Blockchain technology has the potential to make health information exchanges (HIE) more secure, efficient, and interoperable.
Blockchain offers a new model for HIE, enabling disintermediation and allowing near real-time updates across the network for all parties. Blockchain-based systems can reduce or eliminate the friction and costs of current intermediaries, according to a report by Deloitte.
The report, titled “Blockchain: Opportunities for Health Care,” identified a number of practical use cases that could positively impact healthcare organizations, among which the ability to enable truly interoperable electronic health records.
Current healthcare record systems
Medical records and patient information are crucial to the healthcare system. Healthcare organizations, such as hospitals, pharmacists, and insurance companies, need to share patient information.
Currently, healthcare record systems are made of disconnected databases. Medical history is fragmented, preventing doctors and patients from building a complete record of health. Records are often spread across different facilities and providers in incompatible databases.
Furthermore, these systems are loaded with private patient records which are vulnerable to security breaches and fraud. The National Health Care Anti-Fraud Association (NHCAA) in the US estimates that the financial losses due to healthcare fraud are in the tens of billions of dollars each year.
Blockchain technology in healthcare
Many experts and industry observers have praised the potential role of blockchain as a digital record-keeping system to solve the inadequacy and inherent complexities of existing healthcare systems.
According to Deloitte:
“The current state of healthcare records is disjointed and stovepiped due to a lack of common architectures and standards.
“While blockchain technology is not a panacea for data standardization or system integration challenges, it does offer a promising new distributed framework to amplify and support integration of health care information across a range of uses and stakeholders. It addresses several existing pain points and enables a system that is more efficient, disintermediated, and secure.”
In essence, a blockchain is a shared database, which, unlike a traditional database, is decentralized. Data are managed through the consensus of participants in a network who work together to decide which are added. Each participant maintains an identical, full copy of all transactions.
As a digital record-keeping system, a blockchain is considered a much more secure, scalable and tamper-proof alternative to current legacy models. Records on a blockchain are secure, almost impossible to manipulate, auditable and easily accessible with public and private keys.
In other words, a blockchain-based system is easier to audit, more streamlined and much more effective. Ultimately, this means that costs of transferring medical records between institutions, as well as compliance costs, can be dramatically reduced.
Blockchain could benefit healthcare in many ways. According to a report by NEJM Catalyst, applications include:
Clinical data sharing of elements such as advance directives, genetic studies, allergies, problem lists, imaging studies, and pathology reports. Alternatively, instead of storing actual patient data, blockchain could be used to store access controls, such as who a patient has authorized to see their health data.
Public health: A shared, immutable stream of de-identified patient information could more readily identify pandemics, independent of governmental bodies currently aggregating this data.
Research and clinical trials: Distributing patient consent or trial results could foster data sharing, audit trials, and clinical safety analyses.
Administrative and financial information: Insurance eligibility and claims processing workflows could benefit from blockchain and have decreased transactional costs.
Patient and provider identity: National or international patient or provider identities could be secured in the blockchain, providing the basis for health data portability and security.
Patient-generated data from personal health devices, wearables and Internet-of-Things devices, as well as patient-reported outcomes. These could leverage blockchain technology for security and sharing.
Several companies and organizations have started exploring the use of blockchain in healthcare. These include Alphabet’s artificial intelligence outfit DeepMind, which recently announced plans to build a blockchain inspired system to track how every shred of patient data is used, and IBM Watson Health, which signed a research initiative with the US Food and Drug Administration (FDA) earlier this year aimed at defining a secure, efficient and scalable exchange of health data using blockchain technology.