Blockchain will revolutionize the Healthcare Industry as you know it.
No. Blockchain is a Sham. It will never be able to Make a Mark in an Industry as prominent as Healthcare.
You will now spend the next 14 minutes coming to a standstill of whether or not Blockchain will impact the Healthcare industry and if it does – *Spoiler* It Will – How can you be a part of the evolution.
The diagnosis will start with us seeing how Blockchain technology and Healthcare fit together and what are the different use cases of the technology in the industry. Next, the symptoms of Blockchain will be studied and a clear diagnosis will be made in terms of the technology future. Lastly, the measures will be shared to help the businesses offering Healthcare Apps utilize the technology, rightly.
Let’s start with the Medical Evaluation of Blockchain Technology.
The one concrete thing in the unsurety surrounding whether or not Blockchain will do to Healthcare what it did to Finance, is the fact that Blockchain is a part of the 9 Healthcare Trends that businesses will be following in 2018.
But as something that was originally incepted to be a part of payment ecosystem, how does Blockchain fit into the Healthcare Industry?
Let’s begin the answer to this ‘How’ with the issue that gave scope for Blockchain technology intervention.
There’s a terminology called ‘Physician Burnout’ doing rounds in the hospital chambers and the rate of Physician Burnout has increased to 80%. And the physicians are blaming EMR for it.
When you look at a doctor’s job, it has 8/9 hours of clinic time after which they go home and after 4 – 5 hours of rest, they are finding themselves in front of their EMR healthcare app, where they are feeding in data and updating medical records.
Now, take this burnout and add it to the rising malpractices that are linked back to the lack of security in maintaining EHR.
When you take these two gruesome non-hypothetical events and try to find a solution that offers both – a Platform where the information is updated in real time and stays that way, unchanged thus preventing any or all scope of tampering, you get Blockchain.
How does Blockchain Technology Fit in the Healthcare Industry?
The growing demand for integrated care delivery mixed with an increasing focus on health management increases the demand for an information technology ecosystem that would remove the dependency on the middlemen.
Blockchain, the technology behind cryptocurrency, being an open decentralized system, offers just that. The Blockchain Healthcare technology doesn’t need multiple levels of authentication but at the same time, it gives access to chronologically arranged data to everyone who is a part of the architecture.
By bringing all the collective data in one place for the stakeholders to view and work around in a way that the changes made by one person in the data are visible to everyone else in the system.
The features that the combination of Blockchain and Healthcare ecosystem comes with – Decentralization, Immutability, and Security – combine together to solve a number of challenges that face the Healthcare industry today.
Healthcare Challenges that Blockchain Technology Solves
1. Fragmented Data
One of the biggest reasons for EMR frauds or data theft can be traced back to one server where all the medical data, coming in from all the different platforms, merged. When every data is stored in a common place, the moment the system is hacked, data gets compromised.
With Blockchain, your healthcare app gets to store the patients’ data across a number of different nodes, eliminating the risk of central server getting hacked or crashed.
2. Timely Access of Data
The distributed ledger that comes as a package with Blockchain and Healthcare mix, enables distributed and secure access to the patient’s health data and the updates that are made to the patient’s shared data are also done in real time.
3. System Interoperability
Blockchain offers a decentralized form of computer network and internet across boundaries. So when a health organization seeks information about the patient from another healthcare organization, they no more have to wait for the data to travel several miles.
4. Data Security
Blockchain in itself has become a synonym to Security. Being completely decentralized and immutable, the patient data is A. Only accessible to those who have the need to interact with it and B. Any change when made to it is visible to everyone in the Blockchain, making it impossible for someone to fetch the data without others knowing.
5. Patient Generated Data
While it is still possible (although difficult) to get consolidated patient data from across different healthcare organizations, combining the data that the users generate through their personal healthcare device – wearables – with the ones generated by healthcare organizations is not easy.
Blockchain Healthcare makes it possible to consolidate users generated IoT data with their healthcare organization data in one place.
6. Cost Effectiveness
Since there is no third party involved in fetching the patient data or in transferring the data from one party to another, there is greater cost-effectiveness attached with employing Blockchain technology in Healthcare than in a scenario where a decentralized system is missing.
7. Disintermediation of Trust
In a non-decentralized world, an HIE is appointed to establish the point-to-point sharing and bookkeeping of the exchanged patient data, while in a decentralized scenario a.ka. Blockchain technology in Healthcare, all the participants have access to the distributed ledger, which ensures a transparent, secure exchange.
8. Consistent Rules Through Smart Contract
Smart Contract, the crucial element of Blockchain technology helps develop a consistent, rule base process for healthcare organizations when it comes to accessing patient’s data.
The Blockchain technology elements that have helped Healthcare industry manage the challenges that have been present ever since the inception, are the same elements that have curated a series of use cases for themselves in the Healthcare domain.
In that respect, let us look into some of the scenarios which validate the growing impact of Blockchain in the Healthcare industry –
Blockchain Use Cases in a Healthcare Scenario
1. Patient’s Medical Verification
Suppose you visited a doctor in 2010 to get consultation on a disease that was then treated, but in 2018, after 8 years, the condition relapses. Now, in a centralized world, you will be needing the details of the evaluation from 8 years back, for which you will have to track down the consulting doctor and hope that he has the records.
Cut to the Decentralized Blockchain world, where Blockchain Technology in Healthcare is the norm.
With the help of your healthcare app that has a Blockchain functionality embedded in it, you and your present doctor will have the complete record of what you were affected from back in 2010.
2. Supply Chain Management
Healthcare industry is 80% dependent entirely on the global supply chain of medical product and services. The capability of Blockchain Healthcare to keep immutable records solves a number of issues that are associated with Supply Chain Management.
Let us look at some of the issues that get solved with Blockchain application in the healthcare industry –
- Assuring that the active ingredients used for drug creation are as per the medical standards.
- Traceability of Counterfeit products – Counterfeit drugs and devices are the number one issue that healthcare organizations face. Tracking the origin of the counterfeit drug and device can solve a number of issues later.
- Information related to the movement of pharmaceuticals and the inventory offers great value to all – pharmaceutical companies, pharmacies, and the healthcare providers.
- Managing medicine and devices recall are also a lot easier to execute.
3. Clinical Research and Drug Development
The traceability of data that is generated during the process of the clinical trial is a key to evaluate the proposed medical interventions.
Also, when Blockchain and Healthcare are combined in a way that it is integrated with the users’ health based IoT devices, detailed documentation of observational data and patients’ actions can be made.
Since the information that is collected with the integration of Blockchain Healthcare is much higher, better drug formulation can be done which would be more in direct sync with the users’ exact condition.
4. Impact of Treatment Regimen
Through the validated access into detailed patient data, healthcare research companies are able to study the impact of a specific treatment regimen on a large fraction of customer’s population. This kind of downstream research on the impact of the treatment regimen on a patient’s well being provides an enhanced basis for the continued improvement in intervention customization to meet the patient’s specific characteristics.
5. Change in Business Model
Blockchain, when integrated with the operations and environment of the stakeholders can lead to the creation of new business models. Here are some of the examples of how the healthcare stakeholders’ business model can change with the expansion to Blockchain Healthcare –
- Pharmaceutical Companies – With the data that is collected on the Blockchain platform in real time, pharma companies can provide a range of different medical products and treatment regimen that are customized according to the patient’s exact genomic.
- Pharmacies – With the data of patient requirements now readily available, pharmacies can look over the drug prescriptions and can guide patients on how the drug needs to be taken.
- Healthcare Professionals – Healthcare providers can now access the information that is related to the patient’s conditions and requirements. When integrated with the real-time data of patient’s health performance, collected through wearables, healthcare providers can employ new methods to alert the patients of health risk and can guide them when there is a change of environment.
I know that while some of you reading the piece would be getting excited about the prospect of innovation that Blockchain and Healthcare together can bring in the world, there’ll be a great percentage of you all who would not be sold on the idea of over technicalizing the industry that doesn’t really need the complexities.
This is for the latter. The non-believers.
I know where you are coming from. For an industry like Healthcare to be revolutionized by a fairly untested technology like Blockchain, the concept that offers a superficial promise of easing out the traditional industry will have to face a number of ground-level challenges.
Let us look at some of the real world challenges that are preventing Blockchain from making the ideal level of la-la land impact that the world is expecting to see in the Healthcare Industry.
1. Different Geographical Locations Come With Different Set of Medical Guidelines
Integration of compliances like HIPAA and PCI is already a concept that we mobile application developers suffer from. Now when you add a technical concept into the mix that does not have the back of any medical board, the process becomes even more difficult. And you know what makes it worse? The difference in Compliances according to different regions.
So, the number one issue that keeps the technology from being accepted widely is the unsurety that is Blockchain Healthcare Apps even compliant with the medical guidelines?
Unlike the general belief, saving the data on a blockchain does not mean non-compliance. Instead, in reality, the technology makes the enforcement of compliances a lot more transparent and seamless.
To ensure that your healthcare app fits in the criteria set by HIPAA compliances, collect the patient’s medical information coming in from everywhere – insurance provider, diagnostic center, and even the wearables – in a way that it adheres to the compliances and then store it on the blockchain.
Also, if you are putting the medical data on a public blockchain, you can maintain the anonymity of the private information by encrypting it in a way that only the patient can decrypt it.
2. Unclarity in terms of Deciding Who Actually Needs the Access
When was the last time you heard someone say that they have stuck with one doctor, one clinic, and one pathology lab? Been a while, right?
With the changing perceptions that patients have in terms of seeking medical guidance, the number and kind of service providers have changed from their original, conceived numbers.
In a situation where anybody could ask for your medical document for any number of reasons – for documentation purpose or for clinical research, how can Blockchain ensure “security”?
Permissioned Blockchain and Smart Contracts
Let’s take a momentarily break here and see what happens when people talk about Blockchain. They assume that there is a platform which opens for everyone to view and because it is so transparent, while on one hand, any changes that would be made would be visible, so chances of tampering would be to a minimum and it is true.
The general understanding of what Blockchain is true, but what it is is a half-truth.
There are two types of Blockchains – Public and Permissioned. The one you read above is a classic case of Public blockchain, the type which is not suitable for an industry like Healthcare or even Finance.
The one that is suited for the highly private sector like Healthcare is…
Permissioned – Our one solution to the issue of unclarity in terms of how secure Blockchain really is. What happens is that while the data will be saved cryptographically in an open blockchain platform, the access to view it will be permissioned and only those with the access will be able to see it.
The other solution would be data manipulation & permissioning with the help of smart contracts. Using the smart contract technique, you will be able to set standards as to who can view an information and under what condition.
3. Size of Data That can be Stored in a Block
If we make a rough estimate of the amount of medical data that is generated by healthcare stakeholders, the number would be somewhere in the 80 – 120 MB ballpark. A number that easily surpasses the amount of data that can be stored in a typical blockchain architecture because of the block size limitation.
A well planned Architecture will prove to be an obvious clever solution with the system’s components made by storing them on and off-chain data after a very careful study of the data types, which would make sense in the respective domains e.g. a combination of the on-chain and the off-chain data in either the conventional RDBMS/No-SQL or in a IPFS.
4. Restriction in Number of Transactions that can be Done Every day
The time that it presently takes to load data in a blockchain is undoubtedly slow. The probable solution to tackle this issue can be using platforms like Hyperledger Fabric, EOS, and Fabric, etc. which enables scaling of a number of more transactions per block while helping in reaching a consensus in a much lesser time by applying an advanced consensus also which are way ahead of a conventional proof of work.
5. Data Immutability
The fact that Blockchain does not allow changes to be made once an information is uploaded, is both a boon and a bane. While on one hand immutability ensures heightened security, on the other it restricts scalability.
The solution to this immutability issue would require an extension in the present architecture, which would enable recording of only the edits or the one that uses clever on-chain off-chain data partitioning in short terms.
So we have now been a part of He said She said, with both the parties making some excellent points, here are the *drumrolls* Moment of Truth – The future of Blockchain in Healthcare.
The Technology will Not Change the Healthcare Industry from its Core Next Year or Even its Next.
But, the Tech Revolution is on the route of becoming a Healthcare Evolution.
Blockchain is definitely maturing and maturing with the technology behind cryptocurrency is its adoption within the healthcare domain.
As you can see in the illustration above, Blockchain has entered the Phase 1 as a number of healthcare mobile apps have integrated the technology in their process to help put patients in charge of their data, better the quality of Healthcare Research and Development, and better the service delivery.
The technology now, after having been adopted in phase 1 can now be seen making an appearance in Phase 2 where it is now being standardized – an example of this would be its integration in the healthcare supply chain.
The next step in the journey that the Blockchain technology has to cover is of getting adopted to a much bigger extent than its present self. While there are no use cases of the near future that the technology has predicted for itself, we can assume that when you see medical boards around the world accepting the technology and setting guidelines around it, the technology would have entered Phase 3 of its maturity.
The last phase, phase 4 where there will be optimization and an integration of business process will come when the industry, along with all its stakeholders will move to a decentralized world.
Marking the journey that Blockchain is on – the route to decentralize healthcare industry – are the Blockchain Healthcare Companies that are have adopted the technology to simplify the Healthcare industry in their own way.
Famous Blockchain Healthcare Companies
Brands like the ones you read above about are the ones that are playing their part in making the healthcare industry stakeholders get accustomed with the disruptive technology.
This brings us to our last section. Where to start if you wish to join the league of these companies and offer a product that would be a blend of Healthcare App and Blockchain App.
How to Add a Blockchain Dose in your Healthcare App?
Whether you are starting with the Healthcare App Development Process for the first time or whether you are planning to add a Blockchain feature in your existing mHealth app, the right step to follow is to start small.
Here are the healthcare app features that you can move to Blockchain –
1. Medical Data Management
By bringing all the patient data on one platform that is shared with the stakeholders, it becomes a lot easier for the involved parties to get the information in real time and remain updated with what is happening with the patient’s life, medically in real time.
2. Claims and Billing Management
Claim and Bill Management is the part of a process where the filing and the processing of the medical claim that is related to the patients’ diagnosis, medications, and treatments are done. There have a number of incidents where the medical files were compromised, which led to fraud and theft cases.
Blockchain makes it easy to eliminate these instances as the technology in its basic self works around a recording of medical data and storing it in the open, in a way that any change, when made in the information, is visible to everyone who is a part of the chain.
3. Data Security
The part in your app where you store the patients’ medical history can be moved to Blockchain. Since it is impossible to change the data that is stored on Blockchain without everyone noticing, everyone in the chain always knows how the data is being utilized and they can allow/ disallow it accordingly.
4. Medical Research
Proof of date is the biggest requirement of the medical research domain, and bringing in a paradigm shift in the concept is Blockchain’s Timestamp. The main functionalities of the technology – historicity of data and traceability – are exactly what help reduce the instances of errors and frauds in clinical trials.
Another element reducing the fraud instances in clinical researches is the immutable record of an experiment, trial, result, and protocol.
So there you have it. The verdict – Blockchain has not yet but definitely will bring in a Healthcare Evolution. And now you know how you can prepare your healthcare app for it when the time does come.