National Defibrillator Database: How to do it wrong and how to do it right

The problem

When a person suffers a sudden cardiac arrest every second until they receive a shock from a defibrillator drastically decreases the chances of them making a recovery. Getting a defibrillator to the patient quickly is literally a matter of life and death.

There are lots of defibrillators out there (although no where near enough to really be effective in a sudden cardiac arrest that could happen to anyone anywhere at any time) but no one knows where. The retailers who sold defibrillators know where some are, the fourteen different ambulance services know where some are, and a few other organisations such as charities know where some are. But just knowing where the defibrillators are isn’t enough. To be useful you also need to know if the defibrillator is available at any given time and whether it has been maintained.

And no one knows all of this, so no one is able to provide full and up to date information about all of the defibrillators across the UK for use by Ambulance Services and the general public when responding to a sudden cardiac arrest.

That’s the problem, what gets in the way of a solution?

The barriers

The barriers to achieving this aim come down to two main factors; it’s a disparate space with lots of organisations doing different things, and many of those organisations rely on individuals who have lots of other work to before they get around to entering details about a new defibrillator in a place they’ve never even heard of.

There are fourteen Ambulance Services across the UK, retailers and suppliers, charities, and thousands of parish councils, sports centres, shops and offices that all have a piece of the picture about defibrillator availability and no way of sharing their information.

The second major barrier is that currently creating even the smallest piece of the picture is almost entirely manual. It requires individuals who are already busy with their day job at the parish council, sports centre, shop or office to check the defibrillator, record the information, and send it somewhere. And then it requires other individuals to receive that data and manually enter it into a database.

Building for the past (or how to do it wrong)

If we were trying to solve this problem in the 1980’s we’d definitely build a centralised database, controlled by a single organisation, that requires other parties to send their data to be added to this central system. We’d try to get all those parties to ‘collaborate’ with the central authority (which of course many of them wouldn’t want to do as they have a vested interest in not sharing data to make their solution the one that succeeds), and we’d spend lots of time and money building something that is out of date before it even launches.

If everyone who has tried to solve this problem in the same way, and no one has managed a solution yet, maybe they’re trying to solve the wrong problem. Maybe the problem isn’t about trying to get people to cooperate to get all the data in one place, maybe the problem is about getting all the data to all the people so they can do what they want with it.

Building for the future ( or how to do it right)

Decentralise, distribute, and digitise is the future thinking approach. Use Blockchain technology to identify each unique defibrillator device at manufacturing source, record the logistics steps in the blockchain, record the location of where the defibrillator and it’s availability, record regular system checks (without the need for manual inspection), record the usage of the device in emergency situations.

Recording all this data about defibrillators in this way meets the Multichain criteria for choosing blockchain over a relational database: ‘Blockchain works for databases that are shared by multiple writers, who don’t entirely trust each other, and who modify that database directly, and there is some interaction between the transactions created by these writers, and an authoritative final transaction log on whose contents all nodes provably agree is required’.

Blockchain technology has proven use in the fashion industry for ensuring the authenticity of garments. If it works for a shirt it’ll work even better for a defibrillator that has a unique identifier and a proven and vital need to make location and usage data available to other organisations.

So, rather than trying to get fourteen ambulance services, numerous suppliers and retailers, and thousands of defibrillator owners to all share their data on a regular basis to update a single central system that none of them have any stake in, the blockchain approach allows for device to share it’s data to a decentralised ledger and make that data available to all the contributors, so if any of them choose to maintain their own centralised database of defibrillator locations they can pull that data and more from the blockchain, ensuring that all lists are always as up to date as possible.

If the aim is to make more available more data about defibrillators, then this approach achieves that in a way that the old approach could never do.