The blockchain disruption

How the technology can revolutionise healthcare by ensuring greater transparency and enhanced data security

Cover Story

By Team HR

The world is in the midst of a revolutionary technology: Blockchain. Invented by Satoshi Nakamoto in 2008 to serve as the public transaction ledger of the cryptocurrency bitcoin, today blockchain technology has VCs investing over $1.4bn in the technology in the past three years. The World Economic Forum estimates 10% of the global GDP is to be stored using blockchain by 2027.

Mohua Sengupta, EVP & Global Head of Services, 3i Infotech

In simple words, blockchain technology is a technology that creates immutable and distributable data records which are shared peer to peer between networked database systems. Blockchain relies on established cryptographic techniques to allow each participant in a network to interact without preexisting trust between the parties. The financial and healthcare sectors are expected to greatly benefit from blockchain. The banks that use this technology save $8–12 billion annually, point out reports.

In healthcare, blockchain can be leveraged to revamp the sector and make it more cost effective, ensure data security and reduce cost. A paper “Blockchain: Opportunities for health care” by Deloitte Consulting LLP, describes blockchain as a new model for health information exchanges. This technology could provide new models for healthcare business.

Says Dr Harish Pillai, CEO – Aster Hospitals & Clinics, India, Aster DM Healthcare, "Till date, 40% of healthcare data is unrecorded or are filled with error that misleads the information, whereby blockchain will help you to solve all these issues to un-scattered patient crucial data, streamline overall managerial process, provide easy access to information, remove outdated system with the latest technology. Some of the key advantages of block chain in healthcare are:

Dr K M Cherian, Chairman and CEO, Frontier Lifeline Hospital

Data security: Blockchain ensures security of patient data. Says Mohua Sengupta, EVP & Global Head of Services, 3i Infotech, “While no technology is 100% secure, blockchain is definitely more secure than the other technologies we use today. Blockchain prevents unauthorised individuals from accessing patients’ confidential data.” Patient updated data: With blockchain technology, patients are able to upload their data and store it securely for future use without being worried about data security or without having to overwrite the earlier data, since all data is time stamped in blockchain.

Sharing data and provide consent to share: In the world of connected healthcare, patients can easily provide their consent to share personal data with various stakeholders as they deem fit, and sharing across nodes is also easy. Says Dr KM Cherian, Chairman and CEO, Frontier Lifeline Hospital, “Each member in the blockchain network has a secret key and a public key cryptographically linked with each identifier. The private key would enable each member to unlock the details relevant to them. Important information is exchanged between different systems in health sector, the current system meets failure often when it has to handle the data efficiently and to provide the required data to clinicians and patients when they demand.”

Direct billing: The blockchain system enables the corresponding accounts and finance department to do direct billing and secured money transactions without the involvement of any third party.

Dr Harish Pillai, CEO, Aster Hospitals and Clinics, India

Claim processing simplified: Claim processing involves multiple parties, including third parties, and hence clearing a claim securely takes time. With blockchain technology, multiple stakeholders can be connected as separate and secured nodes, making approvals and validations easier and hence claim processing is faster and simpler. Sharing public health data even across borders: “Today when the world is struggling to address the cross-border movement of communicable diseases, blockchain comes as a much-needed solution to address the matter securely, without having to compromise patients’ confidentiality,” says Sengupta.

Drug traceability: During the launch of a blockchain-based 360-degree ecosystem for healthcare, Ritu Tyagi, Head of Global Marketing, Healthureum, said, "Drug traceability is a major issue and we believe blockchain technology will keep a track of every stage of supply chain system and easy drug traceability." With the help of blockchain, it will be easier to track the transaction nodes between the key participants like drug manufacturers, wholesalers, pharmacists, medical representatives- thus securing the product information, combating the problem of counterfeit drugs, thus contributing to overall drug traceability on the smooth road. In the long term, a nationwide blockchain network for electronic medical records may improve efficiencies and support better health outcomes for patients.

However, there are various factors influencing the slow adoption of block chain in healthcare.

Major cultural shift – “Although the healthcare sector is slowly getting digitised, healthcare companies still rely on paperwork for many processes. Therefore, it would be difficult for the companies to shift to electronic health records on a short notice. For any industry, altering consumer’s behaviour and changing their routine functions is challenging,” says Dr Pillai.

Healthcare is distributed - At present, insurance payers and healthcare providers are not in sync when it comes to handling records. Therefore, it would be very difficult for them to adopt blockchain technology.

Unwillingness to disclose data- There are several cases where the hospitals are not willing to share their exact cost data with insurance companies. "The prime reason for this is insurance companies charge different rates for different patients," says Dr Pillai.

Only when multiple organisations use it: “It is not just in healthcare, like any new path breaking technology, blockchain is taking its time to be centre of any business. Also, using blockchain technology is advantageous only when there are multiple organisations on the blockchain. This is making the adoption of blockchain even slower. Unlike most new technologies that ensure a first mover’s advantage, blockchain doesn’t,” says Sengupta.

It is only when multiple stakeholders are on a blockchain or on related blockchain, even from different sectors, that the advantages of blockchain technology can be unlocked. For instance, if we take claims processing as a use case, then maximum benefit can be unlocked only when multiple hospitals, health insurance companies, banks, TPAs are all on the blockchain and talking. And it’s a challenge for multiple organisations to take the leap at the same time.

“We expect to see more active participation from the regulators and the Government into the blockchain space to define regulations and provide some impetus for organisations to jump on to blockchain bandwagon,” says Sengupta.

According to Hyperledger’s survey, 42.9% of healthcare organisations suppose that the interoperability of electronic health records will help for faster blockchain implementation; with 28.6% of respondents ready to use this technology in care settings today. There will be increasingly more opportunity to deploy blockchain applications in healthcare. “However, there are also merits to centralisation, including speed, privacy, and more. Knowing when to opt for centralisation vs. decentralisation will be the key,” says Dr Pillai.