Over the years, blockchain technology has proven to be a versatile tool for decentralized monetary transactions and data exchange in various industries, such as banking, cyber security, supply chain management, government and healthcare. Blockchains essentially act as distributed ledgers that record transactions on a common digital platform. Distributed verification, digital signatures, immutability, time-stamped transactions, consortium networks, and smart contracts, are some of the characteristics of blockchain-enabled platforms. Although blockchain technology has primarily been used in the financial industry, several stakeholders in healthcare have adopted blockchain for various operations, including maintenance of patient records, while ensuring privacy and security as the records are stored on a network, recruiting patients for trials and providing transparency and traceability in the supply chain. Gradually, blockchain technology has disclosed unprecedented opportunities in this sector by unlocking significant advantages. The global blockchain in healthcare market size is estimated to be worth USD 58 million in 2023 and is expected to grow at compounded annual growth rate (CAGR) of 22%, during the forecast period, according to Roots Analysis. This innovative technology appropriately identifies dangerous mistakes in the medical industry; it also facilitates safe storage and management of healthcare data and transactions. In addition, the blockchain applications include clinical trials (to prevent data manipulation and enhance transparency of clinical trial data), supply chain management (to reduce the prevalence of counterfeit medications / drugs), telemedicine (to protect medical records from unauthorized access or tampering) and electronic medical records (to facilitate patients’ data security between different healthcare providers).
The term blockchain refers to the way it stores transaction data in blocks that are linked to form a chain. Since every entry is stored as a block on the chain, the length of the chain increases as more transactions are recorded and stored. This digital ledger technology was developed in 2008 by Satoshi Nakamoto. This works by keeping track of transactions in a distributed ledger. Once entered into a blockchain, data can never be removed. In addition, every transaction ever made is accurately and verifiably recorded in a blockchain. It is designed in such a way that transactions are immutable, which means that digital information, or transactions records can be recorded and distributed but cannot be altered, deleted or destroyed. Thus, it is important to emphasize that blockchains are secure and cannot be hampered.
TYPES OF BLOCKCHAIN TECHNOLOGY
Blockchain is considered to be one of the most remarkable technological conceptions till date, however, the field is unexplored, and the current extent of application is still regarded as beginning of the forthcoming revolution. Depending on the level of intelligence embedded into a system, (in terms of versatility and performance), it can be classified into multiple types:
§ Permissionless or Public Blockchain: A public blockchain, also referred to as permission-less network, is a completely decentralized blockchain network where anyone can participate without restrictions. It is important to note that the majority of the cryptocurrencies operate on a public blockchain that is subject to regulations or agreements. One of the advantages of public blockchains is that they are completely independent of organizations. As long as computers are connected to them, the public blockchain will continue to function even if the organization that launched it ceases to exist. Additionally, given the transparency of the network, public blockchains are mostly secure as it is impossible to alter or modify data once it has been validated on the blockchain. Public blockchains are most frequently used for mining and exchanging cryptocurrencies, such as Bitcoin.
§ Permissioned or Private Blockchain: A blockchain network that works in a closed network or that is under the control of a single entity, is a private blockchain. A private or permissioned blockchain allows organizations to set controls on who can access the data of blockchain. Only the users who are granted permissions can access specific sets of data. Additionally, private blockchains are typically operated on a small network inside a company or organization. The oracle blockchain platform is one of the more well-known examples of a private or permissioned blockchain.
§ Federated or Consortium Blockchain: In a consortium blockchain, preset nodes control the consensus processes. It has a validator node that performs transaction initiation, reception, and validation. A consortium blockchain typically outperforms a public blockchain network in terms of security, scalability, and efficiency. Moreover, banking and payments are two uses for this type of blockchain.
APPLICATION OF BLOCKCHAIN TECHNOLOGY IN DRUG DISCOVERY AND CLINICAL TRIALS
Blockchain technology has revolutionized the process, from target identification to drug product being available in the market for public use. It can effectively and potentially be used as a method to significantly improve the drug life cycle management. The cycle includes drug discovery, development, manufacturing, distribution, usage, and finally disposal. Once a novel compound is identified, the preclinical phase of drug development begins with in vivo testing to study about the medicine’s safety and efficacy.
During research in various phases of a clinical trial, new drugs and treatments are tested to find ways to treat recently discovered or existing pathologies. The different phases of clinical trials are the steps taken by a scientist to examine the effect of new drugs and medicines on patients. Additionally, the trials that involve new drugs, in particular, are commonly conducted in four phases. It is a well-known fact that approximately 80% of the medical studies fail to produce desired results due to the presence of various errors, which include fraud, data misrepresentation, and trial misconduct. Blockchain technology can set up a strong foundation for an enhanced clinical practice. Some of the benefits of blockchain in drug discovery are mentioned below:
§ Blockchain offers drug data traceability, which can aid in improving the safety of drugs throughout the stages of clinical trials
§ Data security and verification ensure that the clinical protocol complies with good clinical practices (GCP) and regulatory codes of conduct
§ This technology also leads to better transparency, accessibility, and trackability.
Various applications of blockchain technology in clinical trials have been mentioned below:
§ Patient Recruitment: It is considered as one of the most tedious procedures in the clinical trial process. Blockchain technology can reduce the time significantly as it helps to anonymously connect patients registered for trials and their trial sites. Subsequently, the principal investigator (PI) can select potential participants according to the inclusion and exclusion criteria defined in a protocol.
§ Medical Data Sharing and Privacy: Blockchain provides a secure tracking system as the ledger contains all the updated information, making it possible for all participants to be aware of the progress of the clinical trial being conducted. Additionally, each patient has an encrypted address, which is mapped to his / her identity; as a result, protecting the identity of the patient is easier.
§ Data Integrity: Each transaction is validated using a consensus algorithm; therefore, it is possible to trace back and identify the origin of the problem in case of fault or error detection in a chain.
§ Transparency: Transparency reduces the probability of clinical sites that are selectively reporting optimistic results. This can be avoided with the use of a blockchain ledger, and clinical trial researchers can also increase the checks within their organizations to make sure their trials are completed ethically and with complete transparency.
Further, drug manufacturers and distributors of the pharma ecosystem are present across different parts of the globe, this makes drug tracking and tracing difficult for pharma companies. In this complex system, many cases of fraud go unrecognized, this negatively impacts the manufacturers and patients and causes loss of revenues for the drug companies. Blockchain can be an effective solution in preventing counterfeit drugs and other pharma products, by tracking every transaction going through the supply chain. With real-time data access on the blockchain network, it will be extremely difficult to add counterfeit products into the supply chain.
ADVANTAGES OF BLOCKCHAIN IN HEALTHCARE MARKET
§ Enhanced Data Security: Blockchain’s decentralized and encrypted ledger ensures that patient data is highly secure. Unauthorized access and data breaches become significantly more challenging, enhancing patient privacy and confidentiality.
§ Interoperability: Blockchain promotes interoperability by creating a standardized format for sharing healthcare data across different systems and organizations. This simplifies data exchange between healthcare providers, improving patient care coordination.
§ Immutable Record Keeping: Once data is recorded on the blockchain, it cannot be altered or deleted. This immutability ensures the integrity of medical records, reducing errors and preventing data tampering.
§ Streamlined Processes: Smart contracts on the blockchain automate administrative processes such as claims processing and billing. This reduces administrative costs and paperwork, leading to more efficient healthcare operations.
§ Patient Empowerment: Patients gain greater control over their health data. They can grant and revoke access to their records, fostering transparency and trust in the healthcare system. This also allows patients to actively participate in their own care decisions.
CHALLENGES ASSOCIATED WITH BLOCKCHAIN IN HEALTHCARE MARKET
§ Data Privacy and Security: While blockchain provides enhanced security through cryptography and immutability, it can also raise concerns about data privacy. Striking the right balance between data security and patient privacy, especially in public blockchains, is challenging.
§ Patient Consent and Control: Determining how patients can grant and revoke access to their medical data on the blockchain, and ensuring that they have control over their information, is a critical ethical and technical challenge.
§ Scalability: As healthcare systems generate vast amounts of data, ensuring that the blockchain network can scale to handle this volume is a concern. Scalability solutions need to be developed and implemented.
In the last decade, the popularity of blockchain technology has invariably grown. Specifically, it has made a considerable impact in the healthcare and financial sectors. Blockchain has the potential to revolutionize the healthcare sector by overcoming the existing challenges. One of the features of blockchain is that it lets organizations establish transparency and privacy, helping to conceal sensitive patient data while enabling access and sharing when necessary. In the future, blockchain technology may aid in the provision of personalized, authentic, and reliable clinical trial services by combining up-to-date and secure patient data with other emerging technologies. Considering the fact that blockchain technology is already employed in healthcare and various other industries, additional efforts and initiatives will allow the industries to leverage the full potential of blockchain technology.
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