Blockchain and its capabilities within the financial services industry has certainly claimed the limelight over the years. However, another very real use of distributed ledger technology has slowly become prevalent. This time, it concerns an area that is very personal to the majority of people – the healthcare sector. And as you can imagine, it raises a lot of questions for people and governments alike.
Blockchain technology is set to benefit the way in which the healthcare information of people is captured, stored, accessed and used electronically. This system is known by various names including, electronic health records (EHR), electronic medical records (EMR) and electronic patient records (EPR). The EHR/EMR/EPR programs of various governments around the world means that people’s health information can be viewed securely online, from anywhere and at any time. This feature grants medical staff access to a patient’s complete health background, therefore leading to better treatment options. If one considers the concerns and controversies that have swirled around EHR programs however, this is where the good news ends.
Opt-in or opt-out?
Do people need to compulsorily have their health data digitised into an electronic record? And how successful have governments been in making their people oblige to digitising their health data? The answer to these questions varies depending on the country. After the failure of the NHS National Programme for Information Technology, the UK government is now aiming to introduce a comprehensive system of electronic health records by 2020. In the US, the government has been offering incentives for EMR/EHR adoption. And in Australia, we have been given the option to opt-out of the governments EHR system, with the records permanently deleted from the system.
Why the controversy?
The debate surrounding EHR is mainly around the use and management of patient data. Information security and data privacy are at the centre of ongoing concerns from people and experts alike. Data is the most critical asset in the healthcare industry, since it is the single best version of truth about the health of a patient. With many data breaches related to health information recorded last year alone, it is no wonder that people are jittery about the vulnerability of their healthcare records.
Is blockchain the answer?
The reason experts have expressed concerns around EHR is due to the existence of a centralised record system that could potentially allow anyone with the correct login credentials to view the data. However, this can be mitigated with technology that can store health data securely and ensure that only the right people (and not only the ones who have the login credentials) can access the information they need. Blockchain’s digital distributed ledger-based technology can potentially revolutionise the usage and protection of health data. Blockchain provides tools for cryptographic assurance of data integrity, standardisation of auditing and formalising contracts for data access. It has the ability to both simplify and automate processes and verify and authorise access, using predefined parameters. A permissioned distributed ledger could be leveraged for securing the data stored in EHR, augmented by tools like digital wallets, pass keys and digital signatures. Utilising these tools in conjunction with blockchain, EHR users can maintain more control over their information, revoke access as desired and ensure that only authorised people have access to the information. Encryption of information can also be a potential add on to enhance security.
Blockchain’s usage in healthcare is evidenced from a related case study in the health insurance industry. Insurance major MetLife, is experimenting with a blockchain based parametric insurance product for pregnant women with gestational diabetes. The technology allows the patient’s condition to be verified by their doctor through the smart contract system. Insurance payouts are then processed only once the patient’s condition is verified.
Is blockchain on the government’s radar?
Governments across the world have shown interest in leveraging blockchain technology to enable secure EHR data exchange. Some governments have piloted the use of blockchain technology to allow scientists and researchers access to medical information contained within EHRs. In January 2017, the US Food and Drug Administration announced a research partnership with IBM Watson to find ways to safely share data from EHRs, clinical trials, genetic sequencing and even mobile wearables utilising the blockchain approach.
In Australia, the Department of Health has worked on a proof of concept that uses blockchain technology to record who is accessing its medical data. As the government’s first implementation of blockchain technology, it created a platform that allows health researchers to undertake large scale studies using patient data in a secure cloud-based environment, while minimising the risk of deidentified health data being retraced to individual patients.
More work needed
Entities involved in developing blockchain technology are required to meet regulatory requirements laid out by government bodies. These bodies usually have regulatory powers over the financial services sector and its use of blockchain.
The Australian Government’s Digital Transformation Agency (DTA) has mentioned that although blockchain technology is promising, it still needs more compelling evidence that it can deliver better value for government services, especially around EHR. Perhaps one could take a leaf out of MetLife’s book and focus more on the use of blockchain powered smart contracts for making health records and transactions more secure, efficient and cost effective.