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
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Austin’s MyPass Initiative: A Pilot Study for Blockchain in the Homeless Community
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
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