Beyond Bitcoin: potential applications of blockchain technology in dermatology

Abstract

Dear Editor, Since its initial popularization in 2008 as the underpinnings of the digital currency Bitcoin, blockchain has seen its implications spread beyond the financial industry.1 The field of dermatology presents promising potential applications for this burgeoning technology. Blockchain facilitates communication on a peer‐to‐peer platform with users sharing data directly with each other (Fig. 1). Computational algorithms ensure that the database is permanent, chronologically ordered and universally available on a network while remaining cryptographically secure. These attributes allow blockchain to remove intermediary costs, reduce manual errors and decrease risks of single points of failure.1 Potential implementation of blockchain technology in dermatology. (1) Dermatologists store encrypted patient data via blockchain. The stored data are securely distributed across the entire network of participating parties. (2) Data can be decrypted by participating parties and patients, using a private digital key. (3) Once decrypted, data can be used for various applications. Secure data storage and distribution are particularly useful for dermatology. Given our field's visual nature, digital imaging has become ubiquitous for documenting diseases, following patient progression and assessing treatment efficacy. With increasing image acquisition, needs for better standardization of imaging techniques and storage system interoperability have emerged.2 Blockchain offers the ideal solution. Encrypted images can be stored via blockchain, with image ownership and locations encoded as transactions. Every participating party could access data from other clinical practices, as long as patient permission and a secure digital decryption key were obtained. As information would be duplicated throughout the network – not backed up at individual institutions – this approach could reduce single‐site storage capacity needs. Patients could also access medical records via private digital keys, selectively sharing information while retaining data control. This model would eliminate burdens of printing patient records, physically transferring images or repeating unnecessary biopsies when patients change dermatologists. Patients could more easily obtain second opinions, grant viewership rights to guardians, or provide information for clinical research. Dermatologists would have enhanced focus on collaboration, care coordination and outcomes‐based care. Blockchain technology may also expedite machine learning advances in dermatology. Recent innovations highlight potential roles for artificial intelligence in skin cancer diagnosis.3 Allowing machine learning algorithms access to numerous images on a secure blockchain network would drive further optimization of computer‐assisted analysis. Importantly, blockchain would provide immutable trails between what the algorithms suggested and actual diagnoses, allowing for continuously learning feedback loops and improved diagnosis. A best practice for implementation of blockchain includes data encryption to ensure confidentiality. Speed and scalability are being addressed with ongoing research, and the cost‐effectiveness of implementation will also need to be explored.4 As these challenges are addressed, dermatology has the opportunity to lead other specialties in harnessing this emerging technology's potential to revolutionize the standardization, storage and distribution of information. Funding sources: None. Conflicts of interest: None to declare.