Blockchain for Electronic Health Records (EHR)
Today electronic health records of an individual are in a very unstructured manner and controlled by healthcare providers in their respective central databases. These databases lack interoperability, security and are vulnerable to hacking. Although we have computers in nearly every medical facility and mobile phones in every pocket, we still face difficulty in collecting, exchanging and sharing our medical history with a new doctor.
Sharing medical data between various healthcare providers while maintaining the privacy and integrity of the patient’s data is the biggest challenge that health care systems face today.
1. The health care system is not digitized everywhere in the world. Therefore, many healthcare providers still follow the traditional process and provide prescriptions on paper and graphs. In such a scenario, it becomes difficult for both patients and healthcare providers to refer to these prescriptions whenever required in the future.
2. Lack of interoperability: The healthcare systems work in silos and lack interoperability. Even the healthcare systems of different departments within the same hospital cannot interact with each other. So you can imagine the level of difficulty when systems of various healthcare providers have to interact with each other.
3. Non-availability of clinic history: In case of emergency conditions or if a patient wants to change the healthcare provider, it becomes challenging for him to procure his clinical history and share that with the new service provider. All diagnostic tests have to be performed again to know the exact problem, thus resulting in delayed treatment and further aggravation of the issue.
4. When the doctor is treating a patient who needs emergency care, it becomes challenging for him to know if the patient is allergic to any specific medicine. Therefore, he has to be extra cautious and has to perform drug allergy tests to validate this because the consequences can be pretty dire if the patient is administered any such medicine that he is allergic to.
5. It is nearly impossible for hospital pharmacies to have a clear picture of the patient data. This, in turn, becomes a challenge for them to predict the inventory required to meet the needs of hospitals. For example, in the case of a sudden outbreak or some seasonal diseases, the pharmacies can go out of stock due to the non-availability of this data. Further, the drug shortages lead to delayed treatment and force healthcare providers and patients to shift to alternate medicines, decreasing the effectiveness of the treatment.
6. Telemedicine also referred to as telehealth or e-medicine, cannot be used effectively. Telemedicine refers to providing healthcare to patients remotely through phones, computers, etc. It allows the healthcare providers to evaluate, diagnose and treat patients without the need for an in-person visit. However every time a patient consults online, he is required to fill in all his history details. There is no effective way for patients to share their health data with the healthcare provider effectively through remote technology. Moreover, most health reports and consultations are on paper, thus making it cumbersome to be shared online to avail the telemedicine services.
Now let’s see how Blockchain can solve these issues:
Every patient will have a unique identity over the Blockchain network, and his clinical data generated at various stages will be associated with this unique identity as an Electronic health record digital asset.
- Blockchain technology can provide a truly interoperable network. Whenever a patient undergoes any diagnostic test or consultation, this information will be incorporated into the patient’s unique electronic health chain. Even the health-related data collected from smart devices can also be securely incorporated into it. The electronic health record (EHR) data can then be easily exchanged among various health providers as and when needed. This would even reduce the cost of healthcare treatment by avoiding redundant diagnostic tests. And most importantly, the healthcare provider can provide better patient care based on this accurate data.
2. While blockchain technology will help individuals to maintain their electronic health records, smart contracts will ensure that only authorized healthcare providers can access these health records. The individuals/patients will be the owners of their medical data. The hospitals or research institutes will require encrypted keys to get access to the patients' data.
The patient will have the provision to select who can access his information and for what duration. Individuals can also preauthorize the healthcare providers to see their information during any unforeseen emergencies.
3. The technology also offers flexibility to individuals either to reveal their identity or share their data anonymously/pseudo anonymously. They can even decide what part of the information should be shared with these care providers.
4. Once implemented, the electronic health records on Blockchain will serve as a common and integrated backbone for the health industry. It will also reduce the overhead costs for hospitals and healthcare providers.
5. This transparent system can help the government to effectively identify the needed citizens for which the health schemes have been started.
6. The hospitals can give the controlled and needed access to their pharmacies to maintain the required inventory to prevent the shortage of medicines and thus prevent any delay of medical care to the patients.
Case 1: Blockchain helps in reducing time delays during emergency cases
During emergency cases, the doctor rarely has access to the patient’s clinical history. He has to perform all the required tests that result in delayed treatment. Through his EHR on Blockchain, the doctor can easily access the patient’s clinical history, and thus, the need to do redundant tests will be avoided that can fasten the treatment and cut down the medical costs at the same time. The health care providers can also be made aware of the allergies and drug incompatibilities of the patient through the EHR on Blockchain. In the current scenario, a doctor is required to perform the drug allergy tests again as the allergic medicine can further worsen a patient’s condition.
Let’s understand it through an example; a patient is allergic to a specific drug, say penicillin. He gets some bacterial infection and visits a doctor for his treatment. Suppose the doctor has access to the patient’s medical history. In that case, he will be aware that the patient has an allergy to penicillin, and subsequently, he will prescribe him some other medication avoiding penicillin. Thus, avoiding any unwanted medical error and any further health complications.
Case 2: Blockchain and Telemedicine can transform healthcare
The distributed Hyperledger technology will also play a critical role in better adoption and working of telemedicine and remote monitoring. If the patient cannot physically visit the healthcare provider, he can easily share his EHR data present on Blockchain and get medical advice while sitting at his home. Thus, reducing clinic visits and also saving the commutation time required to visit a clinic. In addition, IoT devices, along with Blockchain, can provide real-time data on vital patient measurements such as blood pressure, heartbeat, etc., for better diagnosis. It will also assist in timely follow-ups with doctors, thus making it easier to detect early signs of certain severe health conditions.
Last but not least, this technology would be a great help for the people who live in rural areas and do not have access to good medical facilities. It can be an excellent opportunity for better collaboration between the healthcare providers as well. They can share the patient’s information with each other to get an expert advice, with due consent of the patient on the Blockchain.
Case 3: Blockchain helps in better integration of data of Wearables
The growing trend of consumer health wearables like fitbits, health bands, apple health kits, and watches is ushering in a new era of consumerization of healthcare. These devices record the daily data and activities of a consumer like calories, step counts, miles, heart rate, etc. With blockchain technology, all this daily data can be clubbed with other medical health care data like clinic visits, demographics, allergies, lab tests, and much more. Further, with the implementation of smart contracts, this data can be used to provide better medical care and monitoring by doctors.
Let us understand it through a practical world scenario. Andrew is diagnosed with fatty liver, and therefore, Dr. Steve designed a special exercise regimen for him. A smart contract is set between them to check whether Andrew is sticking to the regimen prescribed by the doctor. Andrew’s wearable smart gear logs in his daily movements, exercise regimen, and other essential data points. After every three days, the smart contract verifies if the terms of the contract are fulfilled.
And Dr. Steve only gets notified if Andrew fails to adhere to his exercise regimen continuously for two times. Thus, you can see the smart contracts, when clubbed with Blockchain, can be a game-changer for the healthcare industry.
Case 4: Getting compensated for your data
You will be shocked to know that your health data clubbed with millions of other users is sold by health informatics companies to pharmaceutical companies for billions of dollars. Pharma companies use this bundled data for research and marketing purposes. Of course, the name and other crucial identifying details are taken off before bundling and sharing the data of millions of users. The biggest irony here is that this data belongs to you and got recorded against the payment done by you or your insurance company, but it gets sold without your prior knowledge and consent.
With Blockchain, this situation is bound to change where you control your own data. With this technology, you can share your data anonymously or with your actual identity. Once you give your approval on this, your consent will be recorded on the Blockchain. The pharma companies can verify your consent by using a key that connects to the Blockchain and can then use your data for medical research and marketing purposes. Subsequently, you will also be given a pie of the revenue generated from this transaction.
Additionally, it will be a great help for these pharma companies because having a direct relationship with the patient will help them get more valuable insights, which is not feasible in the current world.
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