Special Feature: Blockchain, Demystified – PharmaLive

It’s a word that’s been popping up more and more frequently in the pharma context, but not everyone understands what it is and what it can do. Med Ad News asked technology experts to explain blockchain.

Med Ad News: Give us a non-technical person’s description of blockchain. What is it and how does it work?

Gunjan Bhardwaj

Gunjan Bhardwaj, Founder and CEO, and Abhijit Keskar, Head of Blockchain and MD, Innoplexus: Imagine a note book where every person who makes a note keeps an exact copy of all the pages at all the times.

Blockchain (which literally means a chain of blocks containing transaction data and code), is a distributed repository of transactions and code (smart contracts/chain code). It is distributed across various nodes (servers) hosted by multiple entities. It is intended to enable the building of intermediary-less (peer-to-peer) distributed apps where transparency and trust are built into the system. Instead of a “controlling intermediary” hosting transaction (data) and code (rules of the game), blockchain has multiple nodes (which contain multiple copies of immutable transaction and code), which not only serve as the repository but also makes it highly available. Validation and recording of transactions are done by the blockchain system itself. This ensures that no one can manipulate or delete the transactions.

There are public blockchains (open to all, like EOS and Ethereum) and private (or permissioned) blockchains (like Hyper-ledger fabric), which are used by a small group of business entities.

For example, for a blockchain hosted payment system, a new transaction (say, a payment transaction) once initiated, can be added to a box, which can be added to the blockchain. Blockchain can get it validated and executed through one of the nodes (called miner in case of public blockchain and endorser in case of private blockchain). Once executed, it also is broadcasted to all the nodes.

Dan Chichester

Dan Chichester, Chief Experience Officer, Ogilvy Health: Blockchain is a core underlying technology for tracking data assets. Consider any transaction or exchange you engage with online that has value: financial transactions, land titles, medical records. These assets are stored in a cryptographically linked digital ledger. The ledger is decentralized and distributed across everyone on the network. Instead of a central authority, it is a democratization of the data. Every change is a new entry in the ledger: data are only ever appended. Before new data (a block) can be added, a cryptographic puzzle (or consensus algorithm) must be solved and verified by all computers on the network. At this point, no one can share or alter the transaction in any way. This ensures trust in each other, and trust in every block in the chain. By cutting out the middleman, blockchain revolutionizes the way we access, verify, and transact with each other: faster, more autonomous, more secure, and less expensive peer-to-peer interactions with data.

Med Ad News: In what ways (aside from cryptocurrencies) have businesses taken advantage of blockchain, particularly in customer-facing and sales & marketing-related implementations?

Gunjan and Abhijit: Blockchain is a disruptive technology and together with AI it has the potential to transform many industries fundamentally. It has been a bit unfortunate that blockchain has been used frequently and is best known in the context of cryptocurrencies. There are many other profound use cases for blockchain. 

Abhijit Keskar

Whenever there is a need/opportunity to avoid having an intermediary (or a central governing authority), and/or a need to have a transparent, trust-based system for peer-to-peer transactions among disparate peers, blockchain can be a useful option. 

For example, if there is a need to build a system for trading of experimental data between individuals/organizations, a public blockchain like EOS or Ethereum is a good choice.

If there is a need to build a system that can get daily anonymized health data from patients and provide aggregate insights to pharma companies or hospitals, then public blockchain is a suitable option.

If I have a need to create a transparent system to provide a real-time view of demand and supply to the entire chain, a public blockchain-based system can add value. 

If I have a need to create an intermediary-less payment (clearing and settlement) system, a hyper-ledger based system can be most suitable.

Dan: Businesses have been quick to recognize the potential of blockchain, well beyond cryptocurrencies. 

Qualification verification: In hiring, blockchain can validate a potential employee’s work history – tenures, titles, degrees – without the time-consuming traditional background check. In travel, British Airways is processing security checkups via blockchain. In the supply chain, Walmart, Anheuser-Busch, and Ford are leveraging blockchain to authenticate the source of produce, crops, and raw materials.

Faster payments: Reconciling invoices and billing statements is potentially eliminated with blockchain, opening the way to almost instant payments, improving cash flow for a business. In healthcare care, this can also apply to speedier insurance reimbursement—and possibly streamlined prior authorization.

DataBNB: Companies, such as Storj, are beta testing blockchain secured sharing of excess hard drive space, renting it out to the cloud like renting a room on Airbnb. This could become a new revenue stream for average individuals, while also reducing data storage costs for companies and individuals.

Data your way: Burger King Russia is serving up a blockchain-powered rewards program called (wait for it) WhopperCoin. These tokens can be stored, traded, and even transferred online, and used to purchase BK meals – a significant data-powered approach to customer loyalty.

Med Ad News: How might blockchain be applied specifically to pharma and healthcare marketing communications?

Gunjan and Abhijit: Public blockchain can be applied to connect the end user (patient) with pharma/healthcare. It can be used to capture the feedback, aggregated insight about the effectiveness of the medicine, or other insights from patients without having to store any patient data directly by the pharma company.

A private blockchain can be used to build an ecosystem of partners where partners of a pharma or healthcare company can share data with the pharma company in a trustworthy way without any risk of misuse or plagiarism.

Dan: Blockchain introduces new considerations to marketing, shifting the balance of “power,” creating more trust, and heightening accuracy in measurement.

Power to the patient: Until blockchain, a company was the primary beneficiary of patient and consumer data: a one-way pull of email, phone, address, activity. There is some customer benefit in the form of personalized marketing, but data collection remains invasive and individuals can be suspicious of how their valuable info is being put to use. With blockchain, the free-for-all data grab may be coming to an end. In one scenario, individuals can simply anonymize their data. In another, they can choose to trade their online attention by opting-in to receive ads – but only in exchange for something of value. Instead of the data remaining on an application server, they act as a key to unlock certain content – and return to the individual when they’re finished with them.

CRM and loyalty programs fueled by blockchain can also provide more value to a patient, allowing for activity to be measured/redeemed in real time and even shared across multiple brands for additional benefits – while still maintaining important privacy. 

Data integrity: Companies can build loyalty and confidence by choosing to share blockchain-verifiable aspects of a product’s lifecycle, especially when it comes to ethical sourcing: where it was made, the environment it came from, the conditions of the workers manufacturing it. As customers come to care more about the integrity of a company and its policies, the data can be critical differentiators in choosing relationships and care.

Very verifiable key performance indicators (KPIs): Digital marketing may be in for an upset if blockchain can remove the current intermediaries between the ad dollar and the person who views the ad. A trusted direct chain that verifies ad metrics would be a boon to advertisers, and provide new options for healthcare care professionals and patients to interact.

In the realm of influencer marketing, blockchain can remove barriers for tracking returns on investment (ROI), and verify legitimacy, distinguishing between real and fake followers and ensuring engagement. Smart contracts can be set up to deliver payment on the completion of specific actions or delivering specific desired results.

Med Ad News: In what ways do you foresee blockchain changing the playing field for pharma and healthcare, both for marketing and in other areas, in the next five years?

Gunjan and Abhijit: Blockchain can help bring the overall pharma/healthcare ecosystem together, by enabling a trust-based exchange of data between all the constituencies. It can also potentially help in bringing various pharma companies closer, enabling the formation of a consortium of pharma companies who can share data with each other in a trustworthy way. Breaking off of silos is likely to happen in the next five years.

Dan: Blockchain’s veracity is a confidence engine that can up the game in logistics and research for pharma, delivering additional benefits to patients through new efficiencies and trust. A few examples that are being explored include:

Compliance in the supply chain: Drugs need to be handled in very particular ways, with environmental conditions (temperature, humidity, air quality) potentially having a direct impact on quality and efficacy. While current Internet of Things devices monitor these conditions, they are in separate ledgers across separate logistics companies, stores, pharmacies, etc. A single blockchain ledger allows any participant in the supply chain to ensure that proper handling and storage conditions were adhered to. This can also be linked to smart contracts that automatically execute when compliance is not met, alerting relevant parties in the supply chain.

Consent in clinical trials: Ten percent of trials suffer from some form of consent issue, such as unapproved forms, unsigned papers, or not informing patients about revisions to protocols. Blockchain provides a mechanism for time-stamping forms, storing, and tracking consent in a secure and publicly verifiable way, as well as sharing information in real time. Smart contracts in this instance can be bound to protocol revisions, so any change requires patient consent for renewal. The blockchain advantage is more transparency and trust for stakeholders and patients.

Better data in clinical trials: Blockchain’s decentralized and fixed ledger ensures that clinical trial data are stored in a secure and publicly verifiable manner that is protected from falsification. This prevents tampering with the trial results, reduces concerns about conflicts of interest, and improves overall reliability and confidence in a trial.

Better quantity/quality of patient recruitment: With blockchain, individual patients are in control of their data, providing consent – or revoking it. A patient can choose to make data visible to trial recruiters, who can then connect if that data are a match for a trial. Blockchain’s security also allows a patient to participate in a clinical trial without anyone else knowing, helping to eliminate a fear some have of their data being compromised. The more patients who are comfortable with providing data, the more lives can be improved and saved thanks to new therapies.

Med Ad News: Are there any particular companies or entities in pharma that have been showing signs of jumping on the blockchain bandwagon more quickly than others? How have they been doing so and what have the results been?

Dan: The most evident instance is one focused on a particular aspect of pharma supply chains. Called the MediLedger Network, this consortium including Pfizer, Amgen, Gilead, Genentech and others, seeks to make it easier to verify that returned drugs are authentic. Typically, this is the job of wholesalers, who need to contact manufacturers to track down serial number – a process that can take up to two days. With blockchain, the infrastructure is a barcode scanner and a web browser, verifying in less than a second and getting product back into commercial distribution. This same rapid verification can also help hospitals and pharmacies verify that a drug is legitimate as it goes back on the shelf. (Counterfeit barcodes are possible, but the digital ledger will flag and record suspicious activity.) This is one example of blockchain’s potential for building trust and confidence among pharma, customers, health professionals, and patients.