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Why Healthcare Needs Blockchain

By Tal Rapke
Why Healthcare Needs Blockchain 101

Dr Tal Rapke is a trained doctor and former pharmaceutical executive, founder of Australia-based startup ScalaMed, a mobile prescription exchange system powered by blockchain. He is also a mentor at Blockchain Centre Vilnius.

Any one of us in the healthcare industry will tell you – we’re drowning in data. From clinical trials to complex billing, patient records to medical research, to new wearables - the amount of data we are generating is increasing. However, while such information is crucial, the way it’s currently handled leaves little to be desired.

Enter blockchain.

No doubt you’ve heard the IT buzzword murmured around the workplace – blockchain is an ingenious invention here to overhaul industries with its secure data access technology. It might not be a cure-all for healthcare, as with any new technology it will take time to see its full potential transpire, but it’s undoubtedly a big step in the right direction.

Described as a new backbone for the internet, blockchain:

- was originally developed as the accounting method for virtual currency Bitcoin.
- is a digitized, decentralized, public ledger of transactions.
- is constantly growing as ‘completed’ blocks (the most recent transactions) are recorded and added to it in chronological order.
- allows market participants to keep track of digital transactions without central recordkeeping.
- stores data across a network, eliminating points of vulnerability that computer hackers can exploit.
- doesn’t require two parties to trust each other

How is it relevant to healthcare?

Blockchain has the potential to democratize data, allowing digital information to be distributed beyond silos and ultimately introduce a more patient-centred approach to medical care – something America’s healthcare industry is severely lacking.

According to a recent research campaign carried out by ScalaMed, patients often feel sidelined in their own treatment plans and yearn for more control.

The study, which surveyed 800 individuals, uncovered a number of key issues Americans face when it comes to managing their prescribed medication, while also highlighting how little they know about where their medical records are stored and who has access to their data.

The company puts the patient at the centre of their medicine management plan by creating a single source of truth about an individual’s prescriptions. The system is underpinned by secure blockchain technology, similar to a digital inbox, allowing patients to carry their prescriptions with them on their smartphone at all times. It is a safe, secure and mobile prescription exchange system that streamlines the process of managing your medication.

Others in the field are also exploring blockchain’s potential – the Massachusetts Institute of Technology (MIT) recently trialled an e-health record system using blockchain, and IBM and the US’s Food and Drug Administration have secured a research agreement on blockchain for healthcare. The first government-hosted blockchain healthcare hackathon also took place this year.

So much more than a buzzword

So the blockchain revolution has made its way to the healthcare industry, but it’s only the beginning of what could be achieved if we choose to welcome it with open arms. Here are five more reasons why healthcare needs blockchain.

1. Electronic health records (EHR) interoperability
Blockchain can enable secure and seamless access to e-health records – handing control over to the patients themselves and integrating health data from numerous sources. This saves time for both patients and doctors, and significantly simplifies the management of patients on multiple drugs requiring complex treatment plans.
Instead of giving all my healthcare data to Google and Apple, I may instead put it in a decentralised ledger, where I can give access to various people at various times, and decide who uses it on what condition.

2. Ensures authentic clinical trials
After providing secure access to EHRs, blockchain is then in a position to offer clinical researchers with a census-level pool of medical data. This not only helps them gain population-level insight into treatment and outcomes, but also tracks and audits clinical trial results as they’re rolled out, ensuring clinical data is authentic every step of the way.

3. Keeps counterfeits at bay
Counterfeit pharmaceuticals are a growing concern in the developing world – but it’s one that can be rapidly addressed by using blockchain technology. Once in place, pharmaceutical companies can log and authenticate every step in their supply chain – improving transparency and ensuring medication provenance. The MediLedger Project is just one example of a blockchain system that is currently in place to securely link manufacturers, distributors, hospitals and pharmacies.

4. Encourage health outcomes (and save money in the process)
The healthcare industry has historically been a pay-for-service model, so when a doctor prescribes a treatment it is done so at a set cost. But blockchain’s smart contracts has the potential to encourage health outcomes by linking them to payments. What’s more, it could cut billing and administration costs in half in the process.
For example, if a doctor prescribes blood pressure medication to a patient with hypertension, additional incentivized payments could be made automatically when a patient achieves a target blood pressure by using an Internet of Things based blood pressure monitor and smart contracts through the blockchain.
A lot of things are very manual, but if you can automate with smart contracts, it’s a much smarter and efficient way of handling how funds flow around the system.

5. But most importantly, it will save lives
According to a 2003 report by the World Health Organization (WHO) into medication adherence, approximately 50% of patients with chronic illness don’t take their medications as prescribed. This poor adherence to medication leads to wastage, disease progression, increased morbidity and death, increased burden on medical resources, and is estimated to cost approximately USD 100 billion per year.
A 2012 study published in the Annals of Internal Medicine recorded a lack of adherence to taking medication as the cause of almost 125,000 deaths in the US per year.

While it can be easy to write this issue off as the patient’s responsibility, and naturally they have a huge role to play in solving this issue, the medication-taking experience is a complex interaction that involves patient, physician, and the broader healthcare system, and all of these protagonists need to be functioning together correctly if we are to reach a state where avoidable medical treatment is minimized.

This is where blockchain technology has a huge role to play by not only streamlining the healthcare management process, but empowering the patient to feel engaged and motivated to manage their disease and medications themselves.

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