We conclude our four-part series (see the earlier posts here, here, and here) with a survey of how blockchains are (or could be) used in different industries, but especially in the medical and healthcare sectors.
In the previous posts, we provided a step-by-step introduction to blockchains – showing how a fully distributed ledger can be maintained in a consistent state by a large group of unaffiliated peers, mutually distrustful and potentially malicious, and who may not always be responsive. Distributed ledger (or database) technology is not new, but the blockchain as used by Bitcoin offered the first practical solution to solve most of the problems that thwarted researchers in the past. It solved the problem of scale (the number of nodes that have to maintain the ledger), the problem of trust (between pseudonymous peers), the problem of mutability (preventing retrospective changes to the ledger), the problem of centralization (where an attack on a central database can lead to massive data loss or denial of service), and several others. Bitcoin’s successor, Ethereum, as described in our previous post, added a whole new twist to the simple ledger as a repository of immutable records. Records can now contain code which can run business rules incorruptibly and effect changes in the system.

That the success of Bitcoin and Ethereum as a showcase of blockchain technology should have captured the attention of other industries is no surprise. After all, some of the operational issues that such diverse industries as banking, transportation, education and pharmaceuticals face appear to be partly mitigated by a blockchain-based solution. For instance, many of these industries suffer from poor or inaccurate record keeping, which adds to costs, inconvenience and fraud. A blockchain-based solution appears, at least superficially, to address some of these inefficiencies. For example, education records can be maintained permanently on a blockchain (rather than in easily lost or alterable paper records); a drug shipment can be tagged on the blockchain during each stage of its manufacture through transportation between various intermediaries to the ultimate retailer, preventing counterfeiting.
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