In the fifth and final part of our series on Healthcare and Blockchain Technology (BTC), we will look back on the progress, or maybe more the accumulative promise, of BTC in healthcare. We have reviewed the potential and legitimate opportunity of insurance companies to use a well-documented feature of smart contracts in the blockchain for customer and claims management. Additionally, we also discussed the very public interest the U.S. Department of Veteran’s Administration has in blockchain.
Since we published our first blog on this subject, I have received material feedback. Because it came from my usual sources, I was expecting to read their thoughts on technology in that it was either moving too fast, or that it’s not relevant for most industries – in particular, healthcare as the “high touch” emphasis. Yet, some of the feedback was surprising and my biggest surprise came from people who were very optimistic for blockchain and are now disappointed by how slow it has been moving. I guess you could say that their enthusiasm was maybe driven by hype, and they failed to consider the reality of how things change in healthcare.
Though most will tell you that healthcare is notoriously slow to adopt new technologies, I generally do not agree. Insurance companies were among the first to use mainframe computers to calculate risk, handle financial management and policy pricing, and payments. Hospitals were among the first to adopt mainframe computers, along with many other technologies. The challenge is that once they adopt it, they generally don’t continue to evolve, which is why in the early 2000s, we still had hospitals using greenscreen computer monitors. When systems are adopted and work, the hospitals would rather stay there until the government mandates changes, as they did in 2009. Doctors also are fairly quick to adapt technologies that improve lives or give them more revenue, not as much to make things more efficient, though. This is something I’ve personally experienced in my professional interactions with over 1,000 providers. I recall doctors adopted landlines, typewriters, copiers, Dictaphone (dictation machine), pagers, faxes and mobile phones, as fast or faster than many industries. Doctors even got into computers, however, this was driven mostly for accounting, creating patient statements and then eventually electronic billing. Not even electronic scheduling or medical record updates drove doctors pre-2012 to these efficiency opportunities. The issue was that the technology had to make their lives better.
I also use this example on the use and adoption of what today is the latest technology, the Blockchain. It may as well take a decade to see it used consistently in healthcare however, the growth rate from near zero today will explode over these next 10 years. There will be many successes and many failures, with billions invested. In the end, I am convinced that the Blockchain, or one of its derivatives, will have a place in healthcare 10 years from now.
In our last blog, we ended our thoughts on where we think new technology has an opportunity today. In our optimum design, the Blockchain will be first controlled (contractually) by the patient using smart devices. The patient will control all input, output and use of their personal health information for use by direct care, both in an identified format and de-identified (for research use).
In our vision of a Personal Wellness BLOCKCHAIN Record (PWBR®) the patient-controlled EHR is something transformative. In our PWBR design, consumers could start with a basic EHR template, and both input data manually and upload data where it will be scanned and loaded into their profile. The data, fully encrypted, would be accessible only to the consumer and their delegates, either permanently or for a specific window in time. Those delegates can be caregivers or family members.
The patient can also release all their information to others contractually or only a de-identified part of the personal data to researchers and/or pharmaceutical companies. This would allow either access to historical data only or historical, and future updates permanently or for a designated period. Additionally, this would allow the patient to always have access to their records – anytime, anywhere in the world, and even track what type of organization is accessing their information.
The value of having such a large amount of data across hundreds of millions of users continuously and in real-time, could revolutionize critical trials and be the first time in history such information is available on a real-time basis and across the globe. It is difficult, in today’s terms, to comprehend the value of such a data process to society. We can go a couple of steps further by securely connecting our own Internet of Things (IoT) devices and our smart phones. We could go even one-step further, and possibly aggregate claims data by accessing the patient’s claim history in a way that is de-identified and available for machine learning. Adding social interactions, the patient profile would multiply the value of the information available for researchers. Again, all this information would be de-identified, so the patient’s protected health information is not compromised, and their information is only accessible when they give permission. The more complex the medical profile, the more valuable the information is.
This model allows the consumer to have their medical information available for treatment, allows the consumer to effectively monetize their information and history, all while providing a value to researchers and society. The more information the patient allows access to (always excluding information that would identify them personally), the more compensation the patient could theoretically receive – all in the Blockchain!
We see the blockchain EHR world as truly describing, “One Record…Global Connectivity™”. A patient-managed electronic wellness record will change everything, as it changes who is in control.
We envision that with the use of machine learning (ML), a.k.a. artificial intelligence (AI), we will be fascinated by the information and correlations we can make; correlations and data comparisons and matching that are not at all possible today. In our next blog series, we will dive deeper into the potential of artificial intelligence in healthcare.
-Noel J. Guillama, President