The modern healthcare system is essentially a set of dependent and independent institutions. Because of its mission-critical nature, the system’s evolution involved a lot of ad-hoc changes. Thus, many important, long-term aspects were neglected during this development, including harmonious transfer of medical records among these institutions. Therefore, the healthcare industry becomes yet another opportunity for blockchain to cause disruption – and the disruption is already happening. As mentioned in one of IBM’s blog posts on blockchain, “healthcare payers and providers are [already] using blockchain to manage clinical trials data and electronic medical records while maintaining regulatory compliance.” Here, I will discuss one such initiative carried out by researchers at MIT, called MedRec.
MedRec essentially uses blockchain to substitute for centralized intermediaries among healthcare institutions. MedRec is pushing for improved document communication among these institutions. As of now, patients face significant inconveniences in viewing their reports and rectifying incorrect data. So the Electronic Health Record (EHR) scenario is very much like that of personal finance, where one can have several bank accounts, assets, loans and credit cards, but no unified, singular way to access and control them. However, financial institutions have the notion of currency, which simplifies communication and asset transfer among them. As the official MedRec website says, “with medical information we are still in the age of barter.” It also mentions that “[EHRs] were never designed to manage the complexities of multi-institutional, lifetime medical records. As patients move between providers, their data becomes scattered across different organizations, losing easy access to past records.” However, the analogy mentioned doesn’t apply at all times. In the health records domain, there is no homogeneous like-for-like trade possible, unlike the finance industry. In the financial markets, competition and more choices result in lower consumer costs, but in healthcare records domain, that may lead to incompatible/inaccessible barriers to interchange and control. This is the place where blockchain can play its part and remove friction from EHR transfers. Thus, researchers at MIT did a first implementation of MedRec on the Ethereum blockchain in 2016.
MedRec uses Ethereum’s platform to build smart contracts which link patients and providers to the addresses of existing medical records. It doesn’t directly store patient data; it encodes metadata that allows records to be accessed securely by patients, unifying access to data across different providers. This metadata contains information about ownership, permission, and integrity of the data being requested. The initial implementation used an ingenious technique to incentivize the mining of the MedRec blockchain for the system to scale well. The mining process would be performed by medical researchers, who in turn would gain access to aggregate and anonymized data that might be used to further medical research.
However, MedRec is different from other blockchains in the sense that it is not correctly welcoming external developers. It is not an open source blockchain, yet. The dev team is still iterating over the chain architecture and continually improving it. The MedRec website says that they “will open the source code once we have developed a working prototype of Medrec 2.0.” This will be a more production-ready system, and it seems promising from now itself as MedRec is backed by a technology leader like MIT.
Saurabh Chaturvedi is a freelance developer and technical writer with a keen interest in blockchain, Bitcoin, and other cryptocurrencies.
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