Blockchain: The Future of Healthcare Data? Dr Robert M. Learney PhD MBBS Centre for Cryptocurrency Research and Engineering Imperial College London

Blockchain: The Future of Healthcare Data? Dr Robert M. Learney PhD MBBS Centre for Cryptocurrency Research and Engineering Imperial College London

Distributed Ledgers: The Future of Healthcare Data? Dr Robert M. Learney PhD MBBS Centre for Cryptocurrency Research and Engineering Imperial College London

Meet the Team Will Knottenbelt Cathy Mulligan Rob Learney Melek Somai Professor of Applied Quant. Analysis Cathy Mulligan Smart Cities Telecoms Government Advisor Rob Learney Bioengineering Future of Medicine Melek Somai Public Health Digital Transformation Iain Stewart Mathematics of Security & Scaling

Triple Aims of Healthcare Experience of Care Population Health Per Capita Costs DM Berwick, 2008. Health Affairs

Core Elements Patient Involvement Local Population Needs Emphasis on Prevention Financial Management Macro-System Integration DM Berwick, 2008. Health Affairs

How to Connect the Dots?

The ‘Integrator’ Patient Involvement Local Population Needs Emphasis on Prevention Financial Management Macro-System Integration

Local Population Needs Emphasis on Prevention Patient Involvement Local Population Needs Emphasis on Prevention Financial Management Macro-System Integration

The ‘Integrator’ Patient Involvement Local Population Needs Emphasis on Prevention Financial Management Macro-System Integration

The ‘Integrator’ Patient Involvement Local Population Needs Emphasis on Prevention Financial Management Macro-System Integration

The Future of Healthcare is Data

All Driven By Data Patient Involvement Local Population Needs Emphasis on Prevention Financial Management Macro-System Integration

Imagine: Healthcare in 2027 Alim 26 Married 1 Young Child Works at a Supermarket

Imagine: Healthcare in 2027 Alim 26 Married 1 Young Child Works at a Supermarket Severe Asthma

Alim’s Healthcare Journey

Alim’s Healthcare Journey

Alim’s Healthcare Journey

Alim’s Healthcare Journey

Alim’s Healthcare Journey

Alim’s Healthcare Journey

Alim’s Healthcare Journey

Alim’s Healthcare Journey $ Sells data back to watch manufacturer Sells data to inhaler manufacturer

Alim’s Healthcare Journey Every healthcare encounter is still an experiment

Millions of Patients Millions of Journeys

NHS Atlas of Variation in Healthcare, Public Health England Sept. 2016

Artificial Intelligences / Expert Systems Healthcare Records Devices & Software Doesn’t have to be sinister Can design systems so it’s not possible to be sinister

Artificial Intelligences / Expert Systems Healthcare Records Devices & Software Doesn’t have to be sinister Can design systems so it’s not possible to be sinister

Roadblocks to Progress Identity Management System Secure Data Storage Secure Backup System Legal Compliance Data Formats Communication Protocols APIs Repetition & Reinvention Opaque/Absent Standards It’s like going back to scratch each time you want to create a new healthcare app, service or product

Roadblocks to Progress Identity Management System Secure Data Storage Secure Backup System Legal Compliance Data Formats Communication Protocols APIs Repetition & Reinvention Opaque/Absent Standards It’s like going back to scratch each time you want to create a new healthcare app, service or product

N-Squared Problem of APIs C D E F G H I Image of table

Monopoly Pressures

Permissionless Innovation Healthcare Service Established Companies Patients Companies New New entrants, established companies, patients and the NHS all able to take part and benefit from the healthcare economy

What is Distributed Ledger Technology?

Key Features of DLT: High availability Synchronised records Secure against intrusion Cryptographic keys Impossible to alter history

Cryptographic Signatures Core Components DLT P2P Message Passing Cryptographic Signatures Distributed Copies Consensus Mechanism

DLT vs. Blockchain

DLT Permissions Closed Group Traditional Systems PAXOS PBFT New Systems Hyperledger Open Group Blockchains Bitcoin Ethereum Tangles IOTA Permissions

One Possible System

A Patient Chain

A Patient Chain Healthcare Events Root Identity

Time Place Patient Provider

Antibiotic Prescription

Asthma Management App

Asthma Management AI

Re-Imagining Radiology

Process Request X-Ray

Government Financial Control AI Bid Offer Marketplace Government Financial Control AI

Data Location

Request Logged +

Request Logged + Proxy Re-Encryption

Remaining Issues Who should be allowed to read/write? Who should process and store (act as nodes)? What automatic permissions built in? Digital identities for healthcare practitioners? Transitioning legacy systems? Novel architecture

In Conclusion

DLT in Healthcare Always available, distributed records Access controlled by cryptographic keys Standardised message passing Audit trail embedded into system Unable to hide illegal views or sharing Permissionless innovation

Asthma Management AI Traffic Monitoring AI Air Pollution AI

Request Logged