Distributed Medical Health Ledger

Medical records are housed centrally at health centers in Africa and other parts of the world. In the event of a disaster, such as the recent tornado in Malawi, records are lost making it difficult to get medical histories such as blood type and allergies to medicine. This often lead to life threatening reactions to patients and even death.

Global epidemics such as the Corona Virus of 2019 was extremely challenging to health practitioners as they had little medical histories of their patients, making interventions without prior histories. This makes targeted interventions difficult and sometimes impossible leading to patient deterioration.

Moving from one health center to another means patients start new medical records at that medical facility, loosing critical health histories vital to their treatment. Histories such as Vaccinations, prescriptions of medication, injuries, implants, and related interventions are vital during healthcare as they may determine the course of medical intervention a health care giver takes.

Our solution is having a ubiquitous distributed medical health ledger that contains medical histories and is hosted on numerous servers for redundancy. It is a blockchain system that maintains medical records.

The ledger will have several modes to interact with it, including short message service, and web interface. A health practitioner will be able to query and amend records on the system having logged in using their credentials. These changes will be cascaded throughout the blockchain ledger using a smart contract (called chain code) on all distributed nodes/computers of the system ensuring that records are not changed erroneously or destroyed in the event of loss of one node.

This will make it possible for targeted interventions for health care providers, and to other stakeholders in the health sector. For instance, development partners wishing to provide medical funding for a specific health issue can interrogate the ledger to find out how their intervention will be handled (such as how many people will they reach, who they are, whether they are taking their medication regularly, whether there are other conditions they are facing as a result of the intervention and many more metrics).

Most (%) of medical health centers especially in developing countries do not have access to the internet. Our solution's ability to be used using short message service makes it easily accessible anywhere using minimal infrastructure to the health center thereby making it accessible.

Security of the information will be guaranteed as only licensed medical practitioners will be able to amend or add records to the blockchain. This will be made possible at point of registration of the service for them to use it by entering their license number which can be easily verified from National regulators of the health sector in a given country.

Our solution targets all citizens of a given nation, but the citizens using public health infrastructure are going to benefit the most. In Kenya, most health centers do not have a medical health record for patients. Patients buy booklets that they come with per clinic visit, and the health professional enters health histories therein. Often this is then lost as patients go home with the booklets, leading to loss of vital information pertinent to the patient.

Majority of these patients have low earning potential, and are unable to get proper medical care owing to lack of infrastructure and properly maintained records. 

Our ledger will help health professionals to know if interventions they are making are helping. For instance, in hypertension care, it is important to maintain a history of blood pressure over time to understand when to modify a prescription and/or diet. But there are simply no records showing proper histories.

Accident and emergency services will be greatly improved through provision of the health ledger.

Our team comprises members of technology and the medical field. We have access to medical health centers which has given us the ability to understand the problem better. Our office is 2 minutes away from a health center, and has a medical doctor on the team to guide us on what sort of data to capture, how the interface should be best made to deliver useful information first and fast, and similar criteria.

This team member has been the point of contact with healthcare professionals.

We have created a working prototype using Hyperledger Fabric and installed it on a local network for purposes of testing. This prototype is currently using short message service from our mobile phones and a modem to receive  requests.

We got data from a local healthcare center with their consent to be able to test.

Our prototype is not serving any patients currently, as it is under development. It does have real world data from a nearby health center.

We are looking to have our solution become a universal health record especially during extraordinary times such as during a pandemic, or natural disasters like the recent tropical cyclone that hit Malawi and related countries. We are hoping to create publicity for the adoption of the ledger and be able to build it to the scale where it can serve millions of people. 

Being selected as a Solver team would ensure we access resources including mentorship, conferences, and gaining inspiration to be able to implement the project.

At present majority of the medical health records are database-based systems that are installed on the hospital's machines or server. Our proposition is using blockchain ledger and smart contracts to interact with the data, ensuring its safety and accessibility anywhere.

Another innovative point is use of short message to be able to query. Most health centers do not have access to computers and even electricity. We wanted the solution to be able to run from even the most basic of mobile phones.

We created some milestones to lead us to versions of software that result to the distributed medical health record, and we are tergeting to get to a minimum viable product by achieving the first version. We check with healthcare professionals on minimum data they need in hand from a medical health history standpoint and increment our development to the next goal. Here are some indicators specific to this undertaking:

1. Access basic information, blood type, age, weight, and other metrics related to the physical nature of the patient.

2. Access to at least 5 latest medical complaints made by the patient, interventions made on them, medications prescribed, by home, and any follow-up information available.

3. Ability to create new records in the event no record exists. 

4. Ability to amend medical records based on existing health records at a health center.

The 1st impact we expect is improved patient care from having history of medical care for patients.

We expect patients in the event of emergencies to be treated easily from their previously known conditions being maintained and retrieved from the blockchain distributed medical health ledger.

The core technology powering our solution is Hyperledger Fabric. We us it to create a blockchain ledger and chaincode/ smart contract.

We also use an SMS gateway. We use the opensource gateway Kannel.

We use Postgres Database, an open source database, to cache SMS incoming to the solution prior to the data being processed by smart contracts/chaincode.

Our primary development language is Java, with some schema being maintained as XML.

We are exploring using drones to deploy medication based on inputs of interventions on the blockchain.

We work on solving social challenges using technology, and our environment is comprised of diverse ethnic groups and tribal backgrounds. Kenya has 42 ethnic groups, and we are privileged to work in 2 areas with over 60% diversity. We work here because we are designed (our company) as a social good organization and are only incorporated as a for-profit because it was the fastest way to start working.

Our work is all inclusive: Be it gender, ethnic background, tribe, we serve those most needy by crafting our solutions to fit their accessibility: mainly financial barriers. 

Our project team membership is comprised of interdisciplinary roles, from engineering to medical profession, with a 50% gender constitution.

As we grow, we are looking forward to be more inclusive in our work.

Our business model is providing a service for government-based health centers, on a subscription basis. This means the masses would access the services for free, and medical practitioners would gain invaluable. data and processed data/information to made medical interventions better.

Another model is based on accessing information for purposes of research. Research organizations would subscribe to get data to be able to conduct their work, such as medical researchers and institutions, development partners to gain insights on how their interventions are being received, to name but a few additional mechanisms.

We see this becoming financially sustainable through a blend of financial interventions including service contracts to governments. We see potential in ability to offer critical data to development partners on their various health interventions, which would be an additional revenue stream to us.

Private hospitals that charge patients would also be a potential revenue channel for them to get medical histories.

We have raised $30,000 from our local business community that support health centers where we have been collecting data on how to build a prototype.

We have also managed to create partnerships that would lead to more funding. We are 3 months old on this solution and strongly believe this is a significant start for such a young solution.