that option 1 would be likely and that 2 would be closer to the real life scenario.

      Blockchain technologies are working their way towards more security and anonymity. There are many authentication and identification companies which are interesting:
      https://letstalkpayments.com/12-companies-leveraging-blockchain-for-identification-and-authentication/

      1. Mihail Stanculescu says:

        Option 1 – “allow general information such as diagnoses, tests, and medications to be public information anonymously and this may even be an aid to medical studies with so much large data—with the consent of the patients” would not work simply because many patients are re-identifiable by combining different pieces of data. See k-anonymity. Some studies have shown that a patient could be re-identified (with 95%+ precision) based on ICD codes, or lab tests… See for example http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.850.6093&rep=rep1&type=pdf

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