Since Satoshi Nakamoto (pseudonym) first published a paper titled “Bitcoin: A Peer-to-Peer Electronic Cash System” in 2008, the blockchain technology behind his concept has continued to gain reputation and acceptance. Bitcoin is the first and most controversial application of blockchain which has generated multibillion-dollar worth of anonymous transactions. Blockchain has been termed as “new internet” by many people and has, no doubt, been a tech buzz word for the past few years. Transparency and trust aptly describe the technology underlying the fabric of bitcoin. Blockchain technology is a consensus distributed ledger for digital transactions. In lay man’s terms, think of blockchain as a database that is shared and saved on several computers in which any addition or changes in the content of the stored information will require the verification and approval of everyone involved in the changes. This is explained by bitcoin’s three main design components which are: distributed network, shared ledger and digital transactions.
Beyond financial transaction application of blockchain in bitcoin, the technology has some unique features and strengths that give credence to its application in diverse sectors such as agriculture, governance, legal system, voting system, land use/real estate, smart contracts, database and record management, and value chain.
Notable among these features are the fact that the technology is immutable, reliable, secured and transparent. Prior to the invention of blockchain, third parties, such as banks, were saddled with the responsibility of managing risks associated with financial transactions but through blockchain, these risks can be eliminated without a third party.
However, while the elimination third party is a unique selling point for blockchain, it is also the main source of controversy and resistance to adoption by government, policy makers and regulatory agencies.
Relevance to healthcare
The healthcare systems of developing countries have lots of gaps that translate to poor health indices and outcomes. The implication of these deficiencies on labour force and economy is huge and calls for pragmatic interventions.
Inefficiency and corruption in the sector can be better managed if a tested and proven technology, such as blockchain, can be applied to solve the healthcare-related challenges. For instance, blockchain technology is being currently deployed to solve Electronic Medical Records (EMR) challenges. At the moment, many health institutions do not have updated digital health records of their patients and where the records exist, they do in isolation. This implies that the medical records of a patient in University College Hospital in Ibadan, for instance, is not accessible, real time, to the patient or healthcare providers in Ahmadu Bello University Teaching Hospital in Zaria, should the patient travel there and require healthcare services.
Having EMR on a blockchain backend can ensure data integrity and security. Since the information is not stored ne a single computer in a single location, it is practically not feasible to alter records or lose records due to deliberate sabotage or disasters such as fire outbreak.
Assurance of quality medical records will, no doubt, reduce preventable deaths in accidents and emergencies, and improve the management of communicable and non-communicable diseases.
Supply chain management of medicines, medical equipment and allied products is another viable application of blockchain technology in healthcare system. The issue of counterfeit and substandard drugs in Nigeria has been a source of concern for health policy actors because of its huge implications on health outcomes. The strengths of blockchain technology in terms of immutability, distributed ledger and reliability are the exact antidotes to the weaknesses of the supply chain of medicines in Nigeria.
At the moment, the country still largely depends on imported medicines, distributed through an unfortunate and chaotic drug distribution system. Counterfeit medicines clandestinely get introduced to the supply chain of medicines and unsuspecting consumers purchase these medicines to their peril. With blockchain technology, pharmaceutical companies can create a niche for their brands by ensuring that their products’ details are logged into blockchain and their progression across the supply chain is made available to consumers in a user-friendly manner. With this, the demand side of counterfeit medicines will be blocked and immutable technology will replace unethical human practices that keep a few criminals wealthy at the expense of innocent citizens.
Applications of blockchain technology are evolving and the use in cases discussed above are at different stages of development, ranging from ideation to piloting to actual scale-up of technology development. There are also some questions about cost of building the technology and how it integrates with other existing infrastructure in country.