Access to comprehensive, quality healthcare services are not only central to human well-being and the development of society but also plays an important role in economic progress. The healthcare industry is also one of the fastest-growing industries in the world and is expected to reach a value of $11,908.9 billion by 2022 [ ]. Access to efficient, affordable, and scientifically progressive healthcare is one of the key necessities of modern life, affecting everyone on a global basis. 1 During the last half of the 20th century, many countries have moved on to introduce nationwide healthcare systems, both via public and private channels which have improved health standards across the globe. The introduction of electronic health record (EHR) systems enabled the digitization of health data and was the first step towards more efficient healthcare systems. However, the industry is still characterized as cumbersome and opaque, mostly due to an inefficient and outdated infrastructure. In this context, can have a significant impact, assisting all stakeholders, across the entire healthcare spectrum, including patients, practitioners, pharmaceuticals, insurers, and medical equipment producers in solving the existing challenges in the healthcare industry. Nearly all functions across the healthcare value chain are in a prime position to benefit from blockchain technology. blockchain technology Challenges in Health Care The introduction of electronic health record (EHR) management systems has certainly improved the quality of healthcare through the digitization of health data. However, EHRs in their current form are criticized due to potential privacy and security issues, and often provide inaccurate information [ ]. Other important concerns regarding EHRs include data manipulation, delayed communication, and trustless cooperation in data collection, storage, and distribution [ ]. 2 3 Despite the existence of EHRs, which do facilitate data sharing to some extent, it is evident there is a clear lack of interoperability between health information systems. The EHR system of a patient's provider might be different from the EHR system of another of its providers. Hence, this results in knowledge and data still being kept siloed and separated. According to a survey by Black Book, 70% of hospitals are not using data outside their own EHR system [ ]. In the current scenario, it remains difficult to share patient data between various actors within the healthcare industry, affecting treatment and medical research. 4 Healthcare professionals often lack access to all of the patient’s relevant information or need significant time to gain access to it. These delays have large impacts on the quality of treatment and care. In the best-case scenario, patients are engaged in costly and time-consuming redundant medical care, such as undergoing the same procedure several times. However, in the case of emergencies, not having direct access to all medical records of information can lead to improper treatment and mistakes, as prior conditions or allergies might not be detected. According to a study published by Johns Hopkins University, every year over 250,000 people die due to medical errors, which is also the third leading cause of death in the U.S. [ ]. A significant amount of these mortalities could certainly be avoided by having full visibility of the patient’s medical history and other relevant data. 5 An emerging problem within the healthcare sector is that of counterfeit and illicit drugs. The circulation of fake and non-approved medicine can compromise the safety and the treatment of patients and can prove fatal in the worst cases. The BBC reported that around 250,000 children a year die due to fake drugs [ ] and “falsified and substandard medicines” have already been classified as one of the urgent health challenges by the WHO [ ]. 6 7 Moreover, it causes losses in revenue for pharmaceutical companies and has a significant effect on growth and jobs in the industry [ ]. In addition, just in the EU alone, IPR infringements caused a loss of 16.5 billion from 2012 to 2016 in the healthcare sector. 8 The existence of accurate patient data and records is crucial for the provision of care and is an integral part of the healthcare system. Therefore, secure and efficient storage of medical data is essential. Unfortunately, due to the many isolated systems that exist in the healthcare industry, the administration of patients and record-keeping can be quite complicated. Furthermore, over recent years, medical data has become an interesting target for hacking attacks. Data breaches in healthcare are not only the costliest in comparison to those in other industries, but have also recorded the largest increase over the past years [ ]. According to the Proenus Barometer, 41.4 million patient records were compromised in 2019, and the number of hacking attacks targeted towards healthcare services increased by 49% [ ]. 9 10 Benefits for Enterprises & Individuals Blockchain technology can have a significant impact in solving these challenges, as it has the ability to benefit enterprises as well as individuals in many aspects. The key characteristics of blockchain technology, decentralization, and immutability, play a primary role in this context. Decentralization means that data stored on the blockchain is visible to everyone, and immutability refers to the fact that this data cannot be tampered with or changed by an individual. These very important features lay the foundation for efficiency, security, and accessibility in areas that have never been attainable previously in the healthcare industry, from managing patient data to tracking drugs through the supply chain. Blockchain technology can benefit virtually all functionalities across the healthcare value chain. Blockchain enables a secure sharing of medical data Blockchain technology can make healthcare information systems more interoperable and accessible by establishing a secure method to share data between healthcare providers. Records of patients can be stored securely on a permissioned blockchain and be made accessible for all relevant healthcare providers. Blockchain gives patients control over their data On a medical data blockchain, as described above, patients would have full control over their data. While healthcare providers are able to update and add more information to a patient's records, the patients themselves can decide who has access to their data. Having people in control over their own health data would be an important and unprecedented new change, as it is currently very difficult to access one’s own data. Blockchain prevents medical errors By allowing practitioners easy access to patients' records via medical data blockchain, blockchain technology can help avoid medical errors caused by missing information. In critical situations, practitioners are able to see all diagnosed preconditions, allergies, and personal information immediately, and furthermore can have access to prior treatments, which can assist them in prescribing the right treatment. Blockchain deters counterfeited and illicit drugs Blockchain technologies' decentral and immutable nature enables the tracing of medicine from its production to its reception by the patient. This allows patients, practitioners, and companies to identify the source and originality of the drugs, which prevents counterfeit and fraudulent products. As a result, the monetary losses related to counterfeit drugs and medicine decrease, whilst simultaneously preventing the negative consequences that can be caused by the use of fraudulent drugs. Blockchain increases data security in healthcare Blockchain technology makes the storage of medical data more secure and reduces the risk of data fraud. The decentral and immutable characteristics of blockchain technology, together with smart contracts and custom transactions, provide the perfect foundation for developing a blockchain-based solution to store data that can not be changed or tampered with, and which malicious hackers cannot threaten to delete. Blockchain can reduce healthcare costs Blockchain technology can help reduce the cost in various areas of the healthcare industry and is expected to save up to $100 billion annually by 2025 according to a study published by Bisresearch [ ]. 11 Blockchain technology can prevent data breaches, reduce the number of redundant treatments, and medical mistakes through more accessibility. In addition, blockchain offers the possibility to store medical data more efficiently, automate payments and transactions and can reduce losses caused by counterfeit drugs. A more specific example of how blockchain can reduce costs are clinician credentialing, which often involves a month-long process. By facilitating this process on a blockchain, clinician credentialing can become shorter and more efficient, as credentials do not have to be verified by many stakeholders but can instead be verified immediately. According to JP Morgan, blockchain technology can reduce the costs and time invested in this process by 80 percent [ ]. 12 Blockchain improves medical research. Blockchain technology enables better knowledge transfer between medical researchers and can provide healthcare organizations and governments with more accurate data about the health of their citizens. Blockchain Technology Applied Enterprises, as well as governments, have already recognized the impact that blockchain technology can have on the healthcare industry. Start-ups as well as larger healthcare organizations are experimenting with blockchain technology. Some of the most well-known use cases of blockchain technology in healthcare are those covering the prescription tracking of drugs, clinical trial management, data sharing through telemedicine sharing, creation of cancer registries, digital identity patient management system, and the evaluation of health insurance claims. World Health Organization - Tokenization of Real Estate [ 13 ] The World Health Organization (WHO), has partnered with many collaborators, including Microsoft, IBM, and Oracle to create a blockchain-based data-sharing platform in response to the COVID-19 outbreak. The goal is to establish more secure and verifiable data sharing between individuals, state authorities, and health institutions to combat the recent ongoing outbreak. MiPasa is the name of this multi-party, multi-source verifiable data-sharing platform and allows the uploading and sharing of data about COVID-19 infections. It is “designed to make it possible to synthesize data sources, address their inconsistencies, help identify errors or misreporting, and seamlessly integrate credible new feeds” [ ]. With MiPasa it might become easier to monitor and foresee epidemiological trends, locally as well as globally. 14 Benefits of the Initiative: Verifiable data sharing More high-quality data available Healthcare Blockchain Applications Built with Lisk Healthcare enterprises can benefit greatly from exploring the potential of blockchain technology. Lisk provides the tools to experiment with this technology and to develop proof of concept blockchain applications to solve challenges in healthcare. The ‘ ’ is a proof of concept blockchain application built with the Lisk SDK and enables the secure and decentral storage of scientific measurements. Global Data Chain Although it is not particularly focused on healthcare, it could easily function as a patient's health data registry. The Global Data Chain illustrates the already existing possibilities to develop proof of concept blockchain applications for healthcare use cases. The program can assist enterprises and developers in developing such blockchain applications for the healthcare industry. Lisk Builders

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