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Engineering Next-gen Blockchain-based EMR: The Henry Ford Moment of Healthcare Industry

“Don’t find the fault, find the remedy.” – Henry Ford

In contrast to healthcare professionals, the government, regulators, security experts, and health tech entrepreneurs aren’t seeing EMR in the same way.

Discussions about issues linked to EMRs are very common among providers.

However, since the time human brains figured out advanced yet practical use cases for blockchain technology, we very often end up catching up with those few people discussing the remedies.

We are going to do exactly the same – for the next 5 minutes.

We will connect the dots and understand how blockchain-based EMRs solve existing problems that providers can’t stop themselves from discussing.

The existing problems with EMRs, making it the most outdated healthcare innovation

EMRs are designed and built to keep very sensitive information of patients in a secure and private manner.

However, intruders and hackers can easily outsmart the current security mechanism of EMRs.

First, crucial private data of patients are stored in a very centralized way.

Access to that one server, computer or node creates a smooth path for intruders to steal all the data.

healthcare blockchain

Second, it is extremely possible to – if not steal – but tamper with data and even permanently delete the data as there is a single authority controlling the EMR and data stored on it.

Third, it is impossible for patients to prove their ownership of the data and control who can access it.

Fourth, the very ‘that is not my job’ nature of EMRs enables data to be circulated within the virtual boundaries of a single organization only.

This leaves providers with no choice but to share data with someone outside of the organization via fax and email which increases the possibility of data stealing, breaching and tampering.

In essence, the problem is not with EMRs, but with the way it handles patient data.

Thus, EMRs do not require a complete makeover. The remedy is within a more advanced and robust security mechanism fueled by blockchain!

Presenting blockchain-based EMR as a remedy: The henry ford moment of healthcare is finally here

Blockchain in healthcare does one job – but in a pixel-perfect manner. It keeps patient data secure.

Major difference between conventional EMRs vs Blockchain-based EMRs:

In conventional EMRs, patient data is stored in a very centralized way.

blockchain in healthcare

But blockchain medical records are stored in multiple nodes or servers or computers which are connected to that blockchain network in a very decentralized way.

In other words, there is no centralized authority controlling the data.

Each node of the blockchain network has a copy of all the patient data and it gets synced automatically to any update.

For example, if a provider from a hospital based in Canada updates the blockchain medical records of one patient, the copy of that block which every other node holds also gets updated.

blockchain in healthcare

Not only this, but all nodes of that healthcare blockchain network can verify the change and even track its past changes.

The best thing about the blockchain in healthcare is that once the data is verified, it cannot be deleted. It stays there permanently.

(We will later discuss how data gets verified and added or updated to the blockchain network.)

This prevents the possibility of data loss and unauthorized data updates.

How does blockchain-based EMR guarantee ultimate data protection?:

Each block which contains the patient data has its own 64-character-long hash number which is impossible for any intruder or hacker to crack.

Because there are 13,500,000,000,000,000 combinations can be possible.

And if somehow he cracks it, his attempt of data breach will not be successful as each block also contains the hash of the previous block.

In the event of any data tampering or breaching attempt, the hash of every block gets changed automatically.

So, in a more practical sense, to steal data from blockchain-based EMR, hackers need to hack all the computers or servers or nodes of the blockchain network at the same time – which is impossible!

This way, intruders and hackers can never be able to access the data stored in the blockchain network, making it the most secure data security mechanism for EMRs.

Adding new block (data) to blockchain-based EMR: This is how 100% accuracy is achieved using blockchain in healthcare

Each block contains the block number, nonce, patient data, hash, and the hash of the previous block.

blockchain in healthcare

Nonce plays a very important role here. It is the number used to generate a hash value for that particular block.

For adding a new block to the blockchain network, it is important to generate a block’s hash value falling under a certain zone of hash values.

So, by changing nonce, we can generate the hash value that falls under our desired zone of hash values from the universe of hash values.

This desired zone of a hash value for a new block is defined based on the hash value of its previous block.

There are authorized stakeholders who keep changing the nonce to generate a hash value for a block.

This process is called mining which requires great computational power.

The mind-blowing part starts from here:

When a stakeholder finally finds the hash value for a block, he/she approves the block.

However, the block still cannot be added to the blockchain network.

In order to add it to the blockchain network, the block is now broadcasted to all nodes or stakeholders who verify the block and agree before adding that block finally to the blockchain network.

Stakeholders responsible for adding blocks are called miners and are also responsible for verifying the information, digital signatures, messages, and public keys of each block.

blockchain in healthcare

Giving more control to patients over their data with smart contracts

The concept of smart contracts was introduced even before the inception of blockchain – in 1994 by Nick Szabo.

But in 2013, a 19-year-old programmer first introduced smart contracts to the blockchain.

Basically, smart contracts are computer programs that get executed automatically when it meets the If Then condition.

So, for example, if data is added, then a smart contract dealing with new data entry is executed.

These smart contracts cannot be tempered.

Smart contracts contain data ownership rights, rules to access the data, sharing and usage of data, along with other terms which give higher control to patients over their data.

How to implement a blockchain-based EMR or blockchain in healthcare?

Blockchain offers a lot of flexibility when it comes to its implementation.

There are major four types of blockchain networks which you can select as per your target market, audience and business needs.

blockchain in healthcare

1. Public blockchain network

As its name suggests, a public blockchain network enjoys the highest level of transparency.

It is accessible to all. Anyone from anywhere in the world can join it and access your EMR.

In fact, they can use it for their operations too by adding new blocks and executing smart contracts.

2. Private blockchain network

A private blockchain network is private to a hospital or any other medical organization.

Employees of that medical organization act as nodes who are having data copies. Anyone from outside cannot access it.

The limitation of a private blockchain network is that data cannot be stored in an extremely decentralized nature as every node is within a single organization.

Here it is worth mentioning that there is no possibility of mining (to find hash value from a specific range) in a private blockchain network.

3. Consortium blockchain network

Such a type of blockchain network is the best choice for the implementation of blockchain-based EMR.

Because here a group of medical organizations which includes pharmacies, labs, and hospitals can have access to a blockchain network and perform operations on it.

This makes workflows smooth and faster.

Another advantage of a consortium blockchain is that it increases the decentralized nature of the blockchain as now the data is saved in multiple nodes of multiple organizations.

4. Hybrid blockchain network

A hybrid blockchain network is the future of blockchain. It is very flexible in nature and enjoys the best advantages or features of both public and private blockchain networks.

The best part of the hybrid blockchain network is that we can control it to use the features of either public or private blockchain networks based on the nature of the job.

For example, the processing time for an operation in a public network is high. So, when we need to execute a job the fastest way possible, we can leverage that feature of a public network.

Similarly, security is highest in a private network. So, when we want to have the maximum possible security, we can utilize that feature of a private network for our EMR working on a hybrid network.

Conclusion – we asked our five random team members about similarities between them & blockchain

In case you don’t know yet, we are an Ontario-based healthcare-focused IT company.

We only practice healthcare IT projects as that’s the only way we found to bring project innovation – rather than just project delivery!

Anyway, here is how our team members responded to the question –

What are the similarities between you and blockchain?

  • Lead UI/UX engineer (working remotely): “We both can neither be touched nor hacked!”
  • Senior backend developer: “Big challenges no longer give both of us butterflies in the stomach!”
  • Business analyst: “Users don’t see what we both see!”
  • Compliance specialist: “People only think of us when they are trapped!”
  • Sales manager: “You might hate us. But cannot ignore us!”