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healthcare Archives – Hyperledger

Hyperledger for Healthcare: How Fabric drives the next-generation pharma supply chain

By 网志, Healthcare, Hyperledger Fabric

Before new medicines can reach the patients that need them, the pharmaceutical and biotech companies that develop them must seek FDA approval. As part of this process, pharmaceutical companies sponsor highly controlled clinical studies in medical centers, called “sites.” The number of active studies has doubled over the last 10 years, and study sites are bursting at the seams. With the rise of personalized medicine and increasingly specialized shipping and storage requirements, this trend can only accelerate.

At LedgerDomain we’ve partnered to tackle this challenge with a broad spectrum of industry leaders, including pharmas, contract manufacturers, research organizations, academic sites, and couriers. At the heart of this effort is the world’s first iOS blockchain app for pharmaceutical supply chain, which we presented last month to the Hyperledger Healthcare Special Interest Group (HC SIG).

Today we’d like to dig beneath the surface of our efforts in this space. We’ll cover some lessons we’ve learned along the way, and how blockchain can speed innovative medicines to the patients who need them. We’ll also give you a sneak peek at a live pilot happening right now, where a blockchain-based solution is being used to deliver lifesaving medicines to real patients.

Why Hyperledger for healthcare?

We chose to join the Linux Foundation and Hyperledger in 2016 after a simple realization – most of our clients and prospects were apprehensive about coin-based models. Hyperledger Fabric represented a different approach to blockchain that aligned with their values at a deeper level. It’s no wonder that the community has come a long way since, emerging as the blockchain platform of choice for global enterprises. 

Coin-based models can serve as a fantastic incentive for participation, but not everyone in every jurisdiction is ready for cryptocurrency. A second factor that sets Hyperledger Fabric apart is its focus on privacy. While everyone is looking for the magic bullet that will enhance track-and-trace capabilities across the drug supply chain, nobody wants to risk leaking patient health records from a public blockchain across the dark web.

The DocuSeal framework

Highly regulated enterprise communities have unique requirements. Much of our work on Hyperledger Fabric has centered on specialized multi-threaded experiences designed for compliance with HIPAA, GDPR, Cal Privacy, and data privacy laws just over the horizon, performing at scale.

With that in mind, we built DocuSeal, a framework designed for blockchain-powered document authentication through an iOS application. With DocuSeal, uploaded documents are sealed in private storage, tied to a unique hash that’s immutably stored on a private blockchain. Documents can be shared with other users or deleted.

DocuSeal makes it possible to verify the authenticity of any document each time it’s accessed. At the same time, the “right to be forgotten” is preserved, as the private storage can be wiped if necessary while the hashes on the blockchain are preserved. To assure real-time performance metrics, we use Selvedge, our enterprise-grade blockchain app server developed in Golang on Hyperledger Fabric. 

We designed the DocuSeal framework so users could be up and running in minutes with simple document storage and sharing – similar to Dropbox – plus serious security and timestamping. But underneath this simple interface, our stakeholders can leverage the power of smart contracts to drive inter-enterprise workflows.

How blockchain can speed innovative medicines to the patients who need them

Testing new medications is an extraordinarily complex process. Right now, over 800 biotechs and pharmas are working with their vendors to supply medicines for over 10,000 clinical studies to tens of thousands of clinical sites. And the number of studies is constantly growing.

While some clinical sites are just a doctor and an assistant, large academic centers aren’t like your neighborhood Walgreens or Boots. They’re massive warehouses with pallets loaded with experimental medications. One of our partners, UCLA, has 700 clinical studies sponsored by 100 different companies. This is a massive undertaking where no single pharma’s proprietary system can predominate, so everyone has fallen back on paper.

With that in mind, in 2017, we joined forces with other industry leaders as part of the Clinical Supply Blockchain Working Group (CSBWG), which includes Pfizer, IQVIA, UPS, Merck, UCLA Health, GSK, Thermo Fisher, and Biogen. Over the course of two years, we built out a pilot on Hyperledger Fabric to address this challenge directly. We named it KitChain

(Want a deeper dive on technical specifications? Check out our white paper!)

Big picture: supply chains and blockchain

KitChain was a major milestone for the supply chain for clinical studies, but meanwhile the stakeholders on the commercial pharmaceutical supply chain were struggling to meet their own challenges. Everyone is looking ahead to 2023, when the Drug Supply Chain Security Act (DSCSA) will come into full effect with sweeping requirements for traceability across the entire pharmaceutical supply chain.

With that in mind, the US Food & Drug Administration (FDA) came out earlier this year in search of enterprising stakeholders to help them tackle the problem of counterfeit and suspect medicines. 

In response to the FDA’s call for pilots to address this challenge, we partnered with UCLA Health to launch the only pilot of its kind. We’re building and testing a last-mile blockchain-driven solution designed to help deliver lifesaving medications to real patients. This solution features an intuitive iOS client running on our Selvedge app server and smart contracts, all powered by Hyperledger Fabric.

This is a “rubber hits the road” moment for supply blockchain: out of the workshop and into the real world. Our living supply chain solution captures all the transactions – from the loading dock to the patient. It will capture the data needed to develop trends and analytics, and be able to surface risk management issues. But most of all, it’s designed to handle the human element – because in the real world, sometimes things happen you don’t expect. A blockchain system that doesn’t allow for human factors will no longer reflect the ground truth. These are all things we’re working on right now, and we look forward to sharing our findings and connecting with you in Phoenix at Hyperledger Global Forum 2020.

The Hyperledger community has grown and matured over the last three years, and we’re honored to be a part of building the future of blockchain. Delivering our full-stack enterprise-grade solution by ourselves would have been impossible, but by joining Hyperledger and the Linux Foundation, we’ve been able to contribute while standing on the shoulders of giants.

About the Author

Ben Taylor is the CEO of LedgerDomain, founded in 2016 to bring Hyperledger blockchain solutions to enterprise ecosystems, unlocking a world of communal computing and real-time performance. After doing undergraduate and graduate work at MIT, Ben spent a quarter of a century incubating and investing in early-stage technology companies.

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Community Spotlight: Meet Richard Bloch, Hyperledger Healthcare SIG Chair

By 网志, Community Spotlight, Special Interest Group

Welcome to our Community Spotlight series, which highlights the work of those taking on leadership roles in our special interest and working groups. Meet Richard Bloch, chair of the Hyperledger Healthcare Special Interest Group (HC-SIG) and founder of Digital Healthcare I/O.

Tell us about yourself. Describe your current role, your current business and background, and your involvement in the Hyperledger HC-SIG.

My name is Rich Bloch. Professionally, I have over 30 years of systems and software engineering and engineering management experience. I spent my first 10 years at Microsoft Corporation, developing Microsoft Word and Microsoft Flight Simulator. After leaving Microsoft to start my consulting groups, Business Learning Incorporated (businesslearninginc.com) and Digital Healthcare I/O (digitalhealthcare.io), I’ve spent much of my career working across a broad range of technology domains including Government (the FAA and various DoD agencies), aerospace, satellite engineering, and of course, healthcare.

I also serve as a community volunteer on the Board of Trustees as Chair, and am a Past Chair of the Foundation Board for Northwest Kidney Centers (NKC), the world’s first dialysis provider and the third largest non-profit kidney care organization in the US. In the chronic kidney disease (CKD) domain, I’m an active community speaker and advocate. In 2019, I was honored to deliver the keynote address at the Patient Engagement at UW Medicine Workshop presented by the Department of Medicine at the University of Washington.

I currently chair the Linux Foundation’s Hyperledger Healthcare Special Interest Group (HC-SIG), an international membership of over 1,000 healthcare professionals interested in identifying and using blockchain technology frameworks and tools to develop real-world, enterprise-grade solutions across the healthcare technologies domain.

What is one issue or problem blockchain can solve in the healthcare industry today? 

It’s important to remember that blockchain technologies–which is a suite of complementary technologies including digital ledger technologies (DLT), self sovereign identity management (SSI), and cryptocurrencies/tokens–is less a stand-alone solution as it a set of unique technologies and protocols. So, to me, the real strength of blockchain technologies are in their universality of applicability. In an article that recently I co-authored, I liken our current understanding of blockchain technologies to the introduction of the Internet back in the early 1990s. Back then, no one really understood what the scope and capabilities were of these new and complex protocols, but we learned and grew to develop successful solutions that ran across the Internet that–today–seem commonplace and natural.

So, to answer the question of what one issue or problem that blockchain technologies might solve in healthcare today, I really can’t say. We’re right now solving many problems in the healthcare domain using all aspects of blockchain technologies–as we understand them today–and I fully expect to develop increasingly more complex solutions as we mature our understanding and use of these blockchain technologies. Some really great enterprise-grade solutions that exist in healthcare today that couldn’t otherwise exist without utilizing aspects of blockchain technologies include the Synaptic Health Alliance , which seeks to identify efficiencies in sharing provider credentialing across payer groups, and the recent collaboration between Boehringer Ingelheim and IBM to develop a more effective, higher quality, and safer clinical trials workflow in Canada.

Where do you hope to see Hyperledger and/or blockchain in five years? 

I very much believe that our understanding of blockchain technologies, and even the technologies themselves, are extremely immature. Consider us at a version 1.0 in the industry. There’s tremendous room to grow here. So, even over this next year, and further into the future, my expectation is that we’ll be developing and implementing blockchain technologies that–while fundamentally recognizable as what we know today–will be significantly improved across many domains including: 

Governance: From nothing today to something tangible and operationally effective, opening up blockchain technologies to a much broader spectrum of customers and industries that simply cannot operate without established governance strategies in place

Understanding: We, as implementers, will have gained experience, and from that experience, wisdom, in how best to make use of these unique technologies

Systems: Better, faster, safer systems are on the horizon thanks to much easier systems-level integration and interoperability. Operationally, performance and scalability will be at parity to more contemporary solutions. And underlying encryption and credentialing technologies will continue to improve, making for an increasingly frictionless implementation experience.

What is the HC-SIG working on currently? Any new developments to share? 

The Hyperledger Healthcare Special Interest Group (HC-SIG) is designed around the personal and professional interests of our international membership. We maintain two fundamental tiers of engagement to keep members informed of activities within and across the SIG:

  • HC-SIG General: Our “front door” to newer members joining the SIG, as well as a more cross-cutting view of the work that we do in our subgroups and ad hoc teams
  • Subgroups and Teams: Key to developing actionable solutions within this SIG,  each subgroup and team focuses on a special area of interest driven by their respective charter/mission statement

With that said, here’s a quick summary of the work being done across our HC-SIG subgroups and teams:

  • Patient/Member Subgroup: Developing patient-centric blockchain technologies solutions. A past solution focused around the implementation of a supply-chain solution developed around the safe distribution of donor milk across healthcare stakeholders. More recently, the subgroup is investigating patient-based access to longitudinal healthcare data.
  • Payer Subgroup: Focused around the payer component of the patient-payer-provider triad in healthcare. The subgroup is developing a white paper that defines a decision support workflow for the successful implementation of blockchain solutions.
  • Healthcare Interoperability Subgroup: Our newest subgroup, with plans to develop a proof-of-concept (POC) that takes a clinical use-case and integrates the policies, transactions and interoperable, clinical knowledge artifacts (assets) into a distributed solution.
  • Academic Research Team: Developing approaches to better present blockchain technologies to academic institutions such that healthcare stakeholders that rely upon and value independent, peer reviewed journals might gain a more objective and trusting understanding of these technologies
  • Use Case Development Team: Developing use cases within the context of the healthcare industry to model blockchain technologies implementation best practices

What’s the most important milestone for the Hyperledger HC-SIG to reach by the end of 2019? 

The HC-SIG exists to engage, educate, and interoperate with our membership. While the charters/mission statements of each of our HC-SIG subgroups and teams differ accordingly, growing and maturing our understanding of membership needs, and how best we might serve them, is fundamental and primary to our ongoing success as a worldwide community of healthcare professionals.

Why should someone participate in the group? Why is it important for Hyperledger to encourage collaboration around adopting blockchain technologies in this industry?

I’m often asked this question of “why should I participate?” and my answer is always this: active membership in the HC-SIG puts you in touch with the unprecedented resource of over 1,000 people around the world who are pre-filtered to have an active interest in healthcare technologies/IT, and then filtered again by their interests/knowledge in applying blockchain technologies to this industry. It’s really a pretty amazing group of professionals who come together every couple of weeks to help one another discuss and solve difficult problems in their respective healthcare communities.

What are a few ways people can participate in and contribute to the HC-SIG? 

As mentioned before, the HC-SIG is designed around the personal and professional interests of our membership. We provide many opportunities for focusing specific interests on blockchain technologies solutions in healthcare either through our HC-SIG subgroups or our ad hoc teams. And, in the spirit of a true open access, open source community, if members don’t see something that interests them, they have full authority and leadership support to develop a new subgroup or team that appeals to them. It’s almost a certainty that there will be others with similar interests who would love to participate in that new idea, whatever it may be.

How can people get involved in the HCSIG? 

This group is run as an open community effort and everyone is welcome to get involved.  The group has regular meetings, a mailing list and a chat channel. For each of these you are welcome to join, introduce yourself, ask questions and take part in the discussion.  There is no invitation necessary and you can simply follow the information on the group wiki to learn how to get involved in the calls, the list and the chat.

Photo credit: CB Bell Media

Change Healthcare: 50 million transactions a day using Hyperledger Fabric

By 网志, Healthcare, Hyperledger Fabric

Change Healthcare is on a mission to modernize the American healthcare system. A central part of that plan is extending its Intelligent Healthcare Network with blockchain technology to provide a faster, better experience for all.  

Change Healthcare operates the largest healthcare network in the country. Formed through years of mergers and acquisition, the healthcare infrastructure company links 900,000 healthcare providers and 5,500 hospitals with 2,200 government and commercial payers.

A network of this scale, built from a mix of companies, means a very complex back end with lots of systems that are working independently. To unite information and give customers faster, better access to data, Change Healthcare turned to Hyperledger Fabric to begin blockchain-enabling its Intelligent Healthcare Network.

The starting point was modeling an existing network linking providers to payers with a blockchain and then seeing if it could stand up to real-world traffic. After testing and assessing options, Change Healthcare’s launched this initial Hyperledger Fabric-powered network in January 2018. It’s been running as a parallel network since, processing as many as 50 million transactions a day—with throughput up to 550 transactions a second. That’s enough to handle all the healthcare claims activity that Change Healthcare handles across its full network.

The Hyperledger team has worked closely with Change Healthcare to document this large-scale network deployment and its performance in a detailed case study. Highlights include system criteria and planning, details on the supported workflow and transactions and future directions, including plans for ensuring interoperability, boosting throughput even further and migrating more business partners to the network.


CLICK HERE TO READ THE CASE STUDY

[VIDEO] Hyperledger Interviews Aaron Symanski, Change Healthcare

By 网志, Hyperledger Fabric

Blockchain technologies hold the promise to unite the disparate processes in healthcare and ultimately improve patient experiences and outcomes. Key healthcare challenges around longitudinal records, identity management and access across multiple solutions all have the ability to be developed on top of blockchain technologies. By developing a shared platform that decentralizes health data without compromising the security of sensitive information, blockchain technologies could lift the costly burden of maintaining patient’s medical histories away from the hospitals, ultimately delivering cost savings back to the patient receiving care.

We spoke with Aaron Symanski, CTO of Change Healthcare about why they decided to join Hyperledger as a Premier member. According to Aaron, it was important for Change Healthcare to get involved with Hyperledger, as they are a leader in blockchain innovation in the healthcare space. Aaron believes blockchain can create a new paradigm for healthcare in data sharing and Change Healthcare is excited to be a part of it.

Change Healthcare will be at HIMSS this year along with Hyperledger. Drop by the Hyperledger booth at 9900-C in the Innovation Zone to learn about blockchain for healthcare and collect your Hyperledger swag! Representatives from Change Healthcare will be in the Hyperledger booth discussing insurance/clinical claims management as a blockchain for healthcare use case.

Emily Vaughn, Product Development Director at Change Healthcare, will speak on behalf of Hyperledger at HIMSS in the Innovation Live Theater on Thursday, March 8 at 3:00. Emily will present Change Healthcare’s Intelligent Healthcare Network, which deploys enterprise-scale, production-ready blockchain powered by Hyperledger Fabric 1.0. In this session, attendees will learn how business blockchain technologies can be used to process clinical, administrative and financial transactions covering $2 trillion in claims each year and ultimately improve the patient experience across the entire healthcare experience.

Emily will also participate in a panel with other Hyperledger members from Intel and Hashed Health on Tuesday, March 6, 9:30-10:30 a.m. “Blockchain Reset – Seeing Through the Hype and Starting Down the Path” will help attendees understand practical strategies for identifying blockchain use cases for your organization.

Learn more about Hyperledger’s onsite activities at HIMSS.

Hyperledger is committed to helping the healthcare industry realize the full potential of blockchain technologies. To this end, Hyperledger formed the Healthcare Working Group. Change Healthcare and other healthcare organizations have come together through this open forum with a mission to further education about appropriate applications for blockchain technologies in the healthcare industry. Through positive collaboration, the group fosters technical and business-level conversations about fundamental distributed ledger applications and how platforms associated with any healthcare solution utilizing a blockchain back-end could be impacted. For more resources, to track and participate in defining healthcare use cases or to join the working group mailing list, visit https://www.hyperledger.org/industries/healthcare.

Please enjoy and share Aaron’s full interview below!