Blockchain Technology: The Physicians Perspective

Blockchain isn’t just about Bitcoins. Or bank transfers.

It’s about patient safety as well.

In spite of huge investments and spending trillion of dollars, we haven’t been able to develop an efficient delivery healthcare and medical treatment. We are regularly plagued by problems like threats to health information, security breaches, ineffective data sharing, business gains, and mistrust among stakeholders- all of which translate in poor delivery models.

We cannot avoid or criticize the problem from outside anymore; we have to look for a viable solution from the available ones.

Blockchain Technology can be a Suitable Solution for Healthcare Information

Blockchain ledger systems were initially used to record transactions of cryptocurrencies. It is a public, decentralized and digital ledger that stores information across multiple nodes or computers in a network. It is impossible to alter the information in any block without changing the information in all the consequent blocks related to it. The system also makes it easy and cheap to track and audit information. But there are some drawbacks like-

· It is a complex technology and normal patients and providers may not be willing to use it

· You can encounter performance issues as the technology is not tested for large scale applications except cryptocurrency

· The permanent nature of information can make it difficult to modify or erase health records

Yet blockchain technology can help solve the major issues in healthcare information related to ownership of the data, accessibility, and ease-of-use and meeting HIPAA compliance. Let’s find out how-

Data Security and Longevity

Blockchain ledger comes with increased security and immutability which makes the data secure. No technology can be 100% foolproof but hacking a blockchain record is much difficult because the hacker has to manipulate multiple layers of information and nodes spread all over the world. Blockchain system also boosts security on the data exchange front. Instead of transacting data on a corporate level, the distributed ledger system enables data exchange at the personal and user level. It allows only the very specific information to be disclosed at a point of time enhancing data privacy.

The blockchain technology is also less prone to crashes or deletion. The data stored in the blocks are kept for an infinite time as long as one stakeholder does his job or passes the data along the chain of process. The information in a single data set in a blockchain ledger is backed by a huge number of contributors making it almost impossible to be lost altogether at a given point in time.

Data Ownership and Data Integrity

Credentialing is possible with the use of blockchain where each user has a unique identifier token. It can be used to authenticate the data as each owner can be tracked down. The unique identification number assigned to each owner enables authentication at the individual level. The data is stored with additional information like timestamp, the location of patient/doctor, interaction, date and so on. Each medical record becomes unique and problems of ownership also vanish as both the original creator and user of data has full or partial ownership based on their contribution in creating the data.

Decentralization

Blockchain is decentralized with nothing being stored centrally. This unique feature of the technology makes it possible to store and access data from multiple locations. The patients, doctors, nurses and other medical staff can individually access the information and also in combination making room for increased interoperability.

The open-source nature of blockchain also helps in establishing the foundation for interconnectivity of medical centers and medical offices on a user to user basis. Patients will also not need to wait for months to transfer their medical records from one provider to another.

The decentralized structure of blockchain and distributed nature of ownership among the original contributors of data also creates distributed liability. Where data is stored centrally, the holder of the data is considered responsible in case of any breach. But blockchain distributes the liability on the same concept of its unique data ownership among the contributing owners.

Increased Quality of Care

Various stakeholders are involved in the patient care scenario that will all benefit from proper access to accurate medical records. Each care provider can maintain his own block of data which is also interconnected to the block of other providers. All of them can readily access all the required information and deliver quality care in an effective manner.

Are We Ready for a Change?

Blockchain brings the much needed independence in the medical data field and also offers liberty to the various stakeholders- but are we ready for such a disruptive change? For one thing, some say that blockchain is difficult to regulate; but regulation may not always be for the good!

If the government and regulatory agencies want to track medical records they can demand access to the unique identifying tokens assigned to the owners and easily solve the problem. Of course, we are going to face resistance from tertiary players and secondary gain parties who want to manipulate the market or establish monopoly. Some skeptics also claim that blockchain will make prices go higher as the technology is costly. But each citizen will have ownership of his or her block valued based on their contribution. Thus proactive patients will have a more valuable block with higher assets and healthier life making up for any increased cost.

Blockchain may not be perfect but it outweighs all the current solutions with a high-risk benefit ratio that we physicians apply every day in our practice. The technology is going to impact patient safety, care, security and unbiased clinical and non-clinical judgments by-

· Empowering patients and doctors as well as other healthcare providers

· Personalizing delivery of healthcare

· Enabling proactive healthcare

· Allowing physicians to deliver quality care with full access to health information conserving data security and privacy

· Eliminating middlemen in healthcare