With blockchain, EHR data are stored on multiple data hubs, he said.
Blockchain technology is designed to require data verification, which also makes tampering with data very difficult. It is a peer-to-peer network in which all data are distributed to all users, and anyone can verify or flag the veracity of information, Dr. Ngo noted. Users will reject blockchains with signs of tampering.
“What this does is create consensus,” he said. “To recalculate the information on all these blocks would be very, very time consuming, and that makes it more secure.” Example: In bitcoin, blockchain allows the formation of new blocks every 10 minutes, so altering proof of work for so many chains would be very time consuming.
Smart Contracts
Blockchain’s potential applications in healthcare include smart contracts with vendors or partners. Unlike traditional contract models, which require third-party verification, “with blockchain implementation of smart contracts, you build the checklist into the program. When everything is checked off, it automatically executes,” said Dr. Ngo. “Healthcare is a cumbersome, hugely inefficient and costly system. Blockchain could decrease time for transactions and data transfer, could decrease costs, decrease labor needs through digitization in a trustworthy setting and decrease waste, such as paper.”
Smart contracts for physician reimbursement or bills for equipment could potentially cut out third parties, such as insurance companies, Dr. Ngo suggested. Traditional transactions must go through central clearinghouses, such as banks. In a blockchain, patients could send payments directly to a physician practice or medical organization. Hospitals could also send payments directly to drug suppliers, potentially reducing fees and delays.
Dr. Ngo envisions blockchain technology being implemented for EHR data, consent management, micropayments for medical services, insurance processing and claims, and supply management for medical practices or hospitals.
“It’s not just the blockchain that is viable in healthcare. It’s blockchain and the other elements of advances in technology, including big data, the Internet of Things, artificial intelligence and predictive modeling, that could all improve inefficiency in healthcare,” said Dr. Ngo.
“Currently, medical records are centralized at a hospital or provider, and [with] stakeholders. They all rely on the provider to house the data,” he said. “But not everyone is linked. Can we implement a way to manage health data where [they are] interconnected, and everyone is an equal stakeholder?” Dr. Ngo believes blockchain’s distributed ledger model, in which changing data is nearly impossible, is one way to do that.
“Hospitals need a secure platform to store and share sensitive data. Data may be lost, [they] could be inaccurate, [they] could be mixed up with other patients, and even though it’s a taboo, [they] could be altered,” he said. Blockchain would allow patients to create permissions for who could view their data. “As a stakeholder, you own your data, not just the system.”
