In recent times,
technological evolution has helped most of the sectors to work in a
much faster, secure and efficient way. However, somehow Healthcare Information Systems have not adapted to these changes. Most of those are still
build on legacy systems are burdensome, slow, and most often
Problem with current
Healthcare Information Systems:
- For every
transaction or interaction in the healthcare system,
stakeholders(patients, doctors, insurance providers etc.) have to
spend time filling out forms, verifying identities and information,
whilst meticulously ensuring privacy and security standards are met.
- Most of the
healthcare systems operate in silo and use different formats and
standards for their data. This makes the
communication and exchange of data between stakeholders of different
systems impractical. The result is a fragmented landscape where each
stakeholder keeps their own record of the same data that is slightly
different from every other stakeholder.
- The current system
is incredibly slow, inflexible and woefully opaque. For example, take
the scenario for a claims process. When a patient needs services
from a provider such as: a general practice, a pharmacy, or nursing
home, that provider uses their health plan to determine how much of
the cost they will pay. In order to determine this cost, the health
plan must validate services received from the provider against the
agreement the patient and health plan they have, and then share their
findings with the provider. This only occurs if the provider is
‘in-network’ with a health plan. For a provider to be considered
in-network a complex agreement needs to be negotiated which adds
significant cost to the provider’s administration costs. One part
of these costs are Billing and Insurance Related (BIR) costs which
includes activities like maintaining benefits databases and keeping
records of services delivered. On average, this whole process takes
between one to two weeks if done electronically and takes three to
five weeks by paper
- Current electronic
health record (EHR) systems use centralized databases in which
medical data remains largely nonportable. Centralization increases
the security risk and requires centralized trust in a single
- As cybercrime around
the world is on the rise, healthcare systems also become targets.
Medical records are being stolen and sold on darknet markets where
they are 10 times more expensive than credit card data. In spring of
2017, over a dozen NHS Hospitals and GP surgeries in the United
Kingdom and over 300,000 machines in 150 countries were the target of
the WannaCry attack.Sometimes the threat
to your privacy isn’t outside the healthcare system, but from
within it. Over a million patients’ health records attending London
hospitals run by the NHS Royal Free Trust are being analyzed and
mined by Google with little transparency and no option for
withdrawal. In another case the medical records of 26 million
patients were exposed because the systems being used by thousands of
GPs were not secure.
- With patients’
data being increasingly digitized each day, it gives others even more
opportunities for your records to be accessed without your
permission. The patient has little autonomy to defend themselves
against this and legacy healthcare systems are not properly prepared
to protect patients’ data.
Medicalchain tries to solve these problems (centralization, slow speed and vulnerable network) in the Healthcare Information System. There is a need of creation of a platform that allows interoperability, safe storage of all the data collected by all healthcare agents and secure and efficient exchange of that information between stakeholders whilst respecting the privacy of all those whose information is involved. All this can be achieved by using blockchain technology. Blockchain technology allows for decentralized peer to peer interactions that can be recorded and verified without a central authority.
proposal involves the implementation of a blockchain healthcare
record as an overarching access control manager of electronic health
- When medical data is
generated, for example from a doctor’s notes or patient’s
wearable device, a digital signature is created for verification.
This data is then encrypted and sent to the encrypted cloud storage
where a pointer to the health record is registered in the blockchain
along with the user’s unique ID.
- Similarly, when a
patient’s data is requested, the ID on the blockchain is used to
retrieve the data from the encrypted cloud storage. Patient consent
is recorded on the blockchain as are records of any health
information that is accessed or shared. The data is decrypted and
displayed on the relevant device or application.
- The patient will be
notified every time data is added to their blockchain, or when there
is a request to access the data.
- Most importantly,
the user will be able to grant or revoke access on multiple levels of
their data using their web or mobile applications.
How Medicalchain is
different from competitors:
The most significant aspect from patients point of view is to have the control of their health records. None of the competitors (both using legacy systems and blockchain platform) are able to manage that. For example, the NHS provided DeepMind with hundreds of
thousands of patient’s records without the permission of those
Thus patients must be able to choose who has access to their records and how long they have access for. This way, patient information is not shared without their permission. The only way to
achieve this is for conditional permissioned access to be a core
feature. Medicalchain is the only company that has implemented this using Hyperledger Fabric platform.
Second, there are no
gas costs associated with private blockchains because they use
predefined verified nodes in Hyperledger platform. That way every time a medical record is
accessed or updated, it doesn’t incur any tansaction cost.
Third, it allows the
platform to verify transactions at much greater speeds.
Permissioned Access to EHRs
Compliance Full, verifiable, and immutable records of the
transactions on the blockchain make audits much easier to conduct and
the decentralized nature of the blockchain lowers the risk of
- Private insurers can be granted access to verifiable and
immutable records to check that the patient’s treatment is
consistent with their expectations. As a result, insurance companies
could provide better and lower cost policies if they knew more about
the patient they are insuring by having access to their health
- Licensing EHRs
to Pharmaceutical Companies for Research Users have full access and
control over their EHR on the Medicalchain platform. This could
enable them to license their EHRs to pharmaceutical companies for
research. When used in conjunction with Medicalchain’s conditional
permissioned access system the users will be able to easily set
boundaries on what information companies have access to and how long
they will be able to access it for.
- Enabling Rapid
Response by Emergency Services with proposed Medicalchain Bracelet In
future, Medicalchain plans to introduce a wearable bracelet which
logs user's health data. The bracelet will allow EHRs, or portions of
critical information to be readily accessible by emergency services
(in the case of an emergency situation) using NFC technology.
- Medicalchain as
a Platform will also allow third party organizations and individuals to develop
and showcase their applications within the eco-system.
- Medicalchain is
issuing tokens (MedTokens) to create a new blockchain based
- Using tokens means
that considerable amounts of money are not spent on payment
settlement mechanisms and their ensuing fees in individual countries.
- Patients will use
tokens to pay for the hosting and storage of their record on our
private blockchain powered by Hyperledger Fabric.
- Tokens will be used
to pay for Medicalchain to request and populate a user’s record for
them. Registered doctors and other healthcare professionals will be
rewarded tokens to remotely review medical information and provide
advice or a second opinion on a case.
- Pharmaceutical and
other research companies will reward patients in tokens by having
time limited access to their health record for research and
- Medicalchain’s app
ecosystem will play a role in the spending and redeeming of
MedTokens. Trusted users in the community will have the option to
verify the identity, contact details and credentials of doctors that
are added to our system in exchange for tokens.
- Patients could pay a
premium to have real time information from wearable devices streamed
to their Medicalchain blockchain.