How we see it.
Today, fewer consumers really understand what is happening to the information they generate, what is being collected and where it goes. They don't realize the profile and patterns they are creating about themselves through their behaviors and habits. Those more aware consumers are becoming increasingly concerned about their privacy and the monetization of their data by corporations.
Healthcare data concerns are no different and actually may be even more important given the personal nature of this information and the social implications of it becoming public. Data privacy concerns have only been heightened by the recent spate of data breaches at retailers, banks and other institutions trusted to secure their transaction information.
In healthcare, where incorrect or incomplete information may have more substantial implications, the need for the consumer to be actively engaged in managing their own health information cannot be more pressing.
Blockchain and its supporting technologies offer the promise of unique identification and the potential of reduced, if not elimination, of fraudulent use of consumer information.
The fragmentation or silos of your health information is legend. But when you look at it from a systems level form follows function. The islands of medical data we leave sprinkled across the health system as we engage with hospitals and our physicians reflect the visits or the hospitalizations we received in those locations. This is called a facility-centric record. The problems become more apparent when we try to get a complete view of everything we have had done when seeking a second opinion or we are acting on behalf of our children or parents to get a copy of the complete medical record – then the complexity and fragmentation becomes painfully apparent. This is called a patient-centric record. Try to get a complete medical record for yourself or for any member of your family and you find yourself having to sign multiple copies of the same forms and have to go to different physical locations to retrieve your record. This historical method of facility-centered storage is giving way to patient centered records – you, the consumer, is driving that evolution – as you should.
The introduction of Electronic Health Record platforms (EHRs) has digitized the ambulatory and physician offices but has also left significant data/software gaps in post -acute and homecare. Another glaring gap in value is the contribution of Consumer Generated Data (CGD) in the form of surveys and wearable devices (fitbit or other monitors). This data is still a challenge to bring into a uniform patient centered medical records along with your medical information: Silos remain – secure blockchain technologies may provide a framework and solution to support your management of your own data.
Medical data and images are often stored in a variety of incompatible formats and across a range of different systems. The solution for this problem is not to replace highly specialized computer software programs that meet specific clinical needs. The solution is identification and location; to uniquely identify you as an individual and convey that unique identifier across a series of systems so when information consolidation is necessary that information can be retrieved and it can be done in a timely uniform and secure fashion but it "lives" in the original clinical systems from which it was generated.
Block chain offers an opportunity to secure and effect data integration in a very profound way. Blockchain's core design principles include security and encryption of transactions and data. By controlling access and use of that data, trust and transparency become central to your engagement with the healthcare system. By uniquely identifying you and your information the risk of duplication and improper identification is dramatically reduced. This is because block chain, at its most fundamental level, is a high security data management solution that builds trust.
Implementation of a fully auditable person identity layer across your health systems avoids the need for custom data manipulation when retrieving clinical data. The unique feature of block chain to hash # data with a time and date and the ability to make it immutable becomes critical for context sensitive decision-making common in healthcare.
The use of block chain for data integration and identity management is in its infancy. It holds promise for the unique identification of people, patients, and providers. And reduces the risk of misidentification and fraud.
As more consumer and medical data is made electronic it creates new opportunities to innovate. By applying sophisticated pattern recognition algorithms to this data insight begin to emerge. Through artificial intelligence these patterns can be programmed to reduce routine and repetitive tasks. Humans are not alway reliable and can fatigue easily with routine and receptive administrative tasks. This is when errors occur.
Digitizing clinical information now offers researchers and public health officials the opportunity to look at entire at-risk populations more efficiently. This has both a public policy and a financial and service planning benefit so services can be customized to the proper populations and be geographically convenient.
Much of the information that consumers contribute to the healthcare encounter is repetitive and redundant. A person with a secure unique identifier can add personal, health care and insurance information to that secure profile. The Health Information and Portability Act (HIPAA) was created to sensitize both the consumer and industry about the importance of securing patient information. Secure Blockchain wallets dramatically reduce risk and the potential for fraud.
By establishing a unique identity of each of the actors in a clinical exchange the groundwork is laid for further automation. Further automation of mundane tasks like insurance verification, appointment scheduling, school forms, and routine medical attestations required for resumption of activity or employment can all be automated if the parties involved know each other and one can attribute these needs with a visit.
Software applications are emerging that take advantage of this digital information and create new and innovative service offerings for both the consumer and for the clinician.
Block chain has the fundamental design considerations of identity, trust, mutability and transparency. These are essential elements of any event-based system. Aggregation of event-based systems create patterns. These patterns emerge across populations. Patterns across populations provide the basis for automation and depending upon the actions taken based on those events form the basis for artificial intelligence.
Artificial intelligence is the development of insight from patterns of behavior previously unavailable or not visible through other means. In artificial intelligence there is collective learning to improve customer service and clinical outcomes.
This can be seen in emerging software platforms targeted at improving customer service at both the retail level as well as in clinical decision-making artificial intelligence. Pattern recognition is being used to improve clinical care and the outcome of hospitalized patients. This is critically important for the improvement in the quality of care to and improvement in the financial utilization of resources.
The emergence of new digital data and other event-based activities including clinical outcomes are giving rise to entirely new data sets. When examining difficult and at times intractable clinical problems or the social determinants for readmission patterns begin to emerge from these analysis. This data, when properly analyzed, is giving rise to new data-driven service innovations as well as new therapeutic options and new products.
Open innovation is a critical success factor in healthcare organizations. The demands of shorter episodes of service and increasing cost pressure require healthcare organizations to look outside their own industry to consider technologies and processes developed elsewhere. This is a new paradigm for healthcare. Examples in the diversity of technologies being surveyed include robotics, Internet of Things (iOT), big data, artificial intelligence and machine learning.
This is most evident in the emerging field of the Internet of Things (IOT)
New product innovation can be seen with consumers, the healthcare supply chain and in clinical processes. The introduction of low-cost sensors and monitoring devices give rise to entirely new levels of digital insight about the physical world. This data can be a gate to provide insight into a patient's recovery outside the hospital, at home or in a less acute facility.
This flood of new data is stimulating the development of new and innovative care delivery models, outcome-based support, outcome-based reimbursement in improvements and the quality of care. These opportunities to innovate are almost limitless and we will learn much from our successes and even more from our failures.