Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 3, 2019
Date Accepted: Feb 26, 2020
Date Submitted to PubMed: Apr 29, 2020
Austin’s MyPass Initiative: A Pilot Study of Using Blockchain Technology for the Homeless
ABSTRACT
Background:
In the homeless population, barriers to housing and supportive services include a lack of control or access to data. Disparate data formats and storage across multiple organizations hinders up-to-date, intersystem access to records and a unified view of an individual’s health and documentation history. The utility of blockchain to solve interoperability in healthcare is supported in recent literature but the technology has yet to be tested in real life conditions encompassing the complex regulatory standards in the health sector.
Objective:
The aim of this work was to test the feasibility and performance of a blockchain system in the homeless community to securely store and share data across a system of providers in the healthcare ecosystem.
Methods:
We performed a series of platform demonstrations and open-ended qualitative feedback interviews to determine key needs and barriers to user and stakeholder adoption. Account creation and data transactions promoting organizational efficiency and improved health outcomes in this population were tested with homeless users and service providers.
Results:
Persons experiencing homelessness (PEH) and care organizations could successfully create accounts, grant and revoke data sharing permissions, and transmit documents across a distributed network of providers. However, there were issues regarding the security of shared data as well as user experience and adoption. We were unable to resolve these problems within the project timeframe and contractual obligations with the platform vendor. Therefore, our team evaluated the performance of various system prototypes to determine if blockchain was suitable to support our objective and use case.
Conclusions:
Blockchain provides decentralized data sharing, validation, immutability, traceability, and integration. These core features enable a secure system for the management and distribution of sensitive information. This work presents concrete evaluation on the effectiveness of blockchain in this context while revealing limitations from the perspectives of user adoption, cost-effectiveness, scalability, and regulatory frameworks. Clinical Trial: N/A
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.