How Blockchain Will Revolutionize Remote Healthcare?

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Remote Healthcare

As I have explained the key trends in the healthcare sector, connected care is increasingly important. Remote healthcare, or “Remote Patient Monitoring” as we often call it, can help transform the healthcare sector. It has the following benefits:

• The transition from an episodic medical care model: We often visit the doctor at a primary care clinic when we have a health issue to address. That’s episodic care. On the other hand, a holistic model will look to prevent issues and improve the quality of life. Remote healthcare can help with this transition from medical clinics.
• Use smart devices to ease the workload of health professionals and primary care doctors through more flexible jobs: Most of us now have smart devices like smartphones and wearable devices. These can measure a lot of our health parameters. You save time; moreover, health professionals can save time, too.
• Communicate our health status better: Again, thanks to the age of the Internet, smart devices that remotely monitor our health parameters can communicate these to health professionals as telehealth services.
• Making patients more responsible: With the telemedicine services tools that modern technology offers, you can be proactive about managing your health. Maintain a healthy body weight, and prevent that heart ailment!

Read more about these benefits in “Remote health care is the future of medicine.”

The challenges facing remote patient monitoring

Remote patient monitoring (RPM) faces certain challenges that constrain its growth. These are as follows:

• Traditional healthcare systems don’t support RPM well: Traditional healthcare systems are geared towards episodic care, whereas RPM intends to also focus on preventive care. Take the example of “Electronic Health Records” (EHRs). By their very design, they support episodic care. There are also legal angles to including RPM data in EHRs. Healthcare industry stakeholders need to first finalize their approach and then transform existing systems to support RPM. Read more about this in “On the challenges of remote patient monitoring.”
• RPM device adoption needs to improve: We now have wearable devices for many healthcare-related use cases; however, the devices aren’t sufficiently usable for continuous use. Continuous use of the device for an extended period is important for RPM to deliver value.
• Assurance about accurate data: This hardly needs an explanation! Fancy devices streaming inaccurate data won’t do any good to RPM.
• Timely and relevant data transmission to health services providers: Secured transmission of accurate data to health services providers at the right time is an important success factor for RPM. It’s not easy to achieve!

Read more about these challenges in “Three challenges to remote patient monitoring.”

Can blockchain have a role in Remote Healthcare and RPM?

Blockchain can help ensure the accuracy of data recorded by RMP devices and facilitate the secure and timely transfer of this data. To understand how, we need to understand how blockchain works, which is as follows:

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• Blockchain is a distributed network that’s also decentralized. Computers in this network are called “nodes”, and a public blockchain network is open to anyone.
• Every node has equal authority, and each node has a complete record of transactions in the blockchain. This makes each node a complete ledger of all transactions. Thus, the name “Distributed Ledger Technology” (DLT).
• No hacker can destroy the network by compromising one computer since the other nodes will maintain the network.
• Digital signatures, modern cryptographic hash functions, and rigorous consensus algorithms protect the data against tampering.

I have explained these features earlier in “How to build your own blockchain using Node.js.” These security features protect data against tampering.

Furthermore, blockchain networks like Ethereum use smart contracts, which work as follows:

• These are tamper-proof, open-source, transparent, and autonomous pieces of code that transfer cryptographic assets based on predefined conditions.
• Their execution results are irreversible. I have explained smart contracts earlier in “Blockchain software development using the Ethereum network”.

Smart contracts can ensure secure and automated transmission of RMP device data to healthcare providers.

A blockchain-in-RMP “Proof of Concept” (PoC) using Ethereum

Let’s now describe a PoC that uses Ethereum smart contracts for secure automated RMP. A group of researchers from Fordham Center for Cybersecurity, Fordham University, New York, has collaborated with the US-based National Center for Biotechnology Information for this PoC.

Following is a summary of the PoC:

• RMP extensively uses the “Internet of Things” (IoT) technology in wearable devices.
• The healthcare research team addressed the use of IoT devices in collecting and disseminating RMP data.
• Their particular concern was the security concerns about recording and transmitting patient data.
• RMP devices extensively collect “Protected Health Information” (PHI). This is sensitive information, and regulations such as HIPAA protect it.
• IoT devices communicate over the Internet, and the security of PHI transmission over the Internet is of utmost concern.
• The research team created a private permissioned blockchain using the Ethereum blockchain protocol.
• In this system, the IoT devices invoke smart contracts and log all events on the blockchain.
• The smart contracts support real-time patient monitoring for vital signs like blood pressure and heart rate, moreover, they would send notifications to patients and healthcare providers. This will facilitate medical intervention when required.
• Smart contracts can help schedule appointments with doctors through mobile devices.
• Every intervention gets recorded in the blockchain.
• The permissioned, private blockchain, with its encryption and other security features, addresses HIPAA compliance.

Read more about this PoC in “Healthcare blockchain system using smart contracts for secure automated remote patient monitoring”.

“Twist in the tale”: Blockchain for IoT

Here we have a “twist in the tale”, since public blockchains as know them don’t work too well with IoT. Note the following points to understand this better:

• Public blockchains like Ethereum are decentralized, secure, and stable.
• Consensus algorithms like “Proof of Work” (POW) make them very secure since hackers simply can’t manage the computing power required to hack these networks. Read more about POW in “Proof of work vs proof of stake comparison”.
• The more nodes join these networks, the more secure they are. Ironically, this high security limits the scalability of these networks! I have explained this in “How to Scale an Ethereum Dapp”.
• Now, consider millions of patients in an RMP program, each using a multitude of wearable IoT devices.
• If we use blockchain to secure patient portal data from these millions of IoT devices, the network won’t scale well. Transaction throughput will be very low. Therefore, the RMP will not be viable.
• Blockchain-crypto communities are working on this scalability challenge with respect to IoT devices. For example, “Tangle” technology uses a “Directed Acyclic Graph” (DAG) to provide security like a blockchain. There is no POW and “crypto mining” here; therefore, it’s a highly scalable network. Read about “Tangle” and their cryptocurrency IOTA in “What is the Tangle? Complete guide to IOTA’s Directed Acyclic Graph (DAG)”.

Another research team has addressed this scalability aspect concerning IoT devices used in RMP. We will now review this.

Implementing IoT-friendly blockchain in RMP: A PoC

This research team at Cornell University has conducted a valuable PoC on implementing IoT-friendly blockchain-like technology in RMP. The researchers are Gautam Srivastava, Ashutosh Dhar Dwivedi, and Rajani Singh. The following is a summary of their PoC:

• They are using a POW-based protocol called GHOSTDAG. Here, it uses DAG, which eliminates the scalability and transaction throughout challenges.
• The researchers further go on to create two blockchains, one of which is public, whereas the other one is private.
• A system on the private blockchain uses smart contracts to analyze patient health data. As private blockchains are permissioned, sensitive patient health data get adequate protection.
• Upon analyzing patent health data, smart contracts issue alerts beyond certain thresholds. The application then makes that health observation available to relevant stakeholders via the public blockchain.

This way, the PoC addressed the accuracy and privacy of patient health data. Moreover, it also took care of the scalability and transaction throughput. Read more about this PoC in “Automated remote patient monitoring: Data sharing and privacy using blockchain.”

Planning to use blockchain for remote healthcare?

As you can see, blockchain has immense potential in remote healthcare. However, it’s a new technology, and solutions addressing remote healthcare jobs are still evolving. If you are planning to use blockchain for remote healthcare, you need healthcare industry expertise at your disposal.

Additionally, blockchain skills are at a premium, and DAG is a niche even within the blockchain technology landscape. You need quality software architects, blockchain developers, and project managers with blockchain experience. You might need professional help.

Our guide, “How to Find The Best Software Development Company?” can help you engage the right blockchain consulting, design, and development partner.

If you are still looking for a reputed software development partner, DevTeam.Space can help you with its expert software development community. Write to us your initial blockchain healthcare solution specifications via this quick form and one of our technical managers will get back to you for further assistance.

Frequently Asked Questions on Blockchain for Remote Healthcare