Blockchain technology in healthcare

December 21, 2017

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Estonia has become the first country in the world to introduce blockchain technology within electronic healthcare systems. The Estonian eHealth Foundation and Guardtime partnered to integrate KSI blockchain with existing Oracle databases to enable increased security and audit functions for the management of patient records. KSI is a blockchain technology designed in Estonia and used globally to make sure networks, systems and data are free of compromise, all while retaining 100% data privacy. 


A blockchain is a distributed public ledger – a database with a set of pre-defined rules for how the ledger is appended by the distributed consensus of the participants in the system. Due to its widely witnessed property, blockchain technology makes it also impossible to change the data already on the blockchain.



Estonia has been at the forefront of innovation in digital society for the last 20 years and is the only country where a majority of citizens carry a PKI smart card providing access to over 1000 electronic government services that are actively used. Electronic patient records are a critical component of these services and by integrating Guardtime’s blockchain technology it becomes possible to provide an independent forensic-quality audit trail for the lifecycle of those patient records, making it impossible for anyone who gains access to those records to manipulate information and cover their tracks.


Estonian eHealth Foundation uses Oracle technology to process and store the patient records and Guardtime's KSI blockchain will be integrated at the Oracle database engine, providing increased security, transparency, auditability and governance for electronic systems and lifecycle management of patient records. KSI instrumented records will be irrefutable.




Mike Gault CEO of Guardtime commented: “Estonian President Toomas Hendrik Ilves has repeatedly pointed out the biggest threat in cyberspace is integrity, and in particular the integrity of patient health care records. We are proud to announce that Estonia is again leading the world in digital innovation. This level of transparency and auditability is a global first and with US health care fraud measured in the hundreds of billions of dollars every year, the Estonian model should provide a valuable template to dramatically reduce this fraud both for the US and the rest of the world.”

Guard time are the world's largest blockchain platform company by revenue, headcount and actual customer deployments. A team of over 150 cryptographers, developers and security architects, with decades of experience defending networks from nation-state attack.




Margus Auväärt, Head of eHealth Foundation added: “Guardtime’s KSI blockchain technology enables us to easily reach the highest integrity levels for our systems and data, as mandated by ISKE, an Estonian cybersecurity standard modeled after BSI IT-Grundschutz by German Federal Office for Information Security. Furthermore, the unparalleled scale and frequency of the KSI blockchain give us the capability to maintain continuous real-time situational awareness into the integrity state of assets under our control, not required by any standards, but enabling us to react to any incidents immediately, before potentially larger-scale damages can occur."


Being a digital society means exposure to cyber threats. With solid investments in cyber security infrastructure, Estonia has developed extensive expertise in this area, becoming one of the most recognized and valued international cyber security experts. 


After Estonia’s experience with the 2007 cyber attacks, scalable blockchain technology was developed to ensure integrity of data stored in government repositories and to protect it data against insider threats. Estonia became host to the NATO Cooperative Cyber Defence Centre of Excellence and the European IT agency.





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