Regulating healthcare through blockchain: Mapping the legal, ethical, technical and governance challenges (360G-Wellcome-210337_Z_18_Z)

Blockchain technologies have the potential to radically reshape many industries, including healthcare. These technologies create a distributed database across a network of computers, using cryptographic methods to verify the consistency of digital records and transactions. This could enable the secure, tamper-proof, transparent, and trustworthy management of health-related data. But some doubt whether blockchain can deliver on its promise. Others fear that it will deliver too much, providing efficiency and security without sufficient operational sensitivity to healthcare contexts. Blockchain is a form of ‘design-based’ regulation, entailing the hard-coding of regulatory norms into systems infrastructure and operation. For example, by creating a transparent and unalterable audit trail regarding data access and usage, or by building in privacy through data encryption. Hard-wiring norms (e.g. traceability and privacy) into healthcare systems might overcome shortcomings of conventional legal and ethical regulation, but is likely to face major implementation challenges. This project will identify, map, and examine the implications for utilising blockchain in healthcare. It will identify the legal ethical, technical, and governance opportunities, risks, and challenges. It will thereby begin to explore whether, and under what conditions, these technologies might be developed whilst remaining faithful to important ethical, democratic, and constitutional values.