The US Centers for Disease Control and Prevention (CDC) has begun a collaboration with Venice, CA-based blockchain firm Gem, among others, to develop proofs of concept that eventually aim to deliver a decentralized health data reporting service. Such a tool could prove invaluable to the CDC during times of crisis and in efforts to address ongoing public health issues, helping all parties involved to understand the facts on the ground and respond quickly and effectively.
Of the challenges currently facing the CDC, Gem CEO Micah Winkelspecht told ETHNews that “data comes from many different sources … [and] many different governments are intermediaries in that process … There’s a lack of trust in terms of the data integrity as it moves from hand to hand across an entire supply chain of people passing this data around.” The agency wants a system that “allows this data to be reported in the field, validated very quickly with a total audit trail all along the way so that you can sort of eliminate those trust barriers across organizations and essentially get that data to become actionable very quickly, by the CDC and other organizations.” A blockchain solution to these challenges would make the CDC just another node in this network of public health organizations, one which could send messages to other nodes through some combination of executable distributed code contracts.
In an interview with ETHNews, Jim Nasr, the chief software architect at the CDC’s Center for Surveillance, Epidemiology, and Laboratory Services, identified the opioid “pandemic” as one area in which “there is a tremendous amount of interest in being able to track, particularly in real time or close to real time … what is really happening.” One way of addressing the crisis would be to “make an inventory of the different data sources we have access to … and create kind of a hash reference to those on a blockchain … to basically exchange information around this.”
Another potential approach the agency is considering: “extracting from death certificates the cause of death and … doing natural language processing on those death certificates to identify the drugs that were in the body” of the decedent. Finally, he noted the CDC’s desire to build “some kind of a dashboard or geo-based heat map that shows the movement” in as close to real time as possible, “so maybe the state department could use it [as a guide when developing] policy.”
Speaking of the CDC’s ability to respond to more immediate crises, Nasr related that a mobile app that can tell disaster victims what kind of drugs they need based on their individual profiles as well as the “characteristics of the situation” already exists. In order to build on that service, the organization wants to “put it securely and transparently on the blockchain to be available for all interested and relevant parties to be able to see it in … close to real time.” That way, “when we dispense medicine, [we can] generate QR codes that [patients] could take to a pharmacy and then only the right amount of the right medicine is dispensed, and that information is recorded … on the blockchain” so that the CDC can verify which patients received what medications.
Addressing the question of what would be uploaded to a CDC/ public health blockchain, he said that while some information would live there, other data would be warehoused in “distributed encrypted storage” and referenced on the blockchain via hash references because the total volume of data would be too great to store on a single ledger. Additionally, the CDC would have to comply with the Health Insurance Portability and Accountability Act, as well as other pertinent rules and regulations, by keeping “personally identifiable information” private and therefore off the blockchain. He speculated that the agency might use cryptographic signatures to simultaneously protect patients’ privacy and identify them on the ledger, but admitted that the CDC has yet to arrive at a “scalable identity management solution.”
Alluding to more distant goals, he said that public health is global by definition, but the CDC expects to launch its blockchain-integrated service domestically before taking it abroad. Eventually, he envisions patients interacting with the blockchain, if not as a full node then in some sort of read mode.
According to Nasr, all blockchain-related activities at the CDC are led by a team of 27 “active proof of concept members” and other less-active contributors, all scattered across various departments within the organization. He added that the size of the dispersed team is evidence of the CDC’s ardent belief in blockchain technology’s potential to transform the field of public health.
The CDC has yet to settle on a particular vendor with whom to partner and continues to experiment with “multiple blockchain networks and frameworks,” including Ethereum. Nasr explained that “our approach, in terms of technology, is to not be coupled and not be limited by any one particular selection that closes the door for us a year or two down the line.”
Winkelspecht described his firm’s role in the collaboration thusly: “the nature of the relationship is that the CDC’s engineers will be using our application development platform to build out their proofs of concept and solutions.”