Zero Knowledge Proofs in Healthcare Data Sharing

Srinivasan Sundararajan|November 27, 2020

Recap of Healthcare Data Sharing

In my previous article ( I had elaborated on the challenges of Patient Master Data Management, Patient 360, and associated Patient Data Sharing. I had also outlined how our Rhodium framework is positioned to address the challenges of Patient Data Management and data sharing using a combination of multi-modal databases and Blockchain.

In this context, I have highlighted our maturity levels and the journey of Patient Data Sharing as follows:

⦁ Single Hospital
⦁ Between Hospitals part of HIE (Health Information Exchange)
⦁ Between Hospitals and Patients
⦁ Between Hospitals, Patients, and Other External Stakeholders

In each of the stages of the journey, I have highlighted various use cases. For example, in the third level of health data sharing between Hospitals and Patients, the use cases of consent management involving patients as well as monetization of personal data by patients themselves are mentioned.

In the fourth level of the journey, you must’ve read about the use case “Zero-Knowledge Proofs”. In this article, I would be elaborating on:

⦁ What is Zero Knowledge Proof (ZKP)?
⦁ What is its role and importance in Healthcare Data Sharing?
⦁ How Blockchain Powered GAVS Rhodium Platform helps address the needs of ZKP?

Introduction to Zero Knowledge Proof

As the name suggests, Zero Knowledge Proof is about proving something without revealing the data behind that proof. Each transaction has a ‘verifier’ and a ‘prover’. In a transaction using ZKPs, the prover attempts to prove something to the verifier without revealing any other details to the verifier

Zero Knowledge Proofs in Healthcare

In today’s healthcare industry, a lot of time-consuming due diligence is done based on a lack of trust.

⦁ Insurance companies are always wary of fraudulent claims (which is anyhow a major issue), hence a lot of documentation and details are obtained and analyzed.
⦁ Hospitals, at the time of patient admission, need to know more about the patient, their insurance status, payment options, etc., hence they do detailed checks.
⦁ Pharmacists may have to verify that the Patient is indeed advised to take the medicines and give the same to the patients.
⦁ Patients most times also want to make sure that the diagnosis and treatment given to them are indeed proper and no wrong diagnosis is done.
⦁ Patients also want to ensure that doctors have legitimate licenses with no history of malpractice or any other wrongdoing.

In a healthcare scenario, either of the parties, i.e. patient, hospital, pharmacy, insurance companies, can take on the role of a verifier, and typically patients and sometimes hospitals are the provers.

While the ZKP can be applied to any of the transactions involving the above parties, currently the research in the industry is mostly focused on patient privacy rights and ZKP initiatives target more on how much or less of information a patient (prover) can share to a verifier before getting the required service based on the assertion of that proof.

Blockchain & Zero Knowledge Proof

While I am not getting into the fundamentals of Blockchain, but the readers should understand that one of the fundamental backbones of Blockchain is trust within the context of pseudo anonymity. In other words, some of the earlier uses of Blockchain, like cryptocurrency, aim to promote trust between unknown individuals without revealing any of their personal identities, yet allowing participation in a transaction.

Some of the characteristics of the Blockchain transaction that makes it conducive for Zero Knowledge Proofs are as follows:

⦁ Each transaction is initiated in the form of a smart contract.
⦁ Smart contract instance (i.e. the particular invocation of that smart contract) has an owner i.e. the public key of the account holder who creates the same, for example, a patient’s medical record can be created and owned by the patient themselves.
⦁ The other party can trust that transaction as long the other party knows the public key of the initiator.
⦁ Some of the important aspects of an approval life cycle like validation, approval, rejection, can be delegated to other stakeholders by delegating that task to the respective public key of that stakeholder.
⦁ For example, if a doctor needs to approve a medical condition of a patient, the same can be delegated to the doctor and only that particular doctor can approve it.
⦁ The anonymity of a person can be maintained, as everyone will see only the public key and other details can be hidden.
⦁ Some of the approval documents can be transferred using off-chain means (outside of the blockchain), such that participants of the blockchain will only see the proof of a claim but not the details behind it.
⦁ Further extending the data transfer with encryption of the sender’s private/public keys can lead to more advanced use cases.

Role of Blockchain Consortium

While Zero Knowledge Proofs can be implemented in any Blockchain platform including totally uncontrolled public blockchain platforms, their usage is best realized in private Blockchain consortiums. Here the identity of all participants is known, and each participant trusts the other, but the due diligence that is needed with the actual submission of proof is avoided.

Organizations that are part of similar domains and business processes form a Blockchain Network to get business benefits of their own processes. Such a Controlled Network among the known and identified organizations is known as a Consortium Blockchain.

Illustrated view of a Consortium Blockchain Involving Multiple Other Organizations, whose access rights differ. Each member controls their own access to Blockchain Network with Cryptographic Keys.

Members typically interact with the Blockchain Network by deploying Smart Contracts (i.e. Creating) as well as accessing the existing contracts.

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Current Industry Research on Zero Knowledge Proof

Zero Knowledge Proof is a new but powerful concept in building trust-based networks. While basic Blockchain platform can help to bring the concept in a trust-based manner, lot of research is being done to come up with a truly algorithmic zero knowledge proof.

A zk-SNARK (“zero-knowledge succinct non-interactive argument of knowledge”) utilizes a concept known as a “zero-knowledge proof”. Developers have already started integrating zk-SNARKs into Ethereum Blockchain platform. Zether, which was built by a group of academics and financial technology researchers including Dan Boneh from Stanford University, uses zero-knowledge proofs.

ZKP In Rhodium Framework

As mentioned in my previous article about Patient Data Sharing, Rhodium is a futuristic framework that aims to take the Patient Data Sharing as a journey across multiple stages, and at the advanced maturity levels Zero Knowledge Proofs definitely find a place. Healthcare organizations can start experimenting and innovating on this front.

Rhodium Patient Data Sharing Journey

Infrastructure Managed Service Provider

Healthcare Industry today is affected by fraud and lack of trust on one side, and on the other side growing privacy concerns of the patient. In this context, the introduction of Zero-Knowledge Proofs as part of healthcare transactions will help the industry to optimize itself and move towards seamless operations.

About the Author

Srini is the Technology Advisor for GAVS. He is currently focused on Data Management Solutions for new-age enterprises using the combination of Multi Modal databases, Blockchain and Data Mining. The solutions aim at data sharing within enterprises as well as with external stakeholders.

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