The birth of the concept of digital citizenship in the medical community

Rage Review : The National Institute of Standards and Technology (NIST) and the Office of the National Coordinator for Health Information (ONC) have collaborated to launch a request report entitled "ONC Blockchain Challenge". ONC is the main federal entity that can coordinate the implementation and use of the most advanced health information technology and electronic health information transactions across the country, and is responsible for national medical interoperability. Part 6 of the report explains the trust architecture of blockchain medicine and expounds on the theory of consensus and encrypted citizens for the first time. ONC and NIST Blockchain Challenge have the potential for open social thinking, because the introduction of blockchain architecture will solve our patient identity authentication problem-achieving national medical interoperability.

Translation: Nicole

Who takes the time to write a ten-page proposal to the government? We all know that nothing will happen if it is read, right? As members of society we have to believe in something, and if we are going to invest our time, committing to improving national healthcare is obviously an important first step.

ONC and NIST Collaboration

The National Institute of Standards and Technology (NIST) and the Office of the National Coordinator for Health Information (ONC) have collaborated to launch a request for reports titled "ONC Blockchain Challenge". ONC is exploring "blockchain applications for health IT and health-related research". The submission period for the report closes on August 8, and the winner will be privately notified on August 22, and the official announcement will be released on August 29.

What is the reason for ONC and NIST to collaborate on this initiative? It is understandable that the organizational missions of both ONC and NIST can be logically aligned to jointly support the ONC Blockchain Challenge. ONC is the primary federal entity that coordinates the national implementation and use of state-of-the-art health information technology and electronic health information transactions and is responsible for national health interoperability.

NIST is a measurement standards laboratory and a non-regulatory agency within the U.S. Department of Commerce with a mission to advance industry innovation and competition. Many IT leaders associate NIST with 800-53 or NIST Professional Publication 800-53, a standards document that recommends security controls for federal information systems and organizations. However, NIST's mission goes much further. NIST is comprised of laboratory programs in areas including nanoscale science and technology, engineering, information technology, electronics research, materials measurement, and physical measurement. ONC and NIST's alliance is an interesting pairing and a signal that industry security and policy are coming together. Together, the two agencies have the potential to create national standards for secure medical interoperability.

The importance of consensus

Among the many ONC Blockchain Challenge reports is one titled “Co-Creating Healthcare Trust: A Crypto-Civic Architecture for Blockchain Interoperability,” which I co-authored with Jeff Brandt, an expert in mobile, security, and healthcare.

ONC Blockchain Challenge

The sixth section of the report explains the trust architecture of blockchain healthcare and for the first time explains the theory behind consensus and digital citizenship.

"To conceptualize different trust ecosystems, we came up with two theoretical foundations: consensus and digital citizenship. The 39-square-mile island of Yap, located at 9°N on the equator, was discovered by the Portuguese in 1527. It is located in the westernmost part of the Caroline Islands and is part of the Commonwealth of Micronesia in the Pacific Ocean. William Henry Furness, who visited the island in 1903, also wrote about the stone coins of Yap in his book published in 1910: The Stone Coins of the Caroline Islands UAP. The Yap people did not use stone coins, their medium of exchange was fei, these large 'coins' were stone wheels, ranging in size from one foot to twelve feet, with a hole in the middle for the insertion of a pole for transportation, the rai stone was worth up to £8,800, and it was not practical to transfer rai from buyer to seller as a medium of payment. Therefore, the community would communicate in the Capitol Square in the center of the village, where all the chiefs would meet to discuss tribal matters. Transfers from family A to family B would be agreed to by consensus. In addition, given the weight of the rai stone, it would generally take eight strong men to move the stone, in a way, to establish community consensus for the transfer of ownership. "

The report explains in detail the value of consensus and how ownership is managed in the healthcare context.

Digital Citizenship

Brandt and I discussed the definition of crypto citizenship and its impact on interoperability. He said

“The concept of digital citizenship is a society of shared trust, where citizens and government establish a new form of relationship, where government involvement is reduced in a decentralized way – where government services and citizens can be managed directly.”

We explain the core architecture of digital citizen interoperability and the concept of self-sovereignty:

“The concept of self-sovereignty (or personal sovereignty, personal autonomy) is that it is a property owned by an individual, from a moral or natural right, that a person has bodily integrity and is the sole controller of their own body and life. Looking back at this definition, we can apply self-sovereignty to the field of medical and medical information. Self-sovereign identity authentication follows this principle: each patient is the source of information and therefore the owner of their own identity information.”

How does this relate to interoperability? How can a patient's medical information be accessed if the vendor cannot verify the patient information? How can medical and treatment information flow between devices and institutions? Currently, information does not flow seamlessly between medical entities. Patients need to request access to their medical information, and usually the information is transmitted inefficiently, usually via fax, email or photocopy.

The report presents an argument that self-management through distributed consensus is an enabler for helping patients take back control of their medical identity verification.

“The pinnacle of interoperability in medical records, with blockchain technology, patients can control their own identity, access data, and conditionally verify shared medical data with providers.”

The ONC and NIST Blockchain Challenge has the potential to open up society’s minds as the introduction of blockchain architecture will solve our patient identity verification problems – enabling national healthcare interoperability.