Thoughts on Integrating Medical Records into Blockchain. Theory

At first glance this approach seems hard to implement, but the more you think about it, the more the logic becomes obvious. In medicine, records are one-time entries, edits are prohibited, the history must be transparent and readable. The maximum you can do is make a new entry that contains a correction or addition to the existing one. In blockchain the same rules apply: transactions cannot be canceled and/or modified, history cannot be deleted . This similarity makes me think about combining these two elements into one system where they complement each other in a symbiosis. It’s just that medicine is historically conservative and slow to adopt technology, while blockchain too quickly became associated solely with crypto and speculation. But in essence, it’s simply a logging mechanism.

What do doctors or other medical workers do? They document their own actions. Previously this was done manually, in notebooks, and now in computers. But the principle remains the same. Made a mistake? Strike through a line, leave it so the original entry remains visible, and write the correct info next to it. Everything is transparent, everything is obvious, nothing is hidden. In electronic systems instead of strikethroughs there is an audit log, versioning, comments. Why is this so important? Because medical documentation is a legal document. Courts, insurance companies, professional committees — they all need evidence that the doctor’s actions were adequate and timely. And if someone starts covering their tracks, there will be no trust.

Now to blockchain. What does it do? Essentially it records events in a chronology where each event is linked to the next and the previous. You can’t delete, you can’t forge, you can only add a new entry. You don’t have to be a cryptocurrency fan, you can consider it a “bubble” or whatever, but the technology itself doesn’t change because of opinions. You have a distributed log of events. It’s protected from modification and accessible for verification. The logic is almost the same as medical documentation, only the implementation is even stricter.

So here comes the question: why not connect these two links? Why not make a blockchain not for money but for recording medical history? Imagine: every treatment step is a transaction. But not financial — informational. Inside the transaction there is an encrypted memo. The doctor enters a diagnosis — that’s a record. Prescribes a medication — a record. Changes dosage — the next record. The patient can also have access with a private key. The medical institution can store encryption keys in a separate system. Yes, there are a million security nuances, but they are solvable.

Why would this be useful? Because the issue of trust disappears. Any record confirmed by a doctor, secretary, or nurse will not disappear or be altered even if the hospital burns down. A medical history is essentially insurance for both sides. If the doctor did everything right — they have proof. If the patient suffered due to mistakes — there is proof as well. And if the patient harmed themselves through negligence or laziness, they cannot blame the doctor. Today documents get lost, databases get damaged, human error and malicious intent happen — there’s plenty of that, especially in countries where the system is weak or corrupted.

The idea of a token as a unit of medical record accounting also sounds logical. It wouldn’t be a tradable asset but a service unit. It cannot be bought or sold on an exchange, it only “lives” inside the system. Each action is a minimal “data package” with a record. I think many blockchain systems were originally conceived this way — the crypto market just dragged them in another direction.

Any new system creates specific problems. Confidentiality, for example. Medical data is the most sensitive information after financial data. Leaking a diagnosis or medical history isn’t just an unfortunate accident — it’s a disaster leading to lawsuits. Such a system must be not just encrypted, but paranoid-level super-secure, and encryption must be reliable. Keys must be stored so no one can access them. The patient might lose a key, so a recovery system must exist, but without the possibility of abuse.

Law. The court can request any medical records if needed. The government must regulate data storage. Laws in most countries are not ready at all to accept blockchain medicine. Everything is built on centralized databases controlled by ministries, insurers, hospital systems. And to change something, regulations must change. That takes many years and significant financial investment from governments.

Accountability. When a record goes to blockchain and it’s incorrect, how do you fix it? Technically you can add a new record correcting the previous one. But how do you reconcile that legally? How do you ensure the correction is made by the right person? So, given all the chaos that often happens in hospitals, the doctor must be doubly careful not to make an error in the records.

Technical load. Medical records typically involve large volumes, data is constantly recorded. Making every entry a transaction is a load. It's a question of scalability, speed, storage cost. A private blockchain? Maybe. A public one? Then confidentiality questions arise.

But despite all these nuances, the idea already looks like a step toward more advanced technologies. Blockchain is about trust in data, and medicine is one of those fields where trust must be maximal. And the idea of keeping medical journals as a securely signed event log looks reasonable. In principle we’re already moving in that direction, just without the word “blockchain”.

So this isn’t reinventing the wheel, but a look at things without the usual blinders. And the future of such a combination is quite realistic — it just won’t come tomorrow.

Image: AI-generated, Sora.