Health care requires forward progression in the chase for quality, safety, and sustainability. When considering how far we have come collectively, success is often celebrated. Be it a new vaccine to curb a pandemic, an advanced diagnostic tool to expedite diagnoses or process alteration to achieve sustained quality, advancement is paramount in both length and quality of life and care delivery. Retrospectively, one can look with ease on the way things were previously and how far we have come. Conversely, one could ask: “How far do we have left to go?” When considering this question, the exploration of needed innovation becomes a vast pool of potential. Where do we begin?
When considering innovation in general, a hot topic presently is blockchain technology. In short, blockchain is, “a shared, immutable ledger that facilitates the process of recording transactions and tracking assets in a business network.”
The concept of blockchain is disruptive in nature, fundamentally altering the standard process of applications and transactions in the business world. As such, blockchain is applicable in many sectors beyond finance, slated to grow in implementation. Considering this, one could venture to apply this to the health care sector, where security, quality, documentation and fluidity are needed in any input. With “assets” being a fluid term, one could argue protected health information falls into this category.
Process overview of blockchain specifically entails a recorded transaction, aka a “block.” This block records given inputs dependent on predetermined parameters (who, what, where, specific conditions, etc.) Each transaction equates to a block, which then links to the previous, creating a chain of data. This data is able to migrate from place to place, accessible by privileged users. According to IBM, as additional blocks are added via transactions, “this renders the blockchain tamper-evident, delivering the key strength of immutability.”
Similar to the concept of operations within financial sectors such as banks, within health care, the implementation of blockchain for electronic health records would theoretically allow an organization to seamlessly operate under a unified structure for all patient data while presenting advanced security, access, speed and process ease, in comparison to modern EHRs. Given transaction costs are lessened with this implementation in the financial sector, applying the disruptive innovation carries similar potential to the health sector
When contemplating the application of blockchain for EHR usage, similarities are seen. With a standard EHR, compliance, auditing, security and safety are all to be considered. With blockchain, given it is a private, self-sustaining network, database management is still seen, but on a simpler level.
With a peer-to-peer network capable of sustaining interactions in a trusted environment, HIPAA security and compliance becomes easily obtained, requiring less management overhead. With an application only accessible by privileged individuals, security is addressed. Furthermore, immutable documentation and transparency within the record would aid in quality care. As each patient encounter is recorded, accurately logging the time of the interaction, the “block” is added to the record, creating sustainable documentation in line with compliance measures.
Beyond EHR usage, applications exist within insurance claim and insurance verification processes, biomedical research processes, and fosters patient-centered care beyond the walls of hospitals, breaking the cycle of centralized, institutionalized data. Research supports blockchain’s effectiveness in several sectors, fostering both enhanced security, efficiency, and transparency. With several methods to create a blockchain network, this disruptive innovation carries the potential to be a gamechanger within the health sector.
Laramey Peugh is a doctor of health science candidate.
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