Part II: The Patient
In Part one of our series, we explored how blockchain will change the processes internal to a hospital system, we specifically explored the impact to the provider and the administrative processes in order to provide patient care. Before we begin, let us review what a blockchain system provides, and after we will explore the patient journey and how blockchain will not only catapult that journey, but create a more effective process, and more importantly an optimal experience.
Let us refresh our understanding by revisiting our original blockchain scenario presented in part I. We will add a little twist to make it relevant to our patient journey. As presented in part l, Blockchain is a transactional system that keeps track of transactions in a ledger. This can be regarded much like what your accountant does when you are getting your taxes completed. I am sure by now you are asking yourself, a ledger, accountant, and taxes…where are we going with this? There are a few differences to keep track of when one thinks of blockchain. The first is verification and the second is validation. If we think about verification and validation, one will immediately think about a signature of sorts. In using our presented example above, the accountant signs your taxes after completion. When the accountant signs the taxes, they are not only validating the taxes, but are also verifying to the government it was done correctly via their signature. Let us call this the contract. Now let us look at the signature. This holds the most important part of a contract, the validation of the contract itself. Without their signature, a valid transaction does not exist. Of course, this is due to the signature holding the most weight throughout the process mentioned above. While the example above is a little flawed, I choose it for the following reason: taxes are not questioned once an accountant signs them. This is because the transaction is considered not only validated, but verified. Let us now continue with this thought process into the patient journey.
Let us begin with the simplest of the transaction: patient registration. Close your eyes and think of a time when you had to go to your doctor’s office for the first time. You went to the front desk, they gave you a stack of papers that contained demographics, medical history, current medications, etc. You give it back to the front desk, they enter in the system, someone signs off on it and PRESTO! You are now a verified and validated patient in the Electronic Health Record (EHR) system. Now, after you appointment, you are referred to a specialist, you get to the specialist, wait in the lobby, and they hand you…yup, you guessed it, another stack of papers that you literally just filled out yesterday while waiting for your Primary Care Provider (PCP) visit. Of course, as one receives those stacks of papers you might have said to yourself, why me… not again… are we still in the stone age…?
Let us now revisit our tax paying scenario. If a problem occurs and you have to go to another accountant, do they all of a sudden have to redo your taxes? Absolutely not! Why…the answer is simple, they view your taxes as valid and verified. In a nutshell, that is what blockchain will do, not only in the simplest of transactions but also the complex transactions in healthcare. It will enable a patient to keep a verified and validated copy of their medical records that all other providers can trust regardless of the system being used. At that point it will no longer be fill out ten different forms, but fill out one form, current medications.
Let us explore this a bit further and introduce provenance of data. This single term is what would allow my above process to be implemented. In short, the provenance of data is a trail that validates the authenticity of the data being presented, traces back to the origin (source of truth), and all its changes after the creation. This in turn enables the receiver of that data to have confidence it is verified and capable of being reused. Finally, we are out of the stone age!
Let us marinate on this concept: if we introduce this technology and create an ecosystem around it, this in itself will change patient care, record transport, and more importantly, overhaul our health systems for the better. Imagine if you can go anywhere and have valid and verified health records that no one questions their validity on your phone! The implications of that alone change the industry. It is important to note that some of the above mentioned is already occurring, but currently not at the rate that I think will allow its use at its greatest potential.
Now that we have a good understanding of how blockchain will benefit our hospital systems and further add value to the patient journey, in part III of our series we will explore what the integration of all these pieces could look like.