Emerging Technology Group updates will be produced every 2 months, as members of the group take it in turns to update the wider NHS library community on key topics. This time, we will be discussing blockchain and its implications for health libraries.
Blockchain: what is it?
Bitcoin and other cryptocurrencies such as Ethereum have been prominently featured in the media over the past 6 months or so. They are all based on the same technology: blockchain. Simply, blockchain is a secure digital record keeping system that is spread out across a large network. Information is stored in encrypted blocks which are then chained together. Information cannot be changed once it has been added to the chain, and because the chain is distributed across the whole network, it is very secure. There are more detailed explanations available on Wikipedia or from the LSE Business Review blog.
Implications for healthcare
There are a number of different ways in which blockchain could be applied in healthcare. One option which has seen significant interest is using blockchain to manage the storage and sharing of medical records, as is being explored at MIT. Till et al (2017) have also argued that blockchain could potentially be used to finance universal health coverage. Other potential applications of blockchain in healthcare could be in securely storing and tracking research metadata, global health patterns, or administrative and financial information (Gordon et al, 2017). This is an area that is seeing a lot of research and there are numerous startups exploring the opportunities available.
What about libraries?
Hoy (2017) argues that the blockchain could be used as a digital rights management (DRM) tool to aid in copyright protection. Blockchain could even potentially be used as a library management system to keep track of circulation in a decentralised way (Cabello et al, 2017). Another potential could be in the creation and maintenance of authority records for cataloguing and metadata. The project Blockchains for the Information Profession by San Jose State University is a good source of information and probably the best way to stay up-to-date in this field.
There’s always a but…
The long term viability of blockchain remains to be seen. One of the concerns that has been raised relates to the wider environmental impact of these distributed networks, which is already consuming more energy than the whole of the Republic of Ireland, although this estimate is also up for debate. In addition to this, there remain numerous barriers to the more widespread adoption of blockchain in healthcare or in libraries, not least technical issues relating to the interoperability of metadata, as well as a current lack of clarity around governance, regulation, and wider economic impact (Deshpande et al, 2017).
What can we do?
Keeping abreast of developments in this field so that we can have informed discussions with others within and outside our organisations would be a good place to start. I would argue that the proliferation of private companies leading the way in implementing blockchain in healthcare is an issue of concern. For any solutions to be sustainable in the long term, we need to be playing an active role in conversations around emerging technologies such as this.
- Cabello, J., Janßen, G., & Mühle, A. (2017). Libchain: Distributed library management system based on the blockchain technology. Available at: https://www.atositchallenge.net/wp-content/uploads/2016/11/LibChain-Atos-IT-Challenge-2017.pdf. Accessed 23/02/2018
- Deshpande, A., Stewart, K., Lepetit, L., and Gunashekar, S. (2017) Distributed ledger technologies/blockchain: challenges, opportunities and the prospects for standards. British Standards Institution. Available at https://www.bsigroup.com/LocalFiles/zh-tw/InfoSec-newsletter/No201706/download/BSI_Blockchain_DLT_Web.pdf. Accessed 23/02/2018
- Gordon, W., Wright, A., and Landman, A. (2017) Blockchain in health care: decoding the hype. Available at: https://catalyst.nejm.org/decoding-blockchain-technology-health/. Accessed 23/03/2018
- Hoy, M. B. (2017). An introduction to the Blockchain and its implications for libraries and medicine. Medical reference services quarterly, 36(3), 273-279. https://doi.org/10.1080/02763869.2017.1332261
- San Jose State University (2017). Blockchains for the information profession. Available at: https://ischoolblogs.sjsu.edu/blockchains/. Accessed 23/03/2018
- Till, B. M., Peters, A. W., Afshar, S., & Meara, J. G. (2017). From blockchain technology to global health equity: can cryptocurrencies finance universal health coverage? BMJ global health, 2(4), e000570. http://gh.bmj.com/content/2/4/e000570
Knowledge Resources Manager
Royal Marsden NHS Foundation Trust.