Farrah Fawcett, actress and model, was diagnosed with cancer in 2006. She battled the disease until her death in 2009, the details of which were widely publicized in tabloid magazines often before she had a chance to tell her friends and family. In an interview in 2009, given just before she died, she is quoted as saying, “It seems that there are areas that should be off limits.” Of course she was a celebrity, the average person has nothing to fear, right?

Consider a 2016 report by the Ponemon Institute that found 89% of health care organizations had a data breach in the last two years. Why is this information stolen? In Farrah Fawcett’s case it was obviously because of her celebrity status, but hackers are going after everyone’s records now and selling it on the black market for a price estimated at 10 to 20 times that of stolen credit card numbers. Health information is worth more because it can be months before the theft and fraudulent use is discovered and because there are so many different ways to monetize this data. The losses aren’t limited to financial either. If someone uses your medical identification to fraudulently obtain services, they can contaminate your records with erroneous information such as blood type, allergy information, etc. which may lead to serious consequences including death.

Despite these facts the use of Electronic Health Records continues to rise.. The percentage of hospitals in the US utilizing electronic health records increased from 9.5% in 2008 to 75.5% in 2014. The benefits of EHR’s are many: ease of transferring medical information between providers, enhancing work flow (ePrescribing), lower storage space requirements, and the possibility of reducing certain types of errors are just a few. Utilizing EHR’s for research purposes is an exciting opportunity also. The ability to gather information from a vast database of patient data would make research more cost effective and comprehensive at the same time.

How do we balance the benefits of digitizing health data against the risk of theft of that data, or to paraphrase Ms Fawcett’s words, how can we make sure that our information is available to the correct people, but off limits to everyone else?

Is there some way to build EHR’s from the ground up to ensure that the right people can access the information they need but remain off limits to everyone else? Many people are saying that a technology known as blockchain is uniquely suited for this task. Blockchain is a type of distributed database that provides the back end for Bitcoin, a type of digital fiat currency. Blockchain is basically a digital ledger that maintains a complete list of data records, the entire history of each record and who created or accessed the record – including a time stamp. The promising thing for healthcare is that limitations on who may access and alter these records can be built in the program itself. In other words, it is trivial to set up a database that is off limits to all but authorized personnel. Additionally, research organizations could access just those portions of the records which are pertinent to what they are studying without accessing patient identifiable content.

So what’s holding this technology back? In part 2, I will explain a little more about how blockchain works and why there is some resistance to it’s use.

Bio:

Jeff Harris is a Pharmacist with over 25 years of leadership experience in hospital, retail, and home health environments. Due to a spinal cord injury, he is currently on long term disability.  Jeff is passionate about patient safety, risk management and cybersecurity issues in healthcare.  He continues to research and write about improving healthcare on a pro-bono basis.