Distributed Ledgers, the Next Step in Patient Generated Health Data (PGHD) - Part 2

An associate of mine provided good feedback on my previous post on Pulse, he disagreed with me in earnest and stated that Blockchain/ Distributed Ledger (DL) wasn't a good platform for storing PGHD (Patient Generated Health Data). I appreciated his comments, I decided to provide a bit more context and information. For those of you that are not familiar with Distributive Ledgers, they are the technology that support Blockchain, which is the foundation of Bitcoin. Basically, Distributive ledgers are an add-hoc standard database with security, transparency and access control more or less built in.

Jeff BrandtThey're called Distributive ledger because the operate like a book ledger, which once you write into them, you can't alter the line entry and distributive because there are many, mirroring each other. Healthcare data collected by a clinician or a device during an encounter is episodic, ledger style based. Once it is signed off by the clinician or entered via a machine into the record, it must not be altered. DL support this style of workflow by nature and provides a consensus strategy, which supports non-repudiation. PGHD, needs a non-reputable structure and assurance, in order to be trusted by clinicians.

My previous article's focus wasn't meant to be on EHRs, but PGHD or data that is collected without a clinician's assistance, i.e., the patient or the collecting device is outside of the doctor's office. In the near future, the number of devices collecting patient and environmental data about a patient will be astounding. My hypothesis is based on the use of DLs to identify, maintain, securing and associate these devices with the correct patient...