author:author:
Cao Lijun, Jiang Zewu
Supporting Organizations:
Summary of the report:
Summary of the report:
The development of the medical and health field has two basic driving forces, one is the development of medical technology, and the other is the accurate acquisition and efficient use of data. The blockchain has great advantages in data privacy protection and data storage. Therefore, the combination of the two will form a good solution, but the actual implementation of the project is still difficult.
1. In the medical industry, data is king: the future development trend of the medical and health field is the efficient use of data, so solutions related to data storage, computing, and transmission all have application scenarios. The distributed storage of blockchain, asymmetric encryption, and the structure of blocks and chains are very in line with the demands of the medical industry to a certain extent. When the two are mature in all aspects, the combination of each other will have a good effect .
2. Opportunities exist in the medical alliance chain: No matter from the maturity of blockchain technology and application implementation, or from the perspective of national government supervision, the alliance chain system is a technical solution that is more likely to be realized at present. On the one hand, it solves the problem of data sharing and promotes the efficient development of the entire industry. On the other hand, the top three hospitals can also cooperate effectively under the supervision of the state.
3. The national supervision is heavy, and it is difficult to implement: medical and health data is a key category of national control data, and relevant policies also clearly indicate that medical and health big data is an important basic strategic resource of the country, which is of great importance to national security and social stability. influence. At present, the policies on medical research and other aspects are relatively relaxed, but if you want to turn medical and health data into commercial institutions or individuals for management and operation, this approach is risky, and it is more difficult to liberalize at the national policy level.
With the continuous development of blockchain technology, this technology can become an effective tool in the medical and health field. However, it will take some time for the industry to implement blockchain, and it will be difficult to achieve it in the short term.
1. Status quo in the field of healthcare
1.1 Basic concepts
According to the definition in the medical and health industry report released by China Industry Information Network, the medical and health industry aims to maintain and promote the physical and mental health of the people, mainly including medical services, health management and promotion, health insurance and related services, involving drugs, medical Equipment, health products, health food, fitness products and other supporting industries have a wide coverage and a long industrial chain. The current understanding of the medical and health industry is not only the traditional treatment of diseases and injuries, but also the scope of the entire upstream and downstream industry chain centered on it. According to the "2020 Life Science and Medical Trends Report" released by Deloitte, with the improvement of socio-economic level, the global average life expectancy has been extended by 5.5 years, from 75 years in 1990 to 80.5 years in 2015, Therefore, people's demand for medical health is increasing. According to the "Medical and Health Investment Analysis Report" issued by Qianzhan Industry Research Institute, as of 2015, the market size of China's health industry has reached 2 trillion yuan. According to its forecast, the market size of China's medical and health industry will reach 8 trillion yuan in 2020 Yuan.
Figure 1: Total Number of Diagnosis and Treatment in Medical Institutions Source: China Industry Information Network
Although Chinese medical history has a history of thousands of years, Chinese medicine has always been another independent medical system besides the Western medical system. The word medical treatment is mainly derived from the Western medical system, and with the progress of social civilization, people are not only concerned about healing diseases, but gradually expand to the whole range of health. In addition to the expansion of the scope of the medical ecology, the medical methods of the entire industry are also undergoing tremendous changes. From the ancient Chinese "watching, hearing, listening and hearing" to various modern medical diagnostic equipment, the update and iteration of medical equipment has also brought the progress of the medical industry. With the development of the Internet and mobile Internet, the speed of telemedicine is also accelerating. By 2018, interactions using mobile devices will account for 65% of interactions in medical institutions, and 80% of doctors have used smartphones and medical applications to provide medical care Serve.
In general, the development of the medical and health field mainly benefits from the increase in the global population and changes in population structure (increased aging), the improvement of socio-economic level, the level of urbanization and the increase in the need for chronic disease management. The continuous development of social economy has increased people's demand for medical health, and people's growing demand has continuously brought new pressure to existing medical technology or medical system, thus effectively promoting the development of the industry. In addition, the continuous development of the industry is also inseparable from the advancement of science and technology and the support of relevant units such as the government to jointly promote the development of the industry.
1.2 Problems in the field of healthcare
Although the medical and health field is growing, there are still many challenges and obstacles in the development of the entire industry. According to a survey conducted by the Healthcare Executive Group, the three most important challenges in the healthcare field in 2018 are clinical data analysis, the status of population health service institutions, and the payment system based on efficacy.
1. Low degree of digitization
With the development of the Internet, the degree of digitalization in the medical and health field has been continuously improved. Whether it is from the perspective of medical equipment or medical services, the trend of electronicization is becoming more and more obvious. However, the overall degree of dataization is still relatively low. Some tertiary hospitals have a high level of medical equipment and medical services, but the middle and lower hospitals are still in the stage of upgrading and have poor dataization capabilities. And in clinical medicine, there is basically no collection and utilization of data, the communication between patients and doctors or pharmaceutical manufacturers is in a broken state, and clinical data cannot be analyzed and utilized, which greatly hinders the progress of clinical medicine.
2. Medical institutions are isolated from each other
Due to the low degree of dataization, there is an obvious information asymmetry among hospitals. For example, everyone will have this kind of experience in seeking medical treatment. When you go to the hospital to see a doctor, the doctor will ask you to do any possible related examinations. However, each of these examinations has been processed in many hospitals. They are isolated from each other, and patient information cannot be synchronized, which brings about a huge waste of manpower and material resources, reduces the efficiency of the industry, and hinders the rapid development of the industry.
3. Network security is under great pressure
Although laws and regulations clearly guarantee data security and privacy in the medical and health field, the rapid development of the Internet has brought more and more devices into the network, which has brought huge hidden dangers to network security work. A 2017 study by IBM Security and the Ponemon Institute showed that the cost of preventing medical data breaches has increased, averaging $380 per record, while data maintenance costs in other industries have fallen by 10%. Therefore, data and network security issues will increasingly become a concern of the industry.
In addition, the medical and health field is still facing many problems, such as high medical costs, mismatch of medical resources, poor medical experience of patients, etc., which will not be described here.
1.3 Development Trends in the Healthcare Field
On the one hand, with the significant improvement of people's living standards, the demand for health and a better life is increasing. On the other hand, with the development of the Internet, digital development in the medical and health field has become the primary development direction of the medical field in various countries.
1. Digitalization of healthcare
With the development of the Internet, all walks of life are undergoing digital transformation, and the medical and health field is no exception. From traditional handwritten medical records to the current electronic medical record system. At present, the degree of digitalization in the medical and health field is still at the middle and lower level, but judging from the policy support of digitalization in the medical and health field in various countries, its digitalization process will continue to accelerate. From the perspective of market performance, the digital transformation of mainstream tertiary hospitals is relatively mature, while the digital transformation of lower-middle hospitals is relatively low. In the future, it will gradually settle down and realize digitalization in the entire industry.
2. Medical and health data sharing
At present, hospitals are isolated from each other and information is not connected to each other. There are two main reasons. On the one hand, medical and health data are not digitized, making information circulation difficult. On the other hand, data security and privacy issues are difficult to solve. Digitization is already on the rise as technology advances. With security and privacy issues effectively addressed, data will be shared in the future. Data sharing brings about the transparency of industry information, which can effectively promote the improvement of industry efficiency and maximize the release of industry value.
3. Accurate and customized medical treatment
As people's demand for medical health is getting higher and higher, professional medical services in the future will continue to be upgraded and iterated. People can capture body data in real time through wearable devices and feed them back to professional medical teams. The medical team can provide customized precision medicine according to the user's individual situation, including drugs, medical devices, and corresponding medical insurance services. Users will not only go for treatment when they are sick, but start corresponding medical services from prediction and prevention, and the entire medical service covers their entire life cycle.
2. Blockchain + medical field
2.1 Feasibility Analysis of Blockchain + Medical Field
The field of blockchain + medical health is feasible and restrictive, which can be explained from the essential attributes of blockchain and the development trend of medical health and existing problems.
1. Distributed storage ensures information security
The blockchain adopts data multi-node, distributed multiple access, gets rid of the dependence on the Internet central server, and avoids the possibility of the central server tampering with data and losing data at a single point. And users can view the patient's historical data and user data at any time, thereby avoiding the risk of data loss. This can also effectively improve the efficiency of the industry. When a patient seeks medical treatment, the doctor does not need to perform relevant examinations on the patient, but can directly view the historical data, which greatly saves manpower and material resources.
2. Asymmetric encryption ensures user privacy
With the development of society, on the one hand, people are paying more and more attention to personal respect and privacy. On the other hand, the characteristics of the medical and health field require users to disclose their information, at least to the hospital during the medical treatment stage, so that it can be effective Solve medical problems. The encryption and decentralization features of the blockchain cater to the demands of user privacy information protection. On the one hand, relevant information can be disclosed to hospitals, so that patients can receive the best medical services, and on the other hand, it can effectively do anonymity Processing, even if the information is disclosed, the protection of the user itself can be maximized.
3. Consortium chain community autonomy promotes information sharing
Most of the medical data is stored in various hospitals and medical equipment manufacturers. Different providers often use different database systems to store medical data, and there is no good coordination between each system. On the one hand, the blockchain can technically guarantee the realization of the data sharing function; on the other hand, from the perspective of community autonomy, it can well promote everyone's data sharing, similar to the R3 alliance. Data sharing, and will also be subject to corresponding incentives or punishment mechanisms.
4. Smart contracts improve industry efficiency
The biggest role of smart contracts is to automate the execution of related procedures, reduce the number of personnel involved, and improve efficiency. The blockchain system can automate most billing and payment procedures, thereby skipping middlemen, reducing administrative costs, and saving time for both patients and medical institutions. And this series of funds and process data can provide an effective basis for later insurance claims and bill management. On the one hand, it can reduce gray costs such as fraudulent insurance and reporting false accounts in the medical and health field, and on the other hand, it can also improve verification. efficiency.
At present, the application of blockchain in the medical and health field still provides a feasible solution, mainly from the aspects of data protection and data sharing. In addition, blockchain records cannot be tampered with and are traceable, and can have certain applications in drug traceability and other aspects. This is mainly the application in the supply chain, so I won’t make too many descriptions in this one.
2.2 Advantages of blockchain + medical field
Combining the most prominent features of blockchain - decentralization, peer-to-peer network, distributed ledger, time stamp, information transparency and non-tampering, etc., applying blockchain technology to the medical and health field will have the following advantages :
(1) Improve data security and reduce network risks
The blockchain ensures the security of the data exchange system and prevents data from being modified by means of encryption and distributed storage. With the increase of various self-use medical devices, most of which are Internet of Things devices, people will have more and more healthy life data in the future, and people have higher and higher requirements for data leakage and privacy protection. Blockchain can provide data interoperability between devices while ensuring security, privacy and reliability, effectively reducing the risk of data storage and transmission. At present, blockchain-related encryption technology has made great progress, and even many blockchain projects focus on the field of data encryption technology. For example, multi-party computing technology (sMPC) encrypts the data to be calculated by decomposing them into multiple fragments, and distributes them to multiple nodes for calculation, ensuring that each node cannot decrypt the original data based on individual fragments. The blockchain can encrypt user privacy information that needs to be kept secret to ensure that the information is only spread or shared in specific scenarios, and other parties cannot decrypt the original information even if it intercepts it.
(2) Data encryption and sharing
The blockchain medical and health platform uses a distributed bookkeeping method. It is no longer like the traditional medical and health data platform, where the platform holds all the information of the users, but each user has a ledger. This ledger can record the information of all users, and there may be some encryption processing depending on the importance of the information. Each user's information is in their own hands and does not belong to any platform. Users can share or sell information based on different prices based on the value of their own information, so that the power to control user information is returned to users.
While ensuring security, privacy and reliability, the blockchain itself is also open and transparent. From the hospital to the patient, the whole process can be guaranteed. Taking electronic medical records as an example, a block chain electronic medical record system can be built in the future. All the medical treatment and physical health data of patients are stored on the chain, which is convenient for doctors to have a comprehensive understanding of patients, and can avoid the need to communicate between hospitals. The problem of information asymmetry caused by transfer requires patients to make the same diagnosis repeatedly.
(3) Improve industry transparency and reduce gray areas
From the perspective of service agencies, after the application of blockchain technology, patients' medical records, expense records, and physical conditions of patients themselves can be recorded on the chain in real time, and service agencies can quickly and accurately query relevant data, and Take this as a basis to reduce disputes between patients and service agencies. From the perspective of patients, the whole process of medicines starting from pharmaceutical manufacturers and flowing into the hands of individual consumers can be guaranteed. The problem of counterfeit drugs can be solved very well, and patients don't need to worry about it.
2.4 Obstacles and restrictions in the blockchain + medical field
The advantages of blockchain technology itself can bring new vitality to the medical and health field, but there are still many problems in the medical and health field itself. Even if the blockchain technology is combined, the original problems cannot be solved well. On the one hand, technology cannot give full play to its greatest advantages, and on the other hand, the industry may not be able to apply blockchain technology.
(1) The degree of digitalization in the industry is low
From the perspective of hospitals, except for the third-level hospitals in the central urban area, the digitalization level of hospitals in second-tier cities, especially third- and fourth-tier cities, is relatively low. In addition, the systems of various hospital systems and medical equipment manufacturers are completely different, which increases the difficulty of data synchronization. In order to unify the data in the future, it is necessary to update the existing medical equipment. It will bring huge financial and material resources, so digitization and standardization are very difficult. From the perspective of patients, the population with the greatest medical and health needs is the elderly. This group of people has a low degree of awareness of informatization. In the process of digitalization, the education cost of the elderly is relatively high and it is difficult.
(2) It is difficult to achieve decentralization
Distributed storage requires multiple nodes to store and calculate various medical data at the same time, which will greatly increase the computing pressure on each node, resulting in an increase in overall operation and maintenance costs, which is difficult for most small hospitals to bear. In the early stage, it may only be represented by top three hospitals to establish relevant medical alliance chains, and then continue to join small hospitals in third and fourth tier cities, so as to realize data sharing at the national level.
(3) Huge amount of medical data
Compared with transaction data, medical data has a more complex structure and more types, and its future storage capacity requirements will be far greater than the transaction data volume of existing digital currencies. If all the medical data content is used as on-chain data, massive data will lead to too large on-chain data, and the storage capacity and storage processing speed will face huge challenges.
Medical and health data is a key category of national control data, and relevant policies also clearly indicate that medical and health big data is an important basic strategic resource of the country, which has an important impact on national security and social stability. Therefore, if you want to turn medical and health data into commercial institutions or individuals for management and operation, the risk of this approach is relatively high, and it is difficult to release it at the national policy level.
3. Application cases
3. Application cases
Since blockchain technology has certain advantages in social products, it is obvious to explore the application of blockchain technology in social products. There are three cases in this analysis:
Case 1: Deep Health Chain (meta chain)
Deep Health Chain (DHC for short, Yuan Chain) is a blockchain-based medical and health service platform, which builds an autonomous ecosystem, breaks the traditional central service model, and allows everyone to obtain global high-quality medical resources and Serve. Patients are the main participants in the system. Patients can upload their own medical data to the DHC chain, and set certain permissions through smart contracts, which effectively protects the user's own data privacy.
The entire ecology of DHC currently has the medical data of more than 30 tertiary hospitals and hundreds of medical institutions. The ecological market it has created can be applied to personal health reports, complete drug supply chains, medical clinical trials, and population health research.
Figure 1: Schematic diagram of the DHC project
DHC currently has a large number of cooperative organizations around the world, including Ruilian Medical, Ruige Vanilla, Ruida Medical and MIMIE; in addition, its customer coverage is also relatively wide, including mobile imaging, mobile medical records, remote consultation, Dr. Shi , medical imaging training platform, etc., the number of customers exceeds 500, and more than 3,000 professional doctors provide services for patients on the platform. The daily diagnostic images are 10,000 cases/day, and the total number of examinations is currently more than 10 million cases.
Case 2: Ali Health
Ali Health announced that it will cooperate with Changzhou City in the "Medical Consortium + Blockchain" pilot project. Controllable data interconnection, using low-cost and high-security methods, solves the "information island" and data security issues that have plagued medical institutions for a long time. The technology was first implemented in Changzhou Wujin Hospital and Zhenglu Town Health Center, and will be gradually promoted to all tertiary hospitals and grassroots hospitals in Changzhou Tianning District Medical Alliance to form a rapidly deployed information network.
Figure 2: AliHealth blockchain functional architecture
After the introduction of Ali Health blockchain technology, business data interconnection can be realized, which improves the experience of doctors and patients, and also ensures the implementation of hierarchical diagnosis and treatment and two-way referral. The circulation and authorization of residents' health information is realized through the block chain between the community and the hospital. Doctors at all levels of hospitals in the medical consortium can know the patient's past medical history and physical examination information when authorized, and the patient does not need to do unnecessary secondary work. Sub-basic inspections reduce medical expenses.
Four. Summary
Four. Summary
The essence of the development of the medical and health field is data. In addition to the promotion of technological development itself, its additional impetus mainly depends on the efficient use of data. Blockchain has great advantages in data privacy protection and data storage. Therefore, the combination of the two will be a good solution, but there are still some difficulties in the actual implementation.
1. In the medical industry, data is king: the future development trend of the medical and health field is the efficient use of data, so solutions related to data storage, computing, and transmission all have application scenarios. The distributed storage of blockchain, asymmetric encryption, and the structure of blocks and chains are very in line with the demands of the medical industry to a certain extent. When the two are mature in all aspects, the combination of each other will have a good effect .
2. The medical alliance chain is a feasible opportunity: No matter from the maturity of blockchain technology and application implementation, or from the perspective of national government supervision, the alliance chain system is a technical solution that is more likely to be realized at present. On the one hand, it solves the problem of data sharing and promotes the efficient development of the entire industry. On the other hand, the top three hospitals can also cooperate effectively under the supervision of the state.
3. The national supervision is heavy, and it is difficult to implement: medical and health data is a key category of national control data, and relevant policies also clearly indicate that medical and health big data is an important basic strategic resource of the country, which is of great importance to national security and social stability. influence. At present, the policies on medical research and other aspects are relatively relaxed, but if you want to turn medical and health data into commercial institutions or individuals for management and operation, this approach is risky, and it is more difficult to liberalize at the national policy level.
With the continuous development of blockchain technology, this technology can become an effective tool in the medical and health field. However, it will take some time for the industry to implement blockchain, and it will be difficult to achieve it in the short term.
