Welcome to the HubBucket Blockchain ("HubBlockchain"), Blockchain technology for Healthcare Providers and Professionals, coupled with Medical Researchers. HubBucket Blockchain ("HubBlockchain") is a research and development - R&D project of HubBucket, Inc. ("HubBucket"). HubBucket aims to create and promote a "secure, efficient and scalable exchange of health data using Blockchain technology."
As our healthcare systems rely more and more on electronic records, the idea of transformative, smart healthcare systems has caught the eyes of tech vendors and research teams alike. Using software to create more efficient records systems, using Big Data and sequencing to improve our understanding of genetics and the use of smart devices to monitor the conditions of patients automatically are just some of the ways technology is impacting our health, but with innovation lies risk. Data breaches are a daily occurrence in today's world. If is a matter of when, not if, enterprise players become the victim of a successful cyberattack, and it is almost expected that, eventually, your data will in some form end up for sale online. However, when medical data is at risk, this deeply sensitive and personal information makes the entire situation far more serious and potentially devastating for victims. This is the reason why HubBucket is taking steps to ensure sensitive medical and healthcare information and data are protected at every stage within the HubBucket Blockchain ("HubBlockchain").
HubBucket will mitigate these risks by working with the U.S. Food and Drug Administration - FDA to secure medical data from sources including electronic medical records, clinical trials, genomic data, and health data from mobile devices, wearables, and the Internet of Things - IoT, etc. In an initial trial focused on oncology, blockchain technology will be used to create an electronic ledger of where, and how, data is transferred and exchanged -- in the same way that cryptocurrency transactions are traced. By creating an audit trail through the ledger, healthcare professionals will be able to hold information leakers accountable, maintain transparency in what data is going where, and secure weak spots in the sharing process. Blockchain technology provides a highly secure, decentralized framework for data sharing that will accelerate innovation throughout the Healthcare and Medical Research industries.
Traditionally, the interoperability of medical data among institutions has followed three models: push, pull, and view (discussed below), each of which has its strengths and weaknesses. Blockchain offers a fourth model, which has the potential to enable secure lifetime medical record sharing across providers.
Push is the idea that a payload of medical information is sent from one provider to another. In the U.S. a secure email standard called Direct is used to provide encrypted transmission between sender (for example, an E.R. physician) and receiver (for example, your primary care doctor). Although this has worked for health care providers in the past, it assumes that infrastructure is in place to actually make it work, such as the existence of an electronic provider directory for the community and a set of legal agreements enabling widespread sharing of data. Push is a transmission between two parties, and no other party has access to the transaction. If you end up being transferred to another hospital, the new hospital may not be able to access data about your care that was pushed to the first hospital. There is no guarantee of data integrity from the point of data generation to the point of data use — it is assumed that the sending system generated an accurate payload and the receiving system ingested the payload accurately — with no standardized audit trail.
Pull is the idea that one provider can query information from another provider. For example, your cardiologist could query information from your primary care doctor. As with push, all consent and permissioning is informal, ad hoc, and done without a standardized audit trail.
View is the idea that one provider can view the data inside another provider’s record. For example, a surgeon in the hospital operating room could view an X-ray you had taken at an urgent care center. Security approaches are ad hoc, not audited in a standardized way, and not necessarily based on an existing patient-provider relationship.
Here’s the idea:
Blockchain was originally conceived of as a ledger for financial transactions. Every financial institution creates a cryptographically secured list of all deposits and withdrawals. Blockchain uses public key cryptographic techniques to create an append-only, immutable, time-stamped chain of content. Copies of the blockchain are distributed on each participating node in the network.
Today humans manually attempt to reconcile medical data among clinics, hospitals, labs, pharmacies, and insurance companies. It does not work well because there is no single list of all the places data can be found or the order in which it was entered. We may know every medication ever prescribed, but it can be unclear which medications the patient is actually taking now. Further, although data standards are better than ever, each electronic health record (EHR) stores data using different workflows, so it is not obvious who recorded what, and when.
Imagine that every EHR sent updates about medications, problems, and allergy lists to an open-source, community-wide trusted ledger, so additions and subtractions to the medical record were well understood and auditable across organizations. Instead of just displaying data from a single database, the EHR could display data from every database referenced in the ledger. The end result would be perfectly reconciled community-wide information about you, with guaranteed integrity from the point of data generation to the point of use, without manual human intervention.
HubBlockchain doesn’t store health records or require a change in practice. It stores a signature of the record on a blockchain and notifies the patient, who is ultimately in control of where that record can travel. The signature assures that an unaltered copy of the record is obtained. It also shifts the locus of control from the institution to the patient, and in return both burdens and enables the patient to take charge of management. For those patients who do not want to manage their data, I imagine that service organizations will evolve to serve as patient delegates for this task. One challenge of the project and the idea is building an interface that can make this responsibility palatable for patients. Most of the individual patient portals that people use today have cumbersome designs, create more work, and have different user interfaces at every institution. A deployed HubBlockchain A.I. system would feature a user interface to simplify patient interaction with health care records that bridge multiple institutions.
As our next step, we plan to enhance the HubBlockchain pilot with more data types, more data contributors, and more data users. The rationale for considering a blockchain in Electronic Health Records - EHR, Electronic Medical Records - EMR and Medical Research data and information is twofold. First, it avoids adding another organization between the patient and the records, in addition to Medical Research organizations. It is not a new clearing house or “safe deposit box” for data. The blockchain implies a decentralized control mechanism in which all have an interest, but no one exclusively owns it. This is an architectural change that generalizes past medical records. Second, it adds due consideration to a time-stamped, programmable ledger. That opens the door for intelligent control of record access without having to create custom functionality for each EHR and EMR vendor. The ledger also inherently includes an audit trail.
Blockchain for Healthcare Providers and Medical Research organizations is very early in its lifecycle, but it has the potential to standardize secure data exchange in a less burdensome way than previous approaches.
Artificial Intelligence - A.I. & Blockchain Technology
The HubBlockchain Team is developing Artificial Intelligence - A.I. for security of the HubBlockchain. Moreover, we are basing the HubBlockchain on various Artificial Neural Networks - ANN, thus providing a more robust blockchain for sensitive medical and healthcare data and information.
The HubBlockchain is being developed as a Hybrid Cloud topology that uses Artificial Intelligence - A.I. and encryption as layers of security. Furthermore, the HubBlockchain will use:
- Machine Learning - ML
- Deep Learning - DL
- Natural Language Processing - NLP
- Natural Language Understanding - NLU
- Neural Machine Translation - NMT
HubBucket is working to improve Medical Diagnoses with Machine Learning, Deep Learning and Machine Vision tools. Large amounts of confidential data are required to develop these tools, however we are non-confidential data for testing purposes. We will run Verifiable Data Audits at every stage in our testing of the HubBlockchain. Data processed by HubBlockchain’s servers will be logged, and a “special digital ledger” will also be added to explain how and why the data has been used. For example, if results from a cancer test were uploaded, it’ll show they were used in an algorithm to check for possible treatments.
The ledger and entries within the system will be used in a similar way to a blockchain (a distributed database). Like a blockchain, the ledger added to the HubBlockchain can’t be erased and the database list continually grows. A value known as a “cryptographic hash” will be generated every time a data entry is added to the ledger. The hash value makes it possible to see the latest entry and all the previous values in the ledger as well, so the data log can be tracked over time, and the Artificial Intelligence - A.I. integrated into HubBlockchain will keep a constant eye on the integrity of the data and information, and will report any issues to the stakeholders of that data, in addition to taking preventive security steps to fight off any cyber attacks.
It’s impossible to change a specific entry secretly, as this alters the hash value and disrupts the data trail and the HubBlockchain A.I. will note any discrepancies, when and whom made those discrepancies. The HubBlockchain's online interface will be accessible by authorized staff working in hospitals and medical research organizations, so data entries can be scrutinized in real time. Alarm signals can be triggered if workers spot any unusual or suspicious activity.
We live in a digital world, yet the majority of medical records such as blood test reports or x-rays are stored on paper. Moreover, most hospitals don’t share access to medical records, which is time consuming for doctors when prescribing treatments and inconvenient for patients. Having medical records on the blockchain can have a positive effect on disease management, disease prevention, and minimize unnecessary healthcare expenses. Digital health records will also open up the possibility for cross-border sharing of medical data if a patient is on holidays and requires treatment abroad.
The HubBucket Blockchain ("HubBlockchain") project is based on Keyless Signature Infrastructure, which protects the data from interference, glitches and viruses. This system enables only the entry of new data and keeps the records secure from any alteration. As a result, medical records on the blockchain will contribute to patients’ empowerment, medical transparency and improved dialog between caregivers and patients.
HubBucket is creating a proof-of-concept to test the HubBucket Blockchain for data security, integrity and patients trust in managing and sharing Electronic Health Records - EHR, Electronic Medical Records - EMR, Medical Research data, images, and information among healthcare stakeholders. This data security test strives to create a system for a seamless interaction between patient and doctor, where patients can share their information with any doctor in the system for a consultation.
Furthermore, in today’s digital world, patients take an active part in their medical journey. 84% of patients use online sources for research before visiting a hospital. They use self tracking devices and wearables such as Fitbit or Apple watch to measure their compliance with a treatment. These new devices make it possible to record, store and share medical information about patients in real time. Digital innovations are changing patients’ behavior in the healthcare landscape. Yet medical records generated by doctors remain stored in a traditional way and only allow patients a limited access to the data. Furthermore, patients tend to visit multiple doctors in their lifetime. Medical records and test results from different physicians are often stored in incompatible databases. Today reconciling medical data among clinics, labs, pharmacies and insurance companies does not work well. For example, it can be unclear which medication patients were prescribed and which medication they are actually taking.
This lack of data sharing costs 150 000 lives and $18.6 billion per year, according to Premier Healthcare Alliance. Blockchain technology can solve this alarming problem. Blockchain can place patients at the center of the healthcare ecosystem, increase security, privacy and interoperability of health data.
This is where HubBlockchain comes in
Blockchain was originally designed as a ledger for financial transactions. These transactions are stored on append-only (only add, never remove or change), immutable and time-stamped blocks that can only be accessed using a private key. However, not only financial transactions can be stored on the blockchain. If we stored medical records on the blockchain, we could add all updates on medication to an open and trusted source. As a result, medical records would be up to date, well understood, and accessible for all stakeholders, patients, hospitals, pharmacies, insurance companies, etc. The outcome of this would be well reconciled medical data and the elimination of manual human intervention. Patients would stay in control of their medical records and have the ability to grant access to other healthcare stakeholders. In this way, we could address diseases in time, prevent loss of life, and minimize unnecessary healthcare expenses.
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HubBucket, Inc. ("HubBucket") is a research and development corporation, that seeks to advance technologies in Healthcare, Health Information Technology - HIT / HealthIT, Medical Technology - MedTech, Medical Research Technology and Renewable Energy.
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