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. 2020 Jun 4;22(6):e16887.
doi: 10.2196/16887.

Using Blockchain Technology to Mitigate Challenges in Service Access for the Homeless and Data Exchange Between Providers: Qualitative Study

Anjum Khurshid #  1 , Vivian Rajeswaren #  2 , Steven Andrews #  1
Affiliations

Using Blockchain Technology to Mitigate Challenges in Service Access for the Homeless and Data Exchange Between Providers: Qualitative Study

Anjum Khurshid et al. J Med Internet Res. .

Abstract

Background: In the homeless population, barriers to housing and supportive services include a lack of control or access to data. Disparate data formats and storage across multiple organizations hinder up-to-date intersystem access to records and a unified view of an individual's health and documentation history. The utility of blockchain to solve interoperability in health care is supported in recent literature, but the technology has yet to be tested in real-life conditions encompassing the complex regulatory standards in the health sector.

Objective: This study aimed to test the feasibility and performance of a blockchain system in a homeless community to securely store and share data across a system of providers in the health care ecosystem.

Methods: We performed a series of platform demonstrations and open-ended qualitative feedback interviews to determine the key needs and barriers to user and stakeholder adoption. Account creation and data transactions promoting organizational efficiency and improved health outcomes in this population were tested with homeless users and service providers.

Results: Persons experiencing homelessness and care organizations could successfully create accounts, grant and revoke data sharing permissions, and transmit documents across a distributed network of providers. However, there were issues regarding the security of shared data, user experience and adoption, and organizational preparedness for service providers as end users. We tested a set of assumptions related to these problems within the project time frame and contractual obligations with an existing blockchain-based platform.

Conclusions: Blockchain technology provides decentralized data sharing, validation, immutability, traceability, and integration. These core features enable a secure system for the management and distribution of sensitive information. This study presents a concrete evaluation of the effectiveness of blockchain through an existing platform while revealing limitations from the perspectives of user adoption, cost-effectiveness, scalability, and regulatory frameworks.

Keywords: blockchain; data autonomy; data sharing; distributed ledger technology; health care; homeless.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Documents needed across service providers and their homeless clients. CUCC: Community Care Clinics; DACC: Downtown Austin Community Court ; DPS: Department of Public Safety; ECHO: Ending Community Homelessness Coalition; EMS: Emergency Medical Services; IC: Integral Care; SNAP: Supplemental Nutrition Assistance Program; SSA: Social Security Administration; VA: Veterans’ Administration.
Figure 2
Figure 2
Distributed ledger technology prototype.
See this image and copyright information in PMC

References

    1. Ending Community Homelessness Coalition. 2016. May 17, [2019-05-03]. Ending Community Homelessness Coalition 2016 Annual Report http://www.webcitation.org/786921PpK .
    1. Khurshid A, Gadnis A. Using blockchain to create transaction identity for persons experiencing homelessness in America: policy proposal. JMIR Res Protoc. 2019 Mar 6;8(3):e10654. doi: 10.2196/10654. https://www.researchprotocols.org/2019/3/e10654/ v8i3e10654 - DOI - PMC - PubMed
    1. Angraal S, Krumholz HM, Schulz WL. Blockchain technology: applications in health care. Circ Cardiovasc Qual Outcomes. 2017 Sep;10(9):e003800. doi: 10.1161/CIRCOUTCOMES.117.003800.CIRCOUTCOMES.117.003800 - DOI - PubMed
    1. Funk E, Riddell J, Ankel F, Cabrera D. Blockchain technology: a data framework to improve validity, trust, and accountability of information exchange in health professions education. Acad Med. 2018 Dec;93(12):1791–4. doi: 10.1097/ACM.0000000000002326. - DOI - PubMed
    1. Kamel Boulos MN, Wilson JT, Clauson KA. Geospatial blockchain: promises, challenges, and scenarios in health and healthcare. Int J Health Geogr. 2018 Jul 5;17(1):25. doi: 10.1186/s12942-018-0144-x. https://ij-healthgeographics.biomedcentral.com/articles/10.1186/s12942-0... 10.1186/s12942-018-0144-x - DOI - DOI - PMC - PubMed

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