The use of blockchain will revolutionise several industries in a way never witnessed before, and Brazil may start at the forefront. Known as a general-purpose technology, blockchain will be used in ways that we are still incapable of predicting, but it is already changing how we deal with information, commercial relations, trust and accountability. It is expected to disrupt the world as much as the invention of the press, the industrial revolution and the internet. One of the areas where major changes are envisioned is healthcare, and Brazilians are thinking of possibilities.
Brazil is a country bursting with creativity, and its continental size presents a lot of that proverbial necessity that gives birth to invention. Local law, for example, rightfully aiming at protecting privacy, forbids hospitals and healthcare companies from sharing patient’s information. That protection has its downside, as it makes it difficult for patients to inform different doctors about their diagnosis and health history. Even the patient – himself the rightful owner of his health records – does not hold most of them, as records are kept in the clinics and hospitals where treatment was sought. That makes an accurate diagnosis hard to be achieved, and it particularly hampers the efficiency of pharmacists and paramedics – two professionals instrumental in saving lives in case of an emergency.
With that and more in mind, young Brazilians working with the AI and blockchain lab Entropia have come up with EverSafe, a project based on a blockchain platform that would reconfigure healthcare in ways that were unthinkable before.
The digitalisation of hospitals in Brazil is not new, and less than 15% of medical facilities with 50 beds or more are believed to not have started the process yet. But health records are not necessarily communicable. They are saved in different formats and different computer languages, and those holding that data often have competing interests, unlike the patient, whose only aim is to stay healthy. The problem is further compounded by the fact that there are two separate health systems, private and public. EverSafe will create a single databank – the blockchain ledger – where each patient will be able to compile and gather his or her health information and make it available at will. Eating habits, health history, previous diagnoses, allergies, prescription drug intake will all be gathered under a single encrypted key that will allow the owner to retrieve the information instantly or share it with any person, hospital and health facility. The patient will also be able to sell that information, even anonymously. Interested buyers can be anyone from researchers, government offices dealing with epidemics, insurance companies, scientists, medical companies running drug tests. All that will be done in a safe, hack-free, encrypted platform. EverSafe also proposes the use of tokens to “gamify” the community, so people would be enticed to record their data and earn tokens for consumption within the network.
That type of incentive is also proposed by another healthcare blockchain project under development in Brazil aiming at increasing donation of bone marrow. “The idea is to create a platform where healthcare institutions can cross-check information with eligible donors,” says Samira Lopes, a member of the collective Women in Blockchain, in an interview to Onco, a Bazilian medical magazine. Donors would be entitled to tokens that serve as currency within that blockchain environment.
Two Brazilians were also part of the seven-member MIT Experimental Learning Group that won the USA Blockchain Challenge in 2016, a private initiative to reward with cash prizes the best projects in “Blockchain Technology and the Potential for Its Use in Health IT and/or Healthcare Related Research Data.” Anne Chang and Luca Forni won the challenge with a white paper presenting a project that would, as explained by Chang, revolutionise the way treatments are prescribed to patients.”
“Today,” she says, “we depend on studies and medical articles that are done in a restricted form, with small samples and that often do not consider specific factors like ethnicity and genetic predisposition.” With blockchain, once medical records are added to the platform, with the due permissions and necessary requirements, that massive amount of anonymous yet verified data will become a goldmine for research and solutions, and person-specific treatments will become less costly and more efficient. “We want to give a more dignified destination [to our medical records]. When the patient is in the hospital, he rarely has access to his records, lab test results, treatments, drug interactions and other information that, even though it belongs to the patient, end up staying in the hospital.” Such transformation may also reduce the frequency of medical errors, which a 2016 study by researchers at Johns Hopkins Medicine says was the third leading cause of death in the USA.
Brazil has adopted other technological innovations in health that are more widely used by the public at large precisely because they do not require access to a blockchain – still a platform to which the average person has no access from a regular phone or notebook. But with the improvement of the technology and its adaptation to everyday gadgets, several of these apps will soon be available in an improved form in a blockchain platform with its main advantages: security, encryption, anonymity and an almost guaranteed absence of fraud and forgery. One of those innovations are the already widely used apps that show the cheapest prices for drugs within one’s location. Government health departments are also discussing the use of blockchain as a means to give transparency to public tenders and avoid overbilling in drug purchases. All of that is very promising, and more so in light of the Goldman Sachs report, leaked in April 2018, which revealed the bank’s advice to clients in the medical field that it was sound business not to aim at curing a disease but at keeping it chronic.