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The CDC Looks to Distributed Ledger Technology to Improve Disease Surveillance

On September 1, 2017, the San Diego County public health office issued a local public health emergency due to an outbreak of hepatitis A in the U.S.

Hepatitis A is a dangerous disease that attacks the liver, traveling from person-to-person through contact with fecally-contaminated environments. The disease is often contracted via a virus from contaminated food or water.

The report states, “approximately 65 percent of the cases have been among people who are homeless, use illicit drugs or a combination of those two factors.” Efforts to address the hepatitis A outbreak involve three primary areas of focus: vaccination, sanitation and education.

Though no new deaths have been reported since October 31, 2017, San Diego County officials have chosen to continue the local health emergency status amid outbreaks in several other states including Michigan, Kentucky, Utah and Colorado.

Data Sharing 

The federal Center for Disease Control (CDC), state and local health departments are charged with disseminating public health data so that efforts can be made to control the spread of a range of infectious diseases such as hepatitis A. Given the prevailing information systems in place within these institutions, this task has proved to be a massively complex undertaking.

According to Jim Nasr, chief software architect at the CDC’s Center for Surveillance, Epidemiology and Laboratory Services, a solution to this issue could be found in the utility of a blockchain. For a number of months, Nasr and his team have been pursuing several blockchain proof-of-concepts (POCs) with the aim to build real applications in 2018. Most POCs will focus on the delivery of better public health surveillance. This means an improved approach to the continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation and evaluation of public health practice. As a result, blockchain technology could be used to more efficiently manage data during a public health crisis or related incident.

Nasr believes that public health is a good fit for utilizing the blockchain. The success of U.S. public health involves the ability of peer organizations — the CDC, state and local health agencies, hospitals and clinics — to collaborate effectively and efficiently. In terms of a blockchain, the token or “currency” for this method of collaboration is data.

“Moving data from one peer to another in a secure, compliant and transparent manner — as quickly as possible — is the key part of the business model,” said Nasr in an October 2, 2017, article published in the MIT Technology Review.  

New Insights

As a highly regarded healthcare innovation firm leading the design, development and pragmatic use of distributed ledger technology, Hashed Health is playing an active role in addressing health delivery challenge tied to public health and disease.

Disease surveillance covers a broad swath of activities involving the sharing of local health and disease data both nationally and internationally. Now, with the advancements in blockchain technology, there is growing interest in identifying surveillance solutions that offer greater utility and efficiency.

It’s here where Hashed Health is advancing a blockchain model that will serve as the platform for reportable disease surveillance. This blockchain system can serve three essential functions.

Auditing Solutions

The blockchain has shown promise as a real-time audit log for the transfer of biosurveillance data from reporting locations to centralized data repositories. This form of permission led blockchain system could enable these transfer logs for all relevant and authorized entities. Transactions recorded include the initial triggering of lab results; the capture of broader contextual clinical data from electronic health records; and the fostering of downstream analyses to identify specific disease strains and genomic sequences. The blockchain can also record relevant inputs to assess the efficacy of any medical countermeasures including patient-reported outcomes.

Registry Curation

With the transfer of transactional data to a distributed ledger from various data sources, the blockchain essentially becomes a registry gathering portal. In this way, it can gather and connect critical data. Infection and disease distribution can be tracked through key criteria such as patient name, geographic area, strain/type, health facility and medical countermeasures.

Countermeasure Supply Chain

In addition to the tracking of data on disease prevalence and outbreak, a blockchain-supported biosurveillance platform can assist in the management and tracking of inventory and location of vital medical countermeasures such as vaccines or other pharmaceuticals. The distributed ledger shows promise in delivering effective, timely and coordinated disease surveillance and response.

From this perspective, the blockchain represents an exciting new development in a world where a public health issue in one geographic location could threaten another locally, nationally or even worldwide. Leaders at Hashed Health are excited to take a lead role in this space by encouraging experts, companies and public health entities to collaborate on this pressing, public issue.

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