The COVID-19 pandemic has fueled an unprecedented push for digital transformation, accelerating the adoption of digital technology in healthcare.1, Telemedicine services boomed in Artificial Intelligence (AI) to detect SARS-CoV-22and in the use of AI to predict blueprints for vaccine development3, With the increasing digital flow of data, there is a need for privacy-preserving technologies to improve research and clinical applications within the health care system.4,5, Data tokenization on the blockchain provides a high degree of privacy and the ability for individual ownership of health data, which other privacy-preserving technologies such as federated learning and generative adversarial networks do not provide.6,7,8 (See Table 1 for a glossary of terms). The use of non-fungible tokens (NFTs) is a potential data-management solution for the governance of data at both the individual and institutional level.
Tokenization is a data-security method and token types include platform tokens, utility tokens, governance tokens, security tokens, and NFTs. NFTs are supported on blockchain platforms such as Ethereum and Hyperledger Fabric, where each NFT is digitally unique. NFTs can be created through mining of existing digital data, or they can use generative data, where the digital product is produced in whole or in part by an autonomous system. Once encoded with blockchain technology, an NFT cannot be modified, and its authenticity is validated through the blockchain in which it is stored. Therefore, before mining, the data must be cleaned, verified by verifiable credentials, and converted into an actionable form. It allows individuals to own and trade digital assets between parties such as multinational medical networks, pharmaceutical companies or insurance companies (Figure 1).
We envision several potential benefits of healthcare data tokenization in the form of NFTs. Ownership of data by patients can result in safer care by improving the fluidity of health information between different care providers. Currently, regulations surrounding the protection of data privacy restrict the sharing of patient data across institutions, and inaccurate or incomplete information can result in misdiagnosis and sub-optimal care. Patient access and ownership of data can remedy this situation. This increased fluidity of health information can provide health economic benefits by reducing duplicate testing or treatment.
Giving patients ownership and access to their health data can also encourage patient engagement in their care9, which may positively affect treatment compliance. Similarly, tokenization of health data allows patients to exercise autonomy over their own data, which may prevent companies from profiting from data collected through personal health applications, or institutional databases by third parties. who then sell sensitive health information. Instead, patients can actively choose to share personal data for research. This may address ongoing ethical concerns surrounding situations in which AI developers use publicly available patient data to develop AI algorithms, which can be monetized, without rewarding patients financially.
Storing health data as NFTs can also ensure the authenticity of the data, preventing modifications after the data has been mined. Data integrity contributes to quality health care during the clinical decision-making process and will also contribute to more accurate findings in research. Blockchain technology can also be used for drug verification to prevent counterfeit drugs. The use of smart contracts within NFTs allows reliable automation of data exchange. A smart contract is a rule-based algorithm that allows for automatic self-execution of the approval process when predetermined conditions or rules are met, removing the need for human input in the execution process.
In order to tokenize health data, modifications have to be made from the existing NFT systems. We focus here on the mining process and less on the transactional nature of existing commercial NFTs. We propose that a dedicated blockchain ledger for healthcare data is identified or created, in which tokenized data is stored and verified, and where the data is not publicly viewable. This is in contrast to existing commercial NFT marketplaces where a digital asset – such as an art or music file – is publicly viewable, although only owned by the person who created or bought it.
A web-based or smartphone application can be created in which each patient has a health wallet, similar to a cryptocurrency wallet, where digital health data can be accessed in the form of NFTs via verifiable credentials. The health data to be tokenized must be characterized, which will include determining whether the data is structured (such as laboratory values) or unstructured (such as radiology images and physician notes) and whether preprocessing of the data is required.
Once the infrastructure is ready, health data can be molded into NFTs. The health data received will be molded into a health NFT and made available in the patient’s health wallet. Patients will then have ownership and access to their own data and can subsequently decide whether to share or transfer ownership of these data to other parties in the network (Figure 1).
However, despite the potential benefits, there are barriers to the adoption of NFTs in health care. NFTs are susceptible to data security compromises due to vulnerabilities with smart contracts. Stolen NFTs are not uncommon, as seen in the Bored App Yacht Club NFT theft, where hackers used phishing techniques to modify smart contracts. Furthermore, the tokenization of health data can lead to unethical exploitation, inducing patients to participate in trials for monetary gain. Furthermore, the complexities of NFTs can present a challenge for some people in terms of managing their own data.
Destruction of NFTs is possible and is currently done by ‘burning’, with NFTs being sent to inaccessible addresses. However, NFTs are generally considered immutable and can exist forever on the blockchain, presenting a challenge to the destruction or modification of any inaccuracies in health data that could compromise patient care and research integrity. Is. The handling, transfer and storage of large amounts of healthcare data can also lead to high maintenance costs and power consumption, resulting in a huge carbon footprint.10, Mining NFTs can vary in cost depending on data size, transaction speed, blockchain utility fees, and data quality. The massive amount of health data from the global population may be too much for existing infrastructure to support. The nascent technology of quantum computing may provide solutions for data storage, retrieval and analysis through quantum speedup and quantum supremacy. To overcome these limitations, future research and practical considerations will aid tokenization of health data.
NFTs in healthcare could revolutionize how sensitive health data is handled. At the heart of the NFT are transparency, accountability, confidentiality and patient autonomy – all of which are important values in health care. Further enhancements to safeguarding data security and simplifying processes as well as increasing access to all will be necessary if NFTs are to start a revolution in digital health.