Creating a patient-centric EMR
Blockchain technology has the potential to change the way we generate, store and share data. Healthcare data is one of the most valuable assets in the healthcare industry. MedCredits is positioning itself to be the platform that lies closest to the source of healthcare data — that is, the patients and doctors.
In our complex digital world it can be easy to lose sight of a very simple fact: patients generate healthcare data through their interactions with doctors and downstream healthcare providers.
As an exercise, let’s walk through a typical case in oncology. A 65 year-old smoker with high blood pressure and high cholesterol develops a nasty cough and sees his primary care physician. He is sent for lab work and a chest x-ray which reveals a nodule. He then undergoes a CT scan which demonstrates an isolated lung mass. He is sent for a biopsy which confirms the diagnosis of lung cancer. The mass is surgically removed and the patient’s vitals and lab work is closely monitored while in the hospital. After discharge, he is referred to an oncologist and radiation oncologist. He is further treated with radiation and chemotherapy, again with frequent lab work and surveillance scans to assess for recurrences.
In this sample case above, we have generated an enormous volume of data: patient history, vital signs, labs, x-ray, CT scans, molecular data, surgical pathology and further data about the patient’s response to different treatments. Instead of a disjointed patient record from various hospitals and clinics, the MedCredits platform allows patients to own and store their data as it is generated and share the data as they please. This is a bottom-up approach to the creation of an electronic medical record (EMR).
Contrast this with a top-down approach as follows: a software team develops an EMR. It advertises the software to doctors and hospitals attempting to convince the hospital administrators and office managers to buy their software. Sadly, the patient is left out of the equation and the EMR is financially driven rather than clinically. In fact, in many cases, patients have to visit the health records office, fill out a request form, and receive clearance to receive their own health records. The fact is: EMRs lie quite far away from the actual source of healthcare data and are simply a method for storing and interacting with data after it is generated.
Giving patients the power to own and share their clinical information at will has many positive implications. First, by placing patients closer to their own data, they become more engaged in their own health maintenance. It also allows them to monetize their data. In the example above, the patient can lease his data to chemotherapy researchers or contribute data to an artificial intelligence (AI) healthcare database. The possibilities are nearly limitless.
The final question then becomes, how do we solve the problem of EMR interoperability? All of our clinical information is currently owned by multiple providers that have limited ability to share the data amongst themselves. Is there some way to connect all these EMRs?
This question is actually misguided. Methods of data storage and sharing have rapidly evolved. Less than 50 years ago, 8-inch floppy disks were made commercially available. Since that time, we have seen the floppy disk evolve into CD-ROMs, USB flash drives, DVDs, Blu-Rays and now cloud storage. In each iteration, backward compatibility proved to be a fairly moot point — the data was transferred to the newer medium. When apple released the iPod in 2001, many were concerned that their music stored on CD-ROMs and tapes would be lost, yet the songs made their way to iTunes despite these concerns. Patient-owned healthcare data is a paradigm shift in the world of EMRs just as the iPod was to portable media players and history will prove concerns over backward compatibility to be misguided.
A more perceptive question regarding healthcare data interoperability would address the development of a worldwide standard for the format of an EMR. In 1994, the world wide web consortium was founded in order to address inconsistencies in how web pages were displayed depending on the web developer. Today, through universal agreements on the standard languages for creating webpages (HTML, CSS and JavaScript), anyone, anywhere in the world, on any operating system using any web browser can access the same content on the internet. Healthcare data must adopt a similar standard format allowing any patient to view his clinical information on any number of EMR “browsers” — that is, universal interoperability. As the first decentralized platform that generates and stores patient data, MedCredits will be a leader in this initiative.
To conclude, healthcare data is generated by patients when they interact with the healthcare system. By directly connecting patients to healthcare providers, MedCredits lies closest to the source of healthcare data. It is positioned to be the leading platform allowing patients to generate, store and share their medical data. MedCredits will pioneer new standards for healthcare data storage, retrieval and presentation.
Many thanks to Dr. Jack Cotlar for his valuable insights.
