In this era of Digital Health, where Health IT has managed to revolutionize the medical industry with advanced clinical data analytics and robust EHR solutions, where patients are availing healthcare convenience using robust medical applications and interactive health wearables, the macro healthcare ecosystem still faces major issues like lack of security and interoperability. The solutions seem to have loopholes posing threat to invaluable patient data and are leaving hospitals skeptical of sharing their data. To deal with such problems at hand, a few renowned players like Harvard, Gartner, Deloitte are betting on Blockchain. In fact, US government bodies such as FDA and HHS are also investing a lot in this technology.
So, why are these players interested in this technology and what is this technology in the first place? You may also be wondering how one technology can solve one of the biggest healthcare issues, let’s find out.
What is Blockchain?
Well, it is the technology behind the renowned Cryptocurrency or Digital Currency- the Bitcoin. In the back of your mind you might be thinking is this the same Bitcoin that Wannacry ransomware hackers used to ask for ransom from the Hospitals and NHS when they hacked into their systems? Well, the answer is yes. But, don’t freak out, take a deep breath. Blockchain is just a technology that powers Bitcoin.
The textbook definition of Blockchain is that it is a distributed database or a shared ledger that can be used as an open database to create and store transaction by anyone who is a participant of the Peer-to-Peer network and has an access key. Blockchain is the list of transactions or records that are stored in the form of a block that cannot be edited once they are validated by the nodes.
How Does Blockchain Work?
In the peer-to-peer network, when someone requests for a transaction, it is sent for approval to the different nodes i.e. the number of connected computers. Once the transaction is validated by the concerned participants, it is stored in the shared ledger in the form of a block with a timestamp. Timestamp is the process of securely tracking the creation and modification time of any document. Every block is connected to a timestamp and the previous block with a Hash. The Hash is the puzzle that requires a computer learning to solve. Now once the block is stored in the ledger, it cannot be modified. To modify one block, Hash of all the blocks has to be solved and that is a lot of computer learning and a hell lot of expense. Thus, it is valid to say that once the transaction is locked in the ledger, it is almost impossible to alter or tamper the information in the block.
How can Blockchain benefit Healthcare?
Now that you have understood how Blockchain works, you will agree when I say that the two integral values that Blockchain technology provides is transparency and tamper-proof data. It is like using Microsoft Word where a password protected document can only be opened in the ‘read only’ mode and to edit the document, you would need administrator’s permission. Also, all the changes are tracked and the data can only be entered in the destination format only.
Moving back to healthcare, currently the problem with the EHR solutions is that they are offered by a lot of vendors and there is no universal standard followed. This means that there will be modules like Patient Diagnosis chart and Patient History in an EMR system, but the functionalities and the details or the information columns will vary from vendor to vendor. This is not because vendors are not aware of the fact, but they want to provide personalized solutions for the convenience of the physicians and that is where the system turns into a silo and hampers the interoperability of the solutions.
Also, different EHR solutions like EMR, HIS, Imaging System, PMS are not interconnected even in the same organizations. They are all written in different languages so that the systems can communicate. The physicians have to move back and forth to access different data from different systems and have to manually fill the missing blanks or use third party API integrations which are not necessarily trustworthy. This is where Blockchain can help.
Blockchain can set up an ideal data structure which can fetch data from physician’s installed EHR and store it in a decentralized cloud where it can be accessed only by an authorized person in a standard ledger format. Different organizations can connect all their systems and establish an interoperable network. And since the standard data structure is based on core values of Blockchain technology, the platform and the digital ledger will be tamper-proof. But to get this done on a macro level, some standardization is must on the local systems. This is possible only if vendors, rather than trying to provide personalized solutions, lean towards solutions that adhere to governance and regulatory framework established by healthcare authorities like HIPAA and HL.
Currently, there are a lot of “IFs” and “BUTs” when it comes to implementation of Blockchain. But the technology is still in its infancy and yet it has managed to deliver this world the best Cryptocurrency ever. And one thing is for sure, if evolution of Healthcare IT is to be plotted, Blockchain will be the blueprint of that roadmap.