The parents always call the Spring Festival “Nian Guan”. In the past, we didn’t understand the flavor. However, with the continuous fermentation and spread of the epidemic in Wuhan, an unprecedented “Nian Guan” is in front of all Chinese children.

At this moment, the tragic melody of “brave old Qin, go to the national disaster together” is singing on the land of China. Our country is “sick” and it is a critical period for our generation to work together to overcome the suffering.

There is no doubt that the economic and social impact of New Coronavirus is far more than that of the SARS 17 years ago. Moreover, what is even more frightening is that due to the existence of a latent period of New Coronavirus, the current public data far from its peak, and when the epidemic will end is unknown.

Like the virus, it ferments the emotions of hundreds of millions of people living at home, including anxiety, panic, rumors, accountability, blessing and so on.

Among them, the most turbulent is the accountability of why the relevant departments failed to give early warning and effectively control the epidemic before the full outbreak of the epidemic.

At the beginning of December 2019, some medical institutions in Wuhan appeared unexplained pneumonia cases. Until around January 20th, when a lot of information about New Coronavirus pneumonia arrived on micro-blog, the public opinion about the outbreak of infectious diseases began to ferment.

On November 16, 2002, the first case of SARS infection occurred in Guangdong Province, and it was not until February that the epidemic of “atypical pneumonia” began to spread and ferment on the Internet.

There is a window period of about 1-2 months. Therefore, the voice of doubt and accountability came.

I didn’t join the media army of online accountability Crusade, although 100000 + is really tempting, on the one hand, it is because there are many conspiracy theories and unconfirmed rumors; On the other hand, it is mainly because the virus epidemic is the common enemy of the people of the whole country, and the enemy cannot be given the opportunity to disintegrate us from within.

I only care about one thing: why has the SARS epidemic been 17 years and our medical level has made a qualitative leap by leaps and bounds, but the epidemic prevention and control level of sudden virus does not seem to have made much progress.

Behind the surging sense of accountability in the media, there is a fact that we must face:

It’s time to upgrade our CDC “hardware + software”.

Blockchain technology will help upgrade the national disease control and early warning network

Yesterday, I saw a very hard core article. The author proposed that blockchain technology can be used to improve the national infectious disease monitoring and early warning network. After seeing it, I was greatly inspired and added some of my ideas and suggestions.

I mentioned in several articles earlier that the development of human science and Technology (productivity) has reached a phased ceiling. At this moment, we should make up for the deficiencies in production relations in time.

On the surface, the upgrading of the national infectious disease monitoring and early warning network by blockchain technology is only the help of the “tool” service of the hardware layer, but behind it is more the iteration of the “organizational reporting relationship” of the software layer.

Before the SARS epidemic in 2003, the Internet was only an information acquisition platform for a few people. After the SARS epidemic, people obtained and transmitted all kinds of messages through Internet portals, forums and social platforms. The Internet has driven the government to open an online platform, provided space for people to expand public affairs discussion, directly promoted the popularization of Online Politics and promoted the progress of social governance.

In the face of every natural disaster, people should not only unite as one and suffer together, but also “reflect” on which link has gone wrong.

Just as we re-examine the Internet from top to bottom after SARS, the new coronavirus pneumonia epidemic in 2020 will probably open a skylight for “blockchain” technology.

The reason is simple: blockchain technology is a systematic upgrade of “hardware + system”.

Loopholes in the traditional disease control and early warning system

As early as 2008, our country launched the “automatic early warning system of infectious diseases” nationwide, which can automatically analyze, early warning and emergency response the monitoring data of dozens of known infectious diseases.

The specific process is as follows: if infectious cases are found in the clinical work of provincial, municipal, district and county hospitals, they can fill in the infectious disease report card and submit it to the hospital information management system. Then the data of the same type of cases of multiple hospitals will be uploaded to the District, municipal, provincial and national data exchange platform, and then uniformly submitted to the national infectious disease network direct reporting system, Finally, the case information will be uploaded to the national infectious disease automatic early warning system.

What potential does blockchain have in the epidemic

The advantages of this system are obvious. For known infectious cases, the country can receive bottom-up data feedback, and then respond in time and allocate resources for prevention and control. However, in the face of unknown infectious cases, the hard injury of the system is exposed:

1) Case data will be approved at all levels when submitted upward. This is to ensure the accuracy of the data and avoid the irreparable impact of subsequent joint and several human errors in certain links.

But this has also brought two side effects:

1. Too much manual intervention and audit mechanism will greatly reduce the reporting efficiency;

2. The review and accountability system of the same organization will reduce the enthusiasm of clinicians to upload cases.

Everyone knows that the ass determines the head. After doctors are under the pressure of being responsible for the data results, they will be very careful with new unknown viruses, for fear that if they make mistakes, they will bring unnecessary trouble and impact. Most doctors may choose not to report or selectively optimistic to classify it as an existing similar disease.

2) There are data islands between hospitals. For the protection of patient privacy and case data, the patient data generated by most hospitals are not synchronized and shared in time. This makes hospitals blindly underestimate the destructive power and impact of unknown viruses, which is not conducive to bottom-up decision-making and promotion among organizations.

The reasons why hospitals are reluctant to synchronize data are complex. On the one hand, the cost of systematic data collection in hospitals is relatively high, including the judgment and classification of initial diagnosis, the type and amount of medication, the recovery of re diagnosis, and various clinical CT, MRI and other medical image data; On the other hand, the data of each hospital often has a certain interest related chain. Clinical medical data is a valuable data asset for hospitals, which can help drug R & D institutions carry out drug R & D and potentially indescribable gray commercial value.

3) The National Center for Disease Control and prevention is a fully centralized decision-making mechanism. Since the characterization of infectious diseases is very important, after the data model characterizes the infectious virus, the transparent and open authority is often not in the hands of the local government, and the decision-making needs to be made by the upper level national CDC. After receiving the data feedback, the national CDC will send experts to further verify and confirm. The whole process will sacrifice great timeliness, which is not conducive to the timely disclosure and prevention and control of dangerous new infectious diseases.

The above reasons can be summarized as follows:

1. Long audit cycle and human interference;

2. Data is not open and shared;

3. Fully centralized decision-making mechanism.

Thoughts on the upgrading of disease control and early warning network by blockchain Technology

While venting our emotions, we must also recognize the fact that the disclosure of infectious diseases is indeed a complex systematic project, involving all levels of social organization structure. A little carelessness will lead to uncontrollable malignant consequences.

For the relevant departments, caution is necessary. While being cautious, how to avoid the occurrence of “concealment” has become the key.

In essence, this is a race between the speed of epidemic spread and the efficiency of approval and decision-making of competent departments. If the latter is slow, we should realize that there is a lack of system behind it. The best strategy to solve the problem is to optimize and adjust the current hospital disease reporting organizational structure system.

As we all know, blockchain technology has many characteristics such as “distributed”, “decentralized”, “tamper proof” and “transparency”. Since 1024, the country has upgraded blockchain technology to the strategic height of core technology breakthrough, and the spring breeze of industrial blockchain has blown.

Since the current automatic early warning system for infectious diseases is outdated, why not upgrade it with the help of “blockchain technology”?

As a blockchain practitioner, I only know a little about blockchain technology. In order to avoid unnecessary trouble, I first make the following statement: 1. I am not a front-line medical staff, nor have I communicated with the medical staff about the difficulties in the transformation of the current system. The following ideas may be impractical; 2. The transformation of blockchain into the medical and health industry is not a new topic. There have been many more detailed solutions. I provide more ideas for everyone to open their brains.

In short, two principles:

1. Listen to the dispatch and scheduling of clinical data;

2. Set layered and hierarchical early warning thresholds and corresponding preventive measures.

1) Based on the open data principle of blockchain, a “disease control alliance chain” is established at the provincial level, led by the local CDC. The first batch of members are local provincial, municipal, district and county-level hospitals. The CDC should set up a reward and punishment system to subsidize hospitals and encourage hospitals to actively submit cases of various infectious diseases, including existing infectious cases, unknown infectious cases and suspected infectious cases.

2) After each new data submission, it will send a broadcast to the major hospitals in the whole alliance chain, and each hospital will set a special person to review the uplink. This can cross verify the uplink data information across hospitals. In this way, doctors do not have to worry about the reporting pressure within the organizational system, but are only responsible for presenting objective clinical data to ensure the timeliness and integrity of the reported data. Moreover, the cross validation process needs to be jointly confirmed by more than 2 / 3 hospitals, which greatly ensures the authenticity of the data.

3) Once a new data is successfully linked, it will be time stamped, and then the newly generated linked data will be automatically classified into a chain as long as the case similarity is more than 95% (the threshold is for reference only). If a new case becomes a solitary block after being chained, it can be regarded as a clinical case that has not yet formed a large infectivity, and only certain prevention and monitoring can be done. If a data link is formed soon after a new case is linked, a threshold can be set. After a certain number is reached, the CDC can coordinate local government forces to carry out matching prevention and control measures (listen to the scheduling of data).

4) Similarly, above the local alliance chain, there will be a national disease control alliance chain with the provincial CDC as the main unit of the alliance chain. After collecting abnormal data and taking corresponding preventive measures, the region shall uniformly report the local infection data to the national CDC and broadcast it on the chain, so that other provinces, cities and regions can attach great importance to and do a good job in prevention and protection as soon as possible.

5) In the initial stage, the data on the disease control chain is only open to the members of the alliance chain. Once a certain communication threshold is reached, it is connected to the authoritative media for transparent disclosure and display, so that the public can enjoy the full right to know and avoid unnecessary suspicion and panic.

I admit that this is a set of possible solutions based on blockchain technology that I have imagined, which only outlines a general direction. I believe that after this epidemic, more experts will join in the transformation of this system. Just like the Internet outbreak after SARS, blockchain technology will usher in a great development.

“Blockchain + medical” is of great value

As for why it is blockchain technology, because blockchain technology is essentially an upgrade of organizational production relations. Data from closed to open, fully centralized decision-making is released to distributed weak centers, the separated collaborative relationship between them, and more efficient optimization through interest binding.

Yes, this is the key for the blockchain to upgrade the “software and hardware” of the disease control and early warning system.

1) Break the current situation of data island between hospitals, so that the information of infectious cases can be aggregated and classified into big data at the first time, which has attracted great attention of local CDCs.

2) Through the risk level threshold setting at all levels, it can assist the CDC in early warning or prevention and control decision-making. Let the data really grasp the decision-making power, assisted by institutions and people, so as to avoid responsible concerns or concealment caused by human decision-making. This is like a smart contract. The thresholds and rules are still formulated by the CDC, but once the conditions are triggered, human intervention is minimized.

3) The hospital is the front-line window for collecting cases. It allows each hospital to be the main body of the disease control alliance chain, and can play a distributed and weak center community governance model, avoiding unnecessary friction between many people or levels.

4) The information on the chain cannot be tampered with. If the epidemic situation is not properly controlled due to force majeure natural factors, the data can be fully traceable, transparent and can resolve social doubts and rumors of various conspiracy theories to the greatest extent.

What I said above is just a cerebellar hole in the application of blockchain technology to infectious disease prevention and control.

Blockchain + healthcare involves many other categories. For example, blockchain + drug anti-counterfeiting traceability, blockchain + automated medical insurance, blockchain + identity authentication, etc., each can extend a lot of hard core content, at least improve the current doctor-patient relationship and give the public better medical services and experience.

As for the Wuhan epidemic, a “come on” is better than everything.

Responsible editor: CT

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