Blockchain – A Game Changer for Healthcare?
Over the years, the healthcare industry has made slow progress towards integrating emerging technologies. But with the ascent of disruptive technologies such as artificial intelligence, machine learning, internet of things, and surprisingly virtual reality, a unique opportunity opened up for distributed ledger technologies to provide a de facto trust infrastructure in the healthcare system and it is believed that integrating blockchain-based solutions could aid professionals at unprecedented rates.
An excerpt from a paper titled Metrics for Assessing Blockchain-based Healthcare Decentralized Apps, authored by Peng Zhang, Michael Walker, Jules White, Douglas C. Schmidt from the Vanderbilt University, provided an insight into how decentralized technologies could be harnessed to address key healthcare industry problems. Its researchers noted:
“Programmable blockchains have generated interest in the healthcare domain as a potential solution to resolve key challenges, such as gapped communications, inefficient clinical report delivery, and fragmented health records.”
Problems with Existing Systems
Electronic health records (EHR) is currently being used by a growing niche of medical stakeholders such as hospitals, doctors, pharmacies, research institutes, and insurance companies to access a secure database of patients’ health information. Initially, the design was tasked with basic patient administration such as organizing appointment schedules and issuing repeat prescriptions. Over time the system evolved, such that for hospitals, it meant storing or sharing accurate health records on their patients and providing the industry vertical access to relevant treatment and diagnosis history, and possibly help focus research on treatment plans and designs of new drug products.
Consequentially, healthcare informatics has grown to become a mammoth in the data industry. Data from this industry is projected to grow to as much as 15 times its 2013 value by 2020.
The growth rate of #healthcaredata is projected to be greater than that of the total global data set. At 153 exabytes back in 2013, the healthcare industry is expected to generate 2,314 exabytes of data by 2020, a 48% annual growth rate. pic.twitter.com/LcSKlovnvC
— John Snow Labs (@JohnSnowLabs) July 15, 2019
Meanwhile, the rate of adoption of EHR in developed countries is quite alarming, as research by Meeker reported an increase in the use of EHR system in the United States nearing a 100 percent, and in another report, physicians who had adopted EHR systems were up about 60% in just under a decade. This growth could further imply a concurrent growth of the problems in EHR.
Most of the data related problems plaguing the healthcare industry revolves around security and integrity due to data-breaches, interoperability, and censorship.
Data Security: In terms of data security and attestation, data stored by EHR systems aren’t always reliable due to possible human errors in data entry, conflicting data entries or worse, data tampering as seen in the cases of medical insurance fraud or pharmaceutical drug trial scandals. More so, data breaches are common attacks experienced in the industry. It’s been pointed out that:
“Globally, healthcare was racked with more cybersecurity breaches than any other industry in 2018, accounting for 25% of 750 reported incidents…
“Health information was the second most at-risk type of data in cybersecurity threats [in 2018] …
“Despite healthcare’s mounting cybersecurity threat, the industry’s security measures haven’t kept pace painting a gloomy picture for 2019.”
Lack of Interoperability: Another huge problem in the healthcare industry involves the silos of health data among disparate institutions. While shared information between homogenous verticals in the industry has a profound impact on the overall healthcare delivery system and could improve care quality, these data silos present a huge setback on both EHR system designs and security layouts. BIS Research measured the low threshold of information sharing among industry verticals, stating:
“Less than 10% of healthcare organizations regularly share medical information with providers outside of their organization.”
More so, running EHR through trusted intermediaries could be quite expensive as suggested by physician and specialist in medical informatics and health IT Dr. Christina Czeschik.
Patient-owned Data Censorship: Another important aspect of health data sharing concerns patients as well, as they are the primary data sources. While some argue about the ethical justification of allowing patients access to their health data, a lot of clinics and some general practitioners claim that putting patients in control of data from EHR provides them the “opportunity to become active partners in their care.”
The design-flaw impact on incumbent healthcare informatics – whether electronic or otherwise – has rippled into many socio-economic and political realms, aggravating the already complex systemic problems. However, this could all be unraveled with a trusted entity, and as far as humans go, none could fit in that role. Blockchain technology seems the only logical route to provide the ideal trust factor in the data stream network, and when it comes to the healthcare sector, no better solution seems applicable.
Surmounting Obstacles
Blockchain is reportedly being touted to be the panacea to a wide array of database-related problems and consequentially being sought out for trustless infrastructure. The thing about the technology is its cryptographic layer – which is made up of complex codes and algorithmic consensus that secures its system; and smart contract ingenuity which makes any blockchain-enabled system communicate seamlessly and almost autonomously. A recent study revealed:
“The adoption of the blockchain technology could save the healthcare industry up to USD 100 – 150 billion per year by 2025 in data breach-related costs, IT costs, operations costs, support function costs and personnel costs, and through a reduction in frauds and counterfeit products.”
Currently, there are a plethora of blockchain-based startups exploring diverse opportunities to disrupt the healthcare system with the blockchain or in a combination with other emerging technologies. The solutions being provided by these startups can generally be grouped into EHR disruptors, pharmaceutical drug monitoring, patient data monetization. However, as Disruptor Daily would find after studying 40 blockchain startups venturing into the healthcare industry, other areas of the application included genomic data security, healthcare cryptocurrencies, and provenance and medical history.
This disruption wave seems rather logical given the stats of expected increase in spending opportunities – to a ballpark of USD 5.61 billion by 2025 – on global blockchain-related research and development in the healthcare sector, as well as the rise in digitized healthcare products, and an increase in the use of online health information systems – all seem to be drawing the attention of both decentralized and centralized interest parties.
It may not be all about the financial opportunities after all, as most people would think the blockchain and all of its underlying systems are limited to fintech innovations. Innovators continue to disprove this biased logic with more out-of-the-box turnkey blockchain applications that optimize processes.
This blockchain-based healthcare niche should be taken seriously, as an alliance comprising of major US healthcare companies are making moves to improve healthcare data using blockchain. Other emerging developments continue to dwarf the limitations of entry barriers and with the likes of IBM offering a proprietary blockchain-based solution to drug prescription tracking to stem drug misuse, and transportation giant Uber venturing into the blockchain-based healthcare sector, it does provide an overall sentiment regarding the future of the market.
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