Blockchain in health care
How the next wave of technology-driven disruption will transform health care
The blockchain technology has become one of the hottest, most-discussed and researched topics. While the IoT and the cloud governed many related trends and provoked news stories in the past couple of years, the recent heavily publicized hype behind Bitcoin — a cryptocurrency powered by the blockchain technology and one of the most searched terms on Google in 2017 — has officially made blockchain a household buzzword.
What is blockchain
Think of blockchain as a beehive with multiple contributors, where all the cells are linked to one another and are visible to all the participants of the network. By (more formal) definition, blockchain is a digital ledger in which transactions made in Bitcoin or another cryptocurrency are recorded chronologically and publicly. Essentially, blockchain is a distributed database that maintains a shared list of records — or blocks — time-stamped and containing history of every block that came before it. This decentralized, open and cryptographic nature of blockchain also means that it allows storing and sharing data in a highly secure manner.
Heralded as one of the most fundamental inventions in the history of computer science, blockchain is set to revolutionize and disrupt hundreds of industries that rely on intermediaries — such as finance, banking, real estate, insurance, education, and legal, among others. And health care is most definitely one of them.
Blockchain in health care
As we look at this year’s digital health trends, let’s explore some of the applications of blockchain in health care, as well as the challenges that threaten implementation of this revolutionary technology in health care on a wide scale.
Medical records
The need for innovation in electronic medical records (EMRs) is well-known, but the restrictive regulatory environment as well as privacy issues have created significant challenges for innovation.
Enter MedRec — a solution catering to the needs of patients, health care providers as well as researchers. It is a decentralized record management system relying on blockchain technology to handle electronic health records. MedRec does not store health records but a signature of the record on a blockchain, notifying the patient and providing a means to share that record as required. This prototype also has a tremendous potential to power medical research — by providing an opportunity for patients to share their personal medical information with researchers.
Digital medicine, care delivery & rewarding prevention
Some of the most exciting opportunities exist in the consumer health space, where blockchain enables combining care delivery with rewards — to encourage consumers’ proactive preventative actions when it comes to their health.
CoverUS, a U.S.-based startup proposes an idea to monetize health-related data through a blockchain-powered marketplace — also making insurance cheaper and encouraging consumers to become healthier in the process by rewarding them for taking good care of themselves. CoverUS CoverCoin rewards can be redeemed for everything from medical co-pays to the transportation needed to keep that doctor’s appointment.
PointNurse is a blockchain-based virtual care network platform for delivering direct primary care and care management services to targeted populations. The platform enables nurse practitioners and other health care team members to conduct assessments, behaviour management programs and care coordination. A smart-contract-based cryptocurrency called Nursecoin is in development as well — with a goal to incentivize community growth, close gaps in care, reward patient behaviour and provider performance — for improved health care delivery.
These solutions have a great potential of improving medication adherence, helping reduce morbidity and death and decrease costs — a great impact to the health care system worldwide.
Clinical trials & research
Patient enrolment, personal data privacy concerns and lack of reproducibility are significant challenges for clinical research, and blockchain can help addressing them. The current system makes it extremely difficult to process all the data generated and recorded — blockchain could simplify and link the diverse, disconnected systems for accelerated medical innovation.
The smart contract functionality can help streamlining the complex data flow of clinical trials where consent for protocols and their revisions should be visible to accessible by patients and stakeholders. Blockchain allows creating a process allowing storing and tracking consent in secure, verifiable way and sharing this information in real time, as required.
E-prescriptions
One of the more obvious applications of blockchain in health care is e-prescribing. Blockchain-powered solutions would make it easier for patients living with chronic illnesses to renew and refill prescriptions in a secure way.
An already successfully implemented e-solution in the space demonstrates the convenient access and savings — in Estonia’s cutting edge e-health-care system. The electronic ID card system is powered by blockchain to ensure data integrity and provide secure access to a patient’s record to authorized individuals. Medications are prescribed electronically, and at the pharmacy, all a patient needs to do is present an ID card. The pharmacist then retrieves patient’s information from the system and issues the medication.
Medication quality & supply chain
Food and medicine are life-essential products, but because of the way today’s global supply chains are run, it’s practically impossible for consumers to know the origins and nature of the products they purchase. Ambrosus, a Switzerland-based blockchain platform, combines high-tech sensors, blockchain protocol and smart contracts to build a universally verifiable, community-driven ecosystem to trace the quality, safety and origins of products moving through supply chains, in pharmaceuticals and food industry.
From imitation Viagra capsules to falsified Lipitor tablets, counterfeit pharmaceuticals are US$200 billion annual business, not to mention millions of lives negatively affected or lost as a result. Ensuring the supply chain integrity via blockchain could help reduce the counterfeit drug implications, reducing harm to patients and preventing massive losses for pharmaceutical companies.
Further exploring the supply chain opportunities for blockchain technology, another interesting application is highly relevant for Canada given the current political landscape and planned legalization of marijuana by July 1, 2018. IBM submitted a proposal to British Columbia outlining the use of blockchain to regulate and transparently capture the history of cannabis products “through the entire supply chain while exerting regulatory control, ultimately ensuring consumer safety — from seed to sale.” Other companies are already working in this space, leveraging blockchain — such as Budbo, Liberty Leaf Holdings and Blox Labs.
Opioid crisis
Canada’s opioid overdose crisis is getting worse, with estimated more than 4,000 lives lost in 2017, according to the Public Health Agency of Canada (PHAC) — a significant increase from 2,861 opioid-related fatalities recorded in 2016. This public health crisis is a difficult, multi-faceted problem; however, according to some experts, blockchain has a potential to help resolve this complex challenge.
By incorporating traceable technology into the drug delivery process, manufacturers can have an ability to safeguard medications produced and sold, throughout the entire system, including suppliers, distributors, physicians, hospitals and pharmacies.
Challenges
Blockchain technology translates into massive exciting opportunities for health care; however, organizational, regulatory, technical and behavioural challenges must be addressed before blockchain can be fully adopted and implemented by health care organizations across the board.
Governance and collaboration issues — and how Canadian organizations choose to tackle them in both public and private spheres — will determine adoption and implementation of blockchain in health care.
What’s next?
At this point in time, the way we see it is that blockchain technology has a tremendous potential to finally put patient at the centre of the system — transforming health care and providing new models, replacing outdated processes for more efficient and better-quality care delivery.
We look forward to experimenting with this new technology and collaborating with our clients, aiming to evolve the health care industry that has a deep need for increased interoperability, privacy and security of data — while decreasing costs and frictions. And we anticipate that blockchain has a potential to do just that.
