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Healthcare

Mar 11
Love0

Combing IoT and DLT to Ensure the Safety of the World’s Vaccine Supply Chains

By everis UK Blockchain for Banking Practice, Emma Landriault & Dario Cerchiaro Blog, Healthcare, Hyperledger Fabric

In March 2020, the world was devastated by a global pandemic that fundamentally restructured the way we live and do business. Now, a year to date later, we are lucky to be at the point where multiple vaccines have been approved and administered to the public. Alas, vaccinating the global population against COVID-19 has proved to be one of the biggest challenges humanity has ever faced, both with unique distribution and logistical challenges. 

To date, as per March 10th, there have currently been ~93.6 million vaccine doses administered in the US and 23.7 million administered in the UK1.

At the moment, there are multiple different COVID-19 vaccines that have been authorized and recommended, with others in advanced stages of development. While they have all been developed with the same goal in mind, there are substantial differences between the jabs from their composition and reported effectiveness, to their price and ease of conservation, and distribution obligations. For instance, some vaccines are incredibly time and temperature-sensitive, requiring a life of 5-8 days only with temperatures as low as -75C, whereas others can be maintained stable for 30 days at a temperature between 2C and 8C. Needless to say, the logistics and operations of selling, storing, shipping, and administering each of these vaccines is incredibly time-consuming and overwhelmingly manual, only increasing the burden when one administrator must manage large purchase order quantities of two or more different Covid-19 vaccines.

With particular reference to the distribution of the vaccine, a few challenges must be noted. Namely

  • Demand Forecasting – What is the total quantity required for shipment 
  • Supply Chain Management – How it should be sent to purchases and distributed once arrived to host countries
  • Quality Assurance – How and by whom it should be administered, and with what specific procedure to ensure appropriate provision
  • Monitor and Mitigation – How people who have received the vaccine should be monitored, particularly where potential collateral effects may rise 

With these vaccines quickly coming to market, it is no surprise that governments and enterprises around the world are exploring solutions, such as vaccine credentials or digital immunization certificates, that can streamline the rollout of vaccines. Many of these solutions leverage combined emerging technologies such as artificial intelligence, machine learning, Internet of Things, and distributed ledger or blockchain technologies

The Powerful Combination of Internet of Things (IoT) and Distributed Ledger Technologies (DLT)

 The combination of IoT and blockchain, in particular, opens the door for new systems that inherently reduce inefficiencies and increase transparency for all involved parties. Take a supply chain for example: the accessibility and geolocation functionality of IoT, paired with the accounting of blockchain and DLTs has created new systems that foster supply chain accountability and integrity unlike any before seen solutions. The coupling of these technologies allow an asset to be tracked from the moment the raw materials are mined and among every step of the supply chain until it is with the end consumer. Without leveraging various device intercommunication capabilities and a strong audit system such as the one perpetuated by DLT, this would be virtually impossible (without large-scale human intervention).

An example of combined IoT, Cloud, and Hyperledger Fabric Solution Architecture(2)

Everis and NTT Data have developed such a tool that combines IoT and Hyperledger Fabric, allowing users to track any type of virtualized asset such as bulk or trade item products, additives, packaging materials, logistic units, and more, from any device. The solution utilizes Hyperledger Fabric to ensure that corresponding transactions are stored and accounted for when reviewing the movement of the assets. This ensures data security, transparency, and an indisputable audit trail, while allowing for automation (via smart contracts), simplification due to a shared truth (ledger), increased security, and certification capabilities.  

Future Applications of Blockchain/DLT in Covid-19 Vaccinations

As both Covid-19 vaccines and DLT+ IoT technology solutions remain in their infancy, only early implementations have been seen – as such, we can expect to see a variety of future applications that have not yet been pushed to production. This may include implementations to alleviate key pains including negotiations, logistics, and fraud prevention.

  • Supply Chain Integrity and Validity of Origin: Analysts project that Covid-19 vaccines will be the highest demand counterfeit drug on the black market for 20213. Track and trace DLT networks with blockchain-based authenticity certificates could allow purchasers to ensure the origin of the vaccination and track the journey throughout an often global fragmented supply chain. We believe that leveraging IoT and a mature enterprise blockchain such as Hyperledger Fabric would create an accountability and tracking flow to benefit all parties, virtually removing the possibility of receiving fraudulent or counterfeit drugs. In this case, Hyperledger Fabric’s architecture and IoT could benefit the proposed solution as outlined below.
 Hyperledger Fabric(4)IoT
FlexibilityThe programmability of Hyperledger Fabric allows for the flexibility required to digitize complex supply chain operations. For example, trust assumptions for chaincodes are separated from trust assumptions for ordering, ensuring that ordering services can be provided by one set of nodes and tolerate some failure or misbehaviour, depending on the lenience in the business case at hand. It also allows for separate channels per company or shipment, and that endorses may be different for each chaincode, allowing for customization while maintaining privacy and security. In this use case, this is particularly relevant as the system design can be built to ensure end-to-end tracking where any (movement) data is logged or payments are made leaving no room for the entry of malicious actors. IoT allows for multiple types of devices to communicate with one another achieved thanks to different IoT protocols such as Bluetooth, ZigBee, MQTT or CoAP. This ensures that sensors or equipment, from the time of production through to delivery, can communicate with devices of key stakeholders throughout the entire process, from the time of production through to delivery,  adding a layer of reassurance for all parties. There is no room for counterfeit drugs to enter the value chain if tracking is end-to-end.
ConfidentialityThere is a possibility to add confidentiality requirements to chaincodes, so that content and state of transactions can only be updated if requirements are met. This ensures that the strictest of confidentiality is ensured across the supply chain. Confidentiality is often embedded in the design of IoT systems. In this use case, it would be key to ensure that the security and authentication measures only permit participants who have defined roles in the system which require the logging of data. As such, end purchasers can review the roles of all parties involved throughout the entire production and shipping process. 
ConsensusThe modular architecture allows for pluggable consensus, which provides an added level of customization. The endorsement policies can include checking the certificate details, roles of the requester, or executing chain code. This allows for originating companies to build a consensus mechanism that suits only their operational process and can remove any possibilities for counterfeit drugs to enter the value chain. It also retains a level of programmability and flexibility, which may be required to build a solution across multi-national vaccine supply chains.With specific solution design and consented user permissions, there is no room for disruption across IoT devices or networks.

Cargo Storage Space: With temperature and time-sensitive lifecycles, the vaccines must be shipped in specific conditions. By tracking cargo ship storage space and corresponding vaccinations through asset tracking DLT networks, logistical burdens can be minimized. 

Smart Contracts for Negotiations: To date, many governments around the world have found themselves susceptible to private battles with vaccination companies. With high global demand and few verified suppliers, private companies hold essentially all bargaining power. As seen in Canada, Italy, and other countries, this allows the companies to delay sending vaccinations even after payments have been made and force better conditions including import tax payment delays, among other critical legal disputes5. By leveraging a smart contract in the negotiation process, any room for intermediation is removed as they will be self-executing with previously agreed upon terms. 

Ultimately, it is clear that there is a strong cause to leverage IoT and DLT technologies to ameliorate the current Covid-19 vaccination system, from logistics to temperature monitoring and negotiations. Though there are currently only a few systems in production, we can assume that the efficiencies brought forth perpetuate more use cases in the future. 

  1. https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/
  2. https://developer.ibm.com/patterns/develop-an-iot-asset-tracking-app-using-blockchain/
  3. https://www.afro.who.int/news/fighting-fake-immunization-travel-certificates-frontier-technologies
  4. https://hyperledger-fabric.readthedocs.io/en/release-1.3/arch-deep-dive.html
  5. https://www.ctvnews.ca/health/coronavirus/negotiating-contracts-for-vaccines-in-development-needed-flexibility-anand-1.5218491

Cover image by torstensimon from Pixabay.

Feb 12
Love0

Working Together on What “Good” Looks Like

By Brian Behlendorf Blog, Healthcare, Hyperledger Aries, Hyperledger Indy

On Tuesday, the Good Health Pass Collaborative (GHPC) launched. This initiative is intended to define, in the context of test results and vaccination records for opening up borders for travel and commerce, a high bar for implementations of identity and credentialing systems to meet with regards to privacy, ethics and portability. They will also work with the implementers of such systems to converge towards common standards and governance.       

A set of Linux Foundation organizations – TrustOverIP, Hyperledger, Linux Foundation Public Health, and its Covid Credentials Initiative – have engaged as supporting organizations and were part of the announcement. We did this based on very encouraging signs during formation discussions that GHPC would not only help bring many of the organizations emerging into the self-sovereign identity space into alignment on platforms and standards we have long championed, but would also give us an external reference point for our position on the importance of privacy in the design and implementation of such systems.

Hyperledger has been home to the pioneering digital identity ledger Indy and agent toolkit Aries, which form the basis of so many production privacy-preserving digital identity systems and, now, are serving as the basis for many of these emerging health pass solutions. The TrustOverIP Foundation led the formal recognition of the need and role for governance organizations in the digital identity landscape – showing how we can get both optionality and interoperability when we weave global identity and credentialing systems together in a decentralized way. 

The Covid Credentials Initiative, starting way back in March 2020, recognized the potential for credentials of all sorts in the fight against this and future pandemics, and have pulled together an amazing community of technologists and entrepreneurs working together on this. Now, as part of Linux Foundation Public Health, we are working to bring together a set of software projects that can implement credential systems and help accelerate adoption of these globally, centered on the needs of public health authorities.

On Thursday’s GHPC webinar, Charlie Walton from Mastercard said GHPC is “in the business of describing what good looks like.” We will be working with GHPC to bring our own communities’ views of not just what good looks like, but how we’re already working together to standardize and implement this work. Furthermore we’ll see if our processes can directly support GHPC’s efforts to harmonize this domain.

We recognize there are quite a few of these initiatives now, reflecting just how broadly this issue is felt across society. We can play – we must play – a key role in channeling all this market activity and good-faith sharing of expertise into applications directly in people’s hands, so we can get back to travel and re-opening workplaces and schools in a safe and equitable way. Our key levers to move the world are open source software and open public engagement, and we will double-down on those tools to have a unique and substantive impact.

Look for more on this soon within our communities. We’re incredibly excited to be a part of this global effort.

Jan 11
Love0

Blockchain technology for healthcare data management

By Alevtina Dubovitskaya and Volkmar Beck, Swisscom Blog, Healthcare, Hyperledger Fabric

The accelerating digitization of the healthcare sector has led to the creation of large volumes of sensitive data stored online. Swiss eHealth strategy promotes the adoption of the electronic patient record to allow registered patients and authorized healthcare professionals to access medical data anytime and anywhere. To achieve this, a reliable, compliant, and privacy-preserving solution is required to support definition, maintenance, and enforcement of fine-grained authorizations (consents). Convergence of distributed ledger technology and intelligent data management approaches provides a unique opportunity to bring trust, transparency, auditability, and optimization of medical data management and other healthcare processes. 

Recent research works and numerous PoC implementations actively demonstrate the value of blockchain technology for connecting health care stakeholders in order to help maintain a complete history of patient’s health care data, ensure traceability of the data exchange and automate claims and reimbursement processing. Transparent and auditable prescription monitoring may help to avoid incompatibility of the prescribed medications and can provide incentives for writing fewer prescriptions for certain medications such as opioids. In the pharmaceutical supply chain, blockchain can bring traceability to the tracking of pharmaceutical goods, from verification of the producer, to the transportation and storage conditions and control over drugs returned to the pharmaceutical company. Applying blockchain technology in biomedical research may facilitate new ways for patients to contribute with their healthcare data while ensuring privacy and security and  may  speed-up participant recruitment and collection of large and integrated heterogeneous data. When building such heterogeneous datasets, ensuring authenticity of the data and their sources is essential in order to make informed unbiased decisions and get valuable insights from the data. 

What are the important aspects and potential hurdles that deserve attention from practitioners when employing blockchain in the healthcare settings? While domain-specific requirements to the system functionality vary depending on the application, desirable properties of a resilient healthcare infrastructure for management of the sensitive data distributed among multiple sources are: data and process interoperability, privacy, security, and compliance. For instance, in the case of connecting healthcare stakeholders to facilitate management of patients’ history, some of the most important requirements are ensuring patients’ rights to access and share their sensitive data but also to erase their personal data. To achieve these, the system must ensure interoperability (i.e., must have the ability to exchange and interpret the data) and must be privacy-preserving (i.e, the patients must be able to have full control over the sharing/access revocation/erasure of their data). 

Data erasure (i.e., the possibility to erase the data) itself is not an “out-of-the box property” of the blockchain technology. It is challenging to comply with the right of data erasure when using immutable ledger. However, different approaches exist to address this issue including off-chain management of sensitive data, privacy-preserving techniques (such as encryption, zero-knowledge proofs (ZKP), secure multi-party computations (MPC), and data pseudonymization and anonymization. If anonymized data are released, a reliable infrastructure is required to support a trustworthy collaborative environment and to verify that the data were not altered. 

The choice of the appropriate approach depends on the underlying blockchain technology, the number of participants in the network and the sensitivity and volume of the data, among others. Moreover, patient control over his identifiable data and his actions (for instance, providing consent or authorizations) has to be efficiently verifiable and compatible with access to the data in an emergency situation such as when the patient is unconscious.

Hyperledger Fabric is a permissioned blockchain technology framework that has been actively employed in the implementations of blockchain-based systems for healthcare data management. To ensure privacy of data subjects, Fabric mainly relies (i) on multiple channels support, which make it possible to limit the access to the data to certain participants of the consortia, and (ii) on private collections where sensitive data can be exchanged peer-to-peer and stored in the private databases, yet accessible from chaincode on authorized peers and hashed to verify authenticity. Storing only hash on-chain is also used to provide verifiability of vast amounts of anonymized data for data-driven research and applications. In this case, contrary to limiting the access to the data, it is of a high importance to set up a reliable multi-cloud environment and collaborative framework – a step forward towards attaining interoperability. 

Blockchain infrastructure offered by Swisscom provides support for multi-cloud environments. Multiple non-endorsing peers provided by Swisscom are now dedicated to support verifiability of public COVID-19 related data, as a part of the multi-party, multi-source verifiable data sharing platform MiPasa. To address the scale of the problem, the types of data, languages, time-zones and jurisdictions,- many vendors joined forces to strengthen and support this blockchain-based shared infrastructure to unlock the potential of the data and deliver integrated, trusted, and verifiable insights across multiple industries around the globe. 

Sep 22
Love0

Answering the FDA’s call: LedgerDomain’s Hyperledger Fabric-based BRUINchain improves tracking and tracing of prescription drugs

By Hyperledger Blog, Healthcare, Hyperledger Fabric

Four billion prescriptions were dispensed at US pharmacies in 2019, and even conservative estimates suggest that over 100 million prescriptions may be incorrectly dispensed. To address this problem, healthcare leaders are actively working to put new tools into the hands of pharmacists to ensure the right drugs reach the right people.

Part of that effort is the Drug Supply Chain Security Act (DSCSA), an ongoing, decade-long effort to track and trace prescription drugs in the United States. The DSCSA is intended to enhance the FDA’s ability to help protect consumers from drugs that may be counterfeit, stolen, contaminated, or otherwise harmful. The vision is to have an interoperable system in place by 2023 that will allow for drug tracing, product verification, and prompt detection and response protocols to handle all suspect medications. To get the system in place, the FDA turned to the public in 2019 and asked for new, cutting-edge approaches to improve the prescription pipeline.

LedgerDomain, an enterprise-grade blockchain solutions provider known for its work on developing the next generation of healthcare and pharmaceutical supply chains, was one of the companies that responded to the FDA’s request. LedgerDomain’s proposal of a blockchain-based solution in collaboration with UCLA and the pharmaceutical company Biogen was selected by the FDA as part of its pilot project program. 

LedgerDomain’s pilot centered on the development and live testing of BRUINchain, a blockchain-based system that meets DSCSA standards for pharmaceutical dispensers all within a shared-permission yet private ecosystem. While the pharmaceutical supply chain has numerous stakeholders, BRUINChain, which is built on Hyperledger Fabric, establishes one version of the truth for the pipeline that is immutable and invaluable.

The team tested BRUINchain within UCLA Health’s network of 500 pharmacists and technicians, focused on tracking the drug Spinraza, the first medication approved to treat children and adults with a rare and often fatal genetic disease called spinal muscular atrophy. The results exceeded UCLA Health and LedgerDomain’s expectations. The BRUINchain app’s barcode scanning functionality on iPhones was 100 percent effective, and the Hyperledger Fabric-based system was able to track every dose of Spinraza at UCLA Health, down to which refrigerator each dose was stored in across the campus. Even before the pilot ended, the team was adding new functionality and products as the network of pharmacists grew more reliant on the BRUINchain system. 

Hyperledger teamed up with LedgerDomain on a detailed case study on the BRUINchain pilot, including deployment details and results, projected cost and time saving and next steps based on the solution’s success to date.

Read the full case study here.

Jan 29
Love5

Five Healthcare Projects Powered by Hyperledger You May Not Know About

By Hyperledger Blog, Healthcare

The New Year brings about various resolutions for millions across the globe. For many, that means putting more focus on their physical and mental health. Blockchain’s ability to revolutionize healthcare is undeniable. When applied to healthcare, blockchain is a shared platform that decentralizes health data without compromising the security of sensitive information. For example, patients can potentially use their own signatures, combined with a hospital signature, to unlock data to provide secure access to medical information for use in treatment. Patients could have full control of their medical information, selecting the information they want shared and viewed by providers or doctors. This model lifts the costly burden of maintaining patient’s medical histories away from hospitals. Also, counterfeit medicine is a big issue pharma companies face in their everyday operations since there are many stakeholders involved in the supply chain. Recall of drugs and avoiding counterfeit drugs from entering into legit marketplaces will help in reducing the losses and improving service delivery to the end customer. Blockchain could be used to maintain the entire supply chain in healthcare.

Below is a list of some interesting healthcare applications powered by Hyperledger technology you may or may not have known about:

Axuall – Axuall is a digital network for verifying identity, credentials, and authenticity in real-time using the Sorvin Network and Hyperledger Indy. The Axuall network is currently in pilot with Hyr Medical and their 650+ physician network in addition to two other health systems. Physicians’ time is better spent practicing medicine than filling out redundant, repetitive credentialing paperwork consisting of unchanging information. Using Axuall’s digital credentialing network, physicians will be able to present fully compliant credential sets to participating healthcare systems and medical groups they are affiliated with or applying to. Utilizing the cryptographic constructs from Hyperledger Indy, healthcare organizations will be able to verify the validity of a physician’s credentials – spanning medical education, training, licensing, board certification, work history, competency evaluations, sanctions, and adverse events – ensuring compliance with industry standards, regulatory mandates, and health system bylaws. 

KitChain – LedgerDomain joined forces with other industry leaders like Pfizer, IQVIA, UPS, Merck, UCLA Health, GSK, Thermo Fisher, and Biogen to build out a pilot on Hyperledger Fabric called KitChain. Scoped and developed over the course of two years, KitChain aims to demonstrate a robust collaborative model for managing the pharmaceutical clinical supply chain, creating an immutable record for shipment and event tracking without the need to resort to paperwork and manual transcription. KitChain has two major components: a frontend mobile application and a backend blockchain server. The backend was implemented in Golang and used Hyperledger Fabric, the LedgerDomain Selvedge blockchain app platform, and LedgerDomain’s DocuSeal framework, encompassing smart contracts and application logic. As such, the pilot has a fully functioning highly secure blockchain backend.

MELLODDY Project – This drug discovery project uses Amazon Web Services technologies to execute Machine Learning algorithms from academic partners on a large scale. The data never leaves the owner’s infrastructure and only non-sensitive models are exchanged. A central dispatcher allows each partner to share a common model to be consolidated collectively. To provide full traceability of the operations, the platform is based on a private blockchain and uses Substra, a software framework for orchestrating distributed machine learning tasks in a secure way. Substra is based on Hyperledger Fabric. MELLODDY is designed to prevent the leaking of proprietary information from one data set to another or through one model to another while at the same time boosting the predictive performance and applicability domain of the models by leveraging all available data. The MELLODDY consortium consists of 17 partners: 

  • 10 pharmaceutical companies: Amgen, Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, GSK, Janssen Pharmaceutica NV, Merck KgaA, Novartis, and Institut de Recherches Servier 
  • Two academic universities: KU Leuven, Budapesti Muszaki es Gazdasagtudomanyi Egyetem
  • Four subject matter experts: Owkin, Substra Foundation, Loodse, Iktos
  • One large AI computing company: NVIDIA

MyClinic.com – Medicalchain was one of the first healthcare blockchain companies to join the Hyperledger community, signing on as a member in 2017. The company’s ethos is to empower patients to have access to their medical records. Providing patients with direct access to their data unlocks the barriers we face in healthcare today such as patient choice and interoperability issues. A doctor-led team based in the UK, Medicalchain trialled the first telemedicine consultation using blockchain technology.  The company’s first blockchain-based product to market, MyClinic.com, makes it easy to schedule appointments, review medical reports and request further investigations or assistance using an Android and iOS app. Now the company is set to focus on scalability with the view to onboarding clinics and patients locally, nationally and internationally.

Verified.Me – SecureKey launched its innovative and in-demand network to Canadian consumers in early 2019. Verified.Me is a blockchain-based digital identity network built upon Hyperledger Fabric 1.2 that enables consumers to stay in control of their information by choosing when to share information and with whom, reducing unnecessary oversharing of personal information. Sun Life Financial has signed on as an early adopter and the first North American (health) insurer, making it easier for their clients to do business with the company.  Dynacare, one of Canada’s largest and most respected providers of health and wellness solutions, has joined the Verified.Me network. Dynacare’s participation will make it easier for Canadians to verify their identities as well as gain safer and faster access to their health information.

Curious about blockchain and advances in healthcare? Contribute to the conversation by joining the Hyperledger Healthcare Special Interest Group (HC-SIG). Open to anyone, the SIG was created to offer healthcare professionals and technologists a forum to discuss the implementation of technology solutions using blockchain technologies in general like Hyperledger frameworks and toolsets in specific.

Cover image: Pixnio free images

Jan 28
Love5

How Hyperledger Besu Will Help Solve the Pharmaceutical Waste Problem in the U.S.

By Adoriasoft Blog, Healthcare, Hyperledger Besu

The problem of surplus medication is getting increasingly serious. Each year, tons of prescription drugs remain unused in clinics, assisted living facilities, and at individual patients’ homes. Often, the law demands that any unused medications be destroyed, which results in a whole complex set of problems. 

On the one hand, about $2 billion worth of prescription drugs are wasted every year. On the other hand, one in every three Americans cannot afford their prescribed medications due to the high cost or absence of medical insurance. At the same time, there is no unified procedure for using surplus medications and making them available to those who need it. 

Another issue to consider in this context is the cost of unused drug disposal, which can be around $1.25 per pound. The rules require that unused drugs be disposed of through incineration that creates additional environmental concerns. 

The obvious solution to this complex problem is establishing a mechanism for returning the unused medications and offering them to patients who need them. In fact, the drug donation and reuse programs have been researched for more than twenty years, but only 38 states have passed laws on drug reuse as of now. 

At the same time, the implementation of these laws gives hope that the multi-faceted problem of surplus drugs can be resolved. However, to achieve true effectiveness and prevent misuse, such programs need to take into account many practical aspects: 

– Control over the donated drugs’ quality and expiration. Of course, to be accepted, drugs must be unexpired and their packaging must be intact. 

– Motivation for pharmacies to act as drug acceptance facilities. Participation in the drug donation program has its costs, which pharmacies are not too eager to bear. 

– Motivation for clinics and patients to donate unused drugs. The law prohibits selling medications, thus, their owners should be motivated in a different way. 

– Data security. Medication-related data is highly sensitive and needs special protection from unauthorized access. 

How technology can help 

Our experience with blockchain and distributed applications proves that these technologies can become the core of an effective and secure platform for unused drug donation and redistribution. It resolves the problems of data security and traceability and can help to automate a number of processes. 

Together with the Save Pharmaceutical project, Adoriasoft is now building a blockchain-based platform to join drug donors (clinics, assisted living facilities, individual persons), drug repositories (pharmacies), and patients. The solution will be a multi-functional product allowing donors to donate the medications they do not need, and pharmacies to approve or reject the donations and, ultimately, to provide them to patients. 

We are using Hyperledger Besu as the base technology for this project. By choosing Hyperledger Besu, we plan to leverage the benefits of the protocol to enable transaction processing. Furthermore, we see Hyperledger Besu as a platform for building a permissioned enterprise-scale network to serve the drug repository system. 

In view of the high sensitivity of healthcare data that is going to be exchanged in the network, the transactions will be processed via smart contracts executed on Hyperledger Besu. Only the parties directly involved in the transaction will have access to its details. 

At the same time, blockchain provides the means of controlling the entire transaction flow from the drug donation by the owner to its final assignment to the patient. The platform will include a mechanism of monitoring the pharmacy income from reselling the donated drugs and distributing it among the other participants. 

Since the law explicitly prohibits donors from demanding payment for the drugs they donate, there should be other methods of motivating them to participate in the program. The state laws establish a tax deduction for drug donation, but our product can include an additional compensation in the form of a tradable digital token. 

The tokens issued on the blockchain can be used towards a discount on the platform or exchanged for other assets. The same tokens can be issued to pharmacies, too, to attract them to the program. 

Blockchain-based drug repository networks are going to be a true quantum leap in the healthcare industry, on the one hand, bringing significant cost savings, and, on the other hand, making medications accessible to patients who were otherwise unable to purchase them. We are proud to be a part of a project of such a social impact and to make the knowledge accumulated by the Hyperledger community serve this noble cause.

Dec 02
Love6

Hyperledger for Healthcare: How Fabric drives the next-generation pharma supply chain

By Ben Taylor, CEO, LedgerDomain Blog, Healthcare, Hyperledger Fabric

Before new medicines can reach the patients that need them, the pharmaceutical and biotech companies that develop them must seek FDA approval. As part of this process, pharmaceutical companies sponsor highly controlled clinical studies in medical centers, called “sites.” The number of active studies has doubled over the last 10 years, and study sites are bursting at the seams. With the rise of personalized medicine and increasingly specialized shipping and storage requirements, this trend can only accelerate.

At LedgerDomain we’ve partnered to tackle this challenge with a broad spectrum of industry leaders, including pharmas, contract manufacturers, research organizations, academic sites, and couriers. At the heart of this effort is the world’s first iOS blockchain app for pharmaceutical supply chain, which we presented last month to the Hyperledger Healthcare Special Interest Group (HC SIG).

Today we’d like to dig beneath the surface of our efforts in this space. We’ll cover some lessons we’ve learned along the way, and how blockchain can speed innovative medicines to the patients who need them. We’ll also give you a sneak peek at a live pilot happening right now, where a blockchain-based solution is being used to deliver lifesaving medicines to real patients.

Why Hyperledger for healthcare?

We chose to join the Linux Foundation and Hyperledger in 2016 after a simple realization – most of our clients and prospects were apprehensive about coin-based models. Hyperledger Fabric represented a different approach to blockchain that aligned with their values at a deeper level. It’s no wonder that the community has come a long way since, emerging as the blockchain platform of choice for global enterprises. 

Coin-based models can serve as a fantastic incentive for participation, but not everyone in every jurisdiction is ready for cryptocurrency. A second factor that sets Hyperledger Fabric apart is its focus on privacy. While everyone is looking for the magic bullet that will enhance track-and-trace capabilities across the drug supply chain, nobody wants to risk leaking patient health records from a public blockchain across the dark web.

The DocuSeal framework

Highly regulated enterprise communities have unique requirements. Much of our work on Hyperledger Fabric has centered on specialized multi-threaded experiences designed for compliance with HIPAA, GDPR, Cal Privacy, and data privacy laws just over the horizon, performing at scale.

With that in mind, we built DocuSeal, a framework designed for blockchain-powered document authentication through an iOS application. With DocuSeal, uploaded documents are sealed in private storage, tied to a unique hash that’s immutably stored on a private blockchain. Documents can be shared with other users or deleted.

DocuSeal makes it possible to verify the authenticity of any document each time it’s accessed. At the same time, the “right to be forgotten” is preserved, as the private storage can be wiped if necessary while the hashes on the blockchain are preserved. To assure real-time performance metrics, we use Selvedge, our enterprise-grade blockchain app server developed in Golang on Hyperledger Fabric. 

We designed the DocuSeal framework so users could be up and running in minutes with simple document storage and sharing – similar to Dropbox – plus serious security and timestamping. But underneath this simple interface, our stakeholders can leverage the power of smart contracts to drive inter-enterprise workflows.

How blockchain can speed innovative medicines to the patients who need them

Testing new medications is an extraordinarily complex process. Right now, over 800 biotechs and pharmas are working with their vendors to supply medicines for over 10,000 clinical studies to tens of thousands of clinical sites. And the number of studies is constantly growing.

While some clinical sites are just a doctor and an assistant, large academic centers aren’t like your neighborhood Walgreens or Boots. They’re massive warehouses with pallets loaded with experimental medications. One of our partners, UCLA, has 700 clinical studies sponsored by 100 different companies. This is a massive undertaking where no single pharma’s proprietary system can predominate, so everyone has fallen back on paper.

With that in mind, in 2017, we joined forces with other industry leaders as part of the Clinical Supply Blockchain Working Group (CSBWG), which includes Pfizer, IQVIA, UPS, Merck, UCLA Health, GSK, Thermo Fisher, and Biogen. Over the course of two years, we built out a pilot on Hyperledger Fabric to address this challenge directly. We named it KitChain

(Want a deeper dive on technical specifications? Check out our white paper!)

Big picture: supply chains and blockchain

KitChain was a major milestone for the supply chain for clinical studies, but meanwhile the stakeholders on the commercial pharmaceutical supply chain were struggling to meet their own challenges. Everyone is looking ahead to 2023, when the Drug Supply Chain Security Act (DSCSA) will come into full effect with sweeping requirements for traceability across the entire pharmaceutical supply chain.

With that in mind, the US Food & Drug Administration (FDA) came out earlier this year in search of enterprising stakeholders to help them tackle the problem of counterfeit and suspect medicines. 

In response to the FDA’s call for pilots to address this challenge, we partnered with UCLA Health to launch the only pilot of its kind. We’re building and testing a last-mile blockchain-driven solution designed to help deliver lifesaving medications to real patients. This solution features an intuitive iOS client running on our Selvedge app server and smart contracts, all powered by Hyperledger Fabric.

This is a “rubber hits the road” moment for supply blockchain: out of the workshop and into the real world. Our living supply chain solution captures all the transactions – from the loading dock to the patient. It will capture the data needed to develop trends and analytics, and be able to surface risk management issues. But most of all, it’s designed to handle the human element – because in the real world, sometimes things happen you don’t expect. A blockchain system that doesn’t allow for human factors will no longer reflect the ground truth. These are all things we’re working on right now, and we look forward to sharing our findings and connecting with you in Phoenix at Hyperledger Global Forum 2020.

The Hyperledger community has grown and matured over the last three years, and we’re honored to be a part of building the future of blockchain. Delivering our full-stack enterprise-grade solution by ourselves would have been impossible, but by joining Hyperledger and the Linux Foundation, we’ve been able to contribute while standing on the shoulders of giants.

About the Author

Ben Taylor is the CEO of LedgerDomain, founded in 2016 to bring Hyperledger blockchain solutions to enterprise ecosystems, unlocking a world of communal computing and real-time performance. After doing undergraduate and graduate work at MIT, Ben spent a quarter of a century incubating and investing in early-stage technology companies.

Coverage image credit

Jun 24
Love1

Change Healthcare: 50 million transactions a day using Hyperledger Fabric

By Hyperledger Blog, Healthcare, Hyperledger Fabric

Change Healthcare is on a mission to modernize the American healthcare system. A central part of that plan is extending its Intelligent Healthcare Network with blockchain technology to provide a faster, better experience for all.  

Change Healthcare operates the largest healthcare network in the country. Formed through years of mergers and acquisition, the healthcare infrastructure company links 900,000 healthcare providers and 5,500 hospitals with 2,200 government and commercial payers.

A network of this scale, built from a mix of companies, means a very complex back end with lots of systems that are working independently. To unite information and give customers faster, better access to data, Change Healthcare turned to Hyperledger Fabric to begin blockchain-enabling its Intelligent Healthcare Network.

The starting point was modeling an existing network linking providers to payers with a blockchain and then seeing if it could stand up to real-world traffic. After testing and assessing options, Change Healthcare’s launched this initial Hyperledger Fabric-powered network in January 2018. It’s been running as a parallel network since, processing as many as 50 million transactions a day—with throughput up to 550 transactions a second. That’s enough to handle all the healthcare claims activity that Change Healthcare handles across its full network.

The Hyperledger team has worked closely with Change Healthcare to document this large-scale network deployment and its performance in a detailed case study. Highlights include system criteria and planning, details on the supported workflow and transactions and future directions, including plans for ensuring interoperability, boosting throughput even further and migrating more business partners to the network.


CLICK HERE TO READ THE CASE STUDY

Feb 20
Love0

HIMSS 2019 – Myndshft Delivers a Recap

By Tyler Wince, Myndshft Blog, Healthcare

HIMSS19 took place in Orlando, FL the week of February 11 and this was the third year Hyperledger had a presence at the conference. HIMSS is the leading Healthcare Information and Technology Conference attracting over 45,000 people from 45+ countries each year. Member companies of the Hyperledger Foundation are invited to spend time working the booth, and I had the opportunity to represent Myndshft interfacing with attendees and answering questions about how blockchain technologies fit into healthcare.

Thoughts on Hyperledger Booth at HIMSS

Most people inquiring about blockchain at HIMSS this year were looking for ideas, thoughts, and examples of how blockchain could and should be implemented in healthcare. HIMSS attendees have been following blockchain topics for the last three years (since Hyperledger first had a presence at HIMSS) and many are savvy to how blockchain provides data immutability, creates a network of members, and the general concept of a distributed ledger. There were a few recurring questions the visitors to the Hyperledger booth asked on a variety of different topics, but they all circled around the idea of where blockchain makes the most sense to be implemented.

*NOTE*: There were quite a few questions about how Hyperledger fit into the world of Bitcoin, Ethereum, and cryptocurrency in general, but most of these discussions ended up at one of the following places below after a basic explanation that Hyperledger focuses on blockchains for business and operates differently than completely public blockchains that utilize cryptocurrency.

The three big questions I heard repeatedly at the booth were:

‘Should I use blockchain to enhance my security?’

‘How am I supposed to integrate my existing technology into a blockchain?’

‘Where is blockchain being used today in healthcare?’

Let’s break them down into each of their parts:

Is blockchain for security?

People still aren’t sure how blockchain security works. Many visitors were conflating the cryptographic properties of blockchain with the idea that they need less security infrastructure to run a blockchain. The question asked at the booth a few times was “Explain to me how a blockchain isn’t hackable?” The discussion that followed typically included an explanation that all existing security measures need to be in place for a blockchain network to be secure, but when you use blockchain, the historical data on the chain isn’t able to be changed.Thus individual records aren’t able to be manipulated without notice, providing organizations with minimal trust to work from a common record of truth.

How can I integrate with my current systems or other blockchains?

Many people wanted to know how data got into and out of a blockchain network and how they were able to continue using their existing systems. The majority of participants had concerns that adopting blockchain would require a rip-and-replace of the IT systems their organization has already spent millions of dollars on. The reality is that Hyperledger blockchains like Fabric and Sawtooth are able to coexist with existing IT systems and provide functionality that their existing systems don’t have and never will have without a network. Listening to the conversations around data integration and interoperability was a good reminder that the SDKs provided for the different blockchain projects within Hyperledger need to be a top priority for development. Without good SDKs and the ability for non-blockchain engineers to use them effectively, it is unlikely that blockchain will gain much adoption beyond some niche use cases.

Where is it being used today?

The last question people had was around how blockchain is being used today in healthcare. There are few companies that already have blockchains up and running for different parts of the healthcare ecosystem today.

Myndshft is a company building a network of payers and providers to bring transparency, speed, and auditability to the prior authorization process. The network  integrates with existing systems of record and use events in those systems to drive execution of “smart contracts” (the rules that govern how a blockchain operates), which automate the prior authorization before writing the results back to the providers system.

Change Healthcare is also running a blockchain for claims processing and monitoring. In conjunction with its clearinghouse, Change is using blockchain to ensure all claims that are processed are auditable and traceable.

Synaptic Health Alliance and the DokChain Alliance are also groups looking into blockchain and how it fits to drive efficiencies and collaboration in healthcare.

Overall, the interest and education around blockchain in the healthcare community is growing rapidly, and nobody is wanting to be left behind or appear as a laggard in their implementation and adoption of blockchain technologies. For more information about what Hyperledger is doing in healthcare or how Myndshft is solving complex administrative problems, please reach out to me via email (tyler@myndshft.com) or join us in the Hyperledger Healthcare-SIG Rocket.Chat. 

Jun 29
Love6

The New York Times Recognizes Brian Behlendorf as one of the Top 10 Most Influential People in Blockchain

By Hyperledger Blog, Finance, Healthcare

We’re thrilled to see Nathaniel Popper of The New York Times include Brian Behlendorf, Hyperledger Executive Director, in a roundup of the top 10 most influential leaders advancing blockchain technologies in the industry today.

Brian has led a life-long career in open source technology starting off as a primary developer of the Apache Web server, the most popular web server software on the Internet, and a founding member of the Apache Software Foundation. Often referring to himself as the “Geek Diplomat” of Hyperledger, Brian has successfully led the effort to attract more than 235 members from all over the world, pulled in hundreds of developers to contribute code and grown the consortium to include 10 tools and frameworks over the past two years. All this has made Hyperledger the fastest growing open source project hosted by The Linux Foundation to date.

Laura Shin wrote another story in The New York Times, that explored how various industries like healthcare, government, food, supply chain management and trade finance are turning to blockchain to improve efficiencies and enable new business models. Brian Behlendorf is quoted in the article saying companies must transform and adapt their business models to leverage blockchain if they want to remain competitive.

The technology, he said, “does force them to transform in the same way that companies that were information-centered have had to transform with the rise of the internet. That same kind of thing will hit any company about transactions or about being a system of record for an industry. If they transform themselves before their competitors do it, they’ll have a future.”

The article referenced Northern Trust as an example of blockchain in production today. Northern Trust utilizes Hyperledger Fabric to automate the paper-intensive process of investing by pensions and endowments in private equity.  Hyperledger technologies run in production deployments and provide real value beyond finance as well. Take for instance, PokitDok, which created a Hyperledger Sawtooth-powered platform called DokChain that manages smart contracts, resolves patient identities, controls access to personal health records, settles healthcare claims and fuels complex medical supply chains.

Another example is Change Healthcare, which last year, signed on as the first healthcare Premier member of Hyperledger. They announced their Intelligent Healthcare Network, built on Hyperledger Fabric, for claims management transparency. With it, organizations can accurately track, in real time, the status of claims submission and remittance across the complete claim.

The fact is companies from small startups to large prominent tech companies are betting a chunk of their business on the future of these technologies. SAP, Oracle, GE, Amazon and Huawei announced Blockchain-as-a-Service products within the last year, all powered by Hyperledger technologies. We, at Hyperledger, proudly support this innovation.

Hyperledger’s end vision is to create the foundational infrastructure that will power enterprise distributed ledger applications and systems and allow for decentralization. And the future is looking very bright! You can check out many other projects, pilots and production deployments of Hyperledger (or add your own) via our Blockchain Showcase. You can also plug into the Hyperledger community at github, Rocket.Chat the wiki or our mailing list. As always, keep up with what’s new with Hyperledger on Twitter.

 

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