An exploration of Blockchain and its applicability to ... · An exploration of Blockchain and its applicability to health professional education, credentialing & research Disclosures:

An exploration of Blockchain and its

applicability to health professional

education, credentialing & research

Disclosures:

Ian Graham MBBS, M Health Planning, Cert. Essential Skills in Medical Education, FRACMA

• Director of Professional Affairs - ANZCA

• Executive Director of Medical Services - East / West Wimmera Health Service

• Consultant - SED Clinical Education Practice and Learning

• Member, Board of Directors - MedBiquitous

• Co-founder and inaugural President - HISA

No other affiliation (financial or otherwise) with any pharmaceutical, medical device, information

technology or communications organisation

Goal: Achieving ‘mutually assured disruption!”

What I like about Blockchain ….

Blockchain • Distributed ledger - avoiding central

management & storage

• Interoperability - connectivity

• Self-sovereignty - user control

• Transparency & provenance -

capacity of parties to transact

• Immutability - permanent, append only

• Trust - confidence in the infrastructure,

privacy & governance

Grech A and Camilleri AF (2017) Blockchain in Education. Inamorato dos Santos, A. (ed.) EUR 28778 EN; European Commission JRC

Science for Policy Report; doi:10.2760/60649

Orcutt M (2018) Blockchain, MIT Technology Review, May/June 2018, pp. 18-23

Blockchain • Recording of every transaction in a

time period

• Recognition of value including non-

financial (e.g. education, information)

• Grouped together in a block

• Blocks ‘chained’ together in

chronological order

• Reminiscent of the base pairs in a

DNA double helix

Funk E, Riddell J, Ankel F, Cabrera D (2018) Blockchain Technology: A Data Framework to Improve Validity, Trust, and

Accountability of Information Exchange in Health Professions Education. Academic Medicine: June 12, 2018 - Volume Publish Ahead of

Print doi: 10.1097/ACM.0000000000002326

What I like about Blockchain ….

• Competency Based Medical Education

(CBME)

xAPI

Undergraduate (Universities)

→ Prevocational training (Hospitals)

→ Vocational training (Colleges)

Blockchain in health professional education

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust


(CBME)

• Competencies & Learning Outcomes

Australian and New Zealand College of Anaesthetists (2017) Anaesthesia Training Program Curriculum, Updated September, 2017

xAPI

AR_PF 2.2

Describe how the history and culture of

various indigenous populations impacts

upon their current health status,

education and communication

Role: Professional

Assessment: CPRQ, FEx

IT_AM 2.3

Demonstrate assessment of the

Adequacy of ventilation and identify

airway obstruction

Role: Medical Expert

Assessment: M-DOPS




(CBME)


• Workplace Based Assessment

xAPI



Above average

Average

Below average

Funk E, Riddell J, Ankel F, Cabrera D (2018) Blockchain Technology: A Data Framework to Improve Validity, Trust, and

Accountability of Information Exchange in Health Professions Education. Academic Medicine: June 12, 2018 - Volume Publish Ahead of

Print doi: 10.1097/ACM.0000000000002326


(CBME)



• Entrustable Professional Activities

EPA No /

Code:EPA1 – Anaesthesia 1

Title:

Provide safe, efficient and effective anaesthesia and

sedation for ASA I-II patient having low risk surgery with

Level 4 supervision

Description:

This activity involves providing general anaesthesia,

regional anaesthesia and sedation to low risk patients

(ASA I-II) - including emergency patients - for minor or

intermediate complexity surgery. This is a core

anaesthetic skill. It involves integration of knowledge

(pharmacology, physiology, anatomy), technical skills

(airway management, intravascular access), and non-

technical skills (patient and team communication,

collaboration, professionalism).

Knowledge Skills Behaviours

Workplace Based Assessments



ten Cate O, Chen HC, Hoff RG, Peters H,Bok H, van der Schaaf MF (2015) Curriculum development for the workplace using

Entrustable Professional Activities (EPAs); AMEE Guide No. 99. Medical Teacher; 37: 983–1002


(CBME)




• EHR / monitors / simulators

Big data



Blockchain • Competency Based Medical Education

(CBME)





• Experience data (xAPI /Tin Can API)

Actor↓

Verb↓

Noun↓

Context

Marion

administered

Propofol

for colonoscopy

xAPI




(CBME)





• Experience data (xAPI /Tin Can API)

• Lifelong portable portfolio



Blockchain in credentialing / scope of practice


• Verification of identification,

qualifications & certifications





• Documenting clinical / teaching

experience & currency of practice








Intercollegiate Collaboration on CBME in Anaesthesia (2018) Draft Entrustable Professional Activities (EPAs), University of Utrecht,

The Netherlands








• Managing appointments /

reappointments & scope of practice










• Measuring performance, documenting

outcomes, peer review and patient

feedback

Quality, Safety and Patient Experience Branch, Victorian Government, Department of Health, Melbourne, Victoria (2011)

Credentialling and defining the scope of clinical practice for medical practitioners in Victorian health services – a policy handbook










• Measuring performance, documenting

outcomes, peer review and patient

feedback

Blockchain in health / clinical research


• Local, regional, national and international

multicentre trials / Human Research Ethics





• Tracking conditions, medical devices,

prostheses, implants







• Personalised control of 3rd party access to

EHR through smart contracts / consent

Informed Consent

Benchoufi M, Porcher R, Ravaud P (2017) Blockchain protocols in clinical trials: Transparency and traceability of consent (2017);

Version 5. F1000Research 6: 66; Published online 2018 Feb 1. doi: 10.12688/f1000research.10531.5









• Conduct of assessments, investigations,

therapies in accordance with protocols

Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, Hróbjartsson A, Mann H, Dickersin K, Berlin J, Doré C,

Parulekar W, Summerskill W, Groves T, Schulz K, Sox H, Rockhold FW, Rennie D, Moher D. (2013) SPIRIT 2013 Statement: Defining

standard protocol items for clinical trials. Ann Intern Med 2013;158:200-207. http://www.spirit-statement.org (Accessed July, 2018)











• Data aggregation and management












• Monetisation of research activity

Mamoshina P, Ojomoko L, Yanovich Y, Ostrovski A, Botezatu A, Prikhodko P, Izumchenko E, Aliper A, Romantsov K, Zhebrak A,

Obioma Ogu I, Zhavoronkov A (2017) Converging blockchain and next-generation artificial intelligence technologies to decentralize

and accelerate biomedical research and healthcare. Oncotarget. 2018 Jan 19; 9(5): 5665–5690. doi: 10.18632/oncotarget.22345












• Monetisation of research activity

Blockchain challenges

Blockchain• Trust (MyHR)

• Explaining the principles of Blockchain

• Gaining consensus across jurisdictions,

Colleges, universities, regulators

• Going beyond Bitcoin

• Challenging centralised authority

• Challenging traditional vendors

• Driving the standards agenda

• Herding cats and facilitating flamingos!


Blockchain challenges

BlockchainHealth professional education

Credentialing / scope of practice

Health / clinical research

Thank you

Dr Ian Graham

[email protected]


Documents

An exploration of Blockchain and its applicability to ... · An exploration of Blockchain and its applicability to health professional education, credentialing & research Disclosures: