How Is Blockchain Technology Applied In The Medical Industry?

In 2009, Bitcoin came out, and blockchain technology, which is the underlying technology and infrastructure of Bitcoin, began to enter the public eye. Over the years, blockchain has achieved breakthrough development in both the depth and breadth of technology and the breadth of application scenarios, and is influencing the future of the digital economy era with its unique technical advantages. In the medical industry, blockchain technology is in a period of exploration and development. This study analyzes the principles and characteristics of blockchain technology, sorts out the application and research status of blockchain technology in the medical industry, and explores the innovation and development prospects of this technology in the industry.

Technical principles and technical characteristics of blockchain

As the name suggests, blockchain () is a kind of data that is generated and stored in blocks and connected end to end in chronological order to form a chain structure. At the same time, cryptography ensures that data cannot be tampered with, cannot be forged, and data cannot be forged. Transport access to a secure decentralized distributed ledger. Its basic technologies include hash operations, digital signatures, consensus algorithms, P2P networks, privacy protection, smart contracts, etc. The chain structure and Merkel tree of the blockchain are constructed through hash operations to achieve tamper resistance and rapid detection. Achieve authority control and identity recognition through digital signatures to prevent nodes from being impersonated. Solve the trust problem of national accounting through consensus algorithms, mainly including workload proof, Byzantine fault tolerance, etc. Through the P2P network, peer-to-peer data sharing and decentralization functions are realized. The function of node verification and permanent storage of execution results is realized through smart contracts.

Blockchain technology is based on the integration of the above-mentioned underlying technologies to form unique innovations. Its main features are: First, decentralization. The consensus algorithm ensures the consistency of transaction confirmations among all nodes, and the entire system is transparent, fair, and credible to all nodes. The second is tamper-proof traceability. Transaction data is permanently and completely stored in the block structure in the form of timestamps, ensuring data traceability. The third is privacy and security. Any node in the blockchain system contains complete block verification logic. No node relies on other nodes to complete transaction confirmation or validity judgment. The private key is the only identity identifier, and anonymous transactions effectively protect user privacy.

In November 2008, against the background of the global financial crisis, Satoshi Nakamoto published a basic paper "Bitcoin: A Peer-to-Peer Electronic Cash System", proposing to change the current centralized financial and monetary system and design a completely decentralized one. A peer-to-peer electronic cash system. Peer-to-peer electronic cash system. In early 2009, he designed the Bitcoin system with blockchain as the underlying architecture, which marked the advent of blockchain technology, the underlying technology of Bitcoin. Since then, the development of blockchain technology has roughly gone through three stages. The first stage is the encrypted digital currency stage, that is, the blockchain 1.0 era. Blockchain technology is mainly used in the field of cryptocurrency. A typical representative is the Bitcoin system, which builds an open, transparent, decentralized, and tamper-proof ledger system. . The second stage is the enterprise application stage, that is, the blockchain 2.0 era. The integration of smart contracts and the improvement of consensus algorithm performance reduce trust and collaboration costs and improve industry assistance efficiency. A typical representative is the Ethereum system. The third stage is the value Internet stage, that is, the blockchain 3.0 stage. Blockchain technology has cross-evolved with emerging technologies such as 5G networks and the Internet of Things, and has penetrated into non-financial fields. The public chain foundation is maturing day by day, and cross-chain solutions continue to develop. , and gradually reconstruct the development ecology of the future Internet.

Application of blockchain in the medical industry at home and abroad

Since 2016, blockchain has become one of the new research hotspots in various industries. Mainly based on China's national knowledge infrastructure, supplemented by Wanfang Database, etc., with the theme of "Blockchain + Medical", the search date is April 10, 2021, and the time limit is from January 1, 2015 to April 2021 On the 10th, a total of 795 relevant research documents were retrieved, including 562 academic journals, accounting for 70.69%; 150 master's and doctoral theses, accounting for 18.11%; others including conferences, newspaper articles, etc. 83, accounting for 10.44%. In terms of topics, there are 384 articles on blockchain and blockchain technology, accounting for 48.30%, 243 articles on electronic medical records, privacy protection, smart contracts, data sharing/sharing models, etc., accounting for 30.56%, and 168 other articles, accounting for 30.56%. 21.14%. Taking the CNKI database as an example, judging from the year of publication, there were only 8 industry-related research documents in 2016. Since then, the number of research documents has doubled year by year, respectively, to 40, 91, 248, and 369 articles from 2017 to 2020. Related The research has begun to take shape.

Abroad, leading countries in blockchain innovation research include the United States, the United Kingdom, Australia, the Netherlands, Singapore, etc. Mainly using other foreign language databases, using "" as the subject search, the search date is April 10, 2021, and the time limit is from January 1, 2015 to April 10, 2021. A total of 533 relevant documents were retrieved. Searching with "" combination """""""", etc., 119, 259, 190, 67, and 415 documents were retrieved respectively. Taking this as an example, looking at the timeline, 2 relevant research documents were retrieved in 2016, and 17, 57, 104, and 208 relevant research documents were retrieved from 2017 to 2020 respectively. The year-on-year growth trend is obvious. The study believes that China leads in the number of innovations and applications in the field of blockchain, but involves fewer core technologies. The United States ranks among the top in the world in terms of blockchain exploration technology and applications.

Main research areas of blockchain technology in the medical industry

The application of blockchain technology in electronic medical records is a primary research focus. etc. to build a patient-centered medical data security sharing framework. Zhai Sheping, Luo Wenjun and others proposed a blockchain electronic medical record sharing solution. Niu Shufen and others proposed a secure sharing system for electronic medical records based on the consortium chain. In 2018, Huashan Hospital Affiliated to Fudan University and Ant Financial jointly launched China’s first blockchain electronic prescription. In 2019, Shanghai Renji Hospital initially implemented remote electronic medical record sharing through blockchain, and Shanghai People's Hospital and Anhui Provincial Hospital jointly built blockchain electronic medical records. It can be said that blockchain-based electronic medical record research and application innovation are very active.

Research on blockchain technology in the field of medical service supply chain traceability is also one of the hot spots. designed a COVID-19 epidemic data tracking system based on blockchain technology. Yang Yi discusses drug traceability management based on blockchain technology. In 2017, the first "blockchain+" drug traceability service platform in China - Ziyun Yao Anbao drug traceability cloud service platform was launched. Its characteristic is that it is based on the traceability technology of the blockchain to realize "one code for one item, and the coded items can be traced at the same time" to realize the supervision of the entire pharmaceutical process. At present, the blockchain-based drug and device traceability system has been gradually applied to the medical service industry and continuously improved.

The existing data-centralized medical information management system has many drawbacks, and many studies have proposed building a decentralized medical system based on blockchain. Yue et al. A blockchain-based healthcare data sharing system was earlier proposed. Zhang et al., Tang Yanjun et al. It is proposed to explore and build a secure sharing health information platform based on blockchain. Feng Tao et al., Wang Hui et al. The blockchain technology storage and security sharing model is designed from a technical perspective. Zhang Chen et al. built a blockchain medical system based on balanced binary sorting tree. Xu Jian and others designed a blockchain medical record secure sharing or storage solution. Blockchain technology provides an effective solution for solving medical information islands, improving the quality of medical services, and ensuring the safe sharing of medical data.

The application of blockchain in hospital management is mainly in processes, supervision, statistics, finance, auditing, archives, etc. Ge Guoshu et al. discussed the application of blockchain in hospital management, including drug procurement, equipment tracking, material procurement, Liu Jingguang et al., Tang Yanjun et al., Gong Yuchen et al. Conduct research on hospital financial management architecture based on blockchain. Ye Hua et al. The role of blockchain technology in the construction of hospital integrity service system was discussed. It can be seen that the mature blockchain application platform will reshape the internal management model of future hospitals and effectively promote the implementation of modern hospital management systems.

Blockchain faces key technical issues in the medical industry

Although all walks of life have optimistic expectations for blockchain applications, the actual implementation of blockchain applications still faces many technical challenges. The paradox of the three elements of blockchain, namely efficiency, decentralization, and security, is currently the focus of many technical studies. At present, there is no project that can achieve the ultimate in efficiency, decentralization and security at the same time. Exploring the balance of the three in combination with reality, and even exploring the limits of Pareto improvement, has always been the research direction of blockchain technology. This issue is the key to the implementation of blockchain in all walks of life, and is also universal for the medical industry.

In the decentralized structure of blockchain technology, each node is an independent ledger. The entire transaction must be completed and reached a consensus by all nodes in the entire network before it can be confirmed. This results in low transaction processing performance and obvious barreling. The effect, that is, the overall performance of the system depends on the worst performing node in the blockchain network. The transaction throughput, transaction speed, and data storage capacity issues of blockchain technology have become important bottlenecks that hinder the implementation of application scenarios, making it difficult for regional blockchain networks to withstand related businesses with higher system requirements such as medical data. Throughput (per, TPS).

For the medical industry, patient privacy data security is an important part of information management. An important feature of blockchain technology is that multiple nodes jointly maintain a set of data ledgers. All data on the ledger must be verified and stored by multiple nodes. This also exposes the privacy protection issues of blockchain. Therefore, blockchain information security and privacy protection are also hot topics in this field. Currently, algorithms such as channel technology, zero-knowledge proof, and homomorphic encryption technology are being continuously integrated and applied, and many technical solutions are in the continuous optimization and exploration stage.

Efficient and versatile cross-chain technology is the key to realizing the interconnection of thousands of chains. At present, the ecological island phenomenon of blockchain is serious, which has become a difficulty affecting the overall expansion of blockchain. For example, the underlying architecture between platforms cannot be interoperable, the designs are quite different, cross-chain data cannot be verified, interface protocols cannot interoperate, and security mechanisms cannot trust each other, etc. Technically speaking, blockchain currently does not have an innovative solution that is open, inclusive, and transcends platforms.

In summary

At present, the application of blockchain in the medical industry is still in its early stages, but many professionals have optimistic expectations for the future development of blockchain and believe that blockchain can break through the status quo and move towards a new stage of development.

At this stage, the large-scale application of blockchain technology faces many technical difficulties. For example, the underlying technology needs to be further matured; effective cryptographic algorithms must be designed to protect privacy issues; issues such as increasing potential transaction throughput, transaction speed, and storage capacity must be improved. These technical issues are also related to the implementation of blockchain in the medical industry. Only by overcoming core technical difficulties can the advantages and potential of blockchain technology be truly released.

As a new technology, blockchain has the characteristics of decentralization, safe sharing, non-tampering, and high privacy. It provides a new perspective to break through the development bottleneck of current hospital management informatization. The application of blockchain can cover all aspects of hospital management such as process, supervision, statistics, finance, auditing, and archives, providing practical technical support for reconstructing the hospital information foundation and reshaping the hospital management process.

It is foreseeable that blockchain technology will reshape the future of informatization in the global medical industry. Since 2016, blockchain technology has become the focus of independent innovation of national core technologies. In 2020, the National Development and Reform Commission defined blockchain technology as a new type of infrastructure. In an important period when the country is vigorously promoting the research and development of basic blockchain technology and improving the construction of the blockchain ecological chain, the medical industry should seize the development opportunities of blockchain and strengthen independent research and innovation of blockchain technology in the medical field. The application potential of blockchain technology can truly realize the new information technology to protect the development of the medical industry.

[Citation of this article: Wei Dongxiao, Liu Ying. Henan Provincial Chest Hospital[J]. China Digital Medicine, 2021, 16(12)89-92.]

标签： #Block #Application #Medical #Node #Privacy