The blockchain revolution continues…next stop: healthcare!
Blockchain has shown the ability to streamline and revolutionize a number of industries and sectors and its ability to have a sizeable impact on the healthcare industry will be no different. Being able to capitalize on this unique technology could potentially connect fragmented clinical information in such a way that providers are able to generate insights that improves the quality of care. A nationwide blockchain network for electronic health records (EHR) could improve clinical efficiencies, track patient records, and enhance patient outcomes.
Unfortunately, collating a given patient’s health records is a puzzle. One piece of the puzzle is held by the primary care provider (usually a family physician) while the remaining pieces are spread out amongst specialists (e.g. nephrologists, surgeons, gastroenterologists), other healthcare providers (e.g. dentists, orthodontists, chiropractors), and medical wearables. This fragmented stream of information means that no one provider has a complete picture of a given patient’s health profile, making it harder to optimize care. Blockchain could be used to devise a common database of health information for each patient that all providers could access regardless of the system they use. A nationwide system could be designed with higher security, allow doctors to spend less time doing administrative work thereby opening up more time for direct patient care, and generate a wealth of data to facilitate various research projects.
In a 2016 study by IBM’s Institute for Business Value entitled “Healthcare Rallies for Blockchain”, 200 healthcare executives across 16 countries were surveyed regarding their views on the role of blockchain in healthcare. Roughly 16% of the executives surveyed expected to use blockchain technology by 2017.1 The study also showed that 56% of the executives planned to have blockchain fully implemented by 2020.1 As you can see, the healthcare industry is wrestling with the potential that blockchain offers.
Before delving further into this topic, it may be beneficial to do a quick review; what is blockchain? At its core, blockchain is a system of records that are encrypted and stored on a decentralized network of computers. The technology is unique in that there is no centralized control over the system, and this offers a number of security benefits:
- Data integrity is enhanced because records are replicated on every computer in the network that continuously sync with each other.
- Security is enhanced because users can only update a specific block of information, which is then time and date stamped and appended to the blockchain.
While the healthcare industry is data rich, there is still debate about the applications of blockchain technology. The rest of this article will focus on the potential uses of blockchain, and a few issues that blockchain can’t really solve.
Potential Benefits of Blockchain in Healthcare
1. Medical Research
If patients were to give their permission, blockchain technology could assist drug development by making patient results more accessible. In doing so, researchers would have a clearer picture of patient profiles and be able to select the appropriate trial cohorts with more granularity. As clinical trials start to produce results, blockchain could assist in organising the information. Due to the diversity of electronic health record systems being used, there is currently no feasible way to process all the data. By making it easier to access and process information, blockchain could speed up the pace of medical innovation.
2. Supply Chain Tracking
Blockchain technology could also be used to reduce loses due to counterfeit drugs, which cost pharmaceutical companies an estimated $200 billion per year.2 Counterfeit drugs are also a serious public health issue throughout the world for various reasons: they may not offer the claimed therapeutic benefits, they can cause serious side effects, they can allow untreated diseases to further spread through a community, and they disproportionately affect people with low socio-economic status.
3. Patient Data Management and Billing
As I mentioned previously, one of the unique opportunities that blockchain presents is to improve access to patient data. The ultimate goal is to have one-stop access to a given patient’s medical history. The patient would also have control over whether their anonymized data could be accessed by researchers.
With insurance fraud costing the U.S. approximately $30 million annually, a blockchain system could help to minimize it.3 Blockchain could also reduce administrative costs associated with the billing process by automating most of the process and thereby eliminating the middle man.
Limitations of Blockchain in Healthcare
1. Cybersecurity and Privacy
One question about blockchain technology is whether it can adequately address cybersecurity and privacy concerns. There does not currently appear to be a way to prevent bad actors from stealing patient health data, or accessing unencrypted medical devices.
That being said, blockchain may prove most useful in maintaining the integrity of healthcare records. Data integrity can be undermined by attacks in which malicious hackers modify patient data. For example, modifying allergy information, birth dates, social security information, or test results. With blockchain, records are stored on a network rather than a single computer, so unauthorized changes might be more easily identified along with when and who made those alterations.
2. Need for Collaboration
A second potential concern regarding the implementation of blockchain in healthcare is the need for the companies supporting patient care to collaborate. The various healthcare entities would be required to embrace information exchange and greater transparency. This could be a roadblock if providers are not willing to embrace change.
3. Other Limitations
Beyond security, privacy, and collaboration, there are others challenges to keep in mind: the financial costs of implementing the system, the difficulty of gaining agreement on an industry standard blockchain between all parties who collect healthcare data, the possibility of compounding misdiagnoses, and a concern that blockchain technology might increase the disparity in medical treatment between the wealthy and underserved minority communities.
Conclusion
Implementing blockchain technology in healthcare may offer various potential benefits including increasing access to data for medical research and improved patient care, safeguarding medical supply chains, and streamlining the billing process. Healthcare providers will need to be careful to protect the privacy of patients and the security of their data.
Kevin Anderson is a graduating medical student at Duke University School of Medicine and will be starting at LEK Consulting later this year. He’s most passionate about healthcare redesign, patient engagement, and the life sciences. His free moments are spent traveling and enjoying sporting events with his wife and daughter.
Image: Pexels
References
- Fraser, Heather. “How Blockchains Can Provide New Benefits for Healthcare – THINK Blog.” IBM Cognitive Advantage Reports, IBM Corporation, 19 Feb. 2017, ibm.com/blogs/think/2017/02/blockchain-healthcare/.
- Blackstone, Erwin A, et al. “Health and Economic Consequences of Counterfeit Drugs.” American Health & Drug Benefits, vol. 7, no. 4, 2014, pp. 216–224.
- Das, Reenita. “Does Blockchain Have A Place In Healthcare?” Forbes, Forbes Magazine, 19 July 2017, forbes.com/sites/reenitadas/2017/05/08/does-blockchain-have-a-place-in-healthcare/amp.
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