21st century PACS: 4 ways blockchain could change the radiology landscape

Blockchain is beginning to make waves in industries outside of digital cryptocurrencies like bitcoin, and could be the next big disruptor in radiology.

That’s according to Morgan P. McBee, MD, Medical University of South Carolina, and Chad Wilcox, MD, University of California Los Angeles. The radiologist duo believes that the distributed ledger technology could have an impact on the storage and distribution of medical images similar to that of picture archiving and communication systems.

The authors discussed how blockchain works, potential challenges researchers may face when trying to adopt it and how the technology could be useful in medical imaging, Jan. 2 in the Journal of Digital Imaging.

Below are four areas ripe for disruption.

Image sharing

It’s 2020, but medical images are still typically transferred among institutions via CD or DVD. And patients are often the ones responsible for remembering these discs and, in some cases, must cough up the costs for the hardware.

Sharing images over blockchain could be done publicly or privately. In one situation, three public or private key transactions on a chain would allow secure image transfer by defining the image source, the corresponding owners of the image and then, after verification, afford access to the image from its source.

There are already platforms that enable image sharing, the authors noted, but blockchain would be a supplement, rather than a replacement for those.

“Such an implementation could eliminate the need for medical imaging facilities to create and import discs and the need for patients to transport them, which may lead to repeat imaging and poor use of limited medical resources,” McBee and Wilcox wrote.

Tracking medical devices

Much like proposals utilizing blockchain to manage pharmaceutical supply chains, the tech could be used to package medical device information with a patient’s imaging data to better inform clinicians.

For example, the chain could detail MRI compatibility for various medical implants and pertinent information regarding a patient’s inferior vena cava filter placement.

“Ready access to this information could assist interventionalists in procedural planning, reduce the likelihood of redundant imaging for these procedures, and potentially preclude the need for secondary interventions,” the authors wrote.

Enhanced research capabilities

Once images are entered into the blockchain, they can’t be altered. This could allow healthcare institutions to control access to their data while still allowing collaboration and image-sharing across various enterprises.

The inability to change the blockchain, the authors noted, increases transparency, safeguards against data manipulation and immediately timestamps images

Artificial intelligence improvements

It’s well-understood that machine learning created, trained and tested on images from multiple institutions across various populations will translate to better clinical use. Current iterations, however, often rely on centralized datasets and servers.

“Blockchains could store multiple different kinds of patient data such as notes, lab values, data from wearable devices, precision medicine and genomic data, and medical imaging and make it available in de-identified batches for machine learning algorithms to consume for corroboration and correlation,” the researchers wrote.

This would not only improve collaboration, but reduce the risk of data loss and untrustworthy AI outcomes, they added.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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