Presentation at the LAST-JD-RIOE Conference:
📆 July 21, 2021
🗣 Thanasis Papaioannou, Athens University of Economics and Business (AUEB)
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DECENTRALIZATION FOR MORE EFFECTIVE
HEALTHCARE: TRUSTWORTHY DATA
EXCHANGE AND TRUSTWORTHY DATA
Dr. Thanasis Papaioannou
Services, Technologies, and Economics group
Athens University of Economics and Business (AUEB)
July 21-22, 2021
DECENTRALISATION AND DIGITAL HEALTH
• Today, improved delivery of healthcare services as well as the creation of new products in the healthcare industry is
highly dependent on an effective coordination in the management of health data across the healthcare domain
and on the ability to apply analytics to them.
• Healthcare data are thus a highly valuable source of information but a major challenge in their management is to be
able to ensure their privacy as well as their trustworthy exchange and handling.
• This challenge can be tackled by Distributed Ledger Technologies:
• The blockchain is a powerful decentralized technology that enables secure data sharing and access
between multiple parties.
• It is actually successfully applied in the financial sector to improve the security of financial transactions and
thanks to its properties, it can support digital health by making it easier to share data securely, with
patient consent, across very fragmented healthcare systems.
HOW BLOCKCHAIN OPERATES
HORIZON 2020 RESEARCH AND INNOVATION ACTION & NEXT GENERATION
INTERNET (NGI) INITIATIVE
Up to 4.2 Millions € funding and mentoring program with best international
experts in Semantic Web, Linked Data, ontology engineering, Blockchain
interoperability, knowledge management, distributed and decentralised
computing, business models for trusted knowledge …
ONTOCHAIN was launched in September 2020 to empower innovators and end users
through 3 Open Calls to develop blockchain-based knowledge management solutions that
will be part of a novel software ecosystem for a better share of knowledge and value.
ONTOCHAIN - Trust traceable and transparent ontological knowledge on blockchain, is a
European project funded by the European Commission under the European Union’s
Horizon 2020 Research and Innovation Programme, and part of the European
Commission’s Next Generation Internet (NGI) initiative.
HORIZON 2020 RESEARCH AND INNOVATION ACTION & NEXT GENERATION
INTERNET (NGI) INITIATIVE
The ONTOCHAIN project aims to develop a new software technologies stack at
the meeting point between the Semantic Web and Blockchain to enable
trustworthy data and services exchange as well as trustworthy content
handling for different domains including the healthcare sector.
ONTOCHAIN intend to support an effective management of different use cases related to healthcare
o IoT security for patient remote monitoring
o Traceability, transparency, care for privacy and secure management of Clinical Trials
o Secure, trustable sharing and management of Electronic Health Records : Patient-centric EHR
o Credential verification for health care providers
o Secure sharing of health/genetic data
o Supply chain transparency for health and medical goods
o Smart contracts for insurance and supply chain settlements
o Traceability of doctor-patient communication
• One of the biggest trends in digital health is the adoption of remote monitoring solutions, where all kinds of
sensors measuring patients’ vital signs are being used to help give healthcare practitioners more visibility into
patients’ health, enabling more proactive and preventative care.
• However, security is a huge issue, both in terms of ensuring that patient data is private and secure as well as
that it is authentic and not tampered to create false information. In some cases, where a connected device
may be depended on an emergency situations, e.g., alerting an elderly person’s carer that they have suffered a
fall or a heart attack, it is also crucial that the supporting systems are very resilient to DDoS or other attacks
➢ Smart contracts for authorization of IoT devices can provide a secure way of using medical sensors and overall,
blockchain features can reduced forgery and privacy hack in healthcare settings thereby increasing the trust
of people in remote monitoring.
IOT SECURITY FOR PATIENT REMOTE MONITORING
SECURE SHARING OF HEALTH DATA
Currently an efficient flow of health data between different stakeholders is paramount:
• Patients should be able to share their personal health information collected by smart devices or
medical records from other institutions with their carers to enhance care coordination as well as to
ensure quick and convenient communication for better personalized and tailored treatment.
• Health data is also precious to researchers, who can use them for analytics to produce reports,
statistics, studies, AI models to improve current treatment practices and medicine.
➢ To face potential privacy issues and vulnerabilities existing in current personal health data
storage and sharing systems, decentralized and permissioned blockchain enabling self-
sovereign data ownership can help protect privacy using channel formation scheme and
enhance identity management using the membership service supported by the blockchain.
SECURE SHARING OF GENETIC DATA
Pharmaceutical and biotechnology companies spend massive amounts of money each
year to acquire genetic information. The genomics industry has developed drastically,
intending to improve human health’s future thanks to the analysis of complete sets of
genes in organisms as well as by considering elements of genetics.
➢ Blockchain here can help create a fair marketplace for genomics where each person
owns his or her own DNA data, control its secure sharing for research purposes in a
privacy-preserving manner and get rewarded in return.
TRACEABILITY, TRANSPARENCY, CARE FOR PRIVACY AND
SECURE MANAGEMENT OF CLINICAL TRIALS
Ensuring the consistency and integrity of drug development data and more effective drug clinical trial data
management has proven to be of vital importance in the recent pandemic.
➢ Blockchain applications in clinical trials have always had the potential to automate outdated ways of
working and rapidly put together disparate data sets, in a secure and auditable manner.
➢ Data stored within blockchain is auditable, trackable, immutable and can be used to create a longitudinal
record of a patient’s health status, as well as participation in clinical trials. With the advantages it brings in
terms of security, and the validating nature of the technology, blockchain application in clinical trials
can unlock actionable insights to help navigate through sanitary crisis and especially the one we are
PATIENT-CENTRIC ELECTRONIC HEALTH RECORDS
1. The healthcare institutions or providers save the patient’s health records on the blockchain with the help of
smart contracts. A public key or a unique ID is generated, which will be required to access the data
2. If a doctor wants to access the information, he must have the patient’s public key for this data. The data is
visible to the healthcare provider only once the key or unique ID matches
3. Patients can share their public key with the healthcare organizations whenever required. This key will
provide institutions access to data but will keep the patient’s identity private.
Enable the patient to manage her/his own health record for more effective healthcare and data privacy.
Also, of interest are:
• Security to health data, privacy to the patient, transparency and interoperability.
• Facilitation of integration among healthcare providers in order to maintain medical history.
CREDENTIAL VERIFICATION FOR HEALTH-CARE PROVIDERS
Similar to tracking the provenance of a medical good, blockchain technology can be used to
track the experience of medical professionals, where trusted medical institutions and healthcare
organisations can log the credentials of their staff, in turn helping to streamline the hiring process for
Key benefits :
• Faster credentialing for healthcare organisations during the hiring process.
• Opportunity for medical institutions, insurers, and healthcare providers to monetise their existing
credentials data on past and existing staff.
• Transparency and reassurance for partners, e.g., organisations sub-contracting locum tenants,
or in emerging virtual health delivery models to inform patients on medical staff experience.
ONTOCHAIN FOR PATIENT DATA MANAGEMENT AND
OntoSSIVault - Gimly ID
• People setup self-sovereign identities.
• Fully controlled by their owners, fully recoverable.
• Identities (i.e., people, organizations, machines, objects) can send transactions
to smart contracts on the blockchain without having to manage passwords or
private keys, in order to
• create own credentials,
• send/accept credentials,
and store them in their data vault.
• People can selectively receive and disclose credentials and data.
ONTOCHAIN SOLUTION: GIMLY ID EXAMPLE
Credential-based Data Management
1. Patient creates identity data.
2. Patient shares identity data with medical clinic and acquires a patient ID.
3. Health record data is associated to patient ID.
4. Patient chooses to share part of its health-data with a particular doctor
specialization that works in the same clinic through role-based access control.
5. Only specific doctors in the medical clinic are able to access the data (along
with the patient name or not).
ONTOCHAIN FOR PRIVACY-AWARE HEALTH DATA
• Healthcare data needs to be analyzed by data mining experts in a secure,
• Healthcare data is not disclosed to anyone.
• Data mining experts are hired to perform the data analysis:
• Through a smart contract executed in a secure trusted enclave
(provided by iExec) healthcare data are processed by the algorithm
provided by the data mining expert.
• The smart contract is authorized to access the healthcare data and the
data-mining algorithm only inside the secure trusted enclave
• The data analytics provided are provably calculated based on the
healthcare data and with the data-mining algorithm by means of
SUPPLY CHAIN TRANSPARENCY FOR HEALTH AND MEDICAL
Another major challenge across the healthcare sector, is ensuring the provenance of medical goods to confirm
➢ Using a blockchain-based system to track items from the manufacturing point and at each stage through the
supply chain enables customers to have full visibility and transparency of the goods they are buying. This
is a top priority for the health industry, especially in developing countries where counterfeit prescription
medicines cause tens of thousands of deaths annually.
TRACEABILITY OF DOCTOR-PATIENT
Miscommunication among healthcare providers or between patients and providers can cost a lot of money and even
put patients’ well-being at risk. Most of the miscommunication that occurs is related to incorrect medical records or
delays in updates, as the process is very time-consuming.
➢ Blockchain can be a beneficial solution to this problem: instead of the information being stored in a single
database, it is stored on multiple nodes in a network after validation. If a change or update is made to the
information in one node, it is updated in all network nodes. It makes it very easy to share updated information with
any doctor or healthcare provider quickly.
➢ Information stored at the blockchain is authentic, updated, and timestamped, making it very easy for
the care providers to go through it and act accordingly, especially in case of emergencies.
➢ Providers are assisted in providing more personalized treatment plans and in conducting faster
SMART CONTRACTS FOR INSURANCE AND SUPPLY CHAIN
Often manufacturers, distributers and healthcare organisations maintain their own versions of
contracts (e.g., because pricing structures often change); thus, disputes over payment chargeback
claims for prescription medicines and other goods arise.
(According to Chronicled,) there are over one million chargeback claims made between
these players every year, more than 5% of which are disputed, requiring lengthy manual
➢ By employing blockchain-based systems in the healthcare sector, various players, such as
pharmaceutical companies, medical device OEMs, wholesalers, insurers and healthcare providers,
can authenticate their identities as organisations, log contract details, track transactions of
goods and services, and payment settlement details for those goods and services, and enable
operation based on fully digital and in some cases automated contract terms.
ONTOCHAIN SOLUTION FOR SUPPLY CHAIN
1. Hierarchical ontologies describe semantics of services and products.
2. Discovery of services/products based on semantic matching.
3. Service/product exchange and associated semantics (e.g., contract terms,
quality, expiration date, etc.) are recorded in blockchain transactions by
means of smart contracts.
HORIZON 2020 RESEARCH AND INNOVATION ACTION & NEXT GENERATION INTERNET (NGI)
• OC1 Research
• OC2 Protocol suite and software ecosystem foundations
• OC3 Application and experimentation 2022
Specifying the ONTOCHAIN framework as human centric decentralised & trustworthy solution based
on available technologies. A first batch of specifications have been delivered by 17 Teams in phase
one of the OC1 and 7 remaining Teams will deliver the full ONTOCHAIN framework in September
Building the ONTOCHAIN concept for the creation of a trustworthy information/service exchange
process & a more trustworthy content handling. This call aims to deliver the ONTOCHAIN Framework
All about co-design
win-win business model
o Decentralized oracles for ONTOCHAIN
o Market mechanisms for ONTOCHAIN
o ONTOCHAIN interoperability & API Gateways
o ONTOCHAIN Network Design and scalability
o Semantic based marketplaces for ONTOCHAIN
o Data Provenance in ONTOCHAIN
145 000€ (Max. funding
AND GET INVOLVED!
contact: [email protected]
Many credits to all the partners and
associates of ONTOCHAIN for their
input material and especially to
Caroline Barelle (European Dynamics)