Health Record Essentials — Deriving Stakeholder Value
This week’s article explores the essential functions of Electronic Health Records and the multiple stakeholders deriving value from their use.
Clinical care increasingly requires healthcare professionals to access patient information that may be distributed across multiple sites and held in a variety of formats and media. As healthcare consumerism and globalisation of the workforce increases, being able to collate this disseminated data into a useful repository for safe clinical practice becomes more important. It goes without saying that accurate, complete record keeping translates to better care for patients, improved efficiency and reduction in costs as well as a myriad of other benefits.
Successes have been variable for a number of reasons. Major hurdles include how to manage interoperability, security, data governance and of course the politics and costs associated with a top-down, centralised approach.
Solving these problems poses quite a challenge. In order to synchronise data across distant geographies (and between disparate entities) and trust its authenticity requires technology that has not until 2008 been available in decentralised systems. With blockchain technology, we have the ability to self-verify author, content and state changes in records. It behoves those building new generation EHR platforms to ensure an interoperability standard and to create an open source ecosystem that allows future developments.
There are many important functions that health records serve which also must be considered in any new designs. We cannot succeed in this without considering the stakeholders who rely on this information.
The major stakeholders include:
- Patients and their carers, Clinicians,Clerical and Research staff
- Managers and Healthcare Purchasers (health authorities or insurers),
- Pharmaceutical and Insurance companies and
- Government regulators.
Blockchains are designed for multiple entities with diverse economic interests to interact in a ‘trustless’ manner in a shared economy. Thus, for the successful startup, defining stakeholder value and assigning relative importance is critical.
Patients require their information to be kept confidential, secure, up to date and accessible. Both patients and providers of care need to be able to trust in the content of this data so as to inform decision making. Patient Generated Data from wearable devices will need to be supported by the records. Patients will need to trust that this data is accurately recorded and physicians will need to verify the source of that data.
Additionally, managers and payers need to have a true reflection of each clinical episode in order to cost and audit the care provided.
It is clear from the table above that the roles performed by health records are multiple and varied. It is also evident that there is overlap in the value and utility derived by each party. The items in bold are more easily accommodated by the use of blockchain by facilitating safe information asset transfers and interrogation of an immutable log of events.
Medicalchain is building a new design with these essential roles in mind. Patients are extremely important stakeholders. We are also making absolutely sure we cater to all the necessary functionality required by the other parties. There is a long road ahead but are working tirelessly to ensure that finally patients can be empowered to take ownership of their records and indeed their health.
Blockchain has provided us with a tool. It arrives as the culmination of decades of research in the fields of distributed peer-to-peer networks and cryptography. It is the first to provide a solution to the byzantine general’s problem and it has opened the door to a new paradigm in transactions.
It is also a blanket term for a number of variations on a theme. Definitions are blurry and implementations are variably ‘pure’ or true to the original version proposed via Bitcoin. There are a number of blockchain enabled EHR providers offering solutions at the moment. Just how each proposed solution (to the problems this article briefly describes) will create value for the people that matter remains to be seen.
In my next article I aim to explore the different blockchains being employed for this important use case. I will also explain why Medicalchain has elected to build a dual blockchain solution using Hyperledger Fabric and Ethereum and why we believe it is the better choice.
Please write to me with comments or suggestions for topics at Stewart@medicalchain.com
Have a great week!
