This interview is part of our new Blockchain In Healthcare series, where we interview the world's leading thought leaders on the front lines of the intersections between blockchain and healthcare.
In this interview we speak with Ain Aaviksoo, Chief Medical Officer of Guardtime Health, to understand how this company is using blockchain to transform the healthcare business, and what the future of the industry holds.
1. What’s the story behind Guardtime? Why and how did you begin?
AA: Guardtime started in 2007, in the aftermath of nationwide Estonian cyberattacks, with a goal to eliminate the need for trusted authorities within Estonian Government networks while protecting the integrity of the most advanced digital society. Guardtime’s KSI Blockchain went into production with the Estonian government, securing the majority of the countries' public databases, in 2012. In 2016, we went live securing the integrity of health data for their entire population, covering over 1.3m patient records.
If Google organizes the world’s information and makes it universally available, then Guardtime validates that information and makes it universally reliable.
2. Please describe your use case and how Guardtime uses blockchain to transform healthcare:
AA: A trusted data and information ecosystem for patients, providers, payers, regulators and pharma to collaborate, allowing each stakeholder to have or see (subject to consent and regulatory oversight) only the information they need to provide more effective patient care.
Unlike Distributed Ledger Technologies which would typically require all data to be shared across every participant leading to scaling, performance and privacy issues, this is capable of summarizing data (from various stakeholders & sources) and presenting only the necessary or agreed patient information without the need to reveal all underlying data or create large data lakes.
By flexibly combining data liquidity, if needed for two doctors to treat the same case, and data visibility, if the data is consented to be used for aggregated analysis in research or outcome-based contract assessments, the ecosystem provides unparalleled protection for authenticity, integrity and safeguarding patient privacy coupled with cool new partnership opportunities.
This is transformative as it seamlessly provides data liquidity and visibility, integrated directly across traditional workflows and boundaries. It provides a single source of truth, supported by independent verification services which ensure all stakeholders have immutable assurance that every participant in the system is operating based on a single, truthful version of the required health data.
I’m of the belief this enables new business opportunities that so far have only been a dream.
3. Could you share a specific customer/user that benefits from what you offer? What has your service done for them?
AA: The NHS, via MyPCR, in conjunction with Healthcare Gateway enables up to 30m NHS patients to benefit from a smartphone enabled personal care record. The blockchain provides immutable proof of health data provenance and integrity, GDPR patient data rights management and automated verification of medication adherence. Enrolled patients have instant access to their primary care information with National Institute for Health and Care Excellence (NICE) personal care pathways created directly on their smartphones.
Personal Care Pathways enable significant cost efficiencies, ensuring patients are continuously updated on their treatment path, with 360-degree feedback of their progress to their GP. Medication adherence is the best way to ensure positive health outcomes for patients at the earliest opportunity and an essential tool in combating rising medical costs. I can perhaps put this into more concrete terms, improving medical adherence has the potential to save over 800m (GBP) a year in the UK and over 290b (USD) in the USA.
‘Personal Care Pathways' are vital to encouraging self-care and to improving the long-term health of patients. They are a core component in ensuring patients have complete access to personalized self-management of their treatment end to end. I believe Blockchain is a fundamental component to delivering this, providing end to end security of records in transit, guaranteeing immutable integrity for every patient record and ensuring GDPR compliance for patient consent.
4. What other blockchain use cases in healthcare are you excited about?
AA: There are so many exciting use-cases in healthcare it can be a challenge to say which are the most compelling. I truly believe medical data, when processed correctly, can be considered a new form of medicine. Consequently, excitement is building around data access management solutions which unlock medical and genomic data for research purposes, so that people can experience independent assurance about their data being processed according to agreed rules and any potential future misuse risk is avoided, whilst still allowing new treatments to be discovered.
Equally, decentralised data access for ‘Outcomes Based Contracting’ as a way to link all participants in the healthcare ecosystem to a single trusted environment where all independent data assets can be independently verified, directly from their original legacy records and/or claims systems would open up access to expensive treatments based on real world patient outcomes.
Finally, Pharma Supply-Chain Visibility to enable the timely prediction of overviews of finished product (drug product) stock levels and production plans for pharmaceuticals across different supply chain levels (pharma production planning, pre-wholesalers, wholesalers, pharmacies) without revealing an individual companies’ proprietary business information; allowing regulators or other system participants, if agreed by the ecosystem participants, to monitor real-time and historical supplies to plan or execute preventive actions to avoid shortages and or rapid fluctuations of medicines.
5. Where will Guardtime be in 5 years?
AA: That’s a great question. I would like to think that Guardtime will be at the heart of the digital transformation in health and life-sciences; continuing our work with partners and customers to ensure a fully joined up (blockchain backed) eco-system bringing together all stakeholders in the patient care pathway, whether that’s enabling patients to access the latest medication via outcome based pricing or helping biobanks or data custodians open up their data to researchers in a secure and GDPR compliant way to help find new cures and deliver new treatments.