BLOCK CHAIN

Research: reducing siloed patient datasets and cross-correlating manual updates.

Blockchain is gaining traction as a tool that could help solve some of the healthcare industry's age-old problems that have resulted in
wasteful spending and higher costs for providers, insurers and patients.

Blockchain technology has the potential to transform health care, placing the patient at
the center of the health care ecosystem and increasing the security, privacy, and
interoperability of health data. This technology could provide a new model for health
information exchanges (HIE) by making electronic medical records more efficient,
disintermediated, and secure. While it is not a panacea, this new, rapidly evolving field
provides fertile ground for experimentation, investment, and proof-of-concept testing.
Many healthcare and blockchain companies are currently working on or have already released blockchain-based systems to
improve healthcare for both professionals and patients. By decentralizing patient health history, tracking pharmaceuticals,
and improving payment options, blockchain is becoming a valuable tool for healthcare, revolutionizing the industry worldwide.

A blockchain powered health information exchange could unlock the true value of
interoperability. Blockchain-based systems have the potential to reduce or eliminate
the friction and costs of current intermediaries.

The promise of blockchain has widespread implications for stakeholders in the health
care ecosystem. Capitalizing on this technology has the potential to connect
fragmented systems to generate insights and to better assess the value of care. In the
long term, a nationwide blockchain network for electronic medical records may improve
efficiencies and support better health outcomes for patients.

What is blockchain?

At its core, blockchain is a distributed system recording and storing transaction records.
More specifically, blockchain is a shared, immutable record of peer-to-peer transactions
built from linked transaction blocks and stored in a digital ledger. Blockchain relies on
established cryptographic techniques to allow each participant in a network to interact
(e.g. store, exchange, and view information), without preexisting trust between the
parties. In a blockchain system, there is no central authority; instead, transaction
records are stored and distributed across all network participants. Interactions with the
blockchain become known to all participants and require verification by the network
before information is added, enabling trustless collaboration between network
participants while recording an immutable audit trail of all interactions.
In the simplest terms, blockchain is a shared record of transactions. It enables participants in a group to securely share data with each
other without a middleman and keep track of what was exchanged and when. Instead of that record being located on a single, hackable
computer, it is maintained across multiple computers, which makes the information extremely difficult to tamper with or delete. That
tamper-proof characteristic, along with a process that ensures any information put into the blockchain is valid, enables trust between
the group participants.

So in the case of the blockchain-enabled provider directory, if one insurance company in the alliance calls a doctor's office to verify an
address and updates that information in the record, all members of the alliance would see the change. That means less work for the rest
of the insurers and the doctor's office.

Change Healthcare, meanwhile, is using blockchain to enable healthcare providers and insurers to track a claim across its entire life
cycle in real time, from filing the claim to each physician being paid. Today, providers and insurers maintain their own data, and the
insurer's idea of the status of a claim may differ from the provider's view. But blockchain would allow both parties to have a shared
understanding of where that claim is in the life cycle and automate the claims adjudication process

blockchain is best put to use when addressing problems of trust, transparency and incentive alignment, and the healthcare industry is
full of such issues, he said. Others noted that blockchain will drive the most value when applied to healthcare processes that suffer from
redundancies or require different sets of data to be reconciled.

Addressing provider directory inaccuracies and creating a more portable patient health record are two areas the group may focus on.
One solution is already in the works. IBM plans to launch a blockchain-enabled bundled-payments tool midyear that will streamline the
typically labor-intensive process of evaluating clinical outcomes and paying providers based on that outcome in real time, Hayes said.

1. Improve Medical Record Access

One of the most popular healthcare use cases for blockchain is patient data management. Medical
records tend to be separated by health agencies, making it impossible to determine a patient’s medical
history without consulting their previous care provider. This process can take a significant amount of
time, and may often result in mistakes due to human error.
“system that prioritizes patient agency, giving a transparent and accessible view of medical history.”
store all of a patient’s information in one place, making it simpler for patients and doctors to view.
2. Cutting Costs
“uses care coordination and financial forecasting to help providers in bundled payments get insight into what happens
to patients when they leave the hospital.” It is currently on the market, helping healthcare providers determine how
much a patient’s care will cost them when bundled with multiple organizations.
3. Improving Medical Record Keeping
It aims to increase transparency between medical institutions by putting all of a patient’s medical information on a
blockchain.
 It includes images, as well as various information concerning a patient’s condition. The information can be
accessed by doctors and the patients themselves through a mobile app. It also increases the security of medical
information through the Decentralized Ledger Technology (DLT).

4. Blockchain for Relief Efforts

5. Stop Counterfeit Drugs
6. Making Electronic Health Records More Accessible
Electronic health records (EHR) can be hard to manage. One healthcare provider’s EHR for a patient may differ from
the same patient’s other provider. MTBC intends to change that by using Application Program Interfaces (API) and
blockchain. The idea is to put the control in the patient’s hands. A patient will have the ability to allow the transfer of
records from one doctor to another. The blockchain API runs on the Hyperledger platform and is currently available.
7. Tracking Clinical Trials and Pharmaceuticals
Multinational Internet of Things supply chain manufacturer Ambrosus currently offers a variety of blockchain platforms
on their website. However, the company is very eager to expand their uses for the pharmaceutical industry. The
company is currently in talks with large pharmaceutical suppliers in relation to launching a pilot program utilizing their
current products.
8. Tracking Medical Credentials
9. Enhance the Security and Control of Healthcare Transactions
One of their most recent developments simplifies claims management and revenue cycle management. It helps
hospitals and health systems manage claims and remittances, improve collection of patient payments, minimize
denials and underpayments, as well as manage daily revenue cycles and business operations more effectively.
10. Improve Patient-Doctor Interactions
With MedicalChain, you have full access and control over your own personal health data. Users are able to grant
doctors immediate access to their health record via their mobile devices while data is kept secure on the blockchain.
Patients can also wear wristbands, which medical professionals can scan to access a person’s medical history if they
are unconscious. It also offers telemedicine communication enabling online video consultations with doctors.
11. Blockchain in Healthcare: Much More to Come

The reason why the blockchain has gained so much admiration is that:
 It is not owned by a single entity, hence it is decentralized

 The data is cryptographically stored inside

 The blockchain is immutable, so no one can tamper with the data that is inside the

blockchain
 The blockchain is transparent so one can track the data if they want to

Blockchain and Decentralization

It really is a pretty simple concept. All the records that are stored within the blockchain, isn’t
saved inside one centralized storage unit. There are multiple computers running within the
network who own a copy of all the data in the blockchain. This is why, whenever anything is
updated in the blockchain, all the nodes in the network get notified of this at once.
This is what we mean by decentralization. There is no single source which is in charge of all
the data anymore.
Health Care and Interoperability
Interoperability is a huge problem in the healthcare industry. In fact, improved healthcare
interoperability is been a top priority for providers, policymakers, and patients for quite
some time now.
So what are the two major areas when it comes to ineffective interoperability?
 The trouble of identifying patients
 Information blocking
The trouble of Identifying Patients
One of the most surprising things that we learned while researching for this guide.
Apparently, there is still no universally recognized patient identifier. This despite the fact
that organizations like CHIME and HIMSS have been pushing for its development for almost
two decades.
This is truly shocking when you consider the fact that a unique patient identifier will be able
to easily solve the problem of mismatched patient EHRs (Electronic health record) which has
in the past led to several errors in patient care and increased the likelihood of patient harm.
This problem has been well expressed by the Director of Center for Biomedical Informatics
(CBMI), Shaun Grannis.
“Matching the correct individual to his or her health data is critical to
their medical care,” he says. “Statistics show that up to one in five
patient records are not accurately matched even within the same health
care system. As many as half of the patient records are mismatched
when data is transferred between healthcare systems.”
Information Blocking
Despite being deemed an illegal practice, information blocking has been a problem in the
healthcare industry. What do we mean by information blocking?
In the healthcare industry, information blocking is described as the result of “an
unreasonable constraint imposed on the exchange of patient data or electronic health
information.” According to the U.S. Office of the National Coordinator for Health
Information Technology, there are three criteria for identifying information blocking:
 There has been interference

 There has been knowledge

 There is no reason for the data to not be accessible.
It goes without saying that information blocking practices that involve unreasonable
interference and awareness are a huge detriment to an efficient healthcare practice.
Blocking can take place because of policies that prevent the sharing of information as well
as practices that makes sharing extremely impractical.
The reason for this is pretty straightforward. Hospitals don’t want to lose out on patients
and want to make it as difficult as possible for them to want to move on to another hospital.
In this digital age, this should have been a draconian practice, but various surveys and
studies say otherwise.
 After surveying 60 HIE leaders, it was discovered that information blocking is extremely

widespread and the various actions that have been taken to curb it are still extremely
ineffective.
 50% of respondents that have been studied by Adler-Milstein reportedly engaged with
health IT companies by participating in information blocking. A quarter of these
respondents also said that hospitals and health systems are guilty of this practice.
According to the researchers, information blocking can be curbed by one of the following
methods:
 By increasing transparency so that each and every action that has been taken by the

participants can be accounted for.

 There should be a strong financial incentive so that the participants will want to share

information with each other.

 A collaborative relationship between health IT companies, hospitals, and HIEs could

further curb information blocking.

Alright, so now we have acquainted ourselves with the interoperability issues that are eating
up the healthcare industry from the inside. Now let’s see how the blockchain is going to
help solve this issue.
Other Advantages of the Medical Healthcare Blockchain
So, now that we know how interoperability can be solved, what other amazing advantages
can the blockchain bring to the medical healthcare institute?
 Since the blockchain is Immutable and traceable, patients can easily send records to

anyone without the fear of data corruption or tampering.

 Similarly, a medical record that has been generated and added to the blockchain will be

completely secure.
 The patient can have some control over how their medical data gets used and shared by

the institutes. Any party which is looking to get the medical data about a patient could
check with the blockchain to get the necessary permission.
 The patient can also be incentivized to for good behavior via a reward mechanism. Eg.

they can get tokens for following a care plan or for staying healthy. Also, they can be
rewarded by tokens for giving their data for clinical trials and research
 Pharma companies need to have an extremely secure supply chain because of the kind of

product they carry. Pharma drugs are consistently stolen from the supply chain to be sold
illegally to various consumers. Also, counterfeit drugs alone cost these companies, nearly
$200 billion annually. A transparent blockchain will help these companies to enable close
tracking of drugs to their point of origin and thus help eliminate falsified medication.
 Image Credit: PwC
 Various medical institutes around the world conduct their own research and clinical trials
on various new drugs and medications. A blockchain will help create a single global
database to collect all this data and put them in one place.
 Insurance fraud is a major problem that is affecting the healthcare industry. This happens
when dishonest providers and patients submit false claims/information to receive payable
benefits. To get an understanding of how serious this problem is, try to wrap your head
around this: According to Boyd Insurance, Medicare fraud in the U.S. alone costs about
$68 billion a year.
In fact, according to the charts, the top two kinds of healthcare frauds are healthcare
related.

“A blockchain environment can eliminate a large portion of this fraud

when providers and patients must enter their information and data to
be verified, recorded and stored and health insurance companies must
have access to that data.”
Since all the data will not be stored in a centralized infrastructure, it will be impossible to
hack the system and get their hands on all of the data. This keeps the system leakage-free
and it also helps secure the privacy of the patients.

Blockchain in HealthcareConclusion
So, there you have it. We have listed down the various advantages that the blockchain can
potentially impart to the healthcare industry. Obviously, until we see a proper
implementation of this partnership, this is all hearsay. What we can state for a fact, is that
various other institutes and spaces have already started experimenting and working with the
blockchain technology.
This space has no lack of money. In fact, consider the following statistics:
 The funding of digital health startups reached an all-time high in the first quarter of 2018
 Global annual health spending surpassed $7 trillion dollars in 2015
 By 2020, the global annual health spending is expected to have ballooned to over $8.734

trillion.
As such, they should be under no financial constraints to research new and exciting
technologies. All signs are pointing towards a decentralized medical future. Let’s see why.
According to a report by BIS research, by 2025, the healthcare industry can save upto $100
billion per year by 2025 in data breach-related costs, IT costs, operations costs, support
function and personnel costs, counterfeit-related frauds and insurance frauds if they
incorporate the blockchain technology.
The report also states that the use of
“a global blockchain in the healthcare market is expected grow at a
CAGR of 63.85% from 2018 to 2025, to reach a value of $5.61 billion by
2025. The use of blockchain for healthcare data exchange will
contribute the largest market share throughout the forecast period,
reaching a value of $1.89 billion by 2025, owing to the use of
blockchain to solve the most widespread problem in healthcare
information systems related to interoperability and non-
standardization that has created data silos in the industry.”
According to the report and the way the blockchain is being adopted by various sectors, it
definitely looks like the future of the healthcare industry is indeed decentralized. Let’s hope
that the blockchain technology provides the horizontal innovation boost to this industry
that it desperately needs.

Blockchain system features:

Associated with cryptocurrency transactions, blockchains are mainly the management of the
transaction data within a shared network; the free network of computers that handle computing the
encryption algorithms that secure the shared servers. This definition introduces the main goal of
the healthureum program which is creating dedicated blockchains networks to the healthcare
industry, with free but respectful access to data by healthcare operators as well as healthcare
clients. This kind of program should ensure the benefits for both sides of the relationship.

Blockchains impacts of patient experience in healthcare industry:

Patients are likely to be better served by the healthcare industry when it is about using blockchain
system. Obviously, this is due to that their lives are involved in the relationship. The case analysis
can, however, supply more detailed bonuses.
• Ownership: Patients still have the upper hand regarding the ownership of the data stored in the
blockchain system. In fact, they can deliberately distribute and make data available to the operator
of their choice. Moreover, the passed data is securely transferred along with all updates that may
help the receiving operators offering the appropriate prestation.

• Authenticity: The blockchain system is highly secured and is well maintained. As a

backup network, the system operates synchronized actions that ensure loyal and
stealth transfer; delays are reduced to insignificant because of the availability and the
free access to data storage; no need to official requests between different actors.

• Money saving: In addition to time-saving, money saving is another important

benefit. Eliminating the extra cost induced by the transactions handler (banks) is the
clearest and apprehendable feature. Indeed, patients are already charged huge money
to get access to healthcare services, paying the fees and paying the transactions
handling became a heavy duty.

• Wider choice: The money-saving property of the blockchain system and the access
to the records of the healthcare operators give patients the opportunity to choose
among affordable operators. It is possible to verify the identity of the actors after
having picked the suitable balanced records; in other words, the transparent
relationships stored along with their parties’ data are the main and critical resource for
patients to identify the actors.

Conclusion:In general, healthcare industry operators emphasize the patient-side benefits when
they promote their services. In the case of blockchain system application, they cannot deny that
they are not the direct benefits providers; they might tell that the cryptocurrency technology is the
responsible of the revolution. The blockchain system applied in the healthcare industry has come
with associated benefits, and none can claim the ownership. In the opposite, all parties have to
thank this technology
Blockchain’s Potential Healthcare Benefits
Blockchain in healthcare can address a variety of problems, such as care coordination, data security, and
interoperability issues. Every day, the healthcare industry is generating new data – medical records, laboratory test
results, billing, clinical trials, remote monitoring, and other sources – which is often trapped in numerous disparate,
isolated databases. Blockchain can harness the data stream to improve quality of care provided by streamlining the
sharing of medical records, protecting sensitive data from hackers, and giving patients more control over their
information. For example, blockchain technology can aggregate a patient’s medical and prescription records from
multiple sites/providers to generate a single, up-to-date record which an ER physician can refer to when treating a
patient.
Electronic Health Records (EHRs) Interoperability. Blockchain could facilitate nationwide interoperability of electronic
health records, which would allow providers access to patients’ medical histories, current medications, and prior
imaging studies. According to one study, full interoperability could save the US healthcare system $77.8 billion per year.
Supply Chain Integrity. Blockchain can verify every transaction among drug manufacturers, wholesalers, pharmacists
and patients, as well as secure drug supply, which could reduce counterfeit drugs ($200 billion in annual losses).
Drug Development. Blockchain can facilitate new drug development by making patient results more widely
accessible.Smart Contracts. Blockchain can create rule-based protocols where contracts are executed when conditions
are met. For example, a patient with health insurance has policy details linked to their profile that are triggered when
they seek medical care, ensuring correct payment to providers.