Part 3 Of 4
Coronavirus headlines seem to be dominating my newsfeed and have been attributed to the recent spike to BTC $10,000. It seems like a good time to look at the multi billion dollar opportunity at the intersection of blockchain and health.
If you missed Part 2, you can find it here!
We all know of at least some of the applications of blockchain to the financial services industry – after all, it was born out of a reinvention of payments and money with bitcoin, and rapidly evolved over a decade into a number of use cases ranging from interbank settlements to digital identity for better AML/KYC. Financial services (including insurance) is estimated to be about twenty to thirty percent of the global economy, and represents a critical instrument through which the rest of it operates. Another 10% is spent on health, which represents a potentially high-impact area ready for blockchain – many intermediaries, lots of paperwork, high costs, and high degrees of inefficiencies – and data gaps that, when they grow too big, result in loss of life.
Let’s take a closer look at healthchain…
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Adapted from Basic Blockchain © 2020 Visionary Future LLC, published by Robinson, an imprint of Little, Brown Book Group
Blockchain technologies could be applied in the health industry in a scalable manner with high-impact results, such as improved welfare for patients and reduced running costs for healthcare systems.
There are some interesting dynamics when it comes to personal data in the healthcare services. On the one hand, people want security and privacy where their medical information is concerned. Most domiciles have put in place regulation in law that governs how personal information can be shared, used and stored, such as the GDPR in Europe. The average consumer would want to know who has accessed their medical information and under what circumstances. Blockchain could provide an immutable record of who looked at a patient’s medical records, how often, and with what authorization. Patient trust in the system can be enhanced because they have a greater insight into the governance of their data.
We have seen a number of instances of the violation of personal data privacy through improper access to personal health records, notwithstanding the emergence in recent years of new health data privacy regulations globally that are accompanied by stiff penalties. First, the patient needs to know there was a violation, and second, he or she typically needs to go through a laborious grievance and investigation process. A blockchain audit trail could offer consumers greater insight as to who accessed their information and when it was made available, and with the help of artificial intelligence blockchain could provide better monitoring and alerts than current data systems.
On the other hand, there are instances where a consumer wants quick access to health information. For example, if you are in a medical emergency, you don’t want to have to wait access your information. You want a ‘break-glass-in-case-of-emergency’ capability. Or if you want to move healthcare providers, you want to easily consolidate and migrate your personal health records. Many medical providers still use fax machines, even in the third decade of the 21st century, an antiquated remnant of the era of paper records that can and should be replaced by secure blockchain protocols. Even in single payor systems, patient access to data has proven highly problematic.
Opening the Medical Record
Opening up the closed architecture of electronic medical records through blockchain enhances the portability of the personal health record, making it easier for consumers to get better and more cost-effective health care.
Improving the Care Experience
Within the hospital or clinic, transitions in care – the moment when a patient is handed from one medical provider to another, or moving from one department to another – are a major source of medical error, hospital-based injury and sometimes even death. Data slippage is often the cause: did the doctor or nurse know about an issue or allergy? Was the correct procedure performed? Better data systems, such as a distributed database, could help consolidate and highlight key medical information more seamlessly across the cycle of care.
Reducing Waste and Fraud
Medical fraud costs more than £160 billion per year, according to the World Health Organisation. As with other areas, we can remediate this through blockchain’s ability to provide an immutable record, and tie together disparate pieces of data that, had they remained separate, would obscure the truth.
The quality and safety of a medical device can be tracked by companies like Spiritus Partners, which monitors the ownership, service history and any safety issues. Defective devices can be discovered and remedied in a fast, reliable and transparent fashion.
Better Reference and Care Data
Even something as simple as knowing who a physician is, what their credentials are, and what private insurance they accept (important particularly in the US market) is today fraught with data quality, timeliness and availability issues, which could be largely or entirely automated with the right distributed ledger.
Improvements to population health can be made with blockchain. While patient privacy needs to be protected, there are also issues of public good to consider. With the right kind of blockchain protocol applied, disease registries can become more dynamic and easier to manage with better data governance.
Going beyond health services into the broader category of health, in biotech, pharmaceutical research and medical research more broadly it is not unusual for only positive results to be published by organisations. But it is the negative data that is instructive as it helps to avoid waste and accelerate drug or device development. With certain variations of blockchain technology, specifically multiparty computation with secret sharing, it becomes possible to facilitate the exchange of anonymised, critical data elements across patient data sets, without revealing information that would lead to competition or privacy issues.
This feeds into the broader category of real-world evidence, a critical input for the long-term viability of the pharmaceuticals and biotech industry, enabling patients to consent for their data to be used as part of a study even after a drug has gone into the market. As new issues with drugs or products surface, relevant or affected patients can be allocated or moved into the research study rather than having to initiate a new trial, wait for data collection, and then analyse the results years later. The clinical data acquires a ‘time machine’ that effectively lets it press a rewind button, letting clinicians go back and ask different questions about patient data without having to re-enrol said patients or re-run a trial, through a different model of patient engagement.
The data-intensive applications that are starting to emerge in digital health share a common hub, the patient, but unfortunately have fragmented the storage of this data into silos. Blockchain in health can bring these scattered bits of information together cohesively for the betterment of the individual and of society. Some bold visionaries imagine a ‘tipping point of transitioning to a person-centric model’ as Frank Ricotta of Burst IQ puts it, where the various elements of consumer health (services like those offered by DNA-testing company 23andMe and other quantified-self products) combine with conventional clinical care, propelled by blockchain, precision medicine, artificial intelligence, connected devices and other technologies.
Health data volume is increasing exponentially, and blockchain married to intelligent code can deliver order to the chaos of patient information.
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Next week, Part 4 and the conclusion of the series will take us into the future of work, of how we organize ourselves and our activities…and blockchain