It’s no secret that many regard blockchain technology as a disruptive force in finance due to its ability to provide a secure, transparent and auditable record of financial transactions without the need for a central authority, such as a bank or credit organization.
But what’s less known is that these same qualities could make the technology the perfect solution to challenges related to personal privacy, data security and integrity in health care, according to Yan Zhuang, an assistant professor of health informatics at the Indiana University Luddy School of Informatics, Computing and Engineering in Indianapolis. Zhuang is studying non-financial applications of blockchain technology, including the management of personal health data and clinical trials recruitment and management.
“My research leverages informatics approaches to tackle persistent challenges in data management and sharing, enabling real-world health care applications to enhance data security and accessibility,” said Zhuang, who joined IU in 2023 from Peking University in China. “The ultimate goal is advancing patient outcomes and improving health care efficiencies. Blockchain is a key focus because its unique capabilities directly address these needs.”
Blockchain offers several features ideal for health care data management, he added.
The first feature is privacy: Users can carry their data on a personal device, offering “self-identity sovereignty” without the need for a central authority or data broker. Other key features include immutability and auditability. Because every user on a blockchain carries random pieces of the blockchain record, the data cannot be falsified. Any changes on one device would not match the same data elsewhere on other devices.
Additionally, all transactions can be deemed legitimate and meeting regulatory compliance before being permanently recorded through a process in blockchain referred to as “consensus.”
“If we bring these features into health care — whether for managing health data or clinical trial process — it becomes incredibly useful,” Zhuang said. “Everyone on the blockchain doesn’t need to know a patient’s identity or see their data; they only need to be assured that the data has been authorized by its owner and that it flows from the original source, such as a hospital, without tampering, with that authorization permanently recorded on the blockchain for audit.”
This creates a transparent, decentralized network that empowers patients to carry, share and use their data as they wish, Zhuang said.
In the area of clinical trials, which are required to ensure that new drugs or medical devices are safe and effective, Zhuang said that blockchain can revolutionize clinical trial recruitment. It can provide a decentralized, transparent system that empowers patients to engage with trials using their authorized data — enhancing screening processes and enabling a more efficient, patient-centric recruitment model. Better practices are needed in the field since many patients remain unaware of these trials or how to participate, he said.
Blockchain’s transparency can also help reduce fraud by offering a cost-effective alternative to expensive on-site data verification while streamlining recruitment through verified, untampered data flow from original sources, he added.
In the U.S., Zhuang said, blockchain technology aligns well with the Trusted Exchange Framework and Common Agreement for nationwide interoperable health information exchanges later released by the U.S. Department of Health and Human Services, as well as decentralized clinical trial guidance published by the Food and Drug Administration.
Additionally, during Zhuang’s time in China, a national initiative was launched to promote blockchain applications in health care. Several Chinese hospitals are piloting blockchain-based medical billing platforms, and a study recently reported in Nature Scientific Reports describes the use of blockchain to securely and privately manage health care data on patients with sexually transmitted diseases in that country, for example.
Zhuang’s lab includes a Ph.D. student, Zhen Hou, as well as four master’s degree students and an undergraduate. The group is focused on leveraging decentralized approaches, such as blockchain and decentralized AI, to all levels of the clinical trial process, such as recruitment and electronic data capture processes, as well as technical solutions to personal data management related to security, scalability, interoperability and efficiency. He is also identifying groups in Indiana to pilot the technology and seeking collaborators to advance this initiative.
“We’re focusing on developing informatics solutions,” he said. “The technology is mature enough to move forward, but it’s still a journey. For hospitals and patients to benefit, we’ve got to make our solutions that are accessible, intuitive and ready to use.”
