Blockchain is the new buzzword, and everybody seems to be talking about it. But what is it about and how could it be used within healthcare?
Blockchain explained
Imagine 20 people standing in a circle on an Italian plaza. Everyone is carrying a small personal notebook. One person in the circle shouts to another “Can I buy your car for 1000 Euros?” All 20 people in the circle write the question down in their personal notebook. The owner of the car answers – yes! And everyone writes the answer down too. And for every part of this transaction; the contract being signed, the money being transferred, the key being handed over, the car registered on the new owner etc. – all 20 people record what is happening in their personal notebooks. The truth about this transaction is now in 20 small notebooks. And not the seller nor the buyer can change any part of the agreement, without making a new one.
This is how blockchain works, only that the 20 people standing in the Italian plaza in reality are millions of computers all over the world, connected on a distributed ledger called Blockchain, and the small “notebooks” they write into are their local copies of the ledger.
There are thousands of Blockchains out there, all with different purposes, designed to keep a specific type of data or enable a specific type of business.
Why is this important?
While until now used primarily in financial services and in the crypto market, Blockchain technology has also evolved into an enabler of digital art and smart contracts. And I will argue that 2022 is the year when its use cases broaden even more.
Technology is never important on its own but the fundamentals of what it changes is. And in the case of blockchain three fundamentals are:
- Decentralization and transparency, making it a perfect technology to use for information or data that should be public and not tampered with.
- So called “trustless” design which refers to the fact that there is no longer any need for trusting a third party to be the “impartial middleman” in the transaction between participants or to argue around accuracy of any information.
- The possibility to create and easily manage “smart contracts”, which in its essence are contracts put on the Blockchain, thus becoming immutable and transparent.
To understand how we can benefit we need to zoom out of IT problems or our day-to-day operations to find structural patterns in a business sector, like the healthcare sector, that can be solved in new ways. The healthcare sector has dysfunctional but well established patterns that are hard to question or even to acknowledge. Blockchain can be a disruptive game changer. And the best way to predict the future, as we all know, is to create it.
Blockchain for Healthcare
Combining the benefits of Blockchain with the challenges in healthcare sector could result in a lot of different solutions. To make it more tangible, we have examples of what it could look like:
Who should own medical records?
Today the medical records belong to health care providers, but the data in it belongs to the patient. Personally, I would quickly sign myself up to any health care provider that would offer me as a patient to own my own medical journal. So that I can decide who to share certain information with and for how long. Also, I can choose if I want to upload data from my smartwatch (that for example keeps track of my heartbeat and sleeping pattern) or not. Being a somewhat healthy 40-something-year-old this would first and foremost be a case of interest for me. But for any patient with a more complex medical situation this could be a matter of life and death. Today errors happen all too often. Visiting multiple doctors in multiple hospitals can, for example, result in drug poisoning, as the physicians can’t see the prescription of each other. With the patient owning the full medical journal the data can warn the doctor of not making such mistakes, even if not everything in the journal is disclosed with them. This increases patient security.
A medical journal owned by the patient and its proof of origin and accuracy on the Blockchain (not the medical data itself) would also open for other use cases, such as sharing relevant information with insurance companies, or automatically use it as exemption cards, or to replace international insurance cards when travelling abroad.
Reimbursement in between actors
With a decentralized healthcare sector, it’s an understatement to say that reimbursement between different actors is an administrative burden. Time spent on finalizing who should be invoiced for what, at which cost is to say the least difficult.
A great usage of the Blockchain is to enable so called “smart contracts” to seal agreements between different actors. All the statistics and data that is currently being collected and compared between different stakeholders would instead be based on a fully transparent and non-discussable set of data. And if proof of execution can be put on the Blockchain too, it would automate the full process from signed (smart) contract, to an execution, to proof of work and to invoicing. Not only would we spend less administrative hours paid by taxes on administration, but the health care providers would also receive their money on time and without negotiation. Even the auditing part would eventually be redundant.
Medtech traceability
Any Medtech company out there should really investigate what Blockchain can do for them.
With a need to prove and secure the solution from smallest component in the supply chain, to a fully secured device with proven track records, the compliance burden today is heavy.
On top of that, the new EU regulation 2017/745 (Medical Device Regulations) states that all medical devices need a unique device identification (UDI) which should be indexed and registered on a central EU database. Medtech devices of higher classes also need to share product data.
The introduction of the EU MDR obligates medical device manufacturers to invest in technology to enable the fast and accurate application of traceability coding to products and packaging at the individual item level. Failure to comply with these procedures may mean that devices are withdrawn from sale, with device manufacturers no longer able to supply their products to other EU member states.
With the use of Blockchain, Medtech companies can for example publish this data publicly:
• Place of production of different components of a medical device
• Manufacturing locations
• Date of shipping
• Batch number
• Expiry date
• Optimum storage temperature
• Unique Device Identification (UDI)
• Etcetera
This should automate a lot of the compliance burden today and simplify for anyone in the eco system to access reliable data, guaranteed to be from the right originator (preventing pirated or falsified copies). And to report usage and provide relevant information to the authorities. In the end this would increase patient security as hospitals and caretakers can validate the authenticity. This would have been very useful in the Covid-19 vaccination processes where there were falsified batches of vaccine in circulation.
There are so many more use cases for Blockchain and healthcare. To keep hospital queues on the Blockchain to avoid any tampering and show full transparency. Or to keep registers on which drugs that are approved for different treatments. Or secure and validate someone’s certifications and educations to remove the risk for falsifications etc. We can’t cover them all in this text, but feel free to reach out to have a deeper discussion.
Let us innovate together!
OK, so how is the Blockchain implemented, in practice? Is it hard? How do I get started?
We have technical knowledge, and we are experts in the field of discovering business needs from our many projects with different clients. And the combination of these two elements is the fundament in getting started.
We are interested in discovering the possibilities with you and we have a unique offer including a 6-week PoC where we work with a business case and a proposed solution for you. Are you curious about Blockchain and how it can enable your business? Reach out!
Liselott Lading
Business Consultant (Data)
