The healthcare industry has a labyrinth of issues from trying to decipher what is covered by your insurance, to how to pay for things if you don’t have insurance, to wondering if you really need something or if you’re being upsold — and why hell the is everything so expensive?
Part of the issue with the healthcare industry is that it is designed by people who don’t use it. Doctors are in operating rooms, not sitting in business meetings about how to innovate the industry.
Can Blockchian Help?
It won’t fix all the issues with the healthcare industry, but the blockchain will definitely help add transparency to storage of data for patients and physicians. Blockchain will also reduce the need for third-party data reconciliation and will help put scientists and other researchers working on medical advancements together and share their findings on clinical trials.
What is the blockchain, and why is it important to be aware of if you work in healthcare? Blockchain is a distributed ledger, an unchangeable record of peer-to-peer transactions built from blocks and the best part is that it is decentralized. Whether you work in the healthcare industry or go to the doctor once in a while, the blockchain is going to affect multiple aspects of the industry.
The blockchain creates a system of trust through encryption; allowing companies to work together even though they may not trust each other. This eliminates the need for third-party intermediaries. Decentralized networks help with hackers who go after centralized companies holding sensitive information, similar to what happened with the Equifax data breach. The other reason this is exciting is this process will give the patient more control over their medical information since they will own and control it. Users could even make money by selling medical information to research companies, instead of companies getting access without the patient’s consent.
The world is moving towards more and more global surveillance with advances in artificial intelligence. At first, I didn’t like the idea of my medical data being stored in a way that can be accessed outside my doctor’s office, but to access the blockchain I would have to give permission because I own my medical records.
It is better to have the information stored in a decentralized manner where the patient can grant doctors access versus a governmental database that patients cannot access or review. If patients notice incorrect information has been added to their file, then another entry has to be made following the incorrect on but the error also remains. This could help give a record of negligence if a doctor kept making mistakes. This also helps with liability if the patient goes to multiple doctors, and there is a medical error, they can then pinpoint the specific entry and which doctor made the error. Currently, if you go to the doctor and they make an error in your file, you may never know because you don’t get to review the information. I went to the doctor once and she asked: “how are your kids doing?” … I said I don’t have any kids and she laughed and replied: “Oh, whoops on here we have that you have 4 kids” … that was at a gynecologist’s office…the one doctor that really should have correct information about that part of my body.
The only issue with liability I can see is if patients fail to disclose information they deem not to be relevant to their specific doctor, like not mentioning an allergy while visiting the knee doctor. That patient might not know the medicine the doctor was going to give them for their knee contains an allergen. The patient hasn’t attended medical school and isn’t aware of the ingredients or side effects of that drug. It is likely that doctors offices will come up with templates of required information to be able to treat the patient and will refuse treatment for liability reasons if the patient refuses to disclose the necessary information.
So how will this work?
- Healthcare providers will collect medical data from the patient
- The data is then stored in existing databases in hospitals
- A hash is created from each source of data and is redirected to the blockchain
- The patient decides who has access to their medical data
- Healthcare stakeholders can query the blockchain to obtain access to the information
The blockchain can also reduce fraudulent insurance claims and provide more cost efficient underwriting. If a patient has outdated insurance they might not tell the doctor and it won’t be discovered until they are seen and the issue goes to billing. If they no longer have insurance the health care provider can then try to recover out of pocket costs but if their information is simply outdated it will alert the doctor’s office before they see the patient and they can update the information before they are seen by the doctor.
Reducing the number of fraudulent claims or claims that cannot be paid out due to missing or incorrect information helps lower costs to the patients and the medical industry. The blockchain can even be used to track expiration dates for medicines or check equipment inspection reports, anything that isn’t HIPPA specific could be shared on the blockchain. This eliminates the need for data reconciliation with third parties verifying that the data in one database matches the data in another.
Besides helping patients, this can also help advancements in healthcare. Data sharing and having an easy to use goto ledger to search for scientists and practitioners will allow for scientists to match their capabilities to someone else in a different state or country and work together to find cures and improve existing treatments. Shared ownership can allow scientists to upload their work and have time-stamped proof of their data but having it open sourced allows them to get credit for the starting point and have someone else finish connecting the dots with a different perspective and skill set.
During clinical trials, information about patient demographics and information on adverse reactions can be shared so others working on the same tests can have access to that knowledge. Everyone benefits from this, would you rather take a drug that has had the same results are making you feel better 50,000 times or 500,000 times? There is currently a government website for this but the processing can take up to 30 days, there might be duplicates happening with that time overlap.
This technology could even help in the emergency room, having a smart contract that only discloses patient information if requested in the emergency room, the patient can have all of their allergies and medications they are taking noted in the smart contract so that if the patient is unconscious they can get medicines that will make them better. Smart contracts can allow the provider to access data when instructed, it can execute the patient’s instructions.
Estonia is already turning these ideas into reality. In 2016, the Estonian E-Health Foundation began using blockchain technology for patient’s health records. They also signed a joint declaration with Finland looking at automatic cross-border data exchange for social insurance benefits and digital prescriptions. Estonia’s Patient Portal gives citizens access to medical documents, referral responses, prescriptions, and insurance information. Individuals can also use the Portal to declare their intentions regarding blood transfusions and organ donation.
It’s not the health records that are secured using blockchain, but the log files that record all the data processing activities performed on those records.
There are a few projects working on implementing this technology some noteworthy ones are Medrec, Hashed Health, Forward Blockchain and DYNOSTICS.