Today’s EHR (Electronic Health Record), although very essential, is available in an unstructured format, and controlled by various healthcare providers which are stored in a central database of each such providers. Making them more vulnerable for the Hackers. Moreover, it doesn’t have a user-friendly interface which lack interoperability; making it difficult to use.
Talking about the healthcare industries then approximately $80 Billion as a whole crouched in making a demure medical error becoming a 3rd leading cause of patient’s death. This antonym is procreated due to unavailability of the clinical history of a patient, reasonably confronted by the researchers of the Johns Hopkins University.
Proteus (leading health IT security firm) discovered that 5.579 Million patient records have been hacked and the hackers now know a lethal allergy or composition of which the patient is prone to, making it a critically irresolvable problem.
Healthcare domain will see considerable and beneficial impact once blockchain technology based systems are processed across the patient and healthcare provider ecosystem.
1. Issues in current system1.1.Manual/Paper driven process:As the complete healthcare system is not digitised we still have complete “patient to prescription” cycle on graphs and papers.
1.2. Siloed and non-interacting systems:The healthcare providers/hospitals which have IT systems are designed in such a way that they cannot interact with other systems in the same hospital/network or operated with the affiliated labs.
1.3. In-accurate diagnosis/prescription:If the patient changes his healthcare provider/hospital then the chances of partial/in-accurate diagnosis and prescriptions are in bulk hence, his clinical history is not available easily and if available then it is not interpreted well and in standard format.
1.4. Supply chain leakage:Pharmacies associated with particular healthcare provider/hospital don’t have accurate and current patient data thus, the system is not able to predict what surgical/pharmaceutical inventory is needed which results in over/ under stock data analysis.
1.5. Fraud prone ecosystem:Globally the total cost of insurance fraud is estimated at over $40 billion per year. The fraud categories range in the form of fraudulent claims, where subsidised medicines are sold in an open market, patient data theft, counterfeit medicines/drugs.
1.6. Delays/Frauds and lack of audit in Government schemes:The Public healthcare system is most hampered because of inability to identify the need of a patient and providing them with customised services. Current manual or disconnected system has very inefficient audibility.
EHR System on Blockchain TechnologyBlockchain technology by definition is secure/shared auditable ledger system to share digital assets associated with unique blockchain address, this fundamental is a core for the proposed system.
With the proposed new system for patient EHR, we prioritise patient as the most important beneficiary along with building trust and confidence for all the other parties involved and every patient will have a unique identity over blockchain network and his clinical data generated at various stages will be associated with this unique identity as EHR digital asset.
2. Advantages with Proposed system
2.1 Control access and EHR ownership with patient:Blockchain will contain references to the EHR data, while Smart Contracts will define and enforce access rules to EHR content. This will ensure that only authorized persons/entities access the EHR data. In addition, the blockchain provides an irrevocable record of all events that the data has undergone. All these will enable population health management and research.
2.2 Transparency and auditability in Government healthcare program:An integrated and synchronized EHR system will put power in Government’s hand to efficiently and accurately involve the needed citizens in state-sponsored schemes. Also, the participation of private players can be very well merged because of a transparent and auditable system.
2.3 Accurate and efficient diagnosis/prescription:The EHR will be a permission shared asset across the EHR network healthcare providers/hospitals.
2.4 Reduced supply chain leakages:Real-time and accurate data about patients enables predictions and inventory management with higher efficiency and accuracy.
2.5 Fraud proof system:
Real-time auditability and immutable nature of blockchain datasets will ensure the system is fraud proof and when implemented with operational checkpoints can be secured till the last mile.
2.6 Clinical Trials:Using blockchain will help make clinical trials reliable at each step by keeping track and time-stamping at each phase of the trial (trial protocol, patient enrolment etc). This can bring life-saving drugs at reduced cost in short span of time to market.
2.7 Preventive healthcare:Current advanced AI or conventional analytics can be utilized to draw out valuable insights from huge and diverse datasets to help individuals/public institutions focus on preventive healthcare rather than curing the ailment.
3. Advantages of Auxledger over existing blockchain solutionsSounds Great! So, what’s the problem?
Well, even though this is of course a step in the right direction, things are still far from perfect.
3.1. Interoperability between different Healthcare OrganisationsThe proposed blockchain solution will isolate the healthcare organizations from each other, not allowing them to interconnect when required.
For example:
To involve needful citizens in the state-sponsored schemes, Government Organisations need data that they can fetch from other healthcare providers which can be achieved with the help of Auxledger as it offers interoperability between different networks.
3.2. Transaction cost independent of market dynamics
Auxledger is a Hybrid Blockchain Network which provides low transaction cost much of a private network, and data reliability of a public network. Moreover, Ethereum/Bitcoin-based transactions cost is dependent on market dynamics whereas the self-regulating economic model of Auxledger proposes simple gas philosophy i.e. “ “no limitations, but pay for what you consume” and doesn’t depend on the market dynamics.
3.3 No need to compromise privacyAccording to the proposed blockchain solution, for giving access to your ledger to the other nodes, you will have to strike down your wall of privacy.
Whereas, Hawk Model of Auxledger used for privacy let the user decide about the parties to which it will disclose information.
Introduced by a new system for patient’s EHR, we prioritise patient as the most important motive with building trust and confidence for all the other parties involved. Auxledger based EHR will assist healthcare providers as well as government organisations, keeping their platform patient-centric. Hence EHR will be fully efficient and reliable.
