679 Blockchain Health Records?
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Dynamic Chiropractic – August 1, 2018, Vol. 36, Issue 08

Blockchain Health Records?

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher

Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).

This is especially unsettling when one considers the information included on a patient's health record. Sadly, hacking hospital databases is a big racket. It is said that a patient's medical record will sell for as much as 10 times what their credit card number will sell for.

Almost a year ago, the folks at MIT began working on a solution using blockchain for patient health records.1 Blockchain is a relatively new technology utilized by Bitcoin to authenticate database entries in a record. Ledgers are modified using a ledger system to add entries, with all prior entries still intact.

Instead of a single record in a single database, the concept is to have the identical records stored on a myriad of computers. In this way, corrupted or compromised records can be immediately recognized, as they will not be identical to the remaining records.2-3

When applied to patient health records, this system would allow for a single patient record to be updated by each doctor, hospital, lab, pharmacy, etc., with which the patient has an interaction. The patient would have control over which provider would be allowed access to their patient record. Payers would also be integrated into the patient record, with reimbursement (supposedly) synchronized to care.4

Wearable devices are also being designed to write information to the patient record. This is expected to increase the level of patient involvement in their own health, as well as provide data for efficacy studies. Patients would have access to their patient record via their smart device.

Along with care and payment information, some believe the "experience data" generated from applying blockchain technology could be the death of randomized, controlled trials. Assuming the data provided from care and the resultant success of that care can be properly measured and quantified, having access to millions of active records would provide researchers and payers with the ability to analyze which interventions are the most effective in the short term and over the life of the patient.

While all of the above is mere speculation at this point, consider what has happened in just the first five months of this year:

  • Amazon, Berkshire Hathaway and JPMorgan Chase formed an independent health care company for their employees in the United States (Jan. 30, 2018).5
  • Apple created AC Wellness as "an independent medical practice dedicated to delivering compassionate, effective healthcare to the Apple employee population" (Feb. 27, 2018).6
  • Adobe and Microsoft have teamed up with Change Healthcare to tackle consumer engagement, including a way to aggregate patient data (May 8, 2018).7

So, while the future of health care data may seem murky to most of us, it is seen as a major opportunity to those organizations that have the money to take advantage of the need for a dramatic change. The take-home message for anyone involved in health care is crystal clear: dramatic changes are underway.

The good news is data has a way of revealing the ultimate superiority of chiropractic care. Our job, individually and collectively, is to ensure we are involved enough to see that data take shape.

It's hard to overstate the importance of being ready for the coming changes in health care. If it sounds like I'm beating the same drum too often in this column space, it's because almost everything I see points to these dramatic changes. We just need to be ready to take advantage of the changes – before they take advantage of us. More to come...

References

  1. "Who Will Build the Health-Care Block-chain?" MIT Technology Review, Sept. 15, 2017.
  2. "What Is Blockchain Technology?" CBInsights Research Briefs, March 2, 2018.
  3. Halpern N. "How Blockchain Can Create Owned and Trusted Health Care Records." Forbes, Dec. 21, 2017.
  4. "The Potential for Blockchain to Transform Electronic Health Records." Harvard Business Review, March 3, 2017.
  5. Wingfield N, Thomas K, Abelson R. "Amazon, Berkshire Hathaway and JPMorgan Team Up to Try to Disrupt Health Care." The New York Times, Jan. 30, 2018.
  6. Bach N. "Apple Is Joining Amazon and Warren Buffett in the Health Care Business." Fortune, Feb. 27, 2018.
  7. Arndt R. "Change Healthcare, Adobe and Microsoft team up for patient engagement." Modern Healthcare, May 8, 2018.

Read more findings on my blog: http://blog.toyourhealth.com/wrblog/. You can also visit me on Facebook.


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