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There’s never been a better time to provide proof-of-health solutions in the healthcare system globally. While it’s difficult to comprehend the significance of the role that technology may offer in such difficult times, essentially it can be nailed down to its basic concept of simplifying work and coordinating activities, which could have helped avoid the worst crisis people have experienced in their lifetime. If the healthcare system would adopt technological innovations in the early stages, it could have benefited and saved many lives.
Although the healthcare system has traditionally been slow in embracing the latest digital solutions, just like many other industries, we’ve observed in a previous article how the Covid-19 crisis has accelerated the adoption of digital technologies on a global scale in several industries, including healthcare.
The latest webcast brought to the audience by Block.co hosted some high profile experts from the industry. They illustrated how blockchain especially, together with other technologies such as IoT, and AI could in the future help elevate prompt responses, and provide more secure and efficient storage of data, something that has been missed in the recent pandemic.
Ahmed Abdulla from Digipharm, Dr. Alice Loveys from EY, and Dimitrios Neocleous from VeChain were hosted by Georgina Kyriakoudes, one of the first in the world to hold an MSc in Digital Currency, founder of Dcentric.Health and creator of the permissioned blockchain ecosystem app called Aria, which aims to transform the patient healthcare experience by giving individuals full control of their medical records.
Blockchain’s benefits in healthcare are primarily identified by efficiency, specifically on the transfer of data, facilitation of goods transport via the supply chain, prevention of counterfeit medicines sale, secure storage, and exchange of data around ID management. The impressive projects all the webcast guests have developed in the industry enable just these features, from the digitization of patient records to storage and exchange of medical data as well as easier processing of funds.
Ahmed Abdulla founded Digipharm with the idea of issuing tokens to allow patients to be in control of their medical records at all times. Moreover, tokens are issued to be paid for anonymously sharing personal medical data to help research; pay for healthcare based on how it has improved quality of life.
“We have experienced a disparity in Covid-19 tests costs around the world. For instance, getting tested in Cyprus costs around €60 while in the US it may add up to a few thousand dollars. This is due to the way countries arrange payment setups from payers to providers. Blockchain empowers people to take ownership of their records and funds while providing transparency of processes. This is where blockchain can be robust, by increasing transparency and allowing the patient to secure money transfer and hold their own records”, stated Ahmed.
His work as blockchain advisor at the UN Economic Commission for Europe is helping set up standards for the blockchain ecosystem, namely how the system should be used safely, and in a way that benefits all stakeholders.
“I lead the blockchain and healthcare team at the UN center for trade facilitation and e-business where we developed a blockchain and trade facilitation white paper; the second phase will soon provide an advanced technology advisory board to advise private or public stakeholders on what’s the best technology to use. It might not always be blockchain, hence we first understand and then advise if the tech is right for them or not. Blockchain is clunky, expensive, and not always proper for the organization we work with”, continued the blockchain expert.
Most people may prefer public and permissionless blockchain because it has major advantages over a private and permissioned one. Transparency stands out for the way the ledger is shared and for due diligence becoming unnecessary as a result. This means costs are also cheaper, in the range of 100% lower. On the other hand, a public decentralized blockchain has a major disadvantage since no legal framework is laid out. This means uncertainty as there is still a grey area in the legal field that might create confusion.
Dimitrios Neocleous is Ecosystem Manager at VeChain Tech and directly supported digital and technological solutions provider I-DANTE with the creation of the E-NewHealthLife and the E-HCert for the Mediterranean Hospital of Cyprus. Both apps give patients control over their health records, improve medical data sharing, and increase hospital operational efficiencies by simplifying the process of visiting a hospital.
E-NewHealthLife is a complex ecosystem solution that starts from a patient’s visit to an emergency room. A card with the reason for a patient’s visit is issued; it gets time-stamped; the patient is sent to the waiting room; once the patient’s turn comes and the medical check is completed, the card is scanned and the visit is closed. Patients can digitally access all diagnoses that took place anytime at the hospital.
“The platform produces a digital health passport, which is an encrypted non-fungible card that patients can use to identify themselves automatically when registering at the hospital’s emergency room. The passport is stored within a mobile app called E-HCert, which keeps track of each patient’s medical data and can be shared as needed”, announced Dimitrios.
E-HCert App is a Covid-19 lab test electronic wallet and pushes up the results of a patient who’s been tested for COVID. It has been proven to be very successful so far; currently, 2000 people who transited through the Larnaca airport in Cyprus have downloaded the app. With time-stamped records, it’s able to provide data such as the day and time when the sample was collected, it offers immutability, security, and integrity of data.
“Covid-19 showed a deficiency in healthcare. The spread of the virus could have been prevented if we had digitization of processes and transparency of data through blockchain, and transfer of data through an authorized share of records. An open permissionless decentralized blockchain helps bring ownership of medical records back to the patient, and that is not possible in a centralized system”, continued the VeChain representative.
Dr. Alice Loveys is EY ‘s healthcare blockchain leader in the US and has been at the forefront of emerging healthcare technologies for her entire career including being a pioneer in electronic health record adoption, health information exchange, and privacy and security.
She believes that “blockchain technology is like a plumbing system that brings clean and transparent trusted data that can be used. It’s not proper for a track and trace system as it invades privacy unless there is the consent from patients, in that case, blockchain transparent share of data would be extremely useful for medical research and testing”.
One problem we experienced during the crisis is the confusion that arose with divulged information and the frustration that comes with it. People do not understand anymore which information can be trusted; at first, it looked like COVID-19 symptoms were not dangerous, then it came out that they actually were. Masks were not useful at the beginning, then they suddenly became necessary.
“Blockchain could have prevented lockdown and economic crisis through data management in that a much faster response would have been provided to tackle misinformation because blockchain can help manage data from different sources”, continues Dr. Loveys. “Moreover, it’s a great way to protect the database. Instead of moving any private sensitive medical data through the more traditional digital systems, blockchain simply allows us to send an algorithm, encrypted data that safeguards the information. It’s not a great use as a database as it does not scale, therefore we would not be able to store information for billions of people in it. But for the data that is in the blockchain, using algorithms, makes it very convenient and secure”.
Another topic discussed during the webcast was the GDPR compliance for blockchain. GDPR (General Data Protection Regulation) was created before blockchain therefore it doesn’t account for decentralized technologies. Generally speaking, it all comes down to how the technology is used and what kind of data is incorporated in it. Timestamping data without invading anyone’s privacy, or timestamp of consented data, should determine no issue at all. This is what privacy by design stands for, taking human values into account in a well-defined manner throughout the whole process.
Block.co, powered by the University of Nicosia, is establishing itself as a global leader in the issuance of digital immutable and secure certificates timestamped on the Bitcoin blockchain. In the field of healthcare, it could include medical records, prescription issuance, insurance disputes, supply chain documentation, and any type of verifiable certificate that requires authenticity at its core.
For more info, contact Block.co directly or email at [[email protected]](mailto:[email protected]).
Tel +357 70007828
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Block.co third webcast ” Blockchain in Healthcare: Bridging Trust in response to COVID-19“ received amazing feedback! We gathered some of the best experts in the field, Georgina Kyriakoudes, Ahmed Abdulla, Dimitri Neocleous, Dr. Alice Loveys to share their experience in the industry and discuss with us the latest updates in the sphere of Healthcare! In its third series of webcasts, Block.co gathered 253 people watching the event from 59 different countries, for a 90-minute webcast where guests answered participants’ questions.
Below is a list of the questions that were made and were not answered due to time constraints during the Blockchain in Healthcare webcast. Please note that the below information is only for educational purposes!
Question 1: I like what Dimitrios was saying regarding ownership and transfer. Health and social care have invested much in Information Management systems and processes. Transfer between NHS and social care is a typical block. Can you elaborate on how the blockchain sits across that – leapfrogs yet goes with the grain of what is already there in terms of shared records protocols, the exponentially growing types of professionals, pharmacists, careers, etc. that need early access to these records for better decision making.
Block.co Team Answer: Blockchain technology has the potential to improve healthcare, placing the patient at the center of the health care ecosystem, while providing security, privacy, and interoperability of health data. Blockchain could provide a new model for health information exchanges and transform electronic medical records to be more efficient, disintermediated, and secure. While it is not a cure, this new, Blockchain in Healthcare rapidly evolving field provides a sandbox for experimentation, investment, and proof-of-concept testing.
Healthcare systems around the world are preparing road maps that define critical policy and technical components needed for nationwide interoperability, including:
Blockchain technology creates distinctive opportunities to scale back complexity, improve trustless collaboration, and create secure and immutable data. National Healthcare Systems need to track this rapidly evolving field to identify trends and sense the areas where government support may be needed for the technology to realize its full potential in health care. To form blockchain’s future, they ought to take into account mapping and gathering the blockchain ecosystem, establishing a blockchain framework to coordinate early-adopters, and supporting a pool for dialogue and discovery.
Question 2: What about the “compatibility” of blockchain solutions in healthcare with GDPR and/or other regulations about personal data protection.
Block.co Team Answer: The General Data Protection Regulation (GDPR), Europe’s new framework for data protection laws, has a vital impact on healthcare organizations. During this more and more patient-centric world where global healthcare organizations collect a large set of data on patients to produce improved health outcomes, this increased regulation has an even larger impact.
GDPR presents challenges across all industries and includes language that has a special impact on healthcare. The regulation defines “personal” data as “any information relating to an identified or identifiable natural person (data subject); an identifiable natural person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person.” On top of this definition, GDPR contains three extra, important definitions that pertain to health data:
However, healthcare organizations that usually manage health data, have an added responsibility to take care of “data concerning health,” “genetic data,” and “biometric data” to a higher standard of protection than personal data, in general. GDPR prohibits the processing of these forms of health data unless one of the three conditions below would apply as per Article 9.
a. The data subject must have given “explicit consent.”
b. “Processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services …”
c. “Processing is necessary for reasons of public interest in the area of public health, such as protecting against serious cross-border threats to health or ensuring high standards of quality and safety of health care and of medicinal products or medical devices …”
Consent VS Explicit Consent – If one pays attention, there’s a difference in the GDPR’s health data use conditions (calls for “explicit consent”) and the general definition (calls for “consent”). Thus, there’s an ongoing debate as to what constitutes the difference between “unambiguous” and “explicit” consent. Despite the debate and the final legal clarifications, there is no doubt that in the purposes of the healthcare the “explicit consent” must have the strongest agreement form listing in detail the use(s) of data and covering the cases of data transfers and storage.
Question 3: How can we use blockchain technology by the government in Africanflavored government, say by Ministry of health to have patient autonomy of medical records that can be accessed by any government hospital irrespective of the ailment and record printed by the previous hospital and doctor, such as referral cases without having to open a new file in the referred hospital.
Block.co Team Answer: Perhaps that would be an ideal implementation of the Block.co solution issuing a digital certificate of medical examination on an Open Public Blockchain such as the Bitcoin blockchain, that would be decentralized in nature, easy to validate online without any special wallets, and would be provided by the patient on-demand, to refer to treatments received in other hospitals or areas. But this would require that the practitioner is aware and can use the open-source code or use Block.co services to issue these certificates. Alternatively, there could be the use of a wallet to store these medical credentials to be submitted on demand to health practitioners. Moreover, there would need to be an alignment of regulation in the matter as decentralized repositories are not recognized at the moment.
Question 4: Is there any data breach threat in the blockchain using a poorly protected private key at communication?
Block.co Team Answer: Millions of health care records have already been breached, and in attempts to combat this issue, solutions often result in the inaccessibility of health records. Health providers often send information to other providers, and this often ends up in mishandling of data, losing records, or passing on inaccurate and old data. In some cases, only one copy of an updated health record exists, and this may result in the loss of information. Health records often contain personal information such as names, social security numbers, and home addresses. When it comes to Blockchain in Healthcare, a poorly protected private key is always a factor to consider. A private key allows us to sign a transaction and spend funds residing in an address (public key) by providing ownership with the signature. It is a unique string of information that represents proof of identification inside the blockchain, which includes the right to access and control the participant’s wallet. It must be kept secret, as it is effectively a personal password. In the case that that private key is poorly protected, there is always a data breach threat.
Question 5: The medical record of a patient is owned by the patient. What happens if a doctor accesses the record without the consent of the patient? Using the smart contract, could there be a governing body, say a legal system that can call the doctor to order?
Block.co Team Answer: Rather than having each physical and electronic copies of records, blockchains may enable the shift to electronic health records (EHR). When looking at Blockchain in Healthcare, medical records on the blockchain would be within the management of the patient rather than a third party, through the patients’ private and public keys. Patients may then control access to their health records, making transferring information less cumbersome. Because blockchain ledgers are immutable, health information may not be deleted or tampered with. Blockchain transactions would be accompanied by a timestamp, permitting those with access to maintain updated information. The doctor would not be able to access the record without the consent of the patient. A patient would need to sign the transaction in a smart contract in order to transfer patient details to the doctor.
Question 6: So, how are private data protected when the patient is simply notified that unauthorized access just took place on her medical record? and, how are the negative results of this breach rectified towards the patient?
Block.co Team Answer: The patient would be notified to sign a transaction enabling access to the party requesting access to the specific medical record. In other cases, there could be a multi-signature wallet requiring multiple transactions in the cases where the patient may need assistance, for example, when underage or when not in a healthy state of mind, or being non-responsive or in critical condition. The patient needs to be responsible for his own data and be empowered through awareness and know-how of this technology. With great power, comes also great responsibility, although it is yet a challenge to enable computer illiterate people to interact with this technology.
Question 7: Can the same record of a patient still be shared with private hospitals and say another government/private hospital abroad on the same blockchain?
Block.co Team Answer: Depending on whether the information is on a public blockchain or a private blockchain. When on a private blockchain, they will need to be granted permission to access the blockchain accordingly.
Question 8: No one has directly spoken about ownership where a large research institution/ consortium is working with the data – it is not solely the person who has said so…
Block.co Team Answer: Indeed, it is solely not the person who has a say so. Technology may be used in both evil and good ways and it is still the obligation and responsibility of people within governments to ensure human liberties and rights are preserved when utilizing such powerful technologies such as blockchain and sometimes the combination of blockchain with AI, IoT, and biometrics. Blockchain in Healthcare, in the same way, that it can empower individuals and increase their standard of living and prosperity, at the same time, it can also empower corrupt governments with alternative agendas and totalitarian states. Block.co believes it is most important for people to be educated around the matter and be able to form a voice and movement to safeguard their human liberties and rights, hence our continuous effort on discussing these matters with our community and providing education, powered by the pioneers in the space, the University of Nicosia.
We would like to thank everyone for attending our webcast and hoping to interact with you in future webinars. If you would like to watch the webinar again, then click here!
For more info, contact Block.co directly or email at [email protected].
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The emergence of disruptive technologies is always complemented by the creation and development of new models, mostly resulting in new economic concepts and business structures. The rise of the internet over 30 years ago, laid the foundation for the creation of new markets, for instance, that book store that sells all publications from around the world — Amazon. Or new concepts like the ‘Instant gratification’ that contributed to the introduction of business models like Netflix, finally allowing consumers to get instant access to films and series.
Blockchain is bound to create new models in all fields that regulate our lives, from a financial perspective to the regulation of infrastructures facilitating interactions and transactions in a way that would not be possible without the internet. This is one of the reasons why it is often referred to as the next generation of the internet or Web3, where WWW revolutionized information, Web2 facilitated interactions and now Web3 has the potential to innovate agreement and value exchange structures using the internet in a decentralized manner.
From a technological perspective, the similarities between the two are impressive.
We are currently believed to be in what were the early stages of the internet, with similar challenges around scalability, costs, and education, limiting the development of breakthrough applications and mass adoption. These internet challenges were resolved over time, therefore we should expect a similar progression in Blockchain.
In 1996, major internet service AOL could not manage a high volume of Internet users and went down for nineteen hours. Gradually the average internet speed in the US went from 50Kbps in 1999 to 18.7Mbps of 2017. Similarly, in 2017 the Ethereum blockchain failed to sustain the spike of on-chain transactions caused by the famous blockchain game CryptoKitties and the platform suffered the most serious network clog to date. These failures are necessary to the development of technology. Just like it was clear in 1996 that the internet had to face a scalability issue, it’s been evident for years now that blockchain also has to find ways to deal with the problem. Developers, programmers, experts, and academics are all working on the improvement of the system but there won’t be a definite solution, just like there wasn’t for the internet.
As popular Bitcoin expert and educator Andreas Antonopoulos mentioned in his book The Internet of Money, “Scale is not a goal to achieve; it is a definition of what you can do with the network today.” Scalability was built on the internet based on layers on top of the basic protocol and it looks like this will be the possible progression for the blockchain too. The Lightning Network, layer2 or off-chain protocol, is paving the way for Bitcoin fast and small payments along with a major focus on providing full privacy to transactions. Many believe in this respect we are still in 1994 Internet time, when the TCP/IP, HTML, and FTP were invented, leading to the successful business models represented by Facebook, Airbnb and Uber later. In the blockchain, breakthrough Dapps have yet to appear and will emerge in the coming years.
User Interface will help drive adoption in the same ways it helped the internet. At the time of the Arpanet, the technical foundation of the internet, the system was difficult to use for both nontechnical and technical people. The search functionality relied on an IP address and navigating the internet meant inserting a long string of numbers in order to find what you were looking for. It was easy to get confused, mistype numbers, etc. When the switch between the IP address and the URL happened, it became easier to navigate the web thanks to a more efficient and user-friendly experience overall.
Blockchain usage and benefit are still clunky. We still need a 12 or 24-word phrase to access a private cryptocurrency wallet and send a transaction to a long string of numbers (just like it happened with the early internet addresses) to validate it. All of this will disappear once user interfaces will be given the right attention and mass adoption will likely benefit from a system easier to use. It is clear that in the blockchain development more focus has been given so far to make the technology more secure, reliable, and robust at the expense of the user experience. Once the strength of the network/system is secured there will be a shift of interest in developing the interface with a resulting better user-friendly experience. Maybe it’s the right evolution and one that will bring a stronger technology structure overall.
Adoption is another important parallel we can highlight, not only with the Internet but with all the disruptive technologies previous to the World Wide Web. It took 46 years for electricity, 35 years for telephone, 14 years for TV, and 7 years for the Web to reach 25% of global market penetration. We can expect a similar growth trajectory to happen in the cryptocurrency/blockchain space, perhaps at a faster rate since the world is more connected now, thanks to the already existing internet interactions.
Stay tuned because in part two of this blog we will explore the parallels between the technologies in education, capitals, and start-ups and the decentralization of the blockchain as the main aspect that will revolutionize the Internet as well.
In the meantime, blockchain as a distributed ledger for a secure network of transactions is finding wide adoption as is the case for academic and ID credentials embraced by The University of Nicosia and Block.co. The University of Nicosia and Block.co can help provide the necessary technical expertise to follow the whole process from creation to publication on the blockchain where the document will be safely stored for life and where it can be independently verified by any third party. They were the first ones to do it globally as early as 2014.
For more info, contact [Block.co](mailto:Block.co) directly or email at [[email protected]](mailto:[email protected]).
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The University of Nicosia (UNic), in Chipre, has just announced it’s allowing students to pay their tuition and other fees with Bitcoin from now on.. Besides, the university, the largest in the country, will also offer a Master’s of Science Degree in Digital Currency, which will be available online and on-campus starting in 2014. “We are acutely aware that digital currency is an ... Nick Assimenos Of University Of Nicosia Talks About Importance Of Blockchain Education. University Of Nicosia, the Cyprus based university which is the first in the world to offer formal education in blockchain and digital currency, has a specific department named the Institute for the Future, which offers initiatives in the blockchain, artificial intelligence (AI), virtual and augmented ... The University of Nicosia and the University of Cyprus are the first higher education institutes to accept the digital currency. For now, only students of Science postgraduate courses can avail of this opportunity. ... Paying through bitcoin wallet is a reliable choice to make when dealing with people who acknowledge bitcoin technology. Order a ... University of Cumbria This is one of the first universities in the world to accept digital currency and to allow a part of tuition fees to be paid using bitcoin. University of Nicosia The University of Nicosia has received its first tuition payment from a student using bitcoin. Back in November, the Cypriot university announced it would accept the cryptocurrency for tuition and fee payments, becoming the world’s first accredited university to do so.. By late November the university had received a payment from Francois Rossouw, a South African student.
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