A fundamental standard for quality healthcare in 2017 is to centre the care on the patient, and that includes medical records. Patient-centred care provides support that is respectful and responsive to the patient’s values, needs, and preferences. Despite placing the patient first, though, the individual has limited access to their health records. A patient often has multiple electronic health records (EHR) scattered across numerous facilities held in closed systems. In the next decade, blockchain enthusiasts say patients will have access and control over their medical information through the blockchain network.
Right now, patients don’t have full control over their personal information. Different physicians hold access and control over a patient's information via electronic health records kept in a variety of private digital portals. Fragmented data is a problem for medically complex patients who see various physicians and require a comprehensive understanding of their conditions. If the patient seeks a longitudinal view of their medical record, they need to collate data from each physician and organize it themselves. In a patient-centric healthcare system, this approach to patient information is profoundly backward. It favours medical service providers over the individual. It is costly and time consumptive. Healthcare institutions do not transfer medical records, forcing patients to repeat information and health examinations every time they visit a new physician or hospital. Physicians report spending as much time on data entry as they do helping patients. Not only is this an inconvenience, missing or lost information can have a substantial impact on emergency situations. Furthermore, the patient does not have control over their private personal data. The individual cannot control who views or uses their data. The way we currently record personal data is a real concern considering an individual’s private information is no longer within their control. While a centralized approach to keeping health records is ideal, it is impossible for hospitals and physicians to create a shared access database. There are currently too many restrictions. This idea was also poorly received by the public as governance, privacy and legal issues arose.
A solution to this problem is to move the electronic health records onto a blockchain network.Every time the patient visits a physician, the interaction enters a ledger that every provider can see. An encrypted block stores the patient's medical data such as their blood, prescription or scan results. This block is shared with everyone on the network and cannot be deleted or altered. If there are changes, it will be immediately detected. The block is then time-stamped and validated by the system. Over time, the blocks grow into a chain of blocks. The result is a clearer medical history of all patients. Patients can access and see their medical history and share the information with their physician.Blockchain also eliminates the potential for someone to mishandle or lose patient records. Medical records on the blockchain, therefore, remain forever authentic and secure.Most importantly, patient-centred medical records, provide individuals the ability to own and control their personal information. They can choose to reveal certain information and for a specific duration to a physician of their choosing. DotHealth, for instance, is a Toronto-based medical startup that hopes to deploy a patient-centred heath records platform in Canada. Founder Huda Idrees believes that patient-focused features like natural language querying enables the patient to remain at the centre of healthcare at all times.Blockchain can streamline the access and sharing of medical records in a secure way that protects a patient’s sensitive data. It also helps physicians gain a longitudinal view of a patient’s history. While this all sounds promising, the introduction of blockchain will depend on the agreement of institutions such as hospitals and clinics to move forward. These organizations need to take an active approach to overcome this technological challenge to build a new healthcare blockchain.Image credit: Wikimedia Commons
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