Blockchain and Healthcare: Harnessing EHR for Better Clinical and Research Outcomes
After I wrote my recent post on blockchain, I started thinking about further applications of the technology and the first thing that came to mind was healthcare.
One of the things that plagues healthcare in the United States is the difficulty of moving records from one provider to another. The implementation of EHR systems has come on slowly over the last few decades and that is mostly due to legal requirements, not a push from physicians.
What is missing from this in many cases is common access for patients. Imagine you move across the country for a job. You have a new insurance provider, new doctors, new pharmacies, and frankly new nightmares from this situation. There isn’t a simple way to make manage your own information through this.
Researchers from the Mayo Clinic and a group of researchers from MIT and Beth Israel Deaconess have described the implementation of blockchain to provide centralized access to medical records for patients. The case study from MIT and Beth Israel Deaconess describes this problem really well:
EHRs were never designed to manage multi-institutional, life time medical records. Patients leave data scattered across various organizations as life events take them away from one provider’s data silo and into another.
The other major benefit of adding blockchain to the EHR equation is the access to healthcare data this provides to researchers. The current state of EHR systems is a major limitation for healthcare research. While researchers work hard to look for solutions using data sets from university-affiliated hospitals, HHS, VHA, Medicare, and Medicaid, this limits the populations that problems can be effectively solved. Blockchain can allow for the sharing of huge amounts of data while also maintaining patient privacy. The Mayo Clinic Article addresses this in the problem statement of their article suggesting the implementation of blockchain in healthcare:
Cross-institutional sharing of healthcare data is a complex undertaking with the potential to significantly increase research and clinical effectiveness[1]. First and foremost, institutions often are reluctant to share data because of privacy concerns[2], and may fear that sending information will give others a competitive advantage[3]. Next, even if privacy concerns could be addressed, there is no broad consensus around the specific technical infrastructure needed to support such a task[4]. Finally, healthcare data itself is complex, and sending information across institutional boundaries requires a shared understanding of both data structures and meaning. Even assuming data can be shared efficiently and securely, these interoperability issues left unchecked will limit the utility of the data. Despite evidence that the value of healthcare data exchange is large[5], these issues, described below, remain significant barriers.
I agree with the authors of both of these pieces that in the long-run, the best way to ensure high quality clinical and research outcomes, industry-wide data sharing is necessary. Blockchain seems like a suitable tool to meet these needs and I hope that the healthcare industry takes great care in implementing solutions that will positively impact healthcare outcomes around the United States.