Widely using blockchain might become one of the biggest challenges for healthcare on its road to embrace the digital revolution. Let’s see why that is and how exactly blockchain could really alter the healthcare system from within.
First of all, what is blockchain?
At first, it seems a fancy word only a handful of people use as if they really understand it. Since it was created in relation to cryptocurrency, people tend to shy away from it, healthcare executives included.
Blockchain is a distributed and tamperproof repository where information can be recorded and shared through a peer-to-peer community.
There are a few characteristics of blockchain that make it appealing to any industry, but even more so to healthcare. There is no central or main administrative entity for blockchain, so there is no way someone could tamper with the data without the other members of the community being aware of it. Each member keeps his or her own copy of the information, any updates can only be validated through a collective consensus.
Blockchain was indeed created to record cryptocurrency transactions (e.g., bitcoin), but it is now an evolved medium, that can be used for memorizing and sharing different types of information, such as contracts, assets, records, transactions, identities, basically anything that could be translated into 1010 form. Blockchain has very specific abilities that can be golden opportunities for healthcare: it ensures transparency and auditability, it does not need mediation, it warranties trust.
In what areas of healthcare can blockchain be used?
Healthcare is ripe for disruption, and the many examples of companies leading the way into the digital revolution prove there are plenty of opportunities for blockchain technology to lead this transformation.
Interoperability – patients could have only one, lifelong, health record
For example, Electronic Health Records (EHRs) lack interoperability and are exceedingly costly. Here is where blockchain could really become a game changer, making communication between EHRs effective.
Currently, doctors often treat acute illnesses in patients with no access to medical history, including prior imaging, or their current drug intake. Such information could influence medical decisions and the outcome for the patient. An EHC that uses blockchain technology could be a convergence point for a patient’s health information. Full interoperability will thus not only immensely benefit the patient, but also save the U.S. healthcare system $77.8 billion per year in costs, since unnecessary tests would be avoided, and administrative costs would be reduced.
Basically, in an ideal interoperable healthcare system, all medical information pertaining to a patient throughout her or his life could be safely integrated to the patient’s unique EHC. This would contain diagnostics, surgeries, tests, allergies, radiology or other imagery results, along with logs from smart devices, wearable or home operating devices, and even results of genetic testing performed by third parties (e.g., 23andMe).
Security and data ownership of one’s personal medical data
Blockchain can ensure controlled access to a patient’s records; Embleema, for instance, already has such capability.
Healthcare is a business, but it is one that has a purpose: the wellbeing of patients. It is therefore crucial to put the patient in the centre of the system, with care providers, insurers, and other financially involved parties orbiting around the patient. The reason this needs to be done is simple, yet complex.
Patients interact with many healthcare providers over their lifetime. Each of these interactions produces crucial and sensitive information that is compiled in a medical record. This information has to be secured, yet still accessible, to the patient. Given the rise of data breaches, it is clear that the information isn’t always secure. Compared to other industries, data breaches are especially expensive for healthcare; costs are 2.5 times greater than the global average.
Blockchain can enable patients to own their health records and control access to them, thus putting the patients at the center of the healthcare data ecosystem. This can be achieved via smart contracts that ensure care providers have access to certain data (e.g., diagnostic, research, before and after, academic, operative planning) that the patient previously agreed to share under certain conditions.
From a security perspective, blockchain can also reduce fraudulent billing, and increase control over counterfeit drugs; it could also be used to verify and validate clinicians’ credentials.
Medical supply chains could also use smart contracts for distribution
Using blockchain in the medical supply business would ensure a constant flow of supply, without any life threatening sincopes, a better predictability and a more secure environment for medical supplies, because it would be easier to check provenance etc.
Blockchain-based contracts can guide healthcare organizations in their care of supply-demand cycles throughout its entire existence. Parties involved would know how the contract is operating, whether it is successful, or if there are setbacks and how to overcome those.
Billing could be registered into a securely distributed ledger and payment could be done via cryptocurrency.
Medical research could also vastly benefit from using blockchain in various ways.
Verifying clinical tests is only one possibility. A contest held, in 2016, by the U.S. Department of Health and Human Services for innovative ideas related to blockchain technology, had a winner, a white paper, written by MIT’s Project PharmOrchard, which proposed using blockchain to power clinical trials that utilize genomic data. Meanwhile, companies like Nebula Genomics are already doing that.
Advantages and challenges in using blockchain in healthcare
The pros for using blockchain in healthcare are clear. Better data sharing between healthcare providers could ensure more diagnoses are accurate, more treatments prove effective, and healthcare organizations are more able to provide cost-effective care. Stakeholders in the healthcare value-chain could safely share access to their networks via blockchain technology, since this will allow them to verify the origin of data and what changes have been made to it, if any.
The main impediment, however, would be the willingness of healthcare organizations to build the required technical infrastructure. Blockchain, especially a really secure one, is expensive, and its incorporation into the present technology presents challenges. Its cultural adoption could prove difficult, since, at least for now, healthcare executives are timid about embracing the newest healthcare trends. Even so, this concept is well worth exploring.