Promising results in using cryptography to access multiple source health data

Blockchain and cryptography are technological solutions often associated with bitcoin. But the same technology is used in several areas and shows great advantages in complex and dynamic systems. During the last year Health Solutions and network security expert Guardtime has partnered with Roche and AstraZeneca in two pilots in Sweden using this technology to answer research questions requiring aggregated statistics from various systems.

The purpose is to be able to answer the question “what medicine is used for what purpose?” and longer term, to enable payers and pharma companies to have better underlying data for agreements that focus on pricing and health outcomes.

Access to relevant health care data is key component

“This is a satellite project from our project “From Horizon to Future” that is sponsored by Vinnova with the goal to deliver a better process for implementation of innovations in Swedish Health care. Solving the problem with access to relevant health care data is a key component”, says Teresa Reinli, Project Lead at Health Solutions.

Swedish health care givers already gather the data needed to evaluate combinations of treatments and implementing value based pricing models. The challenge lies in giving different stake holders access to the right data at the right time, compiled in a way that is useful and secure in terms of patient integrity.

“This is a problem that we have looked at for a long time. There is a lot of health care data available, but the problem is that it is gathered in different silos. To develop models for value-based pricing, and pricing of combinations of medications, we need combined data from different sources. The blockchain-solution is a promising approach”, says Magnus Lejelöv, policy expert at Lif, the trade association for the research based pharmaceutical industry in Sweden.

Secure patient data privacy

The new model enables access to data while respecting patient data privacy, combining secure multi-party computation techniques and blockchain. The beauty of the model is the possibility to get answers to queries requiring a combination of data sources, without having to download a single line of raw data. In fact, no external actor can see any of the data used to answer the research question, and the answer will be presented as a numerical value. This would not have been possible using existing registries in Sweden.

“The definition of quality in terms of registries has evolved over time. Innovative management of health care systems when it comes to paying for pharmaceuticals, performing clinical trials using real world data et cetera requires richer data than what is currently available in the registries”, says Ain Aaviksoo, Chief Medical Officer at Guardtime.

There are different approaches in solving the need for combined data from various sources. One way would be to build systems of big data lakes, requiring all health care data systems to deliver data into a common source. The new model on the other hand makes it possible to get the answers needed without moving any data.

“This is a compromise, where you design a research question and then apply data queries on the different data holders. That means that they remain in control of their data, yet it is possible to combine and get a solidated answer from different sources”, says Ain Aaviksoo.

“The important thing for us is not how it is done, but rather to find a common system that delivers the data needed, and that is used and trusted by all parties – pharmaceutical companies, health care providers and policymakers”, says Magnus Lejelöv.

The technical part of the pilot has been a collaboration between Health Solutions and Guardtime, and Ain Aaviksoo thinks that the partnership has worked well – “What Guardtime has is a generic tool. Health Solutions has the knowledge of the data landscape, understands the relationship between different sources, and has the local trust.  Through this we have found good synergies between the companies.”

What advantages does Sweden as a market have for these models?

“The fact that Sweden has registries and a long experience of making use of the data is a clear advantage. Sweden has a great opportunity to do new things based on that knowledge and experience, something that could take years in other countries”, says Ain Aaviksoo.

What disadvantages does Sweden have?

“You are very proud of your registry systems, and they are a unique source of data. Seeing beyond that is sometimes difficult. It is like, if you only have a hammer, all you see is nails. Trying to squeeze out everything from registries is costly and time consuming. If you instead use your understanding of the limitations of the registries, you could turn that into a strength, looking at new approaches”, says Ain Aaviksoo.

The first pilot financed by Roche looked at how the model could be used in evaluation of combined treatments. The pilot has proven that the model is technically feasible, and legally sound. The second pilot, financed by Astrazeneca, is ongoing and will evaluate how the technology can be used as a tool for value-based pricing. 

The next step is to use the technology in different settings, and hopefully combining data from registries with real world data from hospital sources.


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