What is bitcoin? What is blockchain? If you’ve never heard of either, you probably have no idea what either of them could possibly have to do with healthcare.
Bitcoin is an alternative type of payment system that is sometimes mentioned in the media as “Cryptocurrency” or digital currency. Bitcoin and other digital currencies rely on a platform called blockchain. It was created by developer Satoshi Nakamoto to provide a viable decentralized alternative to the current mainstream financial infrastructure.
This same blockchain platform will be useful for many other non-currency applications that benefit from decentralized control, and high levels of security and privacy, like medical records.
A Wired Magazine article earlier this year explained why blockchain may be a good fit for organizations that store patient data. It is really a generic tool to keep secure data in a distributed, encrypted ledger—and control who has access to that ledger. Rather than having one central administrator that acts as a gatekeeper to data — there is a list of digital transactions — with one shared ledger, but it is spread across a network of synchronized, replicated databases visible to anyone who has been granted access — which gives it unprecedented security benefits. This makes blockchain incredibly appealing to the doctors and hospitals that need secure access to a patient’s entire health history. It would mean that a patient’s every health care interaction goes into a ledger that every authorized provider can see.
So what are some of the reasons that blockchain may be an especially good fit for storing and securely accessing patient data?
#1 A single cohesive record of a patient’s medical history. We lose access to past data, because the provider, not the patient generally retains primary stewardship. Electronic medical records are created by life’s events and maintained separately based on the specific provider for a separate event. This creates a fractured system of record keeping. A blockchain based system would place a patient’s medical history in a single record set that could give the patient a comprehensive immutable log with access to their medical information across different providers and treatment sites
#2 Blockchain transactions are logged publicly and in chronological order. Crucially, each block in a chain cannot be changed, deleted or otherwise modified: it’s an indelible record that a given transaction occurred. That’s exactly what has many in healthcare excited about blockchain’s potential for data security. Its open and decentralized nature could lend itself well to managing health records and proving identity. Rather than a fractured database, the blockchain record can be distributed and shared across networks, with credentialed users able to add to – but not delete or alter – the transaction log. Transactions are encrypted and must be verified by the network.
#3 By its design, blockchain incorporates a master patient index — an electronic medical database that holds information on every patient registered at a healthcare organization. It will avoid problems like entering data in different ways – for example, date of birth can be entered in multiple ways and healthcare organizations have no real way to standardize it. And as an added benefit, the information would be centralized and from a trusted source.
#4 Blockchain could make it possible to automate claims adjudication — the process of paying claims submitted or denying them after comparing claims to the benefit or coverage requirements. Claims can often be denied because of incomplete or incorrect information. Blockchain could help by enabling the updating of information continuously and distributing it to the right network.
#5 Blockchain technology offers advantages for clinical research in a variety of ways. A big advantage is using blockchain to create a layer of de-identified data that researchers could tap to recruit patients. It could also help to structure a more transparent, checkable methodology which can lead to higher integrity of the research. Blockchain’s timestamped records of clinical trials, protocols and results could ultimately foster collaboration between researchers.
With all of these benefits, blockchain may prove to be a solution to the needs of healthcare organizations. Many experts agree that it seems logical and even probable that this type of technology will be adopted, but only time will tell.