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How Blockchain Can Revolutionize the Data Systems Powering the Healthcare Industry Moving electronic medical records to the blockchain will change the way healthcare is delivered

By Wafir Manakad

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While healthcare delivery has seen innovation in troves in the last decade, a particularly crucial segment of the industry has remained largely unchanged -- the electronic medical record (EMR) of a patient.

Medical data has been highly fragmented so far, with individual organizations and government entities having their own inadequate versions of a patient's information. According to a Medicare study, American patients consult seven different physicians in the span of a year, over multiple specialities and practices.

Blockchain promises to bridge the gap in data by providing a tamper-proof public ledger to hold information in a decentralized platform. Originally developed as a means to account for cryptocurrency transactions, it is employed across various industries today. The blockchain is ideal for storing patient health records, thanks in part to its data integrity and authentication features.

An Efficient Health Information Exchange (HIE)

A major drawback of a disconnected EMR system is the effect it has on the interoperability of the various stakeholders in the industry. The flow of patient information from one healthcare provider to another is suppressed, and in a lot of cases, inaccurate. As a result, there are various inefficiencies in the entire process flow of a medical appointment, often leading to an incomplete or faulty diagnosis.

Blockchain provides a secure and distributed register to store the entire gamut of a patient's medical record -- health conditions, prescriptions, billing, insurance and other.

This leads to what you would call a "connected healthcare" system, where all the participants in the ecosystem will have access to a patient's medical history, without having to maintain paper-based records in a conventional manner. With a consent-based mechanism built into the system, patients can choose to share their data with the relevant parties.

Containing The Outbreak of an Epidemic

The spread and outbreak of contagious diseases are aided vastly by the inability to detect the early cases. The most important factor in containing one is the capacity to isolate the infected patients, failing which the disease spreads rapidly turning into a full-blown epidemic.

For example, there were 11,316 reported deaths from Ebola during the 2014 epidemic in Africa, according to a 2016 report by the Centers for Disease Control and Prevention (CDC). Aside from the calamitous loss of human life, the economic impact was notable – The World Bank estimated that $2.2 billion was lost in 2015 in the GDP of Guinea, Liberia and Sierra Leone.

During the early stages of an epidemic, there is usually a lack of coordination between medical institutions. News of a patient diagnosed with a highly contagious disease would take weeks or months to reach clinics in the same locale, leading to a viral outbreak of the disease due to a lack of isolation.

Blockchain could solve this problem by bridging the gap between medical providers, and taking early detection to the next level. With a centralized repository of data on the blockchain, organizations such as the CDC or FDA could analyze this data in real-time, setting up triggers in order to curb the outbreak of the disease in its infancy.

Improved and Faster Organ-matching Systems

Organ transplantation and blood donation have seen vast innovation in surgical techniques and organ preservation. Despite this progress, the shortage of organs remains a point of concern – on an average, 11,000 people die each year waiting for a lifesaving organ transplant, according to Donate Life America.

Today, there are various government and private enterprises that actively collect and store donor and recipient data, however, the degree of fragmentation here is high, often leading to large waitlists and consequently, loss of life. Companies like Apple are taking steps in the right direction -- the Health app packaged with iOS lets users register themselves as organ donors, and this information is shared with the national registry.

Blockchain could provide a common platform for holding multiple parameters of donor and recipient information. Inter-organizational information exchange would become seamless, improving vastly the time required to match a donor with a recipient. Additionally, its incorruptible nature would provide an added layer of safety and verification for a process as critical as organ transplantation.

What Does the Future Hold?

Although the underlying technology behind the blockchain paves the way for future disruptions, caution must be exercised on how soon we can expect to see the ubiquitous use of the technology. There would be technical challenges encountered in the process of moving petabytes of records to the blockchain periodically. In terms of storage and transfer speeds, legacy systems are way ahead today, due in part to how nascent the technology still is.

A major point of contention arising out of EMR on the blockchain is the ownership of this data. Ideally, a patient's medical records should be owned by the patient alone, with a consent-based system of sharing. However, governments would have to put policies in place to regulate the transfer and ownership of this information, and define the relationship between the EMR and the various stakeholders involved, such as the patient, doctor, clinic, pharmacy and insurance company. Health Insurance Portability and Accountability Act (HIPAA) regulates the laws pertaining to medical data privacy in the US and is expected to gain greater prominence in the coming years with blockchain bringing up questions on medical data ownership and security.

Nevertheless, some nascent applications of the technology are beginning to take shape. In a survey undertaken by IBM of healthcare executives both on the insurance and provider side, 16 per cent of the respondents expected to roll-out a commercial blockchain application the same year. The technology is expected to become more commonplace over the next few years.

Moving to the blockchain will pave the way for quantum leaps in health-tech in the future, concepts that would be out of the scope or imagination of this article. For an industry that has remained largely stagnant for the past few decades, blockchain promises to be the innovation to propel it forward.

Wafir Manakad

Co-Founder, Fidoc

Wafir is the co-founder of Fidoc, a digital health platform connecting patients with medical providers in the UAE. Previously, he was an engineer at the trucking division of Daimler AG, where he worked on developing innovative solutions to field issues.

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