Blockchain – A potential disrupter for Healthcare Domain

Do you own bitcoin currency? Whether you do or don’t you’ve probably heard of it and other cryptocurrencies that have been rallying a patronage and experiencing a strong hype right now. The technology powering these cryptocurrencies, Blockchain, is nothing short of a disruption and is believed to have the potential to revolutionise the way we do business. Emerging blockchain technology is ushering in a new era built on strong foundations of customer involvement and objective trade.

Blockchain, an open, distributed ledger that can document transactions between two parties efficiently and in a verifiable and permanent way thus taking away the risk of accidental, or intentional, tweaking of data. This is ensured by storing data (or more specifically tokens of blocks of data) on multiple systems as opposed to a centralized server. The centralized server in any case is much more prone to attack and manipulation rather than a set of systems. This is one reason Blockchain is making waves in financial domain. There has not been even a single instance of hacking in Bitcoin due to this supposedly full proof measure. According to recent industry reports, Blockchain has a disruptive potential to drive efficiency, save billions and reduce risk for the banks. 

Some recent innovations that are leveraging the potential of Blockchain technology across sectors include:

1. Financial Industry – Blockchain has the potential to address the age old problem of double-spend without the involvement of an intermediary. This is making transactions like International money transfers, instantaneous and cheap and taking away fraud from Banking system through consortium of banks for Invoice and bank discounting. 
2. Ridesharing – Ridesharing models created whereby there is no need of intermediary like Uber thereby decreasing cost for end-users and increasing profits for car owners. Thus making social, really social. Eg La’Zooz, Arcade City. 
3. Music Sharing – Ujo Music is building a platform (using Blockchain) for artists that allows them to own and control their creative content and are paid directly for sharing their musical talents with the world. This platform made waves when singer-songwriter Imogen Heap released her song using this platform. This allowed users to purchase licenses to download, stream, remix and sync the song. Each payment was automatically split on the Blockchain, and sent directly to Imogen and each of her collaborators. 

There is no doubt that some industries will reap higher dividend using Blockchain as some say that the blockchain will do to banking what the internet did to media. The Blockchain is set to change the entire approach to research, consulting, business analysis and forecast. In my opinion, another industry that relies on many legacy systems and is ripe for disruption is healthcare.

For example, in one of my recent industry interactions during a Blockchain Meet in Gurgaon, India, the industry experts extensively explored and deliberated on possibilities that could be optimized through Blockchain for enhancing the functional efficiency of India’s healthcare system. Some of multiple use cases included Predictive Analysis, Personalized Medical Insurance, Public Health Blockchain, Monetization of EMR, Precision Medicine, Medication Reconciliation, Medicine Counterfeiting etc. Following use cases that need to be underlined are:

1. Medical Equipment – There was a report carried out by Times of India – ‘Private hospitals reuse disposables, make you pay for them’ in February 2017. A parallel can be drawn, between the issue related to reuse of disposables highlighted in this article, and the double-spending problem faced in the financial word. Reusing of disposable is also like double-spending and can be tackled by the use of Blockchain in the similar fashion as has been done in cryptocurrencies like Bitcoin. This, however, does not require just the technology solution but coordination between regulator, manufacturers, hospitals and insurance companies. 

The regulator need to come up with a guideline on having unique codes that manufacturers need to put on every such item. The Blockchain shall have these unique ids in the database and once this is being used by the hospital and invoiced, the Blockchain should mark it as used (just like the money is marked as spent) with details on the usage. Any subsequent invoice or claim to insurance should verify that the mentioned identifier has not been ‘spent’ earlier. 

This solution would have its own set of challenges like discounted cash transactions, but for that, hospitals would need to come out in open. 

As a side effect, this shall lead to better tax compliance due to tracking from manufacturing to end-use. 

1. Patient Data – With HIPAA compliance and now topped with GDPR guidelines, it is mandatory to ensure that patient’s records are treated with full confidentiality, however, with growing need for having patient history easily accessible through central applications, it is becoming increasingly important to ensure the confidentiality of patient’s ever increasing data. Using cryptographic solutions the data of patients can be stored using distributed ledger technology. This additionally ensures that the data is residing on multiple nodes and is not prone to cyber attacks or manipulation. 

Another important use of this data could be to ensure that the patient’s records can be selectively shared with service providers based on the patient’s wish. This could easily be handled through a Blockchain application whereby Patient authorizes the laboratory services provider to just access the list of tests to be performed and any related details rather than the whole history. For this Identity Management concepts used in Blockchain comes into play. 

To top it, this history (that cannot be tempered with) could be used by the insurance providers, to decide on the insurance premium and come up with customized products, thereby, limiting their risk exposure. Individuals shall be rewarded with discounted rates for their healthy lifestyle, thereby promoting a healthy living. 

1. Organ Transplant – One of the biggest challenge for a successful transplant is matching the donor with the recipient. This problem could be addressed by using the Smart Contracts of Blockchain. There could be a Blockchain based application to store the donor and recipient information. Every time a donor or a recipient is added to directory maintained on Blockchain, a Smart Contract could start a search for matching donor(s)/recipient(s) and inform the concerned authority in real time. This shall help save lot of precious lives. 
2. Tracking Switched Outcomes in Clinical Trials – As per study by COMPare just 13% of the clinical trials report results correctly. When clinical trials are error prone, everybody can guess who the sufferer is – patient. Clinical trials run for years and the data is prone to manipulation based on the desired outcome. With Blockchain the trust on Clinical Trials data can be restored. Transparency to all the data shall dissuade those who selectively report good outcomes and make the entire Clinical Trials History available for audit and verification.

Due to its complexity (technological, regulatory and social), the distributed ledger technology will require broad coordination, and reasonable amount of time for the mainstream adoption. There could be number of such applications that could help save cost, time but above all Human Lives. Healthcare is thus one domain that is on the verge of being disrupted by this revolution called Blockchain. What is needed is a close collaboration between Blockchain Evangelists, Healthcare Professionals and Regulators to bring about a paradigm shift in how Healthcare is viewed. 

Sajal Singhal

Guest Author Sajal Singhal, Manager, Product Development, GlobalLogic India, is a business leader with 19+ years of experience in business intelligence, information management, solution delivery, product development, program management and account management for large enterprises. He is working as Associate Vice President at GlobalLogic – A design-led Product engineering Company. He currently heads the Blockchain practice and is an avid speaker at industry events.