In 2019 we will embrace Blockchain and innovation as
necessary support for the healthcare of our time.
Blockchain can influence the design and implementation of new models by refining data
security; provide more robust audit trail mechanisms required, eliminate medical imaging
acquisitions repetition, reduce transaction costs, while allowing clinicians to access
data easily, compare images, and provide patients with better and quicker treatment
options.
The main technology trends of 2018 that
have been identified in Healthcare such
as AI, machine learning VR/AR, Internet of
things (IoT’s) and Blockchain, should not be seen
as “trends” anymore. In fact, in 2019 we will move from viewing these
as over-hyped buzzwords to embracing them as
necessary support for the healthcare of our time.
The acknowledgement of the potential of these
technologies brings new opportunities for flourishing
new economies, new business models and
most importantly the leverage for enabling true
citizen-centric care and efficiency in the care
process.
Even though the healthcare landscape has seen
benefits from these technologies, the industry is
still on a learning process to better understand how
to fully unleash these tools.
Blockchain as enabling technology for
teleradiology
It has been said that approximately 90% of the
health data generated is medical imaging. A study
indicated a growth of 35 ZB of imaging data by
2020 produced by the world’s devices (Alexander
et al. 2018). In such a scenario, it becomes critical
to establish secure, reliable and efficient
processes and tools for exchanging and leveraging
this growing wealth of data toward improving clinical
outcomes and overall efficiency along the care
process.
At the same time, such great amount of data is exposed– with the current technologies and
approaches, to high risk of cyberattack. Fragmented
PACS systems, siloed databases for
different kind of data (notes in one system, medicine
records in another system), has made it very
difficult to properly use data while ensuring proper
security.
As a consequence, it is not surprising that
several cyberattacks have affected a fair number
of organisations and institutions. One of the most
notable ransom attacks called the WannaCry in
2017 was yet another reminder of the vulnerability
of healthcare organisations and the need of continuously
finding better ways to protect patient data
but also obtain and maintain trust in the ecosystem
and most importantly patient trust.
In such a scenario, Blockchain could likely influence
the design and implementation of new storage
models by not only refining the security of the data
and providing more robust audit trails mechanisms
required by regulatory bodies, but also eliminating
the repetition of medical imaging acquisitions, reducing transaction costs, at the same time
allowing clinicians to have access to data more
easily, compare images, and provide patients with
better and quicker treatment options.
Such innovations can be of benefit in enabling
distributed teleradiology, allowing offsite and onsite
diagnostics to read data while providing transparency
to all parties in the care chain.
A real-world implementation of the above described
scenario was presented at the 2018
Radiological Society of North America (RSNA)
annual meeting, where Medical Diagnostic Web
(MDW) presented the first radiology Blockchain
platform for connecting stakeholders of the imaging
ecosystem.
Blockchain and AI: teaming up for
improved care
The usage of AI and machine learning for processing
large data sets, imaging analysis and clinical decision
support, is becoming more and more widespread
worldwide, along with progressive demystification
of such technologies. Indeed, the importance
and efficiency that is gained from AI in the
field of radiology is currently becoming more and
more difficult to argue against.
In particular in image analytics, AI – thanks to its
pattern recognition and data-crunching capabilities,
can play a fundamental role to support radiology
departments to deal with the ever-increasing
amount of available imaging, making sense of such
enormous quantity of data and extracting valuable
insight for improving diagnosis and therapies. It
doesn’t therefore come as a surprise that the relevant
AI in the medical imaging market is expected
to grow to 2 billion USD by 2023, according to
recent forecasts (Harris 2018).
Still, it is very important for the proper and
successful implementation of these technologies
in an operational environment, that a thorough
learning phase is completed. In such a
scenario, introducing a more open, distributed,
and “democratised” way of accessing and sharing
medical images, via Blockchain-based open and
distributed database, could dramatically improve
AI training process at the same time reducing the
risk of biases of the resulting algorithms, by taking
data from a variety of sparse and different sources,
therefore improving clinical value.
Such a new open environment would greatly
contribute in improving interoperability and accessibility, as key drivers for delivering proper
care at the right time.
Additionally, and coming to a conclusion, a
further layer of security and trust in the data
exchange process could be added, also outlining a
greater role for patients, by using smart contracts.
In such cases, in which data are openly available
but still in control of the relevant providers and of
the patients/data owners, personal smart-contract
based tools could be entrusted by the patients for
sharing the data on the basis of specific and predefined
consent and permission options – seeking
for second opinions and allowing for data access by
third party (and data-driven services) in an automated
fashion.
In conclusion, DLTs and their “cooperation”
with AI hold great promises for the future of radiology
and healthcare at large, but we must always
remain mindful of the fact that an environment
of trust remains a challenge, for all parties within
institutions and between patients and healthcare
providers.
Key points
- 2018 main technology trends in healthcare such as AI, machine learning VR/AR, IoT and Blockchain, should not be seen as “trends” anymore.
- Approximately 90% of the health data generated is medical imaging.
- Fragmented PACS systems and siloed databases make it very difficult to properly use data while ensuring security.
- Blockchain can benefit imaging by enabling distributed teleradiology, allowing offsite and onsite diagnostics, providing transparency to all parties in the care chain