• Blockchain
  • AI, blockchain, cold chain and motorbikes improve blood donations and save lives in Nigeria

    Blood shortages are common in many health systems. An initiative in Nigeria uses mHealth to create a community of voluntary blood donors, and connects hospitals with blood banks, and blood banks with donors. Life Bank, a Lagos start-up also provides a discovery platform on for hospitals to order blood

    LifeBank delivers requested blood in less than 45 minutes, in a WHO Blood Transfusion Safety compliant cold chain. An article in Disrupt Africa says it’ll add other medical products such as oxygen, vaccines and rare drugs to its services.

    Its founder, Giwa-Tubosun, began a non-profit service to encourage people to donate blood. She then moved on to address supply shortages and poor logistics. Two main goals are:

    Increasing access to bloodReducing the number of Nigerian women who die from birth complications.

    LifeBank’s resources include:

    AIBlockchainCold chainmHealthMotorbikes.

    These combine to provide information about blood availability and avoid health workers’ wasted time and frustration seeking blood products. They also minimise ineffective blood transports that result in bacteria proliferation and consequences of health complications.

    Supporters include:

    Co-Creation Hub (CcHub) in 2016 that raised pre-seed fundingEchoVC Partners, a venture capitalistParticipation in Merck’s Lagos-based satellite accelerator this yearSelection for MIT Solv2018 that added grants and access to other resources.

    Its impact is considerable. To date, LifeBank’s delivered some 11,000 products for over 400 hospitals. Over 6,300 people are registered as voluntary blood donors, with over 20% donating blood in the last two years. The result: over 2,100 lives saved.

    A challenge is convincing blood bank partners to use LifeBank. As this is  overcome, it’s it easy to envisage LifeBank eventually operating across Africa.

  • How far into the future should eHealth strategies look?

    By definition, eHealth strategies are about investing in the future. They’re also about taking existing eHealth investments forward, either by switching, enhancing and rolling out further. In 2006, Rosabeth Kanter identified several lesson for innovation strategies. They included an “innovation pyramid” where:

    Not every innovation idea has to be a blockbusterSufficient numbers of small or incremental innovations can lead to big gainsBig bets at the top that get most of the investmentA portfolio of promising midrange ideas in test stageA broad base of early stage ideas or incremental innovations.

    The last one’s relevant for a perspective set out in an eBook from Oracle. Technology Takes Healthcare to Next Level proposes strategies for disruptive technologies of:

    AIBlockchainChatbotsIoT. 

    Each one offers promise for healthcare. Combined, Oracle sees the sum of the parts as greater than the whole. Combining blockchain and IoT allows frictionless data exchange. AI and machine learning put data in motion with minimal human intervention. AI tools can study blockchain’s large volumes of data to find patterns that need responses

    For Africa’s health systems, investment in ICT foundations and patients’ clinical and demographic data’s needed to. The strategic challenge is to choose between sequential investment and progress in an innovation pyramid where these four technologies start their journey. While leaving the disruptive technologies into the future, it can defer the costs. It will also defer the benefits.

     

  • Will AI and Blockchain converge to enhance health analytics?

    While AI and Blockchain are seen by some to offer powerful tools, a view’s emerging that combining them offers significantly more potential for Big Data and health analytics. Or, is it just another dose of eHealth hype? An article in Health IT Analytics  says in the US, AI and Blockchain are now tools of choice for developers, providers and payers in improving their eHealth infrastructure.

    But, it acknowledges that both are near their hype curves peaks. Some providers and payers are reluctant to invest heavily at their maturity stages. Concerns over security, utility and Return on Investment (ROI) are justifications for some organisations to defer investment, leaving others to provide evidence that combining AI and Blockchain can succeed in secure the large data sets and exchanges that Big Data needs for innovative analytics.

    Access to data’s one obstacle. Most data resources are held securely and privately by several institutions. Opening them can create cybersecurity vulnerabilities. Despite this, ideas are fermenting of using Blockchain to produce metadata about the datasets available at several organisations. It can also provide secure, peer-to-peer data exchange. Blockchain can be a pointer to where full data sets are stored, allowing for discoverability without requiring data sets to move each time a transactions completed.

    This strategy enables organisations to keep sensitive data, such as Protected Health Information (PHI) and Personally Identifiable Information (PII) off Blockchain. It’ll reduce risks of breaches. Instead, minimal but sufficient data should be held in Blockchain.

    These comprise complex decisions and projects. It seems premature for Africa’s health systems to pursue combined AI and Blockchain strategies in the medium term. There are other eHealth priorities to address, such as using mHealth to support remote health workers with access to test results and improving their co-ordination with colleagues.

    If the AI and Blockchain are converging in healthcare, Africa’s health systems can watch trajectories and learn from them. If they deliver a significant proportion of their potential, a challenge for Africa’s health systems may be to avoid a sudden disruption to their eHealth strategies and plans. While this can be costly, missing new eHealth opportunities has a cost too, often of missed benefits. 

  • A coffee case study has lessons for blockchain in healthcare

    Coffee has loads of health benefits, though it’s not typically the go-to place for innovative approaches to health information systems. So I was intrigued by a coffee story that appeared in a June edition of Seattle Business magazine.

    Scott Tupper is an anthropologist and founder of Onda Origins coffee, a company that combines ideas on improving wealth disparity in the world, with a passion for information technology, and coffee. He uses the unique characteristics of blockchain technology to improve information accuracy and accountability in the coffee trade, driven through Yave, a company he started for this purpose.

    Blockchain structures are used to capture information at key steps along the coffee supply chain, from farmer to consumer. This creates a single source of truth about the coffee bean’s journey, encrypted and shared across a trusted, distributed network. And that sounds a lot like what we aim to achieve when building health records.

    Yave constructs multiple registers for each coffee consignment journey. The first register records the coffee producer’s name and electronic ID, the shipment’s ID, the coffee’s place of origin, the amount of coffee and the coffee’s description and quality score. That is encrypted and becomes the first block in a new blockchain.

    At key stages in the supply chain, an additional block is added to the chain, such as when the shipment is received at a mill, or passes through exporters and importers, or roasters. The mill register includes details about the milling process followed, initial roasting, and the results of taste test scores. At each stage new registers are created and existing data, such as taste scores, may be updated with new values. Since blockchain data is immutable, the old data is never overwritten. When new data is added, both new and old values remain in the chain and are auditable. At each stage, the new data is broadcast to the network, which can access all the information.

    How these details change across the supply chain helps to set the final assessment of the quality of the coffee bean, which affects pricing, and helps to review the quality of the supply chain, which drives operational improvements. The coffee-folk believe that one of the most valuable aspects of this application of blockchain is the ability to verify coffee’s origin and other key details of steps along the way to our cups, thereby making it easier to make value judgements about the final product and what you and I should pay for it.

    As we learn more about Blockchain technical attributes, we are beginning to recognise it as a tool for democratisation, sharing data ownership and access equally with all participants. This distributed architecture puts participants in control of their data in new ways that are technically extremely challenging with more conventional systems architectures.

    While Blockchain protects our coffee supply chain, it has the potential to transform ownership of our health data too. 

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    Image from the Yave site, https://www.yave.io/

    @yave_io

  • Blockchain for beginners is still needed

    Blockchain is a hot topic everywhere, including in healthcare. I have been writing about it for eHNA, exploring use cases and applications. I've had lots of positive feedback, yet a question remains for many: how does blockchain technology actually work? Today's piece introduces some basic concepts. 

    Firstly, bitcoin and blockchain are not the same thing. Bitcoin is a digital currency or cryptocurrency that is administered on blockchain technology.  It combines many existing concepts, including large databases, voluntary participation, peer-to-peer networks, distributed ledgers, and cryptography, to protect users' information against fraud.

    There are three levels of how blockchain technology is currently being used:

    Storage of digital recordsExchange of digital assets in the form of tokens, and Execution of smart contracts.

    Smart contracts set the ground rules for how transactions take place. They execute the contracts while monitoring compliance and automatically validate the results of each transaction.

    To work, blockchain relies on consensus. This gives rise to the concept of mining. Each new block added to a given blockchain follows a consensus model which is approved by the network of connected nodes.  The level of agreement in consensus models may vary across blockchain networks.

    Encryption of information on a blockchain is achieved by hash functions. These map data of arbitrary size to data of a fixed size through a cryptographic method or algorithm. Hash function outputs are unique, asymmetric and random, ensuring security on the blockchain.

    That's probably not enough information to get you started on mining your own blockchain, but hopefully sufficient to tweak your curiosity about this elegant technology.  I'll post more over the next few weeks.

  • Data accuracy: another use case for blockchain

    As blockchain technology continues to excite the healthcare industry with opportunities for better access to healthcare data, data security and efficiency, 5 companies have banded together to explore another use case for it. 

    Many managed care organisations, health systems, physicians, and other healthcare stakeholders currently maintain separate copies of healthcare provider data.  Reconciling differences in this data can be a time-consuming and expensive processes.  Blockchain could help bring down administrative costs by ensuring data is complete and accurate across all parties.

    Humana, MultiPlan, Optum, Quest Diagnostics and UnitedHealthcare recently announced a cooperative pilot program to use blockchain technology to share healthcare provider data across organisations.  This aims to improve accuracy, streamline administrative activities and improve access to care. It will also examine whether sharing healthcare provider data inputs and changes made by parties across a blockchain can reduce operational costs and improve data quality. 

    With technology's rapid advances, it's critical that African countries make room for these types of emerging opportunities in their eHealth strategies. Along with rigorous prospective assessments to ensure viability and sustainability.

  • An analytical view of Blockchain aids understanding

    Paradigm shifts are regularly sought after by information and ICT initiatives. As a set of ideas, assumptions, and values that can help to live and see the world, a paradigm doesn’t seem easy to shift. In The Business Blockchain, published by Wiley, William Mougayar describes how Blockchain’s a paradigm shift. 

    It’s part of a sequence of paradigm shifts of the Internet, the World Wide Web, and now Blockchain. He’s firm that Blockchain’s different to all that’s originated before. It’s also tricky to understand, with a clear grasp of its philosophy essential to comprehend its technical components.

    Blockchain has six enablers, programmable: 

    AssetsTrustOwnershipMoneyIdentityContracts.

    Creating ATOMIC, Mougayar delves well into each of these. This delving and diving’s a characteristic of the book. It’s the knowledge and insights that these provide ensure it’s not a superficial overview or description. Examples are the explanation of the set of basic principles and the emphasis on Blockchain’s decentralisation features.

    Wynton Marsalis, the jazz trumpeter said to understand art, you must come to art. Art will not come to you. This resonates with Blockchain. Mougayar’s book’s essential to begin the journey. Africa’s health systems need to follow the tricky route to ensure strategic opportunities are not lost. 

  • Healthcare enters the blockchain ecosystem

    Over the last few years, healthcare has seen a record number of security breaches involving healthcare data.  This has prompted several start-ups to realise the work that needs to be done on the cyber-security front to make healthcare data secure.  Blockchain offers one potential solution to this challenge. Other solutions offered by blockchain include interoperability and the ability to connect data silos for more seamless systems and improved patient safety.

    SimplyVital Health is one of those start-ups experimenting with blockchain technology to give the healthcare industry a facelift. The company has developed a decentralised open-source protocol that will enable frictional-less sharing of healthcare data.  Their Health Nexus is a public-permissioned blockchain. It provides a platform to build advanced healthcare applications while maintaining the privacy and security required in the healthcare industry. 

    The developer tools on the Health Nexus are open source and available for free.  Members are able to build and deploy distributed apps utilising the blockchain protocol for transactions, identity and smart contracts, and a distributed hash table (DHT) for data storage, managed by a governance system. This will allow developers to create valuable solutions for pharmacies, healthcare providers, insurers, clinical researchers or patients.  

    Blockchain is certainly paving opportunities for new business models in healthcare.  The trajectory it will follow in the coming years, however, is an unmapped terrain waiting to be explored.  The road ahead for blockchain and healthcare will also require substantial intra-industry cooperation as well as dialogues between the public and private sectors regarding standards and regulatory frameworks.

     

  • Why blockchain may be the future of healthcare

    The blockchain revolution has made its way to the healthcare industry.  If you haven’t heard about it yet, blockchain is a distributed system which records and stores transaction records.  Think of it as a database which stores information.  The main difference is that the data is located in a network of personal computers called nodes where there is no central administrator, such as a government or bank controlling the data.

    On permission-less blockchains, all parties can view all records. On permissioned blockchains, privacy can be maintained by agreement about which parties can view which transactions and where, masking the identity of the party. 

    Blockchain principles were first applied in the financial world as the technology that allowed Bitcoin to operate.  It has applications for many industries and more promisingly for healthcare. 

    This disruptive innovation would be able to solve many of the issues that plague healthcare today, while enjoying unprecedented security benefits because records are spread across a network of replicated databases that are always in sync.  

    A common database of health information can facilitate better sharing of research and evidence-based practices.  It would allow healthcare professionals to access patient records no matter what electronic record system they used and,  even improve supply chain management to prevent resource deficits.

    Blockchain won’t be a cure-all for the industry today, but it would certainly be a step in the right direction.