Assessing the feasibility of tokenisation in healthcare

Abstract

External organisations, hospitals, public health authorities, general practitioners, and insurance companies often want to access patients’ health data for research purposes, treatments, service improvement. Also, because the patient went to this new hospital and this new hospital needs to access their data currently, in order for the new doctor to access your data from another hospital, a consent form must be signed by the patient, indicating what data will be shared, with whom, and for how long. This dissertation proposes a framework to tokenise patients’ health data. It will facilitate external organisations to access patients’ health data on a decentralised database only after authorisation. Therefore, the patient can share their data with the external organisation after receiving tokens. Patients may use tokens to pay for the hospital’s service. The patient could either buy tokens, they could have tokens from a previous visit, or they may have received tokens for sharing their data with external organisations and will pay the hospital with those tokens. Besides tokenising patients’ health data and giving them an incentive to share their data, they also gain complete control over it. With the use of smart contracts, the patient will be able to decide with whom their data will be shared and will also be able to specify which health data the external entity may gain access to. This will allow patients to monitor who is accessing their data. This dissertation developed a custom smart contract for healthcare professionals to enter the patient's data. The smart contract is set up so that their data has changed every time the patients go to the hospital. A new asset will be created to separate the different visits and allow patients to view their data more clearly. A survey was carried out to find out the general public’s opinion on healthcare data and the different uptakes of tokens this survey collected and analysed 151 responses. A related survey was collected and analysed 46 healthcare professionals’ responses to determine what they would do if the health data were tokenised and how they need health data to work. The data stored on the blockchain will be more secure, and smart contracts will facilitate efficient data sharing. Smart contracts will also allow the patient to specify what data may be shared and have a list of all the external organisations with which their data was shared. The smart contracts were implemented in this dissertation using the Hyperledger Fabric blockchain and have a couple of functions that may be used to create, update and delete assets and view these assets. These functions were tested to show the different types of errors that could be displayed and to show what can and cannot be entered when using the functions. Then an analysis of the survey questions was done, explaining what some of the charts meant to this dissertation and also showing how useful this dissertation could be in the real world. One of the charts from the general public survey shows that in fact, a quarter of the people answering the survey did not even want to share their data with anyone. Another chart showed that 73.7% would like to know who is accessing their data, and because of this result detail in the smart contract makes a list of all the external organisations accessing their data. This dissertation tried to develop a framework to tokenise patients’ health data so that patients’ will gain full control of their health data and get an incentive for sharing their data. This was done with smart contracts, Hyperledger Fabric, to be able to put patients’ data on a decentralised database so that their data is more secure, their data will be interchangeable, will have more integrity and interoperability and will have real-time updating and accessing. A BPMN diagram was created to help the reader understand all the scenarios in which tokenisation may be used and help improve healthcare. Primary research was gathered and analysed, in order to see the different ideas of healthcare professionals on the uptake of tokens and to better understand what the general public would want to do with their data. A smart contract was implemented and tested and has different functions that can be used to control the data going in and out of the system.