BLOCKCHAIN: A NEW DATA STANDARD IN ORAL AND MAXILLOFACIAL RADIOLOGY?

Abstract

<h3>Background</h3> Despite the Health Insurance Portability and Accountability Act (HIPAA) efforts, protected health information (PHI) and patient's privacy and safety are still under risk. With exposure of greater than 200 million patients' records for the period 2009–2019, the U.S. government is wondering if enough is being done to keep data safe. Blockchain is becoming a gold standard in health care data management because of its trusted, autonomous, immutable, and secured distributed ledger properties. <h3>Objective</h3> The goals of this retrospective, randomized, double-blind study were to assess (1) the effectiveness of Blockchain patient data conversion, (2) backup storage requirements, and (3) HIPAA compliance, compared with the current data storing and sharing methods and the feasibility of the use of Blockchain in Oral and Maxillofacial Radiology (OMR). <h3>Materials and Methods</h3> Head and neck computed tomography (CT) scans (n = 92,903 files) from the Cancer Imaging Archive (Blockchain folder n=46,465 and Monitoring folder n=46,438) and deidentified PHI were randomly assigned by 1 operator. Data were then converted into cryptographic Blockchain hashes via syncing the CBCT scans database folder with the DDSBlockchain (Charlotte, NC, 28,277) folder into the Hyperledger private Blockchain platform by a second operator. Data conversion percentage was assessed, and an F-test Two-Samples for Variances was conducted to quantify data upload speed (<i>P</i> < .05). Storing sizes of the original data and the Blockchain data were compared, and sharing privacy and safety were corroborated through the HIPAA compliance checklist by a third operator within the private Blockchain platform. <h3>Results</h3> One hundred percent of data uploaded were converted into Blockchain. Blockchain conversion had an average speed of 0.617 files per second. No statistical difference (<i>P</i> = .562) was found when comparing the 2 folders upload speed (average 26 hours, 11 minutes, and 5 seconds). The Blockchain data report storage size was 1.22 MB, whereas the original data folder storage size was 5.36 GB. No HIPAA breach was found during the data upload, conversion, sharing, and storage processes. <h3>Discussion</h3> The Blockchain private platform promises to become a gold standard in OMR PHI data backup because of its data conversion effectiveness, low storage requirements, and trusted, autonomous, immutable, and secured distributed ledger capabilities for keeping data private and safe. Preliminary study results indicated the feasibility of adopting Blockchain in OMR as a new data backup management method.