A tremendous amount of data is produced in the medical arena. Major parts of the data are presented as visual data with or without medical telemetry and metadata. Today, most surgeries and medical procedures are documented in terms of visual light documentation generated by professional medical equipment all the way to ad-hock solutions.
As a result, a growing segment of consumers seek to gain access to this documented data, starting with the medical data itself where the need is mainly under the medical QA, research and medico-legal layer and ending up with sharing data as part of academic and sharing of information requirements.
Medium to large entities are looking for this data mainly in order to seek access to big data, deep learning and analytics. Entities like Google (Verb Surgical, Facebook, Medtronic, etc.) are negotiating for and in process of acquiring as much imaging data as possible.
This natural, self-created eco-system has yet to answer the basic commercial module definition: who owns the data, who needs to pay whom and how much; who are the players that hold the information and who will benefit from the eco-system cycle.
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The reason for using the blockchain to exchange medical imaging between nodes is for the following reasons:
Data over the blockchain is encrypted and unbreakable. It is a proven fact that the data is safe and can not be delivered to unwanted destinations.
Fast transactions layer
All “blocks” on the blockchain are duplicated and broadcast on a fast network layer. On the Ethereum blockchain, a transaction is fully confirmed within active nodes in less than 20 seconds.
The blockchain defines a strict rule of an economical ecosystem. It provides an option for participants to either pay a token (a coin), or to receive a coin dependent on the economical rules. For example, a physician who contributes to the blockchain, (sends a medical image), will receive a token whenever another physician uses/watches this content. This physician, then, can use his received tokens to watch another physician’s content.
The soul of the blockchain relies on a distributed environment, e.g., negating the need for a central server. Every hospital that would like to “join” will install a simple blockchain node application and automatically join the blockchain infrastructure. This way we have a duplication of the blockchain database and no need to have a redundant system and or backup the data.
The idea presented here is to define a strict rule of exchanging medical imaging between hospitals, globally. The proposed system will use the blockchain infrastructure to define the exchange of information between hospitals and internal consumers and also define the economic usage and reward for the medical content providers and consumers.
Participants of the eco-system
There will be three types of participants: A node, which is actually a hospital or any other facility which would like to contribute content and earn rewards for the shared content. In a way, participation is not limited only for hospitals. It is aimed at any other physician or medical content provider wishing to contribute information. To be a node in the blockchain, all you have to do is to download a node application and activate it on a computer connected to the internet. The benefit of becoming a node is the chance to earn some coins or tokens when mining (confirming) blocks — otherwise each of the content providers can connect to the blockchain by third party front-end interfaces.
The second participant is the “super node” — the super node actually holds the content. It is a simple centralized server on the internet (or private network) that will store the content whether it be an image, a document or video. Each super node is rewarded for each piece of content it saves by getting a fractional fee from the usage fee of the content originator. Super nodes will be hosted, most probably, on the cloud and each of the content items is treated as a data transaction within the blockchain, meaning encrypted with a public key.
The third participant is the end user. These combine two types: the content provider and the content consumer. Typically, the content consumer pays the content provider for each consumed content. Typical content providers are medical staff, doctors, physicians, hospitals, medical facilities, researchers, etc. Typical content consumers would be medical staff, doctors, physicians, researchers, big data consumers, etc.
The main purpose of using the blockchain is to define the rules of monetization of the service. The flow will be as such that content providers are paid for their consumed content. Each of the content participants will have to have an initial amount of coins to spend in order to either send content to the blockchain or in order to watch it (consume). Nodes (which are usually owned by hospitals), will be rewarded from the transaction fees and super nodes will be rewarded from a fractional payment that goes to the content providers.
Content provider rules
To be a content provider you have to activate a node or to connect to an external node with any uploader interface that exists on the internet. To be a content provider you have to have the following items:
Content to distribute –content could be any of the following:
- Medical imaging: still image, video, radiological imaging
- Medical record in shape of: PDF, EMR
- Content metadata — medical description of the content
- Coins (or tokens) to spend in order to send the data. The amount is a combination of the following:
- Transaction fee — dependent on the size of the content
- Storage payment — dependent on the period of time until the content expires
Definition of the “content usage price” that will be paid by content consumers and will be one of the followings:
- Pay per view (PPV) amount
- Pay for rent periodically — dependent on the amount of days
- Pay perpetual — rent for lifetime
Content consumer rules
To be a content consumer all you need to do it to browse through available content using one of the indexer interfaces found on the network and pick up the requested content. For this you must own the following:
- Enough coins (or tokens) to view within the following options:
- Pay per view (PPV)
- Pay for rent — dependent on the number of days this content is hired
- Pay perpetually — rent for a live time view
- Enough coins (or tokens) for the transaction fee
In general, the ecosystem defines the rules but does not define who is the user. A content provider can also be a content consumer and vice versa. The flow of payment goes from the content consumer and is split between the super node and the content provider.
Rules can not be changed but financial monetization can and it is generally defined by the users — the ecosystem is actually defined by the ability to pay for specific content and the amount to be paid as defined by the content provider. Content that is too expensive will not be consumed while other, less expensive, will be consumed and benefit the content providers accordingly. There is also a dependency within the content with regards to medical quality and uniqueness, as more unique content will be worth more while other content will be charged standard rates. The cost cannot be changed within the storage expiration period, and it can only be re-distributed with new costs after it has been expired.
Balancing the ecosystem is done with rewards given to node owners and to super-nodes owners. Rewards provide an incentive to node operators owning a node or a super node. A hospital that is actually operating and owns a node can then distribute the rewarded coins (or tokens), internally, to its own physicians that are using the eco-system.
About the tokens in use
This blockchain is based on utility tokens by definition and target, mainly, in order to start using the ecosystem. Any user, whether it is a content provider or consumer, needs to have initial coins to spend. The initial coins are offered, on an initial base, to potential users. A genesis block with initial amounts will be decided later and will be offered initially on a pre-ICO sale. It will be deployed later on the Ethereum blockchain to be purchased on a crowd sale phase. After the ICO ends, all tokens will be forked to a private blockchain in order to be used by the users who purchased them.
The coin (or token), eventually will have its fiat value and conversion and will be exchanged and traded in standard exchange facilities.
The benefit for coin (or token) holders is obviously defined through:
- Usage — paying for viewing of content
- Trading — on fiat value basis
This is where Medical imaging, blockchain and big data meet all together.
The writer is a co-Founder and owner of Kimera, at https://kimera.io
Where Medical Imaging, blockchain and big-data meet was originally published in Data Driven Investor on Medium, where people are continuing the conversation by highlighting and responding to this story.