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Healthcare Needs an Honest Broker


Using their KSI® Blockchain technology, Guardtime is making an exceptional contribution to the security of health data, having the vision to be one part of the global standard of how the data is processed reliably and in a privacy-preserving way.

by Vera Fuller

Guardtime’s technology is a core component that secures the integrity of nationwide data infrastructure in Estonia since 2008. The deep-tech company has offices worldwide: in Estonia, Switzerland, USA, China and Singapore. They have specialized in building cybersecurity and complex data management solutions. Guardtime’s widely accredited KSI® Blockchain technology has proven to be the world’s most scalable, efficient, and trusted blockchain solution, developed with and for governments and enterprises. 

Having featured Guardtime in the Spring 2021 issue of the Baltic Business Quarterly, focusing on cyber security, we are now taking a close look at the company’s involvement within a vital and ever-significant sector: healthcare. Using their KSI® Blockchain technology, Guardtime is making an exceptional contribution to the security of health data, having the vision to be one part of the global standard of how the data is processed reliably and in a privacy-preserving way.

“Natural fragmentation of healthcare systems together with regulatory frameworks most often prevent the sharing of sensitive data. However, this is required for indication-, combination- and outcome-based pricing,” Ain Aaviksoo, Chief Medical Officer at Guardtime, elaborates whilst adding: “Existing solutions are time- and resource-consuming. Our invention, KSI® Blockchain has a number of advantages over traditional integrity solutions, including scalability (to billions of transactions) as well as easy and universal verifiability.” The KSI was originally designed to support the Estonian Government in its quest for zero-trust systems – systems that can provide formally verifiable mathematical proof of the correctness of operations.

Real World Data Engine creating various benefits for the healthcare industry

In addition to blockchain, Guardtime also combines other cryptographic methods, such as secure multi-party computation. “This allows different datasets to “talk to each other” without sharing personal data with each other or anyone else,” the company’s Chief Medical Officer illustrates. These two methods combined are the backbone of Guardtime’s flagship product “Real World Data Engine (RWD-E)”, enabling services thereupon by various stakeholders so that patient data never leaves the data holder’s network. It builds upon queries to the respective data sources, performed locally. 

Beneficial for pharma manufacturers, RWD-E provides the ability to make use of the sensitive data essential for analytics of individual medications. Ain Aaviksoo mentions further benefits regarding public authorities and regulators: “In the long run, the public authorities and payers can negotiate prices for treatments depending on treatments indication, outcome and effect – which can save money for payers.” RWD-E helps to implement such a vision gradually.

Moreover, there are benefits for medical professionals, care providers and researchers. An immediate advantage of the Real World Data Engine for professionals is the ability to know and understand the patterns of medicine use in real time – by indication across the regions and several disease areas. Concerning healthcare providers, Ain Aaviksoo highlights: “RWD-E supported differential pricing – by indication or value – will eventually enable care providers to negotiate price on another level, or steer cost cutting without losing on quality.”

Similarly to clinical professionals, for researchers RWD-E can facilitate a broader selection for a more flexible setup of trial cohorts, if one knows what kind of treatment has been given to an individual. It is not possible or very easy to match individual treatments with varying indications, which is an increasing trend in the development of new medicines.

Last but not least, patients profit from the Real World Date Engine as well. The overall benefit for citizens will be better care thanks to medical personnel having a more complete patient data overview – covering information from different data sources.

Tackling entrenched structures with pragmatism

While addressing the key pain points within the healthcare industry, Guardtime still faces big challenges on the way: their Health Solutions require a fundamental shift in existing structures and stakeholder dynamics of the healthcare industry. “It is slow to change as it is a highly regulated sector, with multiple funders and stakeholders having different incentives and vested interests. Further, it is a politically sensitive field. On the one side, human lives are at stake and companies have societal duties and responsibilities, whereas on the other side, they still need to make a profit at the end of the day,” Ain Aaviksoo explains. He continues drawing from his experience: “Different players have benefitted from health system inefficiencies. These structures tend to be resistant to change – for example, lead investigators from clinical trials hold a disproportionate amount of power and influence. Another observation we have made is that some traders have been profiting from parallel exports, as they buy for low prices and sell high.”

Within these entrenched structures, Guardtime is opting for a pragmatic and secure approach, working to increase data visibility and liquidity while providing a clear value proposition for the industry’s players. “Guardtime's infrastructure is able to play the ‘honest broker’ role, in an environment riddled with mistrust between the government, pharma companies and other players in the health sector,” the Chief Medical Officer at Guardtime shares. Ain Aaviksoo concludes: “No organisation has successfully solved the data problems in value-based payment or fully integrated global supply-chain solutions. Our approach is to gain momentum and achieve the maximum potential using network effects.”

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