To rebuild the health system, we must dare! And it is in this context that we took part in the consultations on Bill 3 on health and social services information. In the field of health data storage, daring also means not doing as before in terms of government databases. The bill gives us the opportunity to dare.
Our suggestions pursue the same objectives as those of the government, namely to promote better exchange of data between health establishments, to improve access to data for managers and researchers, all this while ensuring their confidentiality and allowing the patient to consult his file more easily.
Historically, humans have stored information in protected places. Obviously, the shape of these warehouses has changed. From the guarded building to the hyper-secure giant server, the approach has nonetheless remained the same; they are essentially variations on the vault theme. Distributed ledgers are shaking up the old way of designing databases.
At a time when data theft crimes are a growing scourge around the world, with the arrival of 5G connectivity which multiplies the data in circulation tenfold, as the artificial intelligence revolution begins, the distributed ledger technology appears to be an essential element.
blockchain
Why should Quebec not become one of the pioneers in the use of these technologies to make the storage of our health data a symbol of this digital era which makes data a resource and the security of personal information a condition? of success ? Within the large family of distributed ledgers — of which the blockchain or blockchain — the protection of patient data is guaranteed by four fundamental characteristics, namely decentralization, immutability, transparency and pseudonymity.
First, the decentralization of block chain means that the register is not maintained by a single organization, but by several, thus avoiding the risk of a single point of failure. This guarantees the availability of data whenever it is requested by patients or organizations. Second, the immutability of the blockchain prevents the modification or tampering of data, as well as the conditions under which a person has given consent for their access, use and communication.
Third, the transparency of the blockchain registry allows the visibility of the information contained in this registry to all stakeholders. This allows people to know at all times who has access to their health data and how it is used. The transparency of the blockchain also allows the doctor who has access to a person’s health data to have access to the latter’s medical history.
Finally, the pseudonymity offered by the blockchain makes it possible to reinforce the confidentiality of health data during their use or communication. Indeed, the real identities of people are hidden behind addresses generated by the blockchain. This prevents the identities of the owners of the data used or exchanged between the organizations from being traced. Additionally, the blockchain enables the deployment of smart contracts.
Such applications make it possible to transform the conditions of access, use and communication of health data into computer codes deployed on the blockchain. In this context, the governance of health data will be automated and managed by smart contracts, whose codes are not modifiable and only run when the conditions of access, use and communication of health data are respected by a person or health organization.
In addition, smart contract codes are open. This makes it possible to audit the accuracy and legal compliance of the conditions of access, use and communication of the data implemented in these smart contracts. We hope that these few ideas will inspire other experts to speak out and help provide Quebec with the best legislative framework in this area.