Digital ledger technologies like blockchain may be synonymous with crypto currencies like Bitcoin at the moment, but the search is on to find practical applications for the technology across the healthcare and financial industry, particularly in areas like data security and patient health records storage and access.
According to an industry study conducted by IBM, over half of the healthcare executives surveyed said they were working towards implementing a commercial blockchain application in the next few years.
Blockchain and the Healthcare Industry
According to MedTech Intelligence, the real world applications for blockchain technology in the healthcare space run the gamut from data protection, transmission and storage, to supply chain maintenance and management for the medical devices market:
Imaginations are running wild with ideas of how blockchain technology can change the process flow of data and transactions, and even how entire value chains will be turned on their heads. But while most of the early excitement for blockchain has been in financial services, it has an enormous potential to change healthcare and the medical device landscape.
And while healthcare is historically slow to adopt new technologies, now is the time for medical device companies to begin giving the technology a serious look.
The booming personal medical devices market, with its treasure trove of personal user information and limited security features at the moment has created another front for hackers to exploit.
Most people who use medical devices like pacemakers, devices to monitor medications or vital signs, and respiratory aids probably don’t give much thought to how much sensitive personal information a medical device can store, and how vulnerable that information is to hacking and data breaches.
Advancements in medical home care technology and devices provide critical services that can improve a patient’s quality of life and help to manage serious illnesses and medical emergencies, but securing how that data is stored and transmitted between parties is a growing concern.
According to data from The National Academies of Science Engineering Medicine, the use of home health medical devices has exploded over the last two decades, creating an ever-growing pool of valuable patient data and information.
Government officials, as well as private and public parties in the consumer protection, medical and healthcare, and technology fields alike are making the case for revolutionizing how medical records are stored and distributed using blockchain technology for its potential to address ongoing security and operational issues.
Securing Medical Records and Sensitive Patient Information
One of the most promising areas in which blockchain is poised to transform the healthcare landscape is the security of patient records and medical history. Once upon a time, financial data and information constituted the main focus of identity thieves and hackers. However medical records and healthcare data have become increasingly vulnerable (and valuable) for cyber criminals and hackers.
According to industry statistics, medical data security breaches have increased by as much as 125% over the last decade, with over 90% of healthcare organizations reporting at least one data breach, with a price tag of over $2 million to the institution.
And the costs of hacking and data breaches in the medical industry are not just limited to the medical institutions that are targeted by hackers. The price tag for security breaches across the entire healthcare system in the United States is estimated to have exceeded $50 billion in the last decade alone.
Despite the fact that patient information and medical records are subject to HIPPA (Health Insurance Portability and Accountability Act) regulations, the advent of electronic and digital medical records means that health records pass through more channels and can be accessed by numerous people at medical practices, hospitals, and insurance companies.
The move from paper medical files may improve efficiency and lower administrative costs associated with outdated filing and data storage methods, but it has also introduced a new and complex set of challenges for safeguarding sensitive medical information in the digital age.
Why is Medical and Healthcare Data So Vulnerable to Hacking and Cyber Theft?
Unlike a stolen credit card or hacked bank account, which can be closed and reimbursed once a breach is identified, medical data is permanent and much more difficult to track. In most cases, medical facilities and affected patients can remain unaware that their records and information have been compromised for months or years after the initial breach has occurred.
Medical records leave consumers particularly vulnerable not just to potentially astronomical bills for fraudulent medical services, but to deeper identity theft via access to sensitive information like addresses, date of birth, and social security numbers. And unlike stolen credit card and bank account numbers, which can typically only be sold once, medical information provides an ongoing rate of return for hackers and illicit data brokers across the darkest and most untraceable corners of the Internet, because social security numbers and medical records can’t be cancelled or changed like a credit card or bank account number.
All Medical and Healthcare Sectors are at Risk of Security Breaches
It’s not just small practices with limited infrastructure budgets and security protocols that are falling victim to hackers. In the last few years, major institutions like UCLA Health Systems and Anthem have suffered data breaches affecting millions of consumers.
Data Security and Blockchain
Medical Records: Security and Access
Security experts believe that this can help to solve one of the main problems and vulnerabilities with the medical records and data pipeline: tracking and securing ownership and transmission of private medical files. Unlike a personal financial record, which consumers can access and monitor at any point by simply ordering a copy of their credit report or checking their credit card and bank statements for suspicious activity, patients have surprisingly limited (if any) access to their own medical files, let alone how that information is stored or shared. It is also incredibly difficult to know if and when an individual patient’s records have been exposed to unauthorized access.
For the most part, a doctor or group medical practice acts as the gatekeeper to every patient’s individual medical records and information. For healthy patients that only see one doctor for routine and preventive care and never suffer an emergency, the arrangement typically works. But in life and death situations where a person may require emergency care or surgery in a facility that does not have access to their medical records, list of medications and underlying health conditions, waiting to receive adequate information can be a matter of life and death. Blockchain could put ownership of each patient’s information back into their own hands.
Blockchain and HIPPA Compliance
The regulatory concerns surrounding access to medical records are something of a sticking point in discussions around the best ways to adopt blockchain and digital ledger technologies for sensitive medical records and patient information. Because HIPPA privacy and compliance laws precede the adoption of blockchain technology in the healthcare sector, there are a number of questions around how compliant the technology will be. Healthcare app developers make the case that moving away from the current EHR model (which has proven vulnerable to hacking, malware, and data breaches) to the blockchain model will actually keep medical records more secure, by encrypting the data and allowing patients to control their records and share access with doctors and healthcare institutions as needed.
With single HIPPA violation fines running well over $1 million dollars, as well as the potential damage that medical security breaches pose to consumers, navigating the regulatory landscape while adopting new technology and systems overhauls is a major concern. According to Joe Guagliardo, a legal expert working on compliance and regulatory issues surrounding blockchain implementation in the healthcare space, “What can we do in the healthcare space, what smaller projects can we do, that don’t have the regulatory hurdles? And can we take some baby steps that don’t require breaking down all the walls? Let’s find smaller problems we can solve as a starting point.”
Creating Streamlined Access to Medical Records with Blockchain
The security of medical data is a major concern, but there are additional factors that affect how medical records are stored and shared, which lower efficiency and contribute to the astronomical administrative costs that continue to plague medical practitioners and the industry as a whole.
According to Forbes:
The overall vision for blockchain to disrupt healthcare in the future would be to solve many issues that plague the industry today to create a common database of health information that doctors and providers could access no matter what electronic medical system they used, higher security and privacy, less admin time for doctors so there’s more time to spend on patient care, and even better sharing of research results to facilitate new drug and treatment therapies for disease.
At the moment, there is no easily accessible database that allows patients and their doctors to access the depth of their medical records and history in one place. The average person may visit dozens of healthcare providers over the course of a lifetime or illness. When you factor in prescriptions and medical procedures all recorded across different databases and filing systems, getting a comprehensive picture can be next to impossible.
In addition to efficiency problems, this can also put patient safety at risk, where access to medical histories and lists of medications can literally be a matter of life and death. In emergency situations, doctors and medical teams often don’t have time to make multiple calls to different offices and wait for patient information to be mailed or faxed while the patient waits for treatment.
How Blockchain Can Lower Administrative Healthcare and Medical Costs
Adopting blockchain can also address many of the problems that drive up costs and decrease efficiency for medical practitioners, specifically when it comes to administrative costs. According to recent statistics, the United States was found to spend more than double the worldwide average on healthcare related administrative costs, or 8% vs. 3%.
Doctors as Data Entry Clerks
According to some estimates, doctors in the United States can spend more than half of their time dealing with paperwork and administrative tasks. In fact, industry reports have found that the average doctor spends twice as long filling out related paperwork than the time actually spent with the patient. Not only is the current situation a drag on practice resources and profits, it seriously interferes with a practitioner’s ability to provide adequate care and even take on new patients.
According to the American Medical Association, a sample of doctors across a number of medical specialties found the following:
- 2% of time on paperwork for 27% of patient care time
- EHR software (electronic health records) account for a significant portion of administrative time and labor
Using a digital ledger system like blockchain could simplify data capture, management, and sharing among doctors and healthcare facilities and improve the accuracy and security of electronic medical records.
According to Health and Data Management, adopting blockchain could also potentially simplify the claims process, improve fraud prevention, detection, and verification, and allow providers to direct more resources towards services and patient care (rather than administrative costs).
Secondary Applications for Blockchain in the Healthcare Sector
The issues surrounding security of patient data and medical records and healthcare costs are the focal point of how technology can help to overhaul outdated procedures and systemic issues in the healthcare sector, but there are other areas that can also benefit from greater transparency, ease of access and efficiency:
- Practitioner licensing and credential information – With the rise of new industries and services like tele-medicine next to traditional medical and healthcare services, blockchain can provide a main location to verify and confirm practitioner credentials and clearance to practice.
- Medication monitoring – One of the many operational hurdles faced by managed healthcare plans and service providers is also critical to patient care – sharing essential information like prescriptions and medications across networks that often include multiple practitioners, hospitals, and medical practices. Using a blockchain to store patient data and information could potentially make it much easier to share vital information like prescriptions and medication records between doctors, patients, hospitals, and pharmacies.
- Improved access to public health and population surveillance and data – Although much of the focus on blockchain’s potential has been on medical practice, patient care and insurance, the technology could also be highly beneficial in other life science disciplines and research dissemination on a local and global scale.
Greater efficiency across practice management, data management and billing practices could also prove beneficial in the following areas:
- Revenue cycle management
- Fraud prevention
- Clinical trials
- Better patient experiences
The medical and healthcare industry will not be transformed overnight, and disrupting the complicated and byzantine system currently in place will not be easy. But from improving security and operational efficiency to lowering costs, more and more healthcare institutions are starting to get serious about the future of blockchain.