The IOTA Tangle for Electronic Medical Records Systems

What is IOTA

IOTA tangle for medical records but what is it? IOTA is a Distributed Ledger Technology (DLT) not based on the blockchain but on the ‘tangle’. Is the tangle architecture better than the blockchain? The IOTA developers certainly believe that to be the case.

Internet of Things

The logic underpinning the protocol is the drive to facilitate communication between connected devices. The clue in the name. IOTA as an acronym derives from the concept of ‘Internet of Things (IoT)’.

The estimate is that there will be well over 75 billion connected devices in the world by the year 2025. That is an average of 10 devices per each human inhabitant of the planet. That number will continue growing, quite possibly exponentially. The current arrangement where information flowing to and from all these devices is channelled via centralised cloud-based data centres is simply unsustainable. This is where distributed ledger technology (DLT) comes in. This is where blockchain and the tangle come in. However, the architecture of the two are different. How? Let’s see.

The IOTA Tangle: No blocks and no chain

Many readers will know at least the basics of a blockchain. With blockchain, the essence of the architecture is that data or a transaction is added onto a block. The block is appended to the previous block. It will also be appended to the next block. The growth of the chain of blocks is, therefore, sequential. Blocks are added in that linear fashion therefore forming a chain of blocks (blockchain).

The tangle is different. A transaction or any piece of data references two previous transactions. Each of those transactions will also be referencing two previous transactions of their own. You can therefore mentally envisage a web-like structure rather than a chain. So, instead of a conventional blockchain, IOTA uses what is called a directed acyclic graph (DAG). The name derives from the fact that all transaction arrows point in one direction (‘directed’). It is also ‘acyclic’ as it wouldn’t be possible to follow a transaction path which will take you back to where you started (no cycling).

IOTA tackling the scalability conundrum

One of the biggest and probably THE biggest challenge that has plagued the mass deployment of blockchain technology from the outset is scalability. We discussed this in more detail in an earlier blog.

Most blockchains available today, including the biggest and most prominent i.e. Bitcoin and Ethereum (No.1 and 2 respectively) employ the ‘Proof of Work’ protocol. That means there are coin miners who do the computational work required in validating transactions. With this, the more transactions there are, the slower the system. In fact, this has been the main source of criticism of how blockchain works and its effect on the environment. The amount of complex computational work consumes an enormous amount of electricity. In theory, it is possible to see a situation where a system could be overwhelmed and be rendered unfit for purpose, slowed down by the sheer amount of transactions.

At the time of writing this, Bitcoin’s speed of transaction is a paltry 4-7 per second. A typical Bitcoin transaction takes an average of 10 minutes. That is a lifetime in a world where consumers expect almost instantaneous conclusion of transactions. Of course, developers are busy addressing this and it will undoubtedly improve with work and time. However, the fundamental problem is in the protocol. The degree of the problem can therefore be improved but cannot be eliminated altogether.

IOTA Tangle creating infinite scalability

So, how is IOTA’s tangle different? IOTA’s logic is the exact opposite. To begin with, there are no miners. It means all participants in the network have equal roles and responsibilities. It also means, the more the number of participants and transactions, the faster and more secure the network. This translates into a creation of an ecosystem with potentially infinite scalability.

IOTA Tangle means zero fees

As described above, IOTA is built to be a true peer to peer transactional network. Micro-transactions of very small value can be made without the worry of fees. Much more important is in the data transfer where the data has no inherent monetary value. This is of enormous potential especially in healthcare. It is where IOTA tangle for medical records can become a reality.

A large volume of data is continuously produced by individuals and healthcare providers. This could be cripplingly expensive to exchange if every time this occurs a fee must be paid. This is particularly critical in those parts of the world where the resources are limited. The need there is even greater and, significantly, the fees issue could be a deal-breaker.

Prevailing Issues with IOTA

Like most Distributed Ledger Technology (DLT) networks that have come into being in the last few years, IOTA is having to grapple with problems. These require solutions if the dream of the IOTA tangle for medical records is to be realised.

At the core of all DLT networks is decentralisation. To protect against certain types of attacks on the network, the IOTA Foundation elected to use a coordinator.

The coordinator’s role has been described as ‘checkpointing’ valid transactions. These are then validated by the entire network. You can view this any way you want but this arrangement is a form of centralisation. The IOTA foundation acknowledges as much but promises that the coordinator arrangement is strictly temporary. Work is ongoing to address the security concerns that made a (temporary) coordinator necessary. Once that is completed and deployed, the coordinator will be done away with. This has got to happen.

IOTA, QUBIC and Smart Contracts

The second criticism levelled at IOTA is its apparent limited functionality when it comes to self-executing contracts, better known as ‘smart contracts’. Smart Contract functionality is regarded as an integral, even essential part of any Distributed Ledger Technology (DLT) network. That is regardless of whether that is a blockchain or, like IOTA, deploying the Direct Acyclic Graph (DAG) protocol. It would appear IOTA is working hard to address this.

In mid 2018, IOTA introduced QUBIC. This stands for ‘quorum-based computation‘. This is a new protocol layer on top of IOTA that enables payments and messaging. Among other things, it is meant to facilitate smart contracts. That, if realised on full deployment, will be a big deal. For healthcare systems where providers need to interact seamlessly with health insurers, the potential is enormous. What is more, full deployment of the QUBIC protocol makes the IOTA network tamper-proof. It therefore effectively and conclusively addresses the other weakness (centralisation)discussed above. IOTA can finally do away with the coordinator.

Healthcare Records and IOTA

It would appear that a case for the IOTA tangle for medical records has been made. It appears strong. Let’s summarise the key features:

Infinite scalability i.e. can handle continuing big volume of data and users
Minimal or no fees i.e. deployable in areas with economic constraints
Quantum resistance i.e. can be trusted as a safe conduit and depository of sensitive data

It appears to tick all the important boxes for medical/health record systems of the future