Location Date DECENTRALIZATION FOR MORE EFFECTIVE HEALTHCARE: TRUSTWORTHY DATA EXCHANGE AND TRUSTWORTHY DATA HANDLING Dr. Thanasis Papaioannou Services, Technologies, and Economics group Athens University of Economics and Business (AUEB) http://stecon.cs.aueb.gr/ LAST-JD-RIOE Conference, July 21-22, 2021
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.
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.
NEXT GENERATION INTERNET (NGI) INITIATIVE Objective 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.
an effective management of different use cases related to healthcare (among others): 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
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 disrupting service. ➢ 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
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.
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.
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 leaving behind.
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.
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 healthcare organisations. 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.
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.
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).
Healthcare data needs to be analyzed by data mining experts in a secure, privacy-aware manner. • 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 cryptographic proofs.
Another major challenge across the healthcare sector, is ensuring the provenance of medical goods to confirm their authenticity. ➢ 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.
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 diagnoses.
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 resolution. ➢ 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.
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.
NEXT GENERATION INTERNET (NGI) INITIATIVE • 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 2021. Progress 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 prototypes. OPEN 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 per Applicant)
/channel/UCcF7Ovd99lOKcjMGQdnhIvA Thank you contact: email@example.com Many credits to all the partners and associates of ONTOCHAIN for their input material and especially to Caroline Barelle (European Dynamics)