Regulating healthcare through blockchain: mapping the legal, ethical, technical and governance challenges

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 secure, tamper-proof, transparent and trustworthy management of health-related data. Some doubt whether blockchain can deliver on this and others fear that it will deliver too much, providing efficiency and security without sufficient sensitivity. Blockchain is a form of ‘design-based’ regulation, entailing the hard coding of regulatory norms into systems, for example by creating a transparent and unalterable audit trail regarding data access and usage, or by building in privacy using data encryption. Hard wiring norms, such as traceability and privacy, into healthcare systems might overcome shortcomings of conventional legal and ethical regulation, but is likely to face major challenges during implementation.

We will identify, map and examine the implications of using 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.