Talk for Article "Blockchain could change the way your medical data is shared"

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  1. [ This comment is from a user you have muted ] (show)

    “By distributing information over several servers, blockchain makes pieces of data unreadable unless hackers have access to the entire chain.”

    Unless I am misunderstanding what is meant here, this sounds patently false to me. In the case of e.g. Bitcoin, the data (i.e. the blockchain) is public. In fact, the first thing that you do when you start mining is downloading the whole blockchain.

    The thing that makes the blockchain difficult to manipulate is that the network of servers (miners) has to reach a consensus on whether to accept an update to the blockchain or not. Meaning that you would have to control a majority of the servers in the network to hack it.

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    The summary suggests that blockchain applications would address delays and incompatibilities, but the article addresses neither, talking only about control mechanisms. Maybe a step-by-step example, contrasting with and without blockchain, could explain how technical controls and characteristics affect the process and its outcomes.

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      That may tough considering there is no one way blockchain is applied to healthcare. Unless do you think a list of case examples would be useful? For example: This is how BurstIQ is applying blockchain and how it could change the system… this is how Hashed Health is doing it… this is what Company X is doing etc.

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        That’s a good point. Examples of each would be great, but even one could be enough for the reader to get a sense of the implications or connect with their own experience.

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    One reason to involve blockchain in the management of medical records is that it can give patients more control over their records and also allow an ER to get your doctor’s records while the doctor’s office is closed for the weekend. This avoids having to run duplicate tests and makes the ER aware of the patient’s history immediately. Please see the article I posted on linkedin for details: https://www.linkedin.com/pulse/sharing-medical-records-blockchain-using-cryptography-mark-grand/

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    “Bitcoin, notably, has yet to be hacked (Wirexapp).” strikes me as flatly untrue. One of the thing that Bitcoin is most famous for is the vulnerability to hacking. https://arstechnica.com/tech-policy/2017/12/a-brief-history-of-bitcoin-hacks-and-frauds/ is a good example of quality coverage of the issue. I think it is only possible to claim that Bitcoin “has yet to be hacked” by defining a “hack” in a very very narrow sense. As an end user, I don’t care if my medical information got splashed all over the web because of a cryptographic flaw or because a major hospital’s keys were stolen. Either one is a ‘hack’ in the relevant sense.

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      These hacks are to do with security flaws from the people that were running the bitcoin software. Think of it like your email: barring someone guesses or brute forces your password, you cannot be hacked, but if you let anyone sit down in front of your computer and your browser has your credentials saved or you wrote them in a text file on your desktop… Then you’re out of luck. From a technical point of view, it’s correct to say that the Bitcoin protocol and ensuing blockchain has never been hacked. This is because the protocol at its heart is very simple: you have a public and private key that allows your to receive and send money from a wallet address. Without the private key, you can still receive money to your wallet address but you will never be able to use them. In all of the hacks in your link above, the hackers were simply able to gain access to the private key and then use Bitcoin in the way it was designed.

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        Your example only serves to prove my point. If SSL or some other aspect of email security has not been hacked it still makes no sense to say that email has never been hacked. It has quite famously and repeatedly. Similarly if the cryptography underlying bitcoin has not been hacked it still is deeply wrong and misleading to say that bitcoin has never been hacked. It has quite famously and repeatedly. In a neutral story *we* need not and should not say that the whole idea of health information on the blockchain is a super silly idea. But neither should we blindly repeat the hype of advocates when many credible sources say the opposite.

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          I could change the language to say ‘honeypot and ransomware attacks’ since these are common ways hackers steal healthcare data. It’s also a reason why blockchain is considered.

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        Yes, I can see why some think medical records would not be useable in a blockchain with its high data content (yet). But with quantum storage methods under development this will be possible will it not.

        And thinking about redundancy, is not blockchain a risk in that it only needs one server in the chain to fail and the record is lost. Or in the chain are the servers mirrored? (This is a silly comment – I guess they must be – can someone comment please.)

        One way to provide redundancy is multitudes of small systems is it not.
        Why not give individuals access to their own data, then it would be their prerogative to give a medical professional their Password to access their data on another system. (The data that the medical professional in the opening paragraphs of the article had difficulty with.)

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        My biggest problem with that paragraph is its implication that a blockchain-based EHR system would somehow be inherently more secure than an alternative simply due to the fact that the Bitcoin blockchain / consensus system has not been hacked. I don’t see how that conclusion follows from the premise.

        As Jimmy mentioned, Bitcoin-related services and technology have been hacked on several occasions. So it would be easy to draw the opposite conclusion that a blockchain-based EHR solution would, in fact, be quite vulnerable to attacks. Also, a blockchain-based EHR system does nothing to stop employees from accidentally introducing malware onto the hospital network, so in no way prevents ransomware attacks on hospitals.

        If one wishes to make the claim that it does improve security, the article should contrast blockchain based EHR solutions with alternative EHR systems and explain specifically how the use of blockchain improves security.

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    As a community member, I’d like to contribute to this story, but it is difficult because there are not (yet) audio or transcripts of the interviews. I’d like to see these attached to stories at the earliest possible stage. Ideally, the audio would be attached within moments of finishing the story. If there are technical barriers to this, please do let me know, and I will focus on removing them.

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      I’ll get them fully transcribed by tomorrow. Audio up by today. There are several, but I don’t think there will be a technical issue

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    If I were writing this story, the angle I would take would be that yet another bunch of very smart people have been sucked in to the “blockchain will save the world” religion. These stories never say precisely why blockchain makes things better. There is lots of hand-wavey stuff about security, but no evidence to support the hand-waving. I think there is actually a very interesting story here, but the story is why people keep getting sucked into the idea that proof-of-work in a distributed blockchain is an improvement over various other models that are much less energy- and compute-intensive, and perform much better. Another story would be to examine in real depth whether there really is a problem that blockchain solves here that can’t be solved more cheaply. I think the answer is “no,” but maybe I’m wrong; if so, it would be nice to have an explanation as to why. But the story at present simply takes that as a given, and consequently I don’t think it’s all that useful.

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      I completely agree. I originally wrote about what I called ‘blockchain missionaires.’ But ultimately the problem with EHR should to be explained first. What do you think? Should we start another one, or can this be salvaged?

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