Blockchain’s potential impact on the infrastructure of healthcare

Aug. 1, 2018
Chief Digital Officer, Ciox

Around the world and across multiple industries, blockchain is emerging as a disruptive and innovative technology to enable secure, trustless, and efficient transactions. While you may already be familiar with blockchain as a distributed approach for conducting financial transactions such as bitcoin and other cryptocurrencies, this technology is also finding valuable footing in more traditional industries like healthcare, specifically targeting the exchange of health information.

In a digital, data-driven world where efficiencies are gained with new technologies across all manners of industry, the business of healthcare is still woefully inefficient. Similar to other industries that are embracing digital transformation and redefining their model at scale, it is clear that targeted use of technology could help reduce the waste inherent to the U.S. healthcare system and create greater value for patients and the government in better allocating each dollar spent toward qualitative, long-term positive outcomes.

Consider this: Roughly $2 billion is invested annually into new initiatives in care scheduling, medication tracking, chronic-disease monitoring, and other health-related fields. Far less, however, is spent ensuring that these new initiatives can scale and survive past their initial two-to-three years of operation, addressing a crucial infrastructure challenge: Access to and distribution of standardized, executable, scalable health information.

Blockchain is poised to change that, thanks to the tremendous transformation innovation it can enable on the exchange of medical information.

The foundation: A secured, standardized delivery ecosystem of executable health information

Health information should intuitively remain private between patients, care providers, and authorized third parties as needed, and many who discuss potential uses for blockchain in health records rightly assert that health records themselves should not be stored on the blockchain. Yet, perhaps counterintuitively, leveraging a distributed technology such as blockchain in the health information delivery ecosystem can greatly increase the inaccessibility of clinical information stored in electronic medical records (EMRs) and all other specialty systems for unauthorized parties.

In order to bring the patient to the center of their health information exchange, it is critical that we proof the virtual identities—per the security standards of the National Institute of Standards and Technology (NIST)—of all parties claiming a right to access said information, all the while retaining principles of anonymity and transparency core to blockchain.

From then on, patients can manage their network of care providers as they prefer, and since the blockchain itself does not store health information directly, the likelihood of sensitive data being taken or connected back to an individual is reduced, in contrast to today’s system. In essence, blockchain enables that only authorized parties can ever see necessary information.

Distributing health information on the blockchain would increase transparency over the flow of information, and far more easily identify when someone is trying to impersonate a patient’s identity and gain access to their information.

The immediate benefit: Population health insights, efficiency, and quality-of-care delivery

With federation of information, immediate benefits include a better coordinated care, traceability of patients’ movements from a facility to another, and increased transparency over care practices, all of them creating a holistic over episodic view of patients’ care. Utilizing blockchain, we can provide transparency throughout the exchange of information. When a patient visits his or her primary doctor, then a specialist, each encounter generating a record of the events, both records would be made available via the individual’s healthcare blockchain to both healthcare providers, alongside the patient’s entire medical history on the blockchain.

It’s this shared creation, retrieval, and amendment of episodic health information—from diagnoses to surgeries, prescribed drugs to claim history—that blockchain makes at once available to all authorized parties, and which can be used to generate patient-specific insights.

With such an ecosystem, quality of service and insights on malpractices and fraud can easily surface, bringing safer, more personalized care to patients. All information about the care continuum of patients can be reviewed to identify patterns of incorrect care. Blockchain’s transparency brings an unprecedented level of accountability.

Finally, this approach would also enable public health organizations (such as the CDC, Red Cross, etc.) set to help our communities gain access to better care—if a system could accelerate the distribution of signals that identify the pattern, of say, an epidemic, our communities could only benefit from being proactively helped in solving and caring for upcoming complications.

The ultimate goal: Access to longitudinal health information and delivery of personalized care

There’s no doubt that blockchain has become one of the technologies exponentially driving the future of healthcare. Imagine everyone in the country receiving care from doctors, nurses, caregivers, pharmacists, and other professionals with access to the totality of an individual’s (and broader population’s) health information to deliver better care, and at the same time that same data is codified, abstracted, and distributed with a non-alterable control over privacy. Artificial intelligence can be allowed by patients and organizations to automatically search a universal, uniform health information databank, in search of health-related warning signs and red flags, trends and insights, outbreaks, and under-publicized cures. The possibilities are essentially endless and will fuel the next generation of innovation.

This information is deeply personal at the individual level—who we are, down to a genetic level, what kinds of care we received, and what the outcomes were—and protecting the privacy of an individual while utilizing the broader medical learning potential in the data at aggregate is exactly what blockchain can do for our industry.

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