Can Blockchain Solve the Dilemma in the Ethics of Genomic Biobanks?

Decentralized Biobanking Apps for Patient Tracking of Biospecimen Research: Real-World Usability and Feasibility Study

BACKGROUND

Biobank privacy policies strip patient identifiers from donated specimens, undermining transparency, utility, and value for patients, scientists, and society. We are advancing decentralized biobanking apps that reconnect patients with biospecimens and facilitate engagement through a privacy-preserving nonfungible token (NFT) digital twin framework. The decentralized biobanking platform was first piloted for breast cancer biobank members.

OBJECTIVE

This study aimed to demonstrate the technical feasibility of (1) patient-friendly biobanking apps, (2) integration with institutional biobanks, and (3) establishing the foundation of an NFT digital twin framework for decentralized biobanking.

METHODS

We designed, developed, and deployed a decentralized biobanking mobile app for a feasibility pilot from 2021 to 2023 in the setting of a breast cancer biobank at a National Cancer Institute comprehensive cancer center. The Flutter app was integrated with the biobank's laboratory information management systems via an institutional review board-approved mechanism leveraging authorized, secure devices and anonymous ID codes and complemented with a nontransferable ERC-721 NFT representing the soul-bound connection between an individual and their specimens. Biowallet NFTs were held within a custodial wallet, whereas the user experiences simulated token-gated access to personalized feedback about collection and use of individual and collective deidentified specimens. Quantified app user journeys and NFT deployment data demonstrate technical feasibility complemented with design workshop feedback.

RESULTS

The decentralized biobanking app incorporated key features: "biobank" (learn about biobanking), "biowallet" (track personal biospecimens), "labs" (follow research), and "profile" (share data and preferences). In total, 405 pilot participants downloaded the app, including 361 (89.1%) biobank members. A total of 4 central user journeys were captured. First, all app users were oriented to the ≥60,000-biospecimen collection, and 37.8% (153/405) completed research profiles, collectively enhancing annotations for 760 unused specimens. NFTs were minted for 94.6% (140/148) of app users with specimens at an average cost of US $4.51 (SD US $2.54; range US $1.84-$11.23) per token, projected to US $17,769.40 (SD US $159.52; range US $7265.62-$44,229.27) for the biobank population. In total, 89.3% (125/140) of the users successfully claimed NFTs during the pilot, thereby tracking 1812 personal specimens, including 202 (11.2%) distributed under 42 unique research protocols. Participants embraced the opportunity for direct feedback, community engagement, and potential health benefits, although user onboarding requires further refinement.

CONCLUSIONS

Decentralized biobanking apps demonstrate technical feasibility for empowering patients to track donated biospecimens via integration with institutional biobank infrastructure. Our pilot reveals potential to accelerate biomedical research through patient engagement; however, further development is needed to optimize the accessibility, efficiency, and scalability of platform design and blockchain elements, as well as a robust incentive and governance structure for decentralized biobanking.

Utilizing Blockchain Technology for Healthcare and Biomedical Research: A Review

Blockchain is a decentralized, secure, and immutable public ledger that offers significant benefits over conventional centralized systems by preventing data breaches and cyber-attacks. It has a great potential to improve data security, privacy, and interoperability in healthcare and biomedical research. This review discusses the basic principles and the historical evolution of blockchain and evaluates the implications of blockchain for the existing healthcare infrastructure. It also highlights blockchain technology's advantages in electronic health records, supply chain management, clinical trials, and telemedicine. However, this technology faces several hurdles, including regulatory issues, technical complexity, and economic costs, which suggest a gradual adoption over time. In addition, the review emphasizes its ability to ensure data integrity, enhance collaboration, and protect intellectual property in biomedical research. This review shows that blockchain can enhance healthcare data management by providing secure, efficient, and patient-centric solutions. Furthermore, it also discusses the implications of blockchain for the future of healthcare and biomedical research and suggests that ongoing research and interdisciplinary approaches are essential for overcoming current barriers and realizing the full potential of this technology. Future research should focus on developing privacy-preserving hybrid data storage solutions that comply with international laws and regulations, thus enhancing the sustainability and scalability of this technology in healthcare.

Balancing the safeguarding of privacy and data sharing: perceptions of genomic professionals on patient genomic data ownership in Australia

There are inherent complexities and tensions in achieving a responsible balance between safeguarding patients' privacy and sharing genomic data for advancing health and medical science. A growing body of literature suggests establishing patient genomic data ownership, enabled by blockchain technology, as one approach for managing these priorities. We conducted an online survey, applying a mixed methods approach to collect quantitative (using scale questions) and qualitative data (using open-ended questions). We explored the views of 117 genomic professionals (clinical geneticists, genetic counsellors, bioinformaticians, and researchers) towards patient data ownership in Australia. Data analysis revealed most professionals agreed that patients have rights to data ownership. However, there is a need for a clearer understanding of the nature and implications of data ownership in this context as genomic data often is subject to collective ownership (e.g., with family members and laboratories). This research finds that while the majority of genomic professionals acknowledge the desire for patient data ownership, bioinformaticians and researchers expressed more favourable views than clinical geneticists and genetic counsellors, suggesting that their views on this issue may be shaped by how closely they interact with patients as part of their professional duties. This research also confirms that stronger health system infrastructure is a prerequisite for enabling patient data ownership, which needs to be underpinned by appropriate digital infrastructure (e.g., central vs. decentralised data storage), patient identity ownership (e.g., limited vs. self-sovereign identity), and policy at both federal and state levels.

A scoping review of distributed ledger technology in genomics: thematic analysis and directions for future research

OBJECTIVE

Rising interests in distributed ledger technology (DLT) and genomics have sparked various interdisciplinary research streams with a proliferating number of scattered publications investigating the application of DLT in genomics. This review aims to uncover the current state of research on DLT in genomics, in terms of focal research themes and directions for future research.

MATERIALS AND METHODS

We conducted a scoping review and thematic analysis. To identify the 60 relevant papers, we queried Scopus, Web of Science, PubMed, ACM Digital Library, IEEE Xplore, arXiv, and BiorXiv.

RESULTS

Our analysis resulted in 7 focal themes on DLT in genomics discussed in literature, namely: (1) Data economy and sharing; (2) Data management; (3) Data protection; (4) Data storage; (5) Decentralized data analysis; (6) Proof of useful work; and (7) Ethical, legal, and social implications.

DISCUSSION

Based on the identified themes, we present 7 future research directions: (1) Investigate opportunities for the application of DLT concepts other than Blockchain; (2) Explore people's attitudes and behaviors regarding the commodification of genetic data through DLT-based genetic data markets; (3) Examine opportunities for joint consent management via DLT; (4) Investigate and evaluate data storage models appropriate for DLT; (5) Research the regulation-compliant use of DLT in healthcare information systems; (6) Investigate alternative consensus mechanisms based on Proof of Useful Work; and (7) Explore DLT-enabled approaches for the protection of genetic data ensuring user privacy.

CONCLUSION

While research on DLT in genomics is currently growing, there are many unresolved problems. This literature review outlines extant research and provides future directions for researchers and practitioners.