Health care costs in the United States represent nearly 20% of the gross domestic product. There is a lack of price transparency within the health care system. As a result, consumers spend more on health care plans, get little in return, and do not fully comprehend the value. In fact, many consumers do not have access to learn about the complex structure and underlying costs within this complex system.
The lack of transparency contributes to health management and administrative systems inefficiencies, misaligned incentives, and a slowed rate of innovation. As Americans live longer and the population continues to grow and age, the burden of the health care system grows exponentially.
Blockchain is a decentralized public ledger based on a consensus algorithm. In this system, information is parceled into blocks and then sealed. Chains of blocks are not stored centrally. Instead, each block is copied and distributed through an entire network of peers. These peers can be individuals, public institutions, businesses, or nongovernment organizations. Each of these peers uses a distributed ledger technology.
The benefits of blockchain include immutability, security, verifiability, resilience, and transparency. This means that multiple copies of a blockchain are kept and managed by consensus across a peer-to-peer network. As a result, no one peer can alter the record of past transactions. From a security standpoint, blockchain is a fundamental cryptological law. Anyone in the world can check to see if the rules of the system are being followed. The distributed nature of the ledger makes it resilient. Even if many peers go offline, the information is still accessible. Transactions are transparent and broadcast to all peers. However, the encrypted nature of the transactions means that privacy is assured. The bottom line is trust. Privacy, accountability, and transparency are all tightly managed. However, potential barriers of blockchain in health care still exist. The potential barriers include limited communication between systems and a lack of trust, both of which contribute to resistance to changing how the health care system operates.
Limited Communication Between EMR Systems
Consumers do not want their health care information to be broadcasted on networks without their consent. Regulations such as HIPAA ensure that patient information is not shared without the patient’s consent. Keepers of the data take safeguards to ensure that the data is protected. Not long ago, patient records were documented on paper by all involved in the patient’s care. Today, paper has been replaced by electronic medical records (EMRs). EMRs are a fragmented system designed to ease the access of patient records and safety. It was created to standardize documentation, prevent errors, and create concise charting. The system stores medical records long-term and retrieves them from any location. However, EMRs have limitations, including the inability to communicate with one another. As a result, data cannot be shared between systems. This creates barriers to patient care management.
Lack of Trust
As technology evolves, health care practioners’ gradient to adopt technology varies and the rationale to adopt technologies varies. In this industry, compliance and regulations are critical. Both provide assurance and guidance for both providers and suppliers. However, consider the adoption rate from paper to EMRs. In 2017, 67% of providers reported using an EMR system. What are the other 33% of providers doing? Change is difficult and it perpetuates a risk-adversity mindset for both users and providers.
Blockchain is a system based upon trust. While this technology is constantly evolving, it carries a certain level of risk. Currently, efforts are being made to audit blockchain transactions since there is no warranty or assurance of accuracy. As a result, more work needs to done to validate applications in the health care arena.
Blockchain technologies can be an effective foundation to help industry redesign organizations, products, and services. A patientcentric strategy provides an opportunity for companies to continue to lead the way to implement regulation reforms with support of policymakers and to push the boundaries through technological advances and innovation.
These efforts are foundational to promote competitive collaboration and continued innovation amongst insurers, healthcare providers, and regulators. Technology changes are dynamic and so is patient care. We all must participate in and support technological innovative programs to further patient care. Blockchain is one possibility to foster the development of a robust health data infrastructure through a verification system, asset movement, ownership, and identity.