Why global healthcare should step up to blockchain technology for enhanced patient health outcome?

By Dr Prem Jagyasi 

Global healthcare today demands the highest level of efficiency to deliver value-based care in patient health management. Blockchain technology with its smart data-management and information-sharing system has the right solution to this. 

Its adoption in healthcare is inevitable for its shareability, interoperability and data security that promise to simplify the existing complexities of healthcare systems. The peer-to-peer sharing ledger technology significantly reduces the operating cost of a healthcare system maintaining the best possible security standard.

Frost and Sullivan research on Blockchain Technology in Global Healthcare 2017-25 reports that blockchain has the potential to save billions of dollars by optimizing operation and removing high-cost intermediation.  No other technology till date has offered such unique benefits of streamlining operations along with giving back the power of data control to users. This implies that users can update information and take the responsibility of managing their own medical data. But the tangible benefits of blockchain need to be demonstrated first to make its widespread adoption to happen.

Improved data interoperability, the basis of value-based care:

Ever since the massive digitization of patient health records in the form of EHR (Electronic Health Records), patient data has remained fragmented in silos that do not communicate with each other. This can be crucial in the diagnosis and deciding successive treatment plans. 

For example, a patient suffering from chronic treatment is rushed to the emergency room. The attending doctor, if he has no access to the patient’s prior medical history, may suggest some expensive tests to play safe which may not be required at all but has to be done for proper diagnosis.  The patient’s medical history of his chronic condition may be recorded with the primary care provider or with a medical specialist. Even the health insurance provider may not have any information on this. 

If there is a smooth information exchange between the different parties like patients, providers and payers, the patient may have been brought under specific care management programs which would have saved the huge emergency medical cost. Healthcare system needs to fast bring in data interoperability from disparate systems to escalate the operation efficiency where redundant activities will be automatically eliminated improving patient outcome. 

Decentralized information flow to enhance value-based care:

The efficiency of the providers lies in the fact that how they are helping patients in managing their chronic ailments to reduce their impact and hospital visits. The cloud-based information system of blockchain technology offers a great opportunity for healthcare providers, researchers, scientists and innovators to maintain a consistent progress in public health.

In fact, this decentralized information storage is the key to the efficiency of blockchain technology where the users or members can have quick access to their medical records and share with the healthcare providers as and when necessary.

Core areas where blockchain can deliver value-based care

• Real-time communication with providers informing of available incentives for specific patients.
• Real-time identification of gaps in care and resolving them immediately.
• Direct patients timely and efficiently into various care programs meant for them.
• All providers have the visibility regarding continuous patient care.
• Help physicians in improving decision-making at the time of treatment.

Drug traceability

Counterfeit drugs snatch thousands of lives annually. About 10-30% drugs produced in the developing countries are fake, reports Health Research Funding Organization (HRFO). The US healthcare bears an annual loss of around $200 billion for fake drugs. Immutability of any transaction time-stamped in the Blockchain can be utilized in drug traceability. The drug can be tracked in the blocks as the information once registered cannot be altered. To ensure the authenticity of drugs, trustworthy pharmaceutical companies can register any specific drug in the blockchain. 

Private blockchains controlled by a central authority would be more effective in this matter as they will have a proof that drugs manufactured by these companies are genuine. Different stakeholders of the supply chain like manufacturers, wholesalers or retailers would have different accessibility options depending on their position of the supply chain. The ‘hash’ attached to a block containing drug information will be linked to another block which will make it easy to track as it moves down the supply chain. This gives a data transparency where the drug can be tracked from the origin. This automatically eradicates the circulation of fake drugs.

Ensured security to healthcare data

 A centralized data system is prone to hacking as a single point entry by a hacker can put the entire system in jeopardy. The encryption-embedded blockchain ledger with different levels of database access can save the system from such external attacks and threats. If implemented properly, blockchain can prevent data corruption and collapse of hardware.

This would also simplify the objective of HIPAA (Health Insurance Portability and Accountability Act) of keeping PII (Personally Identifiable Information) and Personal Health Information (PHI) private and secure. 

Creating an easy payment system without any intermediary

The decentralized architecture of blockchain has another important benefit – elimination of intermediaries. Settling of bills and claims through automated payment systems and smart contracts removes the intermediaries and lowers the administrative costs. Insurance companies, on which many patients depend to settle their medical claims, can operate without any apprehension for frauds and scams. Payment through cryptocurrencies would be another major shift where each and every transaction irrespective of geographical location can be made in a secured manner without disclosing the identity of the payer.

Smart data management to aid in medical research

In today’s healthcare, innovation is the order of the day. Advanced medical research plays a great role in ushering treatment breakthroughs. Of the number of clinical trials conducted, it is unfortunate that most of them are not accurately reported. Even if the benefits are assured, the shadow of doubt remains regarding the accuracy of the trials and patients remain deprived of the latest medical advancements. 

Blockchain’s digital ledger technology has the potential in creating effective collaboration between researchers and inventors through the authentication of documents registered in the system which is not easy to tamper. Results of clinical trials in the blockchain will remain secure as the data is immutable.

How the present healthcare is responding to blockchain disruption?

The success of blockchain technology will ultimately depend on the willingness of the healthcare systems in adopting it. Like healthcare, blockchain also functions as a team. Larger the participants in the team more are the benefits. 

The recent survey by PwC Health Research Institute states that nearly 50% of healthcare executives are considering adopting blockchain in their organizations. But hesitation persists owing to lack of trust, proper governance and proven expertise. In spite of blockchain’s inherent security that forms the basis of trust, 47% of the 74 global healthcare organizations surveyed do not feel confident in using blockchain.

A wholehearted acceptance scenario is not visible. With any transformative technology, the biggest challenge lies in creating a new work culture and operational changes to align with it. 

The same is true with Blockchain technology

The Hyperledger’s survey states that 49% of healthcare organizations assume that ‘interoperability’ factor will help in faster adoption of blockchain technology of which 28.6% respondents are willing to implement it in the current settings. 

Lack of knowledge in blockchain technology is one of the prime reasons for healthcare organizations hesitating in adopting it. About ¼ of the respondents in the above survey are still in the knowledge-development phase while a significant fraction is still unaware of this technology and its potential benefits.  Black Book Market Research Survey in 2018 states that only 19% of hospital executives are considering its implementation and only 9% of provider health systems are supposed to implement it by 2018. Caregivers, however, are optimistic of blockchain where 37.9% predict that within next the five years it would be widely adopted.  Adoption of blockchain would need to pass several higher level milestones for full-scale adoption to take place. The undetermined cost of blockchain solutions is certainly another factor that is holding back healthcare executives in going for a time-bound commitment in its adoption. Currently, the healthcare sector is in the wait and watch mode. The pilot projects run by several organizations hopefully will drive in tangible proof convincing enough for this sector to build confidence in this new technology.

About Dr. Prem Jagyasi

A globally acclaimed, award-winning strategic leader and speaker, Dr Prem Jagyasi is a world-renowned medical tourism consultant. He has authored Medical Tourism Guidebook and Wellness Tourism Guidebook.  He has also delivered numerous keynote speeches and focused corporate workshops in 45+ countries. More than 150 international organizations have benefited from his expertise through conferences, expert training, consultancy and brand management services.  http://drprem.com