Applying blockchain technology to vital records management brings benefits such as better security, data integrity and transparency to state and local health departments, an expert says.
The distributed ledger technology “is decentralized, immutable and provides secure, transparent and auditable access to data, enabling greater trust in data management,” said William Crawford, a strategic partnership development consultant currently working at Solve.Care, a blockchain health care IT company. He spoke March 9 during a monthly series titled “Web3, Smart Cities and Digital Assets for State and Local Governance” hosted by the Government Blockchain Association. “Trust is the important part here,” he said.
That’s because in health care, vital records, such as birth, death and marriage certificates, are crucial for proving people’s identity. They are also critical in managing the spread of infectious disease. During the pandemic, for instance, health departments used vital records to track cases and deaths and identify patterns in the spread of the virus, Crawford said. Those insights helped dictate response, including resource deployment and public health measures like social distancing.
Blockchain is a decentralized ledger consisting of blocks, each of which contain transactions. Records are stored as encrypted data on the blockchain, and public and private keys control access. “Public keys are used to identify users in the blockchain, while private keys are used to authenticate and authorize transactions and access to records,” Crawford said.
He described how that would look for a health department’s portal for accessing medical records: “When the patient logs into the portal, they use their private key to authenticate their identity and authorize their access to the records, which are then decrypted using their public key. This ensures secure and easy access to medical records while also protecting sensitive medical information.”
Several state and local government agencies are looking into using blockchain for vital records management. For example, as part of its Illinois Blockchain Initiative, which launched in 2016, that state is studying ways to use blockchain for birth and death certificates, aiming to create a secure and tamper-proof platform for storing and sharing vital records. Last year, California Gov. Gavin Newsom approved a bill that allows county records offices to issue birth, death and marriage certificates on a blockchain. And cities nationwide are testing out other uses for blockchain, such as managing maintenance of city vehicles and giving people experiencing homelessness digital identities.
Historically, vital records have been maintained in paper-based systems, putting them at risk of loss and damage. Crawford pointed to the aftermath of Hurricane Katrina in 2005, when affected Louisiana residents struggled to prove their identity, access health care and apply for government assistance after thousands of vital records were lost or destroyed.
Blockchain is more secure and resilient, he said. “Compared to traditional database systems, Blockchain does not rely on central authority or intermediaries to validate transactions or manage data,” Crawford said. Plus, it enables distributed storage of records, which ensures their availability and accessibility; secure data sharing among authorized parties and across disparate systems and organizations; and enhances patient privacy and control over their health information.
The technology has a couple of shortcomings, he added—namely, lack of scalability and a need for standardization and interoperability. To address scalability, some blockchain companies are using sharding, or breaking the network into smaller pieces (shards), and off-chain transactions.
“Sharding breaks down the blockchain into smaller and more manageable parts to handle their subsets of transactions, while off-chain solutions move some of the transactions processing to a secondary layer,” Crawford said.
He cautioned that blockchain is still an emerging technology, but its future is bright—as long as government can help it along.
“Government agencies and health care providers play a crucial role in driving adoption and promoting the use of the technology,” Crawford said. “By working together and fostering collaboration and partnerships, we can unlock new opportunities and drive innovation in records management, making health care more accessible and efficient for everyone.”
Stephanie Kanowitz is a freelance writer based in northern Virginia.
