健康医疗 区块链

This article was originally published on Blockchain Review. Thank you for supporting the partners who make SitePoint possible.

本文最初发表在《 区块链评论》上 。 感谢您支持使SitePoint成为可能的合作伙伴。

Ever wondered about blockchain applications in healthcare? This post will give you a well-rounded introduction to the transformative potential of blockchain and set out the complex interrelated issues that stand in the way of change.

是否曾想过医疗保健中的区块链应用？ 这篇文章将为您全面介绍区块链的变革潜力，并阐明阻碍变革的复杂相关问题。

As an important step in becoming a doctor, graduating medical school students swear to some form of the Hippocratic Oath.

作为成为医生的重要一步，即将毕业的医学院学生发誓要参加某种形式的希波克拉底誓言。

One of the vows within that oath is “first, do no harm” or “primum nonnocere.”

该誓言中的一个誓言是“首先，不伤害”或“原始无罪”。

While most medical professionals live up to this promise on a daily basis, the same cannot be said for the healthcare systems within which they operate.

尽管大多数医疗专业人员每天都履行这一诺言，但对于他们所运营的医疗保健系统却不能说同样的话。

Despite significant leaps in the medical field, from devices and wearables to genome sequencing and regenerative medicine, individual improvements have not created the fundamental transformation that national healthcare systems require. [1]

尽管从设备和可穿戴设备到基因组测序和再生医学等医学领域都取得了重大飞跃，但个人的进步并没有创造出国家医疗保健系统所需的根本性变革。 [ 1 ]

Health management and administrative systems remain relatively untouched by technology and regulatory reform and stand ill-equipped to serve the current and future needs of their target populations.

卫生管理和行政系统相对不受技术和监管改革的影响，并且设备不足，无法满足其目标人群的当前和未来需求。

人口压力 (Demographic Stresses)

The world is getting older, especially in developed countries, which is placing a significant strain on healthcare systems. According to a 2015 report by the United Nations Department of Economic & Social Affairs [2]:

世界正在变老，尤其是在发达国家，这给医疗保健系统带来了巨大压力。 根据联合国经济和社会事务部2015年的报告[ 2 ]：

• Between 2015 and 2030, the group of over-60s will grow by 56%从2015年到2030年，年龄在60岁以上的群体将增长56％
• In 2015, one in eight people worldwide were aged 60 or over. By 2030, seniors are projected to account for one in six people globally.2015年，全球八分之一的人年龄在60岁以上。 到2030年，预计老年人将占全球人口的六分之一。
• The aging process is most advanced in Europe and Northern America, where more than one in five people are aged 60 or over as of 2015.老化过程在欧洲和北美最为先进，截至2015年，五分之一以上的人年龄在60岁以上。
• By 2030, the elderly are expected to account for more than 25% of the populations in Europe and Northern America, 20% in Oceania, 17% in Asia and Latin America and the Caribbean, and 6% in Africa.到2030年，预计老年人将占欧洲和北美人口的25％以上，大洋洲20％，亚洲和拉丁美洲及加勒比17％，非洲6％。

In the developing world, particularly Sub-Saharan Africa and Asia, future challenges in healthcare will stem from population increases and economic factors rather than aging.

在发展中国家，特别是撒哈拉以南非洲和亚洲，医疗保健方面的未来挑战将来自人口增长和经济因素，而非老龄化。

High population growth coupled with a trickle down of innovations is driving a growing middle-class.

人口的快速增长加上创新的不断发展正在推动中产阶级的增长。

With growth coming almost exclusively from emerging nations, the world's middle class is expected to expand by another three billion over the next two decades. [3]

由于增长几乎完全来自新兴国家，因此在未来二十年中，世界中产阶级有望再增长30亿。 [ 3 ]

Delivering efficient, sustainable and affordable healthcare to the world's aging population and emerging middle class will become more difficult without profound and substantive changes to national healthcare systems.

如果不对国家医疗体系进行深刻而实质性的改变，向世界老龄化人口和新兴的中产阶级提供有效，可持续和负担得起的医疗保健将变得更加困难。

While problems are complex, systemic and by no means easily fixed, the vast majority of constraints experienced by healthcare systems can be traced to a single, yet highly corrosive root cause.

尽管问题很复杂，系统性并且绝不容易解决，但医疗保健系统所遇到的绝大多数限制都可以追溯到一个单一的但具有高度腐蚀性的根本原因。

近视，过时和限制性合规性法规 (Myopic, Outdated & Restrictive Compliance Regulations)

The costs, risks and societal sensitivities surrounding healthcare are profound. Due to the sensitive and central role healthcare plays in society, fearful government officials have been scared to make the deep regulatory changes required to reform healthcare.

围绕医疗保健的成本，风险和社会敏感性是深远的。 由于医疗保健在社会中所发挥的敏感和核心作用，令人恐惧的政府官员不敢进行改革医疗保健所需的深刻监管变革。

Officials know they will be punished by the public and politicians more for underregulating — approving a harmful drug, say — than for tightening the approval process, even if doing so delays a useful innovation. – Regina E. Herzlinger

官员们知道，他们将受到公众和政客的更多惩罚，而不是加强监管程序，因为监管不严(批准有害药物)，即使这样做会拖延有用的创新。 – Regina E. Herzlinger

还记得奥巴马医改传奇吗？ (Remember the Obamacare Saga?)

Sure you do. It's still going on today, many years later.

当然可以。 多年以后的今天，它仍在继续。

The divisive public and congressional debates. The multitude of vested interests and the tangle of regulations. It's not hard to understand why the implementation of far-reaching regulatory reforms have been unattainable and generally avoided by politicians.

公开辩论和国会辩论。 既得利益众多，法规纠缠不清。 不难理解为什么深远的监管改革无法实现，而政治家通常会避免这样做。

Data sharing and privacy laws have resulted in gross inefficiencies, industry-wide fragmentation, and the prevention of real innovation in healthcare. HIPAA, for example, the US Health Insurance Portability and Accountability Act, designed to protect health information, imposes strict rules on healthcare providers.

数据共享和隐私法已导致效率低下，行业范围分散，并阻止了医疗保健领域的真正创新。 HIPAA，例如旨在保护健康信息的《美国健康保险可移植性和责任法案》，对医疗保健提供者施加了严格的规定。

Despite the Act's noble intention to keep patient data secure and private, it remains a large impediment to efficient patient care mainly because of the difficulties in accessing patient information and restrictions on electronic communications.

尽管该法案旨在保护患者数据安全和私密的崇高意图，但这仍然是有效护理患者的主要障碍，主要是因为访问患者信息的困难和电子通信的限制。

Many physicians may be reluctant to embrace EHRs because of malpractice concerns. They may believe that they are better protected against malpractice lawsuits by the handwritten chart system. Furthermore, HIPAA has raised many new issues about data handling. There are also international legal issues about sharing health information. Many unresolved legal concerns surround legal liability in the event of medical errors that are byproducts of health analysis software or EHR data encoding. – A Robust Health Data Infrastructure

由于医疗事故的考虑，许多医生可能不愿接受EHR。 他们可能认为，手写图表系统可以更好地保护他们免受渎职诉讼的伤害。 此外，HIPAA提出了许多有关数据处理的新问题。 关于共享健康信息也存在国际法律问题。 如果医疗分析错误是健康分析软件或EHR数据编码的副产品，则许多未解决的法律问题围绕法律责任。 – 健壮的健康数据基础架构

Government regulations like HIPAA have caused a host of flow-on problems.

像HIPAA这样的政府法规已经引起了一系列的问题。

Healthcare management systems designed to adhere to such restrictive regulations are antiquated and fragmented. Bloated systems that run on paper and siloed record-keeping practices have created healthcare management systems that are inefficient, fragmented, isolated and opaque.

旨在遵守此类限制性法规的医疗保健管理系统过时且分散。 运行在纸上的膨胀系统和孤立的记录保持做法创建了低效，零散，孤立和不透明的医疗保健管理系统。

The shift towards electronic health records (EHR) has done little to improve the splintered nature of healthcare. A severe lack of interoperability within organizations and at the inter-organizational level means that coordination remains minimal. EHR's are fragmented across hospitals, private practices, labs, pharmacies and many other industry players. [6]

向电子健康记录(EHR)的转变对改善医疗保健的零碎性质几乎无济于事。 组织内部和组织间严重缺乏互操作性，这意味着协调仍然很少。 电子病历分散在医院，私人诊所，实验室，药房和许多其他行业参与者之间。 [ 6 ]

On average, Americans visit 16 different doctors in their lifetime. While both the HITECH and the Affordable Care Act's now enable and in some cases mandate that data from your doctor's visits be stored digitally, medical records and results from different facilities and physicians are often stored in incompatible databases. – Brian Forde

美国人一生平均会拜访16位不同的医生。 虽然HITECH和《平价医疗法案》现在均已启用，并且在某些情况下要求将医生就诊时的数据以数字形式存储，但来自不同机构和医生的医疗记录和结果通常存储在不兼容的数据库中。 – 布赖恩·福特 ( Brian Forde)

现实世界对患者健康的影响 (Real-world Implications for Patient Health)

The inability to exchange and make use of electronic health records serves as a major impediment to the development of a robust data infrastructure. [8] As you can imagine, when hospitals, clinics, insurers, governments and doctor's offices are unable to share information, this has negative outcomes for patient health.

无法交换和使用电子健康记录是发展健壮的数据基础架构的主要障碍。 [ 8 ]您可以想象，当医院，诊所，保险公司，政府和医生办公室无法共享信息时，这会对患者的健康产生负面影响。

Einer Elhauge, Founding Director of the Petrie-Flom Center for Health Law Policy, Biotechnology & Bioethics at Harvard writes:

哈佛大学Petrie-Flom卫生法政策，生物技术和生物伦理学中心的创始主任Einer Elhauge写道：

Just as too many cooks can spoil the broth, too many decision makers can spoil health care. Individual decision makers responsible for only one fragment of a relevant set of health care decisions may fail to understand the full picture, may lack the power to take all the appropriate actions given what they know, or may even have affirmative incentives to shift costs onto others. All these forms of fragmentation can lead to bad health care decisions. [9]

正如太多的厨师会破坏肉汤一样，太多的决策者也会破坏医疗保健。 仅负责一组相关医疗保健决策中的一个决策的个体决策者可能无法了解整体情况，可能缺乏根据他们所知道的采取所有适当行动的权力，甚至可能有积极的动机将成本转移到其他方面。 所有这些分散的形式都可能导致不良的医疗保健决策。 [ 9 ]

Take a look at this example scenario.

看一下这个示例场景。

A patient seeks medical advice to find a remedy for his constant fatigue and muscle aches.

病人寻求医疗建议，以找到持续疲倦和肌肉酸痛的治疗方法。

He/she visits a number of doctors, each a specialist in their respective areas and even visits the hospital on one occasion.

他/她拜访了许多医生，每个医生都是各自领域的专家，甚至一次拜访了医院。

He/she receives a battery of tests from each doctor as well as the hospital and is prescribed a range of drugs.

他/她从每位医生以及医院那里接受了一系列检查，并被开出了一系列药物。

The patient's condition proceeds to deteriorate, so he/she decides to visit a new doctor who continues a new testing and treatment regime. Throughout the process, the medical professionals treating the patient have little communication and share minimal information on the patient's medical history.

患者的病情不断恶化，因此他/她决定去拜访一位继续采用新的测试和治疗方案的新医生。 在整个过程中，治疗患者的医疗专业人员之间几乎没有交流，并且分享的患者病史信息很少。

Even though the doctors who treated the patient in this fictitious, albeit credible real-world example may have followed the right medical procedures to treat the problems they were trained to handle, the fragmented nature of the healthcare system resulted in no co-ordination and ultimately substandard patient care.

尽管在这个虚构的，尽管可信的真实示例中治疗患者的医生可能已经遵循了正确的医疗程序来治疗他们受过训练的问题，但是医疗保健系统的分散性导致没有协调，最终不合格的患者护理。

The incapacity to share vital information led doctors to be unable to see the patient's bigger picture which could have shed further light on the health condition. Information sharing between doctors would likely have resulted in better treatment and a reduction in patient, doctor and insurer costs that accompanied needless treatments.

不能共享重要信息导致医生无法看到患者的整体情况，这可能会进一步说明健康状况。 医生之间的信息共享可能会带来更好的治疗，并减少不必要的治疗带来的患者，医生和保险人费用的减少。

Information sharing between doctors would likely have resulted in better treatment and a reduction in patient, doctor and insurer costs that accompanied needless treatments.

医生之间的信息共享可能会带来更好的治疗，并减少不必要的治疗带来的患者，医生和保险人费用的减少。

The corrosive impact of government regulations doesn't end here.

政府法规的腐蚀性影响并没有就此结束。

Fragmented, siloed record-keeping practices and systems that lack basic levels of interoperability are responsible for other major problems in healthcare.

缺乏基本互操作性的零散，孤立的记录保存做法和系统是医疗保健中其他主要问题的原因。

There is now a severe lack of advanced data available for clinical and scientific research and economic, behavioral and infrastructure purposes. With little meaningful data, it's difficult for governments and the healthcare industry to see the bigger picture and make informed decisions to improve the quality of patient care.

现在，严重缺乏可用于临床和科学研究以及经济，行为和基础设施目的的高级数据。 由于缺乏有意义的数据，政府和医疗保健行业很难看到更大的前景并做出明智的决定来提高患者护理质量。

There is also insufficient insurable data for the most at-risk and underserved citizens and the tracking of population health trends. [10]

对于高风险和服务欠缺的公民以及追踪人口健康趋势的可保数据也不足。 [ 10 ]

Perhaps the most destructive impact of fragmentation and the inability to share information is that it has caused deep inefficiencies. Healthcare costs, in the United States, for example, have spiraled out of control.

碎片化和无法共享信息的最大破坏力可能是它造成了严重的低效率。 例如，在美国，医疗保健费用已经失控。

According to the CDC, health expenditures as a percentage of GDP have risen some 4.5% since the year 2000. [11]

根据疾病预防控制中心(CDC)的数据，自2000年以来，卫生支出在GDP中所占的比例增长了约4.5％。[ 11 ]

Health expenditures % of GDP:

卫生支出占GDP的百分比：

• 2000: 13.3%2000：13.3％
• 2009: 17.3%2009：17.3％
• 2014: 17.4%2014年：17.4％
• 2015: 17.8%2015：17.8％

High costs have contributed to insurance companies' reluctance to insure the population and provide an adequate range of services.

高昂的成本导致保险公司不愿为民众提供保险，并不愿提供足够的服务。

Many national healthcare systems are so inefficient they have become unable to deliver any form of care to the most vulnerable and at-risk members of society. Many are even failing to deliver adequate care to those that can afford it.

许多国家医疗保健系统效率低下，以致无法向社会中最弱势和高风险的成员提供任何形式的护理。 许多人甚至没有为负担得起的人提供足够的照顾。

As demographic shifts take place, these inefficiencies will worsen. The reinvention of the national healthcare systems is now required.

随着人口结构的变化，这些低效率的状况将进一步恶化。 现在需要重塑国家医疗体系。

Blockchain technology is a key tool to achieve healthcare objectives for developing and "re-developing" nations.

区块链技术是实现发展中国家和“发展中国家”国家医疗保健目标的关键工具。

One of the fundamental goals that governments and industry seek to achieve is to provide improved quality of healthcare at lower healthcare costs. [12] Making this goal a reality will require governments and industry to play different, but equally important roles.

政府和行业寻求实现的基本目标之一是以更低的医疗费用提供更高的医疗质量。 [ 12 ]实现这一目标将需要政府和行业发挥不同但同样重要的作用。

Governments: must lead change through regulatory reforms that incorporate technological advances and foster an environment designed around competitive collaboration and innovation amongst insurers, healthcare providers, and regulators. It's equally imperative for governments to participate in technological innovation programs and R&D to support the development of a robust health data infrastructure.

政府 ：必须通过包含技术进步的监管改革来引领变革，并营造围绕保险公司，医疗保健提供者和监管机构之间的竞争性合作与创新而设计的环境。 政府同样必须参与技术创新计划和研发，以支持强大的健康数据基础架构的发展。

It's equally imperative for governments to participate in technological innovation programs and R&D to support the development of a robust health data infrastructure.

政府同样必须参与技术创新计划和研发，以支持强大的健康数据基础架构的发展。

Industry: Transforming the mindset of healthcare from a system centered around the care of individuals to a system focused on the overall health of individuals will be foremost. [13]

行业 ：将医疗保健的思维方式从以个人护理为中心的系统转变为以个人整体健康为中心的系统。 [ 13 ]

Industry will need to incorporate new technologies that redefine the value proposition and collaborate with other industry players that provide valuable yet asymmetric information. Industry must also seek new ways to reach beyond current customers by developing innovative business models that reach underserved and high-risk population groups.

行业将需要采用重新定义价值主张的新技术，并与其他提供有价值但不对称信息的行业参与者合作。 工业界还必须通过开发创新的业务模式来寻求覆盖现有客户和高风险人群的新方法，以超越现有客户。

Together: Governments and industry must become more efficient with population growth and globalization. Lowering administrative costs through innovative technologies, while scaling services, and enhancing outcomes is imperative for the sustainability and competitiveness of both nations and industry. Growth will reward those who can embrace the technological arms race and create greater internal capabilities and efficiency.

在一起 ：随着人口增长和全球化，政府和企业必须提高效率。 通过创新技术降低行政成本，同时扩大服务范围，并提高成果，对于国家和行业的可持续性和竞争力至关重要。 增长将奖励那些能够接受技术军备竞赛并创造更大内部能力和效率的人。

医疗保健是高风险游戏 (Healthcare is a High Stakes Game)

Inefficiencies in healthcare systems bleed into all other parts of a society and the economy. Achieving improved quality healthcare at lower costs will prove key to the future success of developed and developing nations.

医疗保健系统的低效率渗入了社会和经济的所有其他部分。 以较低的成本实现高质量的医疗保健将被证明是发达国家和发展中国家未来成功的关键。

Overcoming the myriad of challenges will demand a new approach that focuses on the convergence of technology and networked alliances.

克服无数挑战，将需要一种新方法，侧重于技术和网络联盟的融合。

Blockchain technology is an important tool that can enable both government and industry to make the fundamental changes needed to overhaul national healthcare systems and meet their objectives.

区块链技术是一种重要工具，可以使政府和行业做出必要的根本性改变，以全面改革国家医疗保健系统并实现其目标。

Blockchain technology is a resilient digital infrastructure to enable governments to become more efficient.

区块链技术是一种灵活的数字基础架构，可让政府提高效率 。

Technology is driving rapid change in the global economy. National governments are awakening to the realization that innovation and broad regulatory reforms will be the foundation for national success in the new digital economy.

技术正在推动全球经济的快速变化。 各国政府已经意识到，创新和广泛的监管改革将成为国家在新的数字经济中取得成功的基础。

As the world becomes more urbanized, vast megacities are serving as innovation centers and primary drivers of economic growth. [13] Challenges that accompany urbanization and population increases mean that cities must become smarter in all areas, including healthcare, or risk losing out on key economic benefits.

随着世界城市化程度的提高，巨大的特大城市正在成为创新中心和经济增长的主要动力。 [ 13 ]伴随城市化和人口增长的挑战，意味着城市必须在包括医疗保健在内的所有领域变得更加智慧，否则就有失去主要经济利益的风险。

A Blockchain is a networked database that can fuel and support smart city initiatives and drive economic growth. It enables the creation of a digital infrastructure that is necessary to enable mass transformation to occur and vital national industries to grow.

区块链是一个网络数据库，可以推动和支持智慧城市计划并推动经济增长。 它使创建数字基础架构成为可能，这对于实现大规模转型和重要的民族工业发展至关重要。

Cities, municipalities, and governments are turning to blockchain technology to prepare for current and future challenges. From the US state of Delaware to Singapore, Estonia, Russia, Sweden, UK, South Korea and many others, blockchain based solutions are being sought to provide a better digital infrastructure now and into the future for governments. [14]

城市，市政当局和政府正在转向区块链技术来为当前和未来的挑战做准备。 从美国特拉华州到新加坡，爱沙尼亚，俄罗斯，瑞典，英国，韩国等许多国家，人们正在寻求基于区块链的解决方案，以为政府现在和将来提供更好的数字基础架构。 [ 14 ]

William Mougayar sets out four main areas where governments can utilize blockchain technology. They include [15]:

William Mougayar提出了政府可以利用区块链技术的四个主要领域。 其中包括[ 15 ]：

• Verifications验证方式
• Movement of assets资产变动
• Ownership所有权
• Identity身分识别

The accurate and efficient verification of information such as licenses, permits, transactions, and identities can solve a number of problems for government operations. Data lineage and integrity when handling sensitive information is in the public interest.

对诸如许可证，许可证，交易和身份之类的信息进行准确而有效的验证可以解决政府运营中的许多问题。 处理敏感信息时的数据沿袭和完整性符合公共利益。

The ability to verify data has not been tampered with, identify the source of information and track a chain of custody from creation holds benefits that are self-evident. [16] Imagine the benefits to healthcare data and information sharing.

验证数据的能力未受到篡改，识别信息源以及跟踪创建过程中的监管链的好处不言而喻。 [ 16 ]想象一下医疗数据和信息共享的好处。

Governments and smart cities could issue e-identities to the population, enabling the frictionless use of a variety of national and municipal services. [17] Digital ID's that act like a digital watermark to every transaction, will help governments check identities in real-time, dramatically reducing the rate of fraud other criminal activities. Increased levels of data integrity could also redefine the relationship between citizens and their governments in terms of transparency and trust.

政府和智慧城市可以向居民发布电子身份，从而可以毫不费力地使用各种国家和市政服务。 [ 17 ]数字身份证在每笔交易中都像数字水印一样，将帮助政府实时检查身份，从而大大降低其他犯罪活动的欺诈率。 数据完整性水平的提高还可以在透明度和信任度方面重新定义公民与其政府之间的关系。

Another area where blockchain technology can be of great benefit is in the movement of assets. Blockchain can enable the direct and automatic transfer of payments or assets between governments and citizens for services rendered.

区块链技术可以带来巨大好处的另一个领域是资产的流动。 区块链可以实现政府和公民之间直接或自动转移支付或资产以提供服务。

This will cut out excessive intermediary costs, redundancies and greatly improve the efficiency of government operations in healthcare and many other areas.

这将减少过多的中介费用，裁员，并大大提高政府在医疗保健和许多其他领域的运作效率。

Entire government departments could be replaced by blockchain based registries saving billions of dollars of taxpayer funds. Government offices could become far more efficient as new registries powered by blockchain securely record data, transactions and track provenance.

整个政府部门都可以由基于区块链的注册表代替，从而节省数十亿美元的纳税人资金。 随着由区块链提供支持的新注册管理机构安全地记录数据，交易并追踪出处，政府机关的效率将大大提高。

The truth about 'Smart Cities' is that there is only going to be one way that they can become truly 'smart': through data and analytics. – David Barton

关于“智慧城市”的真相在于，只有一种方法可以使它们真正成为“智能”：通过数据和分析。 – 大卫·巴顿

One of the most profound benefits of blockchain technology, however, is the ability for governments to securely utilize vital sovereign data. For governments, this presents unique opportunities to streamline operations. Real-time analysis of pseudonymous data can be conducted to find trends in health, transport, security, city planning, crime, future proofing and a host of other important issues.

但是，区块链技术最深刻的好处之一就是政府能够安全地利用重要的主权数据。 对于政府而言，这为简化运营提供了独特的机会。 可以对假名数据进行实时分析，以发现健康，交通，安全，城市规划，犯罪，未来证明和许多其他重要问题的趋势。

Armed with valuable data insights, governments can utilize resources in areas that will have the greatest impact on society. This newfound capacity will be a game changer for governments and their citizenry.

借助宝贵的数据见解，政府可以在对社会影响最大的领域中利用资源。 这种新发现的能力将改变政府及其公民的游戏规则。

Blockchain technologies are an effective foundation to help industry redesign organizations, products, and services.

区块链技术是帮助行业重新设计组织，产品和服务的有效基础。

It's important to recognize early on that the drivers of business success are changing as we enter a new globalized digital economy. Consortiums and networked alliances are the new competitive advantage.

重要的是要尽早认识到，随着我们进入新的全球化数字经济，业务成功的动力正在发生变化。 联盟和网络联盟是新的竞争优势。

Companies and industries must connect, collaborate and build networks to help become more efficient and agile. Those that choose to insulate themselves will find an already volatile and competitive global economy even more inhospitable.

公司和行业必须联系，协作和建立网络，以帮助提高效率和敏捷性。 那些选择与自己隔绝的人将发现本已动荡不堪的竞争性全球经济更加荒凉。

The emerging business models are founded on the notion of community: success will be achieved by those who involve their suppliers, their infrastructure providers, and-perhaps most important-their customers in a network where they can build value together. Networks that enable trading, sharing, and enhancing knowledge to build value for mutual benefit are essential." – Governance in the Digital Economy

新兴的业务模型建立在社区概念的基础上：成功的实现将由那些参与其供应商，其基础架构提供商甚至最重要的客户(他们的客户在网络中，他们可以一起创造价值)中实现。 能够进行交易，共享和增强知识以为互利创造价值的网络至关重要。” – 数字经济中的治理

There are three categories of blockchain database applications. A public blockchain is a fully decentralized platform where anyone in the world can view and add information to the platform as well as contribute to the consensus process. [20] A private blockchain, on the other hand, is centralized within one organization, allowing only the owner of the database to view and write information onto the blockchain. [21]

区块链数据库应用程序分为三类。 公共区块链是一个完全去中心化的平台，世界上任何人都可以查看该平台并将信息添加到该平台，并为共识过程做出贡献。 [ 20 ]另一方面，私有区块链集中在一个组织内，仅允许数据库所有者查看信息并将信息写入区块链。 [ 21 ]

Arguably of most consequence to the healthcare industry are consortium blockchains which differ to private and public blockchains in that they are partially decentralized. As Vitalik Buterin explains:

可以说，对医疗保健行业而言最重要的是财团区块链，其与私有和公共区块链的不同之处在于它们是部分分散的。 正如Vitalik Buterin解释的那样：

A consortium blockchain is a blockchain where the consensus process is controlled by a pre-selected set of nodes; for example, one might imagine a consortium of 15 financial institutions, each of which operates a node and of which 10 must sign every block in order for the block to be valid. – Vitalik Buterin

联合体区块链是共识过程由一组预选节点控制的区块链； 例如，可以想象一个由15个金融机构组成的财团，每个财团经营一个节点，并且其中10个必须在每个区块上签名，以使该区块有效。 – 维塔利克·布特林(Vitalik Buterin)

He continues:

他继续：

In general, so far there has been little emphasis on the distinction between consortium blockchains and fully private blockchains, although it is important: the former provides a hybrid between the "low-trust" provided by public blockchains and the "single highly-trusted entity" model of private blockchains, whereas the latter can be more accurately described as a traditional centralized system with a degree of cryptographic auditability attached.

总的来说，到目前为止，很少强调联合体区块链和完全私有区块链之间的区别，尽管这一点很重要：前者提供了公共区块链提供的“低信任度”和“单一高度信任的实体”之间的混合体”模型，而后者可以更准确地描述为传统的集中式系统，并附带一定程度的密码可审计性。

Blockchain-based consortiums are key to the survival and success of the healthcare industry for several reasons. Market pressures are now more intense than ever before.

基于区块链的财团是医疗行业生存和成功的关键，原因有很多。 现在市场压力比以往任何时候都更加强烈。

International competition, the need to develop new products and services at speed, concerns about meeting new regulatory requirements, reductions in corporate R&D budgets and other industry-wide problems, mean that companies are under constant pressure.

国际竞争，对快速开发新产品和服务的需求，对满足新法规要求的担忧，公司研发预算的减少以及其他整个行业的问题，都意味着公司承受着持续的压力。

Consortium blockchains are an efficient way for industry players with shared goals to collaborate and create unique products and services.

对于具有共同目标的行业参与者来说，联盟区块链是一种有效的方式进行协作并创建独特的产品和服务。

Blockchain consortiums deliver everything that older style consortiums do but in a more efficient and secure way. Intellectual property and other sensitive data sets have high-level integrity and information sharing is efficient and safe.

区块链财团提供了旧式财团所做的一切，但以一种更有效，更安全的方式。 知识产权和其他敏感数据集具有高度的完整性，并且信息共享高效而安全。

The construction of a shared industry data infrastructure where companies can gain and share knowledge and develop new technologies without compromising privacy and security is now possible. Blockchain consortiums can serve as the backbone for innovation in healthcare products, services, and delivery.

现在，可以构建共享的行业数据基础结构，使公司可以在不损害隐私和安全的情况下获取和共享知识并开发新技术。 区块链财团可以充当医疗保健产品，服务和交付创新的Struts。

联盟已经形成 (Alliances Are Already Forming)

The healthcare industry is already witnessing the makings of some great alliances. In early 2016, Gem launched the Gem Healthcare Network with Phillips Blockchain Lab. The Gem network, powered by Ethereum blockchain, aims to develop applications and shared infrastructure for healthcare. [24]

医疗保健行业已经见证了一些伟大联盟的建立。 2016年初，Gem与菲利普斯区块链实验室合作推出了Gem医疗保健网络。 由以太坊区块链支持的Gem网络旨在为医疗保健开发应用程序和共享基础架构。 [ 24 ]

Phillips Blockchain Lab, the R&D wing of Phillips is the first healthcare operator to join the network. The network plans to build an inclusive ecosystem of industry players to identify and solve healthcare problems.

Phillips的研发部门Phillips Blockchain Lab是第一家加入该网络的医疗保健运营商。 该网络计划建立一个由行业参与者组成的包容性生态系统，以识别和解决医疗保健问题。

This is a step in the right direction.

这是朝正确方向迈出的一步。

Alliances will need to work outside the walls of the organization and across industry to find collaborative ways that provide mutual benefits to each party. The future of the healthcare industry cannot be secured with isolationism and insularity, rather success will belong to those that are networked, open and nimble.

联盟将需要在组织范围之外和整个行业范围内开展工作，以找到可以为双方带来互惠互利的协作方式。 孤立性和孤立主义无法确保医疗保健行业的未来，而成功将取决于网络化，开放性和敏捷性。

Efficient government, re-aligned industry, new products and service paradigms create sustainability in a changing and dynamic world.

高效的政府，重新调整的行业，新产品和服务范例可在瞬息万变的动态世界中创造可持续性。

It all starts at the top. Governments must lift their game. Innovation and deep regulatory reforms in the digital economy will be the foundation for success.

一切都从顶部开始。 政府必须取消竞争。 数字经济中的创新和深入的监管改革将是成功的基础。

Restrictive and outdated government regulations currently stand as the single biggest inhibitor of healthcare transformation. Governments must release national healthcare systems from the regulatory prisons they have constructed to unlock true innovation.

目前，限制性和过时的政府法规是医疗保健转型的最大障碍。 各国政府必须从其为释放真正创新而建造的监管监狱中释放国家医疗保健系统。

Of course, industry will also need to come to the party.

当然，行业也需要参加聚会。

Health management and administrative systems are rife with inefficiencies, misaligned incentives and remain relatively untouched by innovation.

卫生管理和行政系统效率低下，激励措施错位，并且相对不受创新的影响。

Industry must follow government regulatory changes with the implementation of new technologies that enable collaboration and interoperability. They must reinvent their product and service offerings and adapt to new customer expectations. [25]

行业必须遵循政府法规的变化，并实施能够实现协作和互操作性的新技术。 他们必须重新发明其产品和服务，并适应新的客户期望。 [ 25 ]

It's also imperative for industry to seek new ways to reach beyond current customers by developing innovative business models that extend to underserved and high-risk population groups. Governments and industry must cooperate, lead and utilise technologies that enable an unprecedented level of data access, interoperability, integration, and scalability. [26]

行业还必须通过开发创新的业务模式来寻求新的方法，以超越现有客户，这些业务模式应扩展到服务不足和高风险的人群。 政府和行业必须合作，领导和利用能够实现前所未有的数据访问，互操作性，集成和可伸缩性水平的技术。 [ 26 ]

There are no grand delusions here.

这里没有大错觉。

The transformation of healthcare will be challenging and painful. Mistakes will get made and temptations to revert to old systems and processes will be overwhelming.

医疗保健的转型将是充满挑战和痛苦的。 将会犯错误，并且恢复到旧系统和流程的诱惑将是压倒性的。

But the current trajectory is simply unsustainable.

但是，当前的轨迹根本无法维持。

Something must be done. Technology and globalization, along with current global demographic shifts are demanding innovation and deep changes.

必须做些事情。 技术和全球化以及当前的全球人口变化都要求创新和深刻的变革。

Blockchain technology is a key tool to achieve the central healthcare objectives of nations who must find ways to become more efficient with population growth, globalization, and increased demands on healthcare systems.

区块链技术是实现各国中央医疗保健目标的关键工具，这些国家必须找到方法来随着人口增长，全球化和对医疗保健系统需求的增加而变得更加高效。

The technology is an effective foundation to help industry redesign organizations, products, and services at a time when collaboration, consortiums, and networked alliances are the new competitive advantage.

当协作，联合体和网络联盟成为新的竞争优势时，该技术是帮助行业重新设计组织，产品和服务的有效基础。

Countries and industry must begin utilizing blockchain technology as a foundation to explore the convergence of a variety technological tools to address customer centric needs and social problems that provide excellent business opportunities.

各国和工业界必须开始以区块链技术为基础，探索各种技术工具的融合，以解决以客户为中心的需求和提供绝佳商机的社会问题。

Nations and industries that embrace blockchain will be rewarded with a resilient and antifragile digital infrastructure that enables the cultivation of efficient ecosystems, better products, and services, lower costs at scale, and improved sustainable outcomes for all.

拥抱区块链的国家和行业将获得具有弹性和抗脆弱性的数字基础设施的回报，该基础设施能够培育高效的生态系统，更好的产品和服务，降低大规模成本并改善所有人的可持续成果。

While the path forward may be complicated, we can no longer use that as an excuse for inaction. The only thing stopping us moving forward and accessing a future of untapped potential is fear, uncertainty, and doubt.

尽管前进的道路可能很复杂，但我们不能再将其作为无所作为的借口。 阻止我们前进并获得未开发潜力的未来的唯一一件事就是恐惧，不确定性和怀疑。

In blockchain technology, we now have a tool that can help solve many of our greatest challenges.

在区块链技术中，我们现在拥有可以帮助解决许多最大挑战的工具。

If you like this article on blockchain in healthcare, discover blockchain and identity, trade finance, supply chain, compliance, insurance and government.

如果您喜欢这篇有关医疗保健中的区块链的文章，请发现区块链和身份 ， 贸易融资 ， 供应链 ， 合规 ， 保险和政府 。

翻译自: https://www.sitepoint.com/how-blockchain-can-help-re-invent-healthcare/

健康医疗 区块链