The technological disruption changes our lives drastically and we don’t even manage to notice how we face the necessity of tech solutions in each and every aspect of our life. We seek better customer care, we look for the most qualified doctors, the fastest medical support, and of course, we all need that at the very moment, immediately. The healthcare system has gone through a long journey to become what it is now and through the time we have advanced in almost everything, disruptive innovations for operations, the development of biomedics, genomics, which transfer the reality that we have today, the transformation of the pharma industry and much more, so why do we need that? To put it in one word: to save more lives, to defeat the horror diseases, to create better conditions for people all over the globe and yes, technology has its say here.
It is difficult to find a concise definition of Digital Health. Its scope is very wide. There are a number of definitions that may describe the e-health concept outlining the whole complexity. Simply saying, Digital Health refers to the information and processes, and technologies and systems that enable a person to make informed choices about their own health, take action to improve it, and monitor their progress to realize what works for them and what doesn’t. By contributing their own biological and behavioral data to the health system, people can give permission to carefully selected organizations and people in the system to anticipate and respond to their health and care needs, help good things happen, and, where possible, prevent bad things from happening.
Digital healthcare trends are largely driven by the need for better patient care, faster and more accurate analysis, and on-demand access to medical data. The pace of innovation in digital healthcare began gaining momentum with artificial intelligence (AI), and it is set to further accelerate as the industry turns to blockchain technology.
Global blockchain technology complements healthcare artificial intelligence (AI) and internet of things (IoT) — based marketplace offerings and is expected to cross $500 million by 2022 at a compound annual growth rate (CARG) of 61.4 percent, according to a recent Frost & Sullivan report.
What is wrong about the digital health system? Do we need some “blockchain magic powder”? Let us dive into the industry challenges to find out where the blockchain applications can be of use.
Patient data management
Currently, the HIE (health electronic exchange) serves as the intermediary that facilitates the peer-to-peer exchange of electronic health records (EHR) among member participants. The system also acts as a ledger that tracks what data was exchanged. However, the model has little incentive to offer except the fact that it’s a state-designated body. With blockchain, members or healthcare industry participants have the opportunity to benefit from a distributed ledger to securely access and exchange electronic healthcare information without having to deal with a rather complex system of brokered trust. Another major problem is concerned with the master-patient index (MPI). It involves linking the health records and transactions of patients with their varied “identities” as they interact with various healthcare providers and other entities. The challenge is only becoming more complex and expensive with every passing day. This is also why patient data integrity remains a key concern, as it may become subject to risks such as data selling, data leakage, and fraudulent mismanagement.
To alleviate these limitations and risks, a blockchain-based approach could leverage cryptography to validate patient identity and strengthen data probity, too. Blockchain records can be shared among licensed participants who can add to — but not delete or alter — the transaction logs. The blockchain ensures all the transactions are encrypted and must be verified by the network. It also allows for introducing standardization in building an MPI-like list. For example, instead of allowing multiple ways to input data, the blockchain makes it certain that every participant enters/adds data in a specified way. Blockchain would thus provide much stronger data security and integrity of records and a highly standardized method to maintain data.
Use cases to check
BurstIQ — The company uses blockchain to improve the way medical data is shared and used
Factom — Factom employs blockchain technology to securely store digital health records
MedicalChain — Medicalchain’s blockchain-based platform maintains a record of the origin and protects the patient identity
Unlike the existing central system that fails to see significant volumes of transactions, thereby staying expensive, the use of blockchain would enable an evident reduction in overhead costs, giving participating groups greater incentive for a sustainable business case. Moreover, with near-real-time processing of requests, a platform underpinned by blockchain would facilitate much faster, more secure, and more efficient transitions/exchanges of health records between related parties.
The application of smart contracts in digital health projects will create a new level for the no-intermediary system. The healthcare system today is fraught with excess overhead costs, bureaucracy, and third-party intermediaries — all of which add to cost and complexity. The existing centralized system used to facilitate interoperability and transactions among participants also suffers from inconsistent rules and permissions, which makes it difficult for the member health organization to access the right patient data at the right time. Blockchain enables increased trust among participating parties. By making available smart contracts, the technology helps members to solely rely on contracts that are automatically enforced when certain security conditions are met.
Moreover, by empowering member health organizations to buy, sell and transfer value (e.g., medical claims data, cryptocurrency payments, intellectual property, etc.) without an intermediary or third-party companies, blockchain would facilitate much-needed transparency between pharmacies, insurers, health payers, hospitals, physicians health plans and the overall healthcare ecosystem in general.
Use cases to check
SimplyVital Health — SimplyVital uses blockchain to create an open-source database so healthcare providers can access patient information and coordinate care
Robomed — combines AI and blockchain to offer patients a single point of care. The company deploys chatbots, wearable diagnostic tools, and telemedicine sessions to gather patient information and share it with the patient’s medical team
Patientory — Patientory’s end-to-end encryption ensures that patient data is shared safely and efficiently. Patientory helps the healthcare industry to move more quickly by housing all patient information under one roof.
Pharmacy — stopping drug counterfeit
Blockchains can provide a reliable method for tracking pharmaceuticals through the entire manufacturing and distribution process, thus cutting down on the widespread problem of drug counterfeiting. In conjunction with IoT devices used to measure factors such as temperature, blockchain technology could also be used to verify proper storage and shipping conditions or to authenticate drug quality. However, since each participant of the supply chain i.e. the manufacturer, the logistics company, the stores, and the pharmacies, etc, maintain their own separate ledger, a problem within any particular segment of the supply chain is difficult to track. Blockchain technology provides the pharmaceutical supply chain a better way to add compliance and governance within the supply chain.
Due to its inherent transparency, immutability, and distributed nature, Blockchain technology provides a mechanism that allows any participant in the supply chain to ensure that the supply chain logistics and transportation guidelines (including handling and storage conditions of the drugs), were adhered to.
Additionally, smart contracts can be programmed that automatically execute when compliance conditions are not met, thereby alerting the relevant parties in the supply chain.
Use cases to check
FarmaTrust — FarmaTrust provides future-proof blockchain and AI-based provenance systems for the pharmaceutical and healthcare sector
Chronicled — The networks help pharma companies make sure their medicines arrive efficiently, and they enable law enforcement to review any suspicious activity — like drug trafficking
Blockpharma — By scanning the supply chain and verifying all points of shipment, the company’s app lets patients know if they are taking falsified medicines With the help of a blockchain-based SCM system, Blockpharma weeds out the 15% of all medicines in the world that are fake.
Insurance fraud protection
Blockchain could also be used to combat medical insurance fraud, a problem that is estimated to cost the American healthcare system around $68 billion each year. Immutable records stored on blockchains and shared with an insurance provider can prevent some of the most common types of fraud, including billing for procedures that never took place and charging for unnecessary services.
Clinical Trials recruiting
Since the passage of the Prescription Drug User Fee Act in 1992 (which allowed the FDA to receive funding from pharmaceutical companies), the FDA has collected $7.67 billion in user fees from pharmaceutical manufacturers. This trend of annual funding to the FDA from drug manufacturers is expected to continue to increase.
Patients and physicians have begun to question the current standards for Clinical Trial funding, leading to growing concerns due to the conflict of interest and the high stakes involved.
With this, we can also discuss how blockchain can improve the quality and effectiveness of clinical trials. Medical data on blockchains could be used by trial recruiters to identify patients who could benefit from the drugs being tested. Such a recruitment system could greatly improve clinical trial enrollment, as many patients are never made aware of relevant drug trials and therefore are never given an opportunity to participate in them. While trials are conducted, blockchains can be used to ensure the integrity of the data being collected.
Use cases to check
Exochain — this pharma startup manages secure storage of patient health information on the blockchain. Exochain allows individuals to control how clinical trial researchers may interact with their medical data
The transformation we haven’t noticed. What to expect?
There is no doubt in stating that blockchain represents and promises a revolutionary future of healthcare and medicine. Moreover, we can clearly see the ties that the representatives of future tech have together: the combined applications of blockchain, AI, and IoT will bring the development of digital health to the next level.
With all these positive aspects, there are still some limitations that do not allow the industry to scale. Let us name some of them.
- Do the projects really comply with existing regulations?
The startups and companies who are trying to excel in their new product development process meet the biggest challenge of compliance in terms of data regulation, standards, and requirements that each and every country and region has. There are a number of projects implemented by EU countries
- Blockchain is costly, guys!
On the provider end, blockchain solutions are likely to involve a high initial investment, a fact that certainly prevents wider adoption. In addition, distributed systems tend to be significantly slower than centralized ones in terms of transactions per second. A big blockchain network, with numerous nodes, would probably need more time to transmit and synchronize data when compared to centralized systems. This is especially concerning for huge databases that would eventually need to store and track information of millions of patients. The problem would be even worse for large-sized image files, such as computed tomography or MRI scans.