Zhang Hancheng: When the problem of medical insurance data sharing encounters blockchain

Text / Zhang Hancheng

Health and medical big data is an important basic strategic resource of the country. Improving the efficiency and quality of health care services and expanding the supply of resources are conducive to meeting the people's multi-level and diverse health needs. Forbes released a report titled " Eight Major Healthcare Forecasts for 2019 ", predicting that blockchain, as one of the most concerned technologies in the medical field in recent years, will usher in the test of reality in 2019 . The report pointed out that during 2019 , blockchain technology will shift from perception and hype to early commercial deployment, and show the initial return on investment in enterprise B2B key plans. It is expected that by the end of 2019 , enterprise blockchain applications focused on healthcare will shift from the experimental stage to partial or limited commercial availability. In this regard, industry insiders have analyzed that early participants in the industry have seen their major opportunities in the medical industry and have launched a series of related explorations and attempts. Blockchain technology will lay the foundation for future medical innovation projects.

First let ’s take a look: Medical data is worth sharing the consensus of the masses:

"Patients in a remote area have got tuberculosis", he definitely wants to know, "How do doctors in famous tuberculosis hospitals look?"

A patient "You have cured bone hyperplasia", has a strong body, and wants to share it with everyone;

We often hear where someone is optimistic about a certain disease and which hospital you go to;

In fact, you will often share your medical experience with other friends and be proud of your medical experience.

Of course not eggs! , We have optimistic about hundreds of millions of patients in more than 900,000 hospitals across the country. Have you shared these successful experiences?

No!

In May last year , the National Medical Insurance Bureau will eliminate the pattern of resource division, improve the efficiency of the use of medical insurance funds, and a unified information system will greatly reduce the operating costs of the system. However, there is no unified monitoring platform for the monitoring of this information. The establishment of the Medical Insurance Bureau is conducive to the linkage of the " three doctors " and promotes the transformation of the operating mechanism of public hospitals, so as to more effectively achieve the goals of medical reform and benefit the people. In the past, the issuance of a document and the implementation of work required the relevant functional departments to reach consensus and coordinate with each other. When the objectives, priorities and understanding of the problems of the various departments were inconsistent, inefficiencies, " three guarantees " and medical service prices were prone to occur Such functions are unified into one department management, reducing the cost of communication and coordination, and the linkage between the " three doctors " is more smooth.

But the premise of all work is the linkage of the three doctors and the sharing of the three insurance data.

In addition, there is also the implementation of the medical insurance bureau's responsibility for the price management of medicines and medical services, the purpose of which is to solve the accumulated defects in the circulation of medicines and promote the standardization of medical services. It can be expected that the future medical insurance's leading role in the pricing of medicines and medical services will play a significant role in strictly controlling the unreasonable medical expenses of medical institutions. However, the sharing of drug data and price data also needs to be implemented without modification.

At the same time, in the process of diagnosis and treatment, it is difficult to achieve real-time comprehensive supervision of over-medical, repeated tests, large prescriptions and even the collusion of doctors and patients to erode the medical insurance fund without data sharing.

Why is medical data not shared? Because we have not established a sharing platform that protects privacy and is open and transparent electronic medical records, so that every patient can find a similar medical treatment plan willingly.

Without universal health, there is no universal well-being. Jin Xiaozeng, president of the China Society of Health Information and Health Medical Big Data, said that the implementation of Healthy China and Digital China is the direction of China's health development. Earlier, the General Office of the State Council pointed out in the "Guiding Opinions on Promoting and Regulating the Development of Health and Medical Big Data Applications" that comprehensive application of health and medical big data should be deepened. It can be said that throughout the country, the construction committees of various committees and hospitals are thinking about a problem, how to open and share medical data.

And what is the status quo: we have invested a lot of manpower and material resources in the construction of health and medical big data. It can be said that the hospital's data construction is still good. For example, the patient's signs, examinations, tests, diagnosis, materials, and payment have been digitalized. However, between regions and regions, between hospitals and hospitals, and even within hospitals, the open application of data has not been very successful. The currently constructed large-area electronic medical records database, health archives database, and population information database-based health and medical big data platform have high costs. They promote business plans through emergency rather than projects, and lack scalability and flexibility.

What is the status quo of IT : The IT system in the medical industry is complex and diverse, facing integration pressure, splitting data uniformity, old architecture, and slow processes; lack of new technologies, hospitals do not even have BDA , and data form islands in major medical information systems. More recent applications; in a word, hospital information lags behind other industries.

Do n’t understand the darkness of the night during the day: people who do n’t understand big data analysis do n’t understand medicine; people who understand big data analysis do n’t understand medicine; talents are relatively lacking, and more important doctors do n’t have data resources to do analysis,

So think about it, doctors have no data, and they ca n’t share it internally. You share a hair!

So many times, we are in YY

Also: friends in the medical industry know several characteristics of medical industry data

Not true, the case data is not accurate, and the results of each test may be different, such as the image, the results of each filming may be different.

Incomplete, there is no statistical case information record every time, which is related to the hospital's case management of the patient and the patient's understanding of their case management.

Not timely, no long-term case records, isolation, intermittent.

More industry experts pointed out that data analysis is nonsense in management, and it is a long way to go in the medical business analysis and single disease diagnosis and treatment ...

Under such circumstances, how can medical data be opened and value can be tapped? Will data science become a nonsense for medical service for a long time?

The author has recently studied blockchain technology and found that blockchain and transparent and privacy-protecting technologies have brought us light.

" Electronic medical record sharing platform based on blockchain technology " is a great idea to solve this problem;

Blockchain technology is promising in medical applications

Blockchain is an intelligent peer-to-peer network that uses distributed databases to identify, disseminate, and record information, also known as the Internet of Value. This concept was first proposed by Satoshi Nakamoto in the "Bitcoin White Paper" in 2008. Among them, blockchain technology is the basic technology for building bitcoin data structures and encrypted transmission of transaction information. transaction.

Blockchain technology has the following characteristics: decentralization—the entire network has no centralized hardware or institutions, and the rights and obligations between any nodes are equal; collective maintenance—the data blocks in the system are shared by all nodes in the entire system Maintenance, each node shares rights and obligations; high transparency-open source procedures, which ensure that the books and business rules can be reviewed by everyone; detrust-technically guarantee the transaction is carried out without a third-party organization, No trust or not; anonymity—Because blockchain technology solves the problem of trust, there is no need for both parties to the transaction to understand each other, and the transaction is conducted under anonymity.

Because of these characteristics, blockchain technology is also expected to achieve a variety of applications in the medical field. The most important point of the application of blockchain technology in finance and other fields is that its unique encryption technology guarantees the security of transactions. The same is true in the medical industry. At present, the specific application scenarios of blockchain technology in the medical field are mainly that multiple parties share medical data on the blockchain platform to satisfy the acquisition of patient historical data and use the shared data for modeling and image retrieval. , Auxiliary doctor treatment and health consultation, etc.

For example, electronic health cases, the former cases are all in the hospital and are not in the hands of patients, and can not be shared between different hospitals. Blockchain technology can record and encrypt medical records like bookkeeping. The institution can be used at any time, fully guaranteeing privacy and security, which is the most important application of blockchain technology in the medical field. Other applications include: DNA wallets. Like medical records, genetic data can be stored securely using blockchain technology and obtained through the use of private keys. Healthcare providers can safely share and count patient data to help pharmaceutical companies More efficient drug research and development; insurance payment, driven by the application of blockchain technology in the financial field, payment of health and medical insurance will also be linked to the blockchain; drug anti-counterfeiting, similar to coded anti-counterfeiting technology, There is a special verification label on the surface, which is compared with the blockchain to ensure the legality of the medicine.

Solutions for data quality problems in the medical industry

Blockchain platform is a good medicine to solve medical data sharing. At present, the medical industry is facing many challenges, and the blockchain technology mainly solves the above problems through the specification and protection of data. There are many problems in the medical industry, such as incomplete data collection, irregular management, information islands, leakage of individual privacy, and gray data transactions. The low quality of medical data seriously affects the subsequent circulation, sharing and application, and restricts the quality of medical services throughout the industry development of.

The "2018 Blockchain Medical Data Research Report" (hereinafter referred to as the "Report") released by Chain Tower Think Tank believes that the current problems in medical data platforms are mainly concentrated in three aspects. First, data collection lacks uniform standards and cannot form a complete picture of the patient. Each platform has its own set of standards but they are not perfect. The information collected is mostly scattered information. There are too many heterostructured and semi-structured data. These imperfect data will also have difficulties in integration when brought together Therefore, it is difficult to form a data system that records the complete medical information of patients. Second, the data classification is ambiguous and lacks value data grades. There are many subdivision types of medical data, such as hospital information, device information, doctor diagnosis information, patient information, health information, etc. At this stage, the classification of subdivision information when processing data needs to be improved. Valuable data such as data and image data are relatively scarce, and it is necessary to establish data value standards to form a division of data levels. Third, the pressure on network security is high, and the cost of acquiring information is reduced. Although laws and regulations clearly guarantee data security and privacy in the medical and health field, the rapid development of the Internet field has caused more and more devices to access the network, which brings great hidden dangers to network security, and the risk of patient information data leakage is increasing.

For example, the same patient has many different versions of the medical records, and the data in it does not match a lot, and the doctor who took over did not check carefully, so that the patient may be misdiagnosed. Blockchain technology can help improve the above situation, because no one has the right to manage all data in the blockchain platform, and at the same time all participants are responsible for maintaining information security, which can greatly reduce misdiagnosis or malicious modification of data in the healthcare industry risks of.

The Report also believes that blockchain technology is naturally suitable for recording data and information. The most widely used in the medical industry is the distributed ledger record of medical health data. Electronic medical records and disease data constructed using blockchain technology can fully record health data including vital signs, medications, diagnosis results, medical history and surgery, as well as medical data related to medical personnel, locations, devices, etc. The complete data link of the system extracts the information required by them, which overcomes the shortcomings that there is no unified standard for collection and data processing. When establishing medical records, medical professionals are responsible for ensuring the accuracy and completeness of sensitive medical records, and making these medical records information available only to authorized personnel, which will enable patients to obtain higher quality medical services.

Large enterprises and hospitals will be the first to apply blockchain technology

At present, some pioneers at home and abroad have begun to deploy the application of blockchain technology in the medical field.

August 2017, Ali Health and Changzhou City, Jiangsu Province to launch China's first block-based chain applications in the medical scene - "Medical conjoined block chain" pilot project that will block chain technology used in Changzhou City Medical conjoined In the underlying technical architecture system, it is understood that the plan has been implemented in Changzhou Wujin Hospital and Zhenglu Town Health Center, and to achieve safe and controllable data interconnection between these medical institutions. In April 2018 , Ma Huateng stated that Tencent's blockchain will land in the medical field, leveraging blockchain technology to realize that electronic prescriptions will not be tampered with, and this new technology was added to the WeChat Smart Hospital version 3.0 that was subsequently released . In September 2018 , Huashan Hospital Affiliated to Fudan University joined hands with Ant Financial to launch the country ’s first blockchain electronic prescription. Among them, blockchain technology is mainly used to ensure that the prescription is accurate, tamper-proof, and traceable to solve The prescription does not follow the doctor's instructions to repeat the prescription and other issues. Oracle October 25, 2018 officially announced the launch of cloud-block chain applications to help customers enhance the entire supply chain traceability and transparency, enhance confidence and agility in business transaction processing network. The blockchain application is built on Oracle's blockchain cloud service and can seamlessly connect to Oracle's supply chain management cloud, enterprise resource planning cloud, and various other Oracle cloud applications. And launched a number of industry blockchain solutions, including medical information sharing platform solutions based on blockchain technology.

But overall, most of the blockchain medical projects are in the initial stage, and there are few landings. The construction of the blockchain platform needs to rely on strong resources, background and regional influence. For example, in the blockchain model, the entire network broadcast of data, the entire network storage, and the entire network verification all consume large network bandwidth resources, Node storage resources and computing power resources, the high cost can only be afforded by large enterprises or forming alliances.

Indeed, the promotion of blockchain technology in the medical industry still faces challenges such as its own technology and laws and regulations that need to be improved. First of all, because the IT system in the medical industry is complex and diverse, facing integration pressure, and with an outdated architecture, slow processes, lack of new technologies, and information silos, the informationization of hospitals in general lags behind other industries and is difficult to improve in a short time. Secondly, the medical industry pays more attention to safety. When the technology is not mature, it is very cautious about the application of new technologies. The last thing to consider is whether the application of new technologies will violate relevant laws.

Block chain technology for the application of the State Council Informatization Office network already in January 10, 2019 issued "block chain information service management requirements" (hereinafter referred to as "Regulations") since February 15, 2019 into effect. The relevant person in charge of the State Cyberspace Administration said that as an emerging technology, blockchain has the characteristics of non-tampering and anonymity. While bringing opportunities for national development and convenience for social life, it also brings certain Security Risk. The "Regulations" were issued to clarify the information security management responsibilities of blockchain information service providers, regulate and promote the healthy development of blockchain technology and related services, circumvent the security risks of blockchain information services, and provide services for blockchain information services. Provide effective legal basis for provision, use, management, etc.

The industry believes that the development and application of blockchain technology to the real economy also needs the encouragement and support of the government. The introduction of the "Regulations" has laid a good foundation for the development of the industry, and compliance is the only way out for this technology in the future.

Looking ahead, the application of blockchain technology is consistent with the trend of data opening in the medical industry itself, which is conducive to the safe opening of medical data. It can be predicted that the establishment of a medical data platform shared by multiple parties will help promote the application of blockchain technology in the medical industry; large top three hospitals and international hospitals will take the lead in applying blockchain technology; there will be blocks based on the establishment of the health and planning committee Electronic medical record sharing platform of chain technology.

The current development of blockchain is at an early stage, and the informatization of the medical industry is also said to be slow in the industry. We can only expect forward-thinking companies to invest heavily to accelerate this process. For solution cooperation, please contact Weixin : dangstech .

Zhang Hancheng is an Oracle data expert. His research areas mainly include: Introduction to Big Data Fundamentals, Application Practices of Big Data in Enterprises and Governments, Business Models for Data-Driven Business Transformation, Medical Big Data Operating System, Tax and Big Data, Customs Big Data, Operator Big data construction plan, tourism big data platform construction plan, data asset management, big data industry ecological analysis, data transaction market, blockchain, artificial intelligence and other new technologies are the value and empowerment solutions for traditional enterprises.