Pistoia Alliance Blockchain Webinar 20 June 2017

June 20, 2017

Is there a role for blockchain

in healthcare?

A Pistoia Alliance Debates Webinar

Moderated by Nick Lynch

This webinar is being recorded

Poll Question 1: What is your familiarity

with blockchain?

A. I am using blockchain

B. I am experimenting with blockchain

C. I am aware of blockchain

D. I know next to nothing about it

Poll Question 2: What is your organization’s

familiarity with blockchain?

A. Actively using blockchain

B. Experimenting with blockchain

C. Aware of blockchain

D. Not sure about my organization

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The Panel

5

Nishan Kulatilaka Associate

Director of applied technology

Merck&Co

Gideon Greenspan, CEO

and Founder Coin

Sciences LTD

Darryl Glover chief clinical

officer iSolve

David Houlding, Director of

Healthcare Privacy & Security,

Intel Health & Life Sciences

Gideon Greenspan, MultiChain

A technical introduction to blockchains

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What is a blockchain?

7

• Shared record of signed transactions, grouped

into timestamped blocks that are chained

together and secured by multiparty consensus.

7

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What’s in the transactions?

8

• Data in cleartext

• Encrypted data

• Hashed data (unique fingerprints)

• Asset transfers (financial, IP, proof of origin)

• Asset exchanges

• General purpose code (“smart contracts”)

• Events which trigger that code

• Public keys for encryption

• Administration / permissioning

8

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Without blockchains

99

AcmeInc

HooliInc

MifflinInc

GlobexInc

Intermediary

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With blockchains

1010

Mifflin

Acme

Globex

HooliTransaction

Blockchain

Ensuring consensus between nodes

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How are blockchains the same?

1111

• Code inside a database

– Stored procedures

• Append-only record

– Only INSERT into database

• Safe asset exchanges

– Atomic transactions in databases

• Robustness

– Distributed databases

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How are blockchains worse?

1212

• Confidentiality

– Blockchains share more

• Transaction immediacy

– Blockchains need consensus

• Code execution speed

– Blockchains need a sandbox

• Throughput scalability

– Blockchains work harder

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Blockchains vs centralized databases

1313

Advantages Disadvantages

Disintermediation Confidentiality

Multiorg robustness Performance

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Half-baked blockchains

1414

• One validator blockchain

– Blocks generated by one party

– Central point of failure

• Shared state blockchain

– Distributed database with blocks on top

– Requires nodes to trust each other

• Centrally hosted blockchain

– Everyone relies on one company

– Why not use a regular database?

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About MultiChain

1515

• Popular open source blockchain platform

• 2+ years in development, now 1.0 beta

• Simple permissions, assets, data streams

• 33 platform partners including:

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David Houlding, Intel

How to identify near term opportunities for

blockchain, and how to manage privacy, security,

and compliance with blockchain.

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Near Term Opportunities for Blockchain

1717

• Opportunities• B2B near term, B2C longer term• Existing networks

• E.g. B2B networks that have an existing trusted intermediary / bottleneck

• E.g. existing use cases with multiple siloed databases across multiple organizations and periodic batch ETL, reporting

• Value• Improved transparency. Real-time visibility• Lower costs. Robustness, avoiding single points of failure• Caveat: depends heavily on what data goes on blockchain

and who has access

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Blockchain Privacy, Security, Compliance

1818

• Protecting CIA: Confidentiality, Integrity, and Availability

• Integrity• Immutable blocks, non-repudiation

• Availability• Ransomware, DDoS and blockchain• Storing data on vs off the blockchain

(with pointers, hashes) and availability ramifications

• Consensus, scalability, and avoiding single / few points of failure

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Blockchain Privacy, Security, Compliance

1919

• Confidentiality and Privacy• Data

• Data on blockchain?• It’s about the use cases• Blockchain is plumbing, what are you going to

do with the data on blockchain?• Risk vs benefit: data and access• Minimal but sufficient (to support use case(s))• Data that is on chain stays on chain (immutability)

• Access • Public, permissioned, private• Encryption• Secure enclaves

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Blockchain Privacy, Security, Compliance

2020

• Compliance

• Data sovereignty, trans-border data flow, compliance

• What data is on blockchain?

• Where physically is the data stored, used? Where are the blockchain nodes, and systems connected to them?

• What are the applicable laws, regulations, standards, privacy principles

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Blockchain Privacy, Security, Compliance

2121

• Security beyond what’s baked into blockchain• Learning from bitcoin hacks /

breaches, and hardening• Administrative, physical, technical• People, process, technology• What is behind the nodes in the

blockchain, how secure?• Assess, identify, remediate weakest

links• Vet security of new organizations

joining the network to ensure adequacy

Holistic

Multi-Layered

DefenseIn Depth

Threat Intelligence

Adequacy

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Poll Question 3: What is the single most

significant hurdle or perceived limitation

that blockchain must overcome before it

is adopted widely in healthcare?

A. Security

B. Privacy

C. Technical

D. Regulatory

E. Other

BLOCKCHAIN AND THE LIFE SCIENCES

Nishan Kulatilaka

Applied Technology

June 20, 2017

Focus on Core Blockchain

Concepts

Definitions from Google 24

Healthcare Use Cases• Supply Chain and Serialization

• Track and trace products through distributors

and other nodes

• Clinical Trials

• Provenance of trial master file

• Study recruitment

• Medical Records

• Paradigms for sharing data

• Granular entitlements

25

Truck: http://www.freeiconspng.com/img/9018Syringe: http://www.iconarchive.com/show/medical-health-icons-by-graphicloads/syringe-injection-icon.htmlChart: https://www.clker.com/clipart-patient-chart-medical-clipboard.html

The Path Forward• Collaboration

• Technology that is strongest with large

ecosystems

• Ideation and Proofs of Concepts

• Build often and build fast

• Integration may seem hard, but prototyping is

easy

• Manage the Hype

• Not a cure-all

• Shiny object syndrome

26Collaboration: https://thenounproject.com/term/collaboration/28324/Lightbulb: http://www.freeiconspng.com/img/835Hype cycle: http://media-s3-us-east-1.ceros.com/gartner/images/2016/09/01/47d42afb4d720e2944314651f1729d36/mini-hype-cycle.png

Poll Question 4: How quickly do you think

blockchain will be adopted in

Pharma/Healthcare?

A. <1 year

B. 1-3 years

C. 3-5 years

D. >5 years

E. never/not sure

Poll Question 5: Where will blockchain

technology have the greatest impact ?

A.Pre-clinical DiscoveryB.ClinicalC.RegulatoryD.Manufacturing and Medicines Supply ChainE.Health Records, inc. Personal Genomics

Daryl Glover, iSolve

The use of Advanced Distributed Ledger

Technology (ADLT) to solve challenges in

medicines supply chain and serialization.

New challenges require New solutions. Today, I will discuss the application of the Advanced Digital Ledger Technology (ADLT™) platform for the Biopharma Industry.The Blockchain provides the following:• Bridge between systems that do not easily communicate with

each other• Immutable, Auditable, and Traceable Record Required• Decentralized Network for Trusted Participants• Complement to Existing Systems and Processes

Overview

Origins of ADLT™2017

1940

Cryptography

First adopted by the US

Navy to decipher foreign

code and trade systems.

1970

Public / Private Keys

Encryption method for

messaging also

leveraging Digital

Signatures

2009

Blockchain

Distributed Ledger used

to support and secure

Digital Currency

transactions.

2014

Blockchain 2.0

The use of Private

Blockchains and Smart

Contracts enhance

Blockchain security and

functionality.

What is ADLT™ ?

ADLT™

DispensersRaw Materials Suppliers

Global Sites

CMOs CPOs

3PLs

Wholesale Distributors

A Secure and Distributed Framework that allows information to be

controlled and passed bilaterally to Trusted Participants.

Manufacturing Supply Chain

Market

Market

Product

Pack

Finished

Goods

A101

A102

A103

B202

B203

B201

E502

E503

E501

C302

C303

C301

D402

D403

D401

E502

E503

E501

A101 B201A101

C301B201

D401C301B201

A101

E501

C301B201A101

A101

D401

ADVANCED DIGITAL LEDGER TECHNOLOGY - BLOCKCHAIN

Production

Drug

Product

Raw

Material

API

Key

IntermediariesBulk API

Logistics Supply Chain

PatientPharmacyWholesaler3PLManufacturers

E501

Batch E501

posted to

Blockchain

E501

Batch E501

received by 3PL

posted to

Blockchain

E501

Batch E501

received by

Wholesaler posted

to Blockchain

E501

Batch E501

received by

Pharmacy posted

to Blockchain

E501

Product from

Batch E501

distributed to

Patient

ADVANCED DIGITAL LEDGER TECHNOLOGY - BLOCKCHAIN

E501 @3PL

@MAN

@PHM

@WHS

@3PL@MAN

E501 @WHS

@3PL

E501

@MAN

E501

ADLT™ - Blockchain

ADLT™ Service LayerThe Blockchain as a Middleware Component

Multi-Site Data entering

the BlockchainThe collection of data for

products and materials that

are Multi-Stage and Multi-Site

Security and ValidationThe management of Data

and Transactions from

Trusted Participants

leveraging Digital Keys

Distributed LedgerADLT™ is Distributed to

Trusted Participants who

have access to view

information

Data Traceability

ADLT™ data is managed

by Blocks which creates

Data Origination and

Provenance

MDM

A101

A102

A103

B101

B102

B103

C101

C102

C103

A101

B101

C101

A102

B102

C102

A103

B103

C103

Product Master Data

Prod A, 20mgB101

API-XYZA101

Prod A, 1x7 BlisterC101

ADLT™ is a Secure and Distributed Framework Data is Secured with Digital Keys and Cryptographic Hashes

Trusted ParticipantOnly Registered and Trusted Participants may enter

or view information..

Immutable RecordsAll records are immutable and can’t be modified. New

records may be added to the same block.

ConsensusThe Trusted Participants of the network must approve

transactions as valid.

Private KeysParticipants must have Private (Digital) Keys in order

to enter or view information..

Decentralized NetworkEach participant of the Blockchain receives a copy of

their own Digital Ledger.

Audience Q&APlease use the Question function in GoToWebinar

The 3rd Annual Pistoia Alliance President’s Challenge is open!

• Annua l compet i t ion to f ind the innovators in l i fe sc ience R&D, o f fe r ing :

• A chance to p i t ch i n the f i na l i n f ron t o f P i s to i a members a t ou r Bos ton con fe rence

• $20000 f o r two w inne rs ($5000 f o r t he runne rs up )

• 6 mon ths men to rsh ip f rom P i s to i a A l l i ance member (s )

• Access to E l sev ie r ’s R&D So lu t i ons po r t fo l i o

• This year we are in te res ted in :• B lockcha in fo r hea l thca re• Rea l Wor l d Da ta• Lab o f the fu tu re• Acce le ra te Ea r l y S tage C l in i ca l Tr ia l s• AI / Deep Lea rn ing

• Find out more a t :• https://goo.gl/vicZu6• or one of the Pistoia Alliance team

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Agenda announced for US Conference 2017 in Boston

Pistoia Alliance Membership Introduction 39

We are pleased to announce the outline agenda for our 2017 US Conference on 10th October 2017 in Boston.“Lab of the Future”.• If you’d like to attend, please register now! The

conference is being held at the Hilton Boston Back Bay. A hotel room block has been made available for the benefit of delegates.

• The distinction between the research laboratory, clinic, ambulatory care and the hospital is diminishing as technology blurs the boundaries.

Major advances are being seen in:• Automation• Connectivity• Machine learning• Augmented reality• Quantum computing• Blockchain

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Innovation Update June 2017

40

ip3.pistoiaalliance.org

• Lab of the Future (LoTF)• Sign up to this community

• RWD• Sign up to this community

• AI/Deep Learning – New community• Sign up to this community

[email protected] @pistoiaalliance www.pistoiaalliance.org