Blockchain technology has promised benefits to the legacy world of health record management. Many startups and incumbent solution providers are experimenting with the technology and presenting various solutions.

However, there seems to remain many challenges. We know that health care and medical research generate mountains of data. Industry pundits’ questions how a distributed ledger can help manage this information efficiently.  As blockchain relies on unique identifiers to link records across individuals, some central ledger may need to ensure that duplicate patient identities are not created.[1]

Can blockchain optimize fluidity and privacy in health record keeping?


Digital identity streamlines access

One of the most promising use cases for blockchain in health care is identity management. Currently, doctors and clinical researchers must manually log into and out of many applications each day, a time-consuming process. With a blockchain-based identity management system, individual log-ins can be eliminated, as each application can access a single digital identity, provided by the user.[2] Blockchain identity management can also be used to quickly and accurately identify patients and staff, with the potential to limit access to information errors, as well as mistakes relating to patient misidentification.

Health records aren’t stored directly on the blockchain ledger. Distributed Ledger Technology (DLT) records a series of hash values that show each instance when a record is accessed or updated. Because it is immediately apparent when a record is tampered with, data security and integrity is improved.

Concrete use cases include the Estonian government’s population health management initiatives. Estonia has recently put all their medical health records online, and the elimination of middlemen in accessing information has resulted in savings in costs, time, and resources.[3] Blockchain provides continuous access to patient records and directly links information to clinical outcomes. Access to a shared and unalterable source of patient information “could more readily identify pandemics” such as influenza, and could result in more efficient responses to disease outbreaks.[4]

Access to information = access to care

Technologies such as use binary (pass/fail) markers, extracted from user information and hosted on the blockchain, allowing applications to verify identity and grant access to records or services in real time without having to reverify or go back to source-of-truth.

As every party’s record is linked to the original record registered on the blockchain, solutions such as KABN help enhance interoperability. At present, for example, medical information for a single patient is stored in multiple databases: at hospitals, in doctor’s offices, and at pharmacies. Blockchain could allow all these records to interact with each other, and generating a single verifiable record of a patient’s health data.[5]

Because blockchain’s systems of data exchange are both cryptographically secured and immutable, real-time access to patient data becomes an achievable goal.[6] In addition to benefits for patients seeking treatment, this has significant implications for clinical research and trials.[7] The ability to distribute patient consent and trial results in real time could also provide significant benefits for researchers by improving data sharing and clinical analysis. Additionally, there are benefits for administration and financial information, as processes regarding insurance eligibility and claims could be streamlined by using DLT.[8]

Patient-generated Outcomes

There are immediate benefits in giving individuals control of their digital identities – this is facilitated by blockchain record management. In health care, there is a chance to take this a step further, as blockchain could give patients a chance to have a meaningful impact on their health outcomes.

There is growing awareness that outcomes are improved when patients have access to more complete data about treatment options.[9] Blockchain’s DLT could provide access to information that patients could use to discuss various treatment options. Blockchain also enables patients to report outcomes in real time following treatment, and this data could also be used to evaluate options for care. In time, wearable technology and blockchain applications will offer patients the chance to generate and gather their own data.

Innovative strategies to manage health records, will foster collaboration and improve patient outcomes. As obstacles are removed and blockchain is implemented in more ways, it will transform health care in ways that we cannot yet fully anticipate.