Blockchain is not about bitcoins anymore. Twelve years have passed since the mysterious Satoshi Nakamoto had published his foundational paper on using a peer-to-peer distributed ledger technology to record transactions.
Blockchain is now a well-established and ubiquitous technology used from supply chain management to fintech. It is poised to change how the healthcare industry manages privacy and healthcare data. In a post-Covid-19 world in which telehealth is becoming an important way of providing care, the application of blockchain technology is and will be a game-changer.
This article will introduce the many potentials of how blockchain can be positioned at the center of the public health network. Then, in a series of articles, we will dig deeper and present the innovations and companies that we think will lead the healthcare industry’s blockchain revolution.
Blockchain technology is a way to secure patient data, data sharing, streamlined healthcare providers, ensure the safety of the pharmaceutical supply chain through Mediledger, and ultimately solve issues inherent to a global healthcare world.
Before diving into the many benefits of a blockchain distributed ledger for the medical world, let’s describe what the technology is really about.
What is blockchain technology?
In a nutshell, blockchain technology relies on a network of peer-to-peer computers instead of centralizing the data in a single location. Just like the links of a chain cannot be removed or tampered with without breaking the whole chain, the data blocks will be arranged in chronological order.
Each data block or link will contain a unique identifier, timestamped batches of the access, and a hash of the previous block. The connected blocks of data will be connected in chronological order giving the blockchain its immutability.
Data can be stored securely within the blockchain, but it doesn’t end here. Smart contracts are part of Blockchain 2.0 and expand the use beyond just storing patient data securely. As they are embedded in the blockchain, smart contracts will be automatically processed when a certain condition is met, such as a reimbursement claim.
Even though smart contracts were not part of the original blockchain technology, they dramatically expanded the distributed ledger technology’s uses. As a result, they are now an essential part of the blockchain-based applications that can revolutionize how health data are handled.
To know more about blockchain technology and use cases, we suggest that you read the excellent book by Arshdeep Bahgah and Vijay Madisetti, Blockchain Applications – A hands-on Approach.
Estonia as the healthcare blockchain experiment
With 1.3 million inhabitants, Estonia is a small country the size of Tenessee but a very tech-savvy one. E-citizenship, digital voting, and e-taxes are the norms. In 2016, the Estonian Government and the E-Health Foundation prioritized its population’s Electronic Health Record digitization.
Each citizen receives an electronic ID card containing their entire health record, including imaging data, laboratory test results, and clinicians’ notes. Thanks to the use of blockchain, patients and their physicians access the data securely. Paramedics also automatically access critical information such as blood type, allergies, ongoing medication when an ambulance is dispatched, and urgent care is needed.
There is no more time wasted filling papers when going to the doctor or changing practices; the data remains accessible to all licensed Estonian medical professionals. Furthermore, patients stay in control of their information as, thanks to the blockchain distributed ledger, they can check who had access to their medical information.
Finally, e-prescriptions are also the norm in Estonia, streamlining, even more, the healthcare system. Undoubtedly, it is easier to achieve such results in a country with a limited population, but the Estonian healthcare experiment is certainly an example to study and learn from.
Introduction to the use of blockchain in healthcare
Blockchain technology goes far beyond a simple means of securing the data. Blockchain-based smart contracts could be used to streamline the journey of the patients among the different healthcare providers. We will present four use cases as an appetizer to our journey through the various blockchain solutions applicable to healthcare.
Master Patient Index
Master Patient Index (MPI) is a database that stores essential demographics or health information about patients. It offers a simple way to access critical information about a patient among healthcare organizations’ various components.
The data are only stored once by applying blockchain-based smart contract technology, and access within the smart contract can be restricted. For example, patients can access their own personal files and update their information in real-time if they change their address or phone number.
Electronic Health Records (EHR)
When thinking about interoperability and using a blockchain platform, the EHR is the first application that will come to mind. Combining blockchain, smart contracts, and decentralized storage offers enough flexibility to store all patient medical data.
All medical records can be stored in a distributed ledger, from the physicians’ reports to medical imaging, laboratory results, and prescribed medicines.
The smart contract’s power lies in the fact that the patient records’ security and privacy can be assured by verifying the identities and access rights of the different stakeholders to the patients’ health information.
Provider Directory
Healthcare providers’ directories can be stored using blockchain and smart contracts—the interoperability between different provider directories being ensured by the blockchain network.
The physicians’ credentials could also be verified by combining the university degrees, qualifications, and state licenses to a smart contract.
Medical Insurance Claims
The use of smart contracts can automate and speed up the processing of medical insurance claims between various providers and payers.
The payer can automatically initiate the provider’s payment by submitting the services rendered to a smart contract. Here again, the blockchain is critical to ensure smooth interoperability between various payers and healthcare organizations.
Benefits and Challenges of using blockchain in healthcare
Even though blockchain in healthcare can reduce costs, add security, and ease transactions resilient and scalable, it doesn’t come without challenges.
Blockchain is a new technology, and smart contracts can show security vulnerabilities. Despite the Estonian experiment, the use of this technology in healthcare is still nascent. The core principle of blockchain technology is based on its decentralized nature, which complexifies the implementation of necessary regulations.
The opportunities appear endless for the use of blockchain in healthcare. In the coming weeks, we will explore how innovative companies aim to transform the medical records and the whole healthcare and pharmaceutical industries.
