This article introduces the application of blockchain technology to the management of electronic health records. For other applications of the technology see our articles on blockchain in supply chain logistics and media and entertainment.

The majority of medical records had been mired in the stone-age of paper long after the internet became the standard for sharing information efficiently. Over the past several years, the use of electronic health record (EHR) systems has become more widespread, creating an information network between medical providers, insurers, and customers. Still, the industry is riddled with inefficiencies and questions surrounding the safety and security of personal medical information being sent across the internet

Making the Case

According to the Premier Healthcare Alliance, the current sharing of data between healthcare networks and providers has saved 92,000 lives and $9.1 billion over a four and a half year period, yet hospitals nationwide could save up to 950,000 lives and $93 billion over five years by doing more to share data.

This significant increase in efficiency helps not only patients, but physicians and medical professionals as well. According to a study by the Mayo Clinic, the number of physicians experiencing symptoms of burnout increased just shy of 10% from 2011 to 2014. Among doctors experiencing symptoms of burnout, the number one change they would make is to streamline the EHR system.

These figures provide just one glimpse into the need for improved EHR solutions in the healthcare industry. A Case Study on Blockchain in Healthcare, written through a partnership of Beth Israel Deaconess Medical Center and MIT Media Lab, highlighted the current problem with Electronic Health Records:

“We now face a critical need for such innovation, as personalization and data science prompt patients to engage in the details of their healthcare and restore agency over their medical data…

EHRs were never designed to manage multi-institutional, lifetime medical records. Patients leave data scattered across various organizations as life events take them away from one provider’s data silo and into another.”

Data Control and Verification

The application of blockchain technology to the equation allows patients to have greater agency and control over their medical information, including who it is sent to, when it is viewed, and which parties have access to make changes and updates to medical information. Blockchains utilize many technical functions which provide for both greater security and full transparency.

Once a transaction is entered in a blockchain, it is time stamped and locked, which means that it cannot be altered or viewed without being seen or traced. In the case of EHR records, a blockchain transaction would take the form of any update, change, or access of data or information. This makes it nearly impossible for a malicious actor to change or view EHR information without leaving a trace. As Mike Jacobs, a senior engineer at Optum noted, “As the blocks are added to the blockchain, there is mathematics and encryption used to ensure there’s a secure linkage between logs. The same cybersecurity considerations are at play here.”

Biometric identity verification through the likes of encrypted passwords, fingerprint scanning, and even facial or voice recognition, can be used in conjunction with the blockchain to guarantee the safety and security the system and flow of information. Many blockchain solutions require one or more of these forms of biometric identity verification to unlock access to view applicable blockchain data.

Blockchain, Healthcare and the IoT

With the advent of the internet of things (IoT) which connects physical devices together to gather data, the uses of blockchain to obtain a holistic picture of medical information expands dramatically. Utilizing the security and immutability of the blockchain in conjunction with IoT devices such as wearable heart rate and pulse monitors, enables medical professionals to obtain real-time updates on the status of their patients in order to make better medical decisions.

Medicalchain provides a blockchain-based EHR system which integrates the usage of IoT devices, securing all medical information and data for patients. Through this technology, Medicalchain is also able to provide greater levels of care by through services such as tele-medicine and integrating data from wearable medical devices. The company is in the process of integrating with Apple HealthKit and other common wearable devices in order to give patients and doctors the ability to view data from wearables along with EHR records.

Blockchain Enters the Healthcare IT Mainstream

Interest in this use case for blockchain is not limited to blockchain startups and small companies. Major medical companies are entering the fold. Publicly-traded health IT company MTBC recently announced the release of a new blockchain technology that will be used with the company’s EHR system. As the company’s president A. Hadi Chaudhry noted:

“Right now, every time a physician sees a new patient, a new medical record is created within the EHR used by that provider’s healthcare practice. While this approach is certainly more efficient than paper recordkeeping, issues with interoperability limit physicians’ ability to see patients’ complete healthcare picture as only the encounters within their system are visible…This technology enables medical history to be stored and controlled by the patient through the use of secure blockchain technology, allowing that individual the ability to determine what information members of their healthcare team need to see. This truly puts patients in the driver’s seat when it comes to their healthcare journey.”

The requirement for better patient information led to the creation of a consortium of leading healthcare organizations, including Humana, MultiPlan, Quest Diagnostics, and United Healthcare, which launched a blockchain pilot program which aims to improve the quality of healthcare provider data. The pilot is designed specifically to reduce administrative costs and time constraints, and to improve the quality of up-to-data medical data.

Meanwhile, across the globe, the country of Estonia is working to expand its electronic medical record services. The country already records 95% of the country’s health data and 99% of prescriptions digitally, and is now planning to couple its data collection with blockchain, so “assuring the integrity of retrieved electronic medical records as well as system access logs.” The Estonian government provides a case in which this would be invaluable:

“For example, in an emergency situation, a doctor can use a patient’s ID code to read time-critical information, such as blood type, allergies, recent treatments, on-going medication or pregnancy. The system also compiles data for national statistics, so the ministry can measure health trends, track epidemics, and make sure that its health resources are being spent wisely.”

Improving Healthcare for All

There is little question that the introduction of secure blockchains coupled with healthcare IT solutions will contribute significantly to the improvement the quality of care and efficiency in the healthcare industry. Physicians will be able to access much more detailed patient healthcare records, and patients will have more control over who is able to access and view their medical information.

It is still early in the development of blockchain applications and scaling solutions, but the industry at large has already taken notice, and it may not be long before blockchain solutions are ubiquitous throughout the healthcare industry.