Data is a basic building block of healthcare. The digitisation of healthcare records has yielded big rewards in terms of information sharing, care coordination and research. The volume of healthcare data is increasing at an exponential rate, with more and more sources creating data, inside and outside healthcare institutions. Securing these records is a growing problem.

As we have moved to a digital healthcare system, we have sacrificed the relative security of single paper records for the convenience of freely copiable and alterable digital records. The IOTA Foundation believes that the next evolution of the digital medical record should bring back the integrity of data, with an immutable record that cannot be maliciously altered. This data will inform management decisions by clinicians, and form the basis of trustable decision support systems.

IOTA enables integrity

IOTA aims to enable greater data integrity within the health industry. By securely transmitting and storing individual medical records on the IOTA distributed ledger, access to private medical records can be trusted, secure and controlled. Because the IOTA protocol is free from transaction fees, this data integrity comes for free. Charging micro- or nano-transactional fees for trustworthy and immutable information in a medical context also becomes possible.

Healthcare data has traditionally been siloed in different institutions or even within a single institution. These silos prevent meaningful sharing and reuse of data, and limit the quality of care that can be delivered. To receive medical treatment, an individual may need to consult with multiple providers for a single incident. When individuals transition from primary care clinics to hospitals to specialists and back again, records are not shared seamlessly, reducing their continuity of care.

The IOTA protocol supports initiatives to free the data, using novel secure open-source messaging protocols and common healthcare interoperability standards. IOTA researchers are working towards a longer term vision - of decentralised and secure data stores, controlled by the patient, and following them through their journey. Instead of private data access being controlled by institutions, the individual can be given much more control over which of their discrete medical records can be shared.

The IOTA Foundation is a non-profit organisation, established to drive development and adoption of the IOTA platform. All tools are provided for free and are open sourced. Below are examples of projects being developed with these tools.

Remote Patient Monitoring

Health sensors are becoming increasingly prevalent, both consumer grade and medical grade. Data from these sensors may provide greater insight into the patient's health state between clinic visits. This is particularly useful in chronic disease, where deterioration may be identified sooner, or in medical trials where response may be more granularly monitored. However securing and actioning these data streams remains problematic.

The IOTA masked authenticated messaging (MAM) protocol can help to secure these data streams over the Tangle, using modern healthcare interoperability standards. The IOTA ledger may also be used as a record of the security of devices, proving that they have been updated to the latest most secure internal software (firmware).

Health Data Exchange

The IOTA MAM protocol may be leveraged for transfer of patient data between hospitals. MAM allows for encrypted streams of data that can carry either granular data about a patient or their entire health record. The inbuilt payment system also allows feeless charging for these streams of data, so that institutions can easily recoup the costs of data transfer.

The MAM streaming technology and core IOTA ledger can also be combined to form the basis of a distributed healthcare information exchange.

Research Data Integrity

Clinical research is reliant on the integrity of data collection. The IOTA ledger can act as an immutable ledger to prove the integrity of research data. IOTA's scalability and feeless structure means that very granular continuous real world data can be recorded as it is produced, rather than on episodic case report forms. We expect that this approach will herald a new approach to the collection of real world evidence in trials.