Blockchain & Healthcare: Taking Doctor-Patient Interaction To The Next Level
Healthcare is one of the industries that can benefit most from blockchain technology, as the quality of medical services is heavily dependant on how the patient-related information is recorded, stored, shared and protected.
Blockchain can become a panacea to the major problems that cause unnecessary friction, delay and mistrust in doctor-patient and doctor-doctor communication. As any health-related mistake can cost dear to both parties involved, the industry is ready to invest billions in the innovation that could take it to the next level.
It is clear that the current healthcare system, with its advanced methods of treatment and up-to-date medical equipment, is still antiquated in terms of data management and security. According to some reports blockchain solutions can save up to $100 bln a year by 2025. The technology incorporation is potentially capable of reducing many costs, including those related to data breaches, counterfeit drugs and insurance frauds.
We have dug into the matter and have identified the main healthcare problems that could be cured by blockchain.
Patient Data Management
Efficient patient data management is essential for the healthcare system. Each person is unique, meaning their health condition is kind of unique, too. What works for you may be useless or harmful to your friend, if your bodies react in a different way to the same treatment or drug. Besides, we are well-aware that ‘everybody lies’, making it difficult for a doctor to identify the patient’s condition and prescribe a cure. As a result, doctors often lack complete and reliable medical record that would allow them to provide a high-quality personalized care.
Another problem here is sharing data between healthcare institutions. It’s clear, that this kind of sensitive data should be shared via a global secure network, and not via social media, used by some doctors for the purpose. Besides, when a patient’s medical records are kept in different locations (as they are now), it may cause serious interoperability failures.
For instance, some institutions tend to block this information for fear of losing their patients. Actually, it works: our unwillingness to undergo a lot of medical tests, take new X-rays and go through all this paperwork again and again guarantees our ‘loyalty’ to a familiar clinic even if we are not quite happy with it.
Finally, there is such an issue as data ownership. Today no patient can be granted the full ownership of their medical records. It is made for a reason — if we had complete control over our health-related info, we could easily change it. Sometimes it might be dangerous for a society — say, people whose health condition prevents them from taking a certain job, could make themselves eligible again by deleting some fragments of their medical record. It could have a negative impact both on their own and public health.
But not letting a patient possess his/her info has a downside, too. If our data does not belong to us, it means we have no control over who uses it, and for what purpose.
How blockchain can improve the situation?
By providing a better structure that would collect the info from patients (personal data, test results, procedures taken etc.) and store it in a safe way. Smart contracts may be used for managing data access. In this case, a patient cannot change their info, but they can ‘restrict the audience’. Say, you may share your complete record with your doctor and a ‘limited version’ (no personal info attached) with some pharma research team quite content with anonymous statistical data.
If your info belongs not to a particular institution, but to a blockchain system, it cannot be withheld, lost, compromised or leaked. The privacy of patients is protected cryptographically, each of them having a unique hash identifier.
How many of us follow the treatment or care plan prescribed by the doctor? Do you do all the exercises you need, regularly? Do you take your drugs or supplements on a daily basis? Do you keep always from the habits that make your condition worse?
Ok, you do. But It’s surprising how many others ignore their GP’s recommendations. These people may be too lazy, or lack will power, or rely on home remedies and not on pills. The result is often sad.
The situation may change dramatically if patients are encouraged to follow their care plan by using a reward mechanism. If you do things helping you stay healthy, your ‘good behavior’ is duly rewarded with special tokens. The same tokens might be granted for sharing your data with researchers or taking part in clinical trials.
The patient’s progress and commitment may be evaluated by wearables registering and sharing all the necessary information. This data will allow your GP to see if you do what you are supposed to, accurately assess the efficiency of the care plan and make amendments to it, if necessary.
There are similar blockchain platforms already in use. One of them is HUMENA — a project aimed at encouraging people to meditate, do yoga and breathing exercises. ‘Proof-of-work’ is provided by special sensors measuring heart rate, body temperature and other indicators. If you do your exercises, the system rewards you with ZenVow coins that can be converted into fiat money or spent on the paid services. And, apart from the digital reward, you get a tool enabling you to have a deeper insight into your own health.
Pharma supply chain security
The security of supply chains is extremely important for pharma companies. The character of the product they carry makes it a matter of life and death, literally. Unfortunately, drugs are regularly stolen and sold illegally outside the official supply chain.
Another problem that costs pharma companies around $200 bln annually is counterfeit drugs that may be useless or even dangerous (in some cases useless is dangerous, too). The statistics is scary — 10% to 30% of the drugs sold in the third world countries are counterfeit. Fake drugs can be very different from the original versions — sometimes they don’t contain any active ingredients at all.
A transparent blockchain system is capable of making a pharma supply chain much more secure, greatly reducing the damage caused by counterfeit drugs and thefts. All the drugs will be tracked from the laboratory to the pharmacy shelf. You will be able to determine their point of origin and see if they are authentic or falsified.
Naturally, in this case the blockchain platform should be private and controlled by a central entity, rather than public and decentralized. It will help ensure the trustworthiness of the companies participating through the network. When a drug is produced by a trusted company, a unique hash is generated containing all the necessary product info. Every time the product moves in the supply chain (say, goes from the factory to the warehouse, and from the warehouse to the distributor), the information stored in the blockchain is updated. No space for frauds.
Clinical trial data collection
A lot of medical institutes around the world conduct their separate researches and clinical trials of various medications. This work is very important — to launch a new drug you need to take numerous tests to assess its efficiency and potential side effects. These tests may take several years, involve thousands of people and cost a lot of money to the company. The positive outcome is not guaranteed, though — if the test proves the drug is inefficient, it has no future on the market.
No wonder that frauds are not uncommon in this sphere. Pharma companies tend to tamper with trial data and under-report product-related problems. Unfortunately, with huge volume of work and complexity of data involved, such manipulations are difficult to trace. Besides, the companies are often reluctant to share their trial data for fear of disclosing commercial secrets or damaging the company’s image in the eyes of public and regulators. Lack of transparency and faulty cooperation makes data tampering easier. Add some unintentional mistakes committed along the way, and the picture will look even worse.
A blockchain could improve the situation by helping to create a single global database where all the trial data would be safely stored and available to all the network participants. All the data added to the blockchain will be verified — the majority of nodes have to agree it is coherent with the blockchain history. After it, it will be impossible to modify, reducing the risk of manipulations and mistakes.
Medical insurance frauds
Insurance frauds is one of the major problems of the modern healthcare industry. We are talking about a case when patients or service providers submit false or misleading information to insurance companies to receive payable benefits. It has been reported that such kind of medical fraud costs around $68 mln in U.S. alone.
Insurance frauds include (but are not limited to) performing medically unnecessary surgeries to get higher insurance payments, tampering with test data to justify unnecessary medical services, billing insurance companies for the medical services that were not provided or billing them for more expensive services than were actually provided. On the patient’s side we often deal with hiding the info about pre-existing diseases and lying about the nature or extent of an injury to get higher payouts from the insurance companies.
Most of those problems can be solved if both patients and clinics have to enter their information and data to the blockchain platform for verification, recording and secure storing. In case of need, health insurance companies will have access to this data to calculate the amount of payments due. The additional benefit is that in this case the information is not stored in any centralized database that can be hacked and stolen. Instead, it is be kept in a decentralized leakage-free environment helping protect the privacy of the patients. It is important — few people are ready to make their health issues public or available to an unauthorised third party. Unfortunately, now it happens all the time.
Intelligent healthcare blockchain-based ecosystem might be the future of the healthcare industry, considering the number of advantages it offers. It is capable of making care and treatment more patient-centered and personalized and solve other serious problems of the sector.
Currently, there are pioneer projects like ALLIVE aimed at changing the medical industry for the better. Also, many institutions have already started developing and experimenting with blockchain solutions for medicine.
The good news is that the health industry does not suffer from lack of funds. If blockchain is seen as a perspective technology, the developers will be supported with as much money as they need.
At least, in 2018 the funding of digital health-related startups reached its all-time record.
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