The better the question
Could blockchain become the lifeblood of healthcare?
Blood donation, processing, testing, distribution and transfusion is a complex, highly regulated process. Blockchain can support monitoring and traceability from donor to patient.
About 1 in 10 people entering hospitals every day need some kind of blood transfusion – they are a fundamental cornerstone of medicine. Transfusions are needed to replace the blood of those suffering from cancer or other blood diseases and replenish blood lost in serious accidents and medical procedures like childbirth or surgery.
This demand adds up. It’s estimated that, in the US alone, about 32,000 pints (18,184 litres) of blood products (red cells, platelets or plasma) are transfused every day, so keeping a reliable and steady supply of blood is critical. About 4.5 million Americans would die every year without a transfusion.
Donated blood makes its way to patients via complex blood supply chain networks. Especially in a large country, each unit of blood can travel thousands of miles. Units are also broken down into smaller, similarly vital medical products, such as, plasma, platelets and red blood cells.
Knowing where products are, and what condition they are in, is essential to running any supply chain, from minerals to food to consumer products. But with blood, this accountability is even more important – after all, what’s at stake is not the continuing business of impatient customers, but people’s lives. For that reason, the tracking of blood products is highly regulated.
The challenge is to make that system as effective as possible, and to make data from the full length of the supply chain more visible, to deliver even greater benefits.
Building in trust
EY Canada has been working with Canadian Blood Services (CBS) to address this challenge with a proposal to put blood records on the blockchain. The thinking was simple: if this was done effectively, we could provide near real-time visibility and traceability of blood products throughout the system.
The better the answer
Developing proof of concept for ‘vein-to-vein’ monitoring
Using blockchain to power a self-updating tracking platform that offers powerful insights.
Blockchain – which encodes data in a perfectly secure and transparent way – is an ideal technology to add security and visibility to the blood supply network. By providing a platform that could guarantee the visibility, security, and reliability of records from donation to transfusion, in blockchain EY teams had identified a technology that could make blood product usage data more visible and usable.
Involving personnel from both Canada and the US, and combining multiple business disciplines, EY and CBS teams worked to turn this initial idea into a robust platform that could test the theory and provide the foundations for a transformed blood system.
What are blockchains?
Blockchain is a distributed infrastructure technology. It is a decentralized ledger that keeps a record of each transaction that occurs across a network, which enables a decentralized exchange of trusted data – a shared “record book”.
Blockchains integrate information and process within and across enterprise boundaries and have the potential to streamline and accelerate business processes, increase protection against cybersecurity and reduce or eliminate the roles of intermediaries.
Putting blood on the blockchain
“Here’s how donations work. You roll up your sleeve. A blood donation service takes the blood. They ship it under strict temperature requirements to a production site. They separate it into other products. And they take it to a hospital or blood bank,” says Warren Tomlin, Digital and Innovation Leader for EY Canada. “But then they lose visibility.”
In other words, while hospitals and CBS already maintain precise records that allow them to trace a blood product back to the donor, a product’s complete path to the patient is not visible in real time to them or to others. Blockchain can make data from that path visible, while protecting the security of private information.
With this new system, when a donation occurs, the unit is scanned and all the related blood data is put on the blockchain (supported by the EY OpsChain platform). As the products from that donation move through the supply network, those products are scanned again and again, and their location and status are registered on a single, unified platform. The underpinning blockchain technology manages the integrity of this data at every stage.
Details about the blood are taken at seven key points:
- When the donor donates blood at a CBS collection facility
- When CBS performs tests on the blood, and records the results
- When CBS processes the blood into red blood cells, platelets and plasma
- When these constituent parts of the blood are stored in the CBS inventory
- When logistics operators transport the blood to a hospital
- When the hospital gives a patient a blood transfusion using the registered product
- When the hospital disposes of leftover blood after it is used
“Every time we get an Internet of Things (IoT) update of the temperature, it’s recorded on the blockchain. Every time we know where it is by GPS, that’s recorded on the blockchain,” says Tomlin. “If you think about blockchain and that chain of custody, we end up creating an improved audit trail for these products,” a single visible one that stretches from donor to recipient.
The data trail
Tomlin also stresses the detail and volume of data that is packed to each package of blood recorded on the blockchain. “When someone goes and gives blood, we take that unit and we scan the barcode and ‘tokenize’ the blood,” he explains. “Then we take that barcode and we put it on the blockchain. That gives us our first snowball of data — and as Canadians, we love that analogy. As that snowball rolls around in the snow it gets bigger. It picks up more snow until it becomes the base of the snowman.”
“In the same way, each unit of blood ends up accumulating lots and lots of data,” he continues. “First of all, we get your name, your age, and your ethnicity, and your blood type. That’s all saved in the blockchain. Then, as it moves through the supply chain, it rolls up more data. In the truck it picks ups data from GPS sensors. In a cooler fitted with an IoT sensor, it picks up data about temperature. All that data gets added to the snowball. And that makes tracking much easier than it is today.”
The better the world works
Improving healthcare transparency and outcomes
Driving efficiencies to better match donors with recipients — and improve patient outcomes.
But what do you do with all this data? Better tracking of blood usage presents a huge opportunity to improve the blood system as a whole. With real-time information about blood products as they move from donation through production, testing and distribution, the blood operator can more quickly and accurately identify areas for improvement.
Blockchain can also facilitate researchers’ access to large data sets, while at the same time protecting the privacy of donors and recipients. That could allow them to correlate patient outcomes with variables such as the gender of their blood donor, or the temperature at which the products they received had been transported. In turn, researchers’ findings could inspire changes to the blood system that benefit patients.
“The work with EY has allowed CBS to imagine a very important advancement in healthcare,” says Rick Prinzen, Chief Supply Chain Officer and Vice President of Donor Relations, CBS. “Connecting donor centre donations with in-hospital transfusions and enabling hospitals to have real-time access to the whole blood component product flow and product status represents a significant advancement in driving supply chain value and improved health outcomes”.
What patterns improve supply efficiency? If issues occur with a particular batch of blood, where exactly did those issues occur, and how can they be prevented in future?
These are just a few examples of the questions that this blockchain-enabled program could answer. And better measurement of the movement and status of blood within these vast blood donation networks promises substantial potential for identifying further improvements in the efficiency of the health service as a whole, making sure that the value of donated blood goes further, and saves even more lives.
With positive health outcomes often dependent on tiny variables in how patients are treated, the increased visibility achieved by putting blood on the blockchain could make a transformative difference.
The program initially launched in trial stages, EY solution is now moving toward implementation in markets beyond Canada.
This was a test of the system’s viability. It really works. And we proved that it would really work.
Building on the blockchain
Currently, EY and CBS have a proof of concept. But as the system develops, artificial intelligence and machine learning platforms could be used to analyse that data in increasingly sophisticated ways.
For CBS, putting blood on the blockchain is about making a vital health service even better for Canadians.
For blood operators globally, it’s a first look into how emerging technology can transform the way blood reaches those who need it.
For patients, it offers life-changing results.