How frustrated do you get when you have to fill out the same medical forms over and over and over again any time you visit a new clinic or even just enter a new calendar year?
We’ve all been there. Spend 45 minutes filling out paperwork at Dr. A, only to be referred to Dr. B and spend another 45 minutes answering the exact same questions. Or maybe you delivered a thick packet of records to a new clinic, only to have them never digitally input into the new database. How often are crucial patient details lost in translation?
We get patient privacy with HIPAA, but can’t our records be electronically transferred with our permission? Is it always necessary for an act of Congress to share data in this age of technological advancements?
Obviously, that’s an exaggeration, but sometimes it sure feels like such extreme measures are necessary for providers to share medical information. Just last week I found out a friend battling cancer had to sign an affidavit that he will only fill his pain prescriptions at a single pharmacy, no exceptions. It makes no difference that it’s a Walgreens and therefore transactions will be shared throughout the chain’s network, he can only pick up his meds at a single address. Or no more meds.
Somewhat understandably, these demands are being made in response to the opioid epidemic. Legitimate patients are thoroughly inconvenienced to try and stop the few bad apples that are illegally using and selling prescription drugs. Truthfully, though, how many of us have wondered why it must be so difficult to share data while protecting privacy?
It’s not as though our doctors are scratching our diagnoses onto stone tablets. Thanks to initiatives from the folks behind Medicare and Medicaid, 95 percent of U.S. hospitals adopted electronic medical records (EMRs) over the past 10 years. But that system wasn’t designed to share content. For example, there are 26 different electronic medical records systems currently employed in Boston.
This distribution failure causes poor clinical outcomes, increased healthcare costs and potentially poses safety risks. For example, a 2011 US study in colon cancer treatment found that better sharing of medical data could lead to cost savings of approximately 30 percent. Likewise, a variety of studies have demonstrated the hundreds of thousands of hospitalizations caused each year by drug interaction effects, hospitalizations that can be avoided by proper access and distribution of the patient's medical records.
Of course, at the same time, our medical information is often the most private of personal data. We don’t want just anyone – or even just anyone in the medical community – to gain unrestricted access. And even just housing these records in an electronic database puts them at risk.
According to the US Department of Health and Human Services, more than 15,500,000 EMRs may have been compromised last year in the United States alone. Patient medical records have become lucrative targets for hackers and cyberthieves. An EMR is worth as much as $1,000 on the black market.
With the rise and prevalence of "ransomware" and increased frequency of cyberattacks, it’s never been more important to secure our medical records. After all, we can cancel credit card numbers, we can even change our Social Security numbers, but our medical histories are everlasting.
In this age of vast databases and instant information, smart IDs and fingerprint recognition, can’t there be a better way to accomplish both goals? Turns out there is, and the answer is found in quite the unexpected arena.
We’ve all been reading about the roller coaster ride that has become the cryptocurrency market, right? Bitcoin and other digital currencies are rapidly transforming into the universal exchange our global society will use in the future. Well, the same concept is now applied to medical records, and it makes a lot of sense.
How can medical records and Bitcoin have any common utility, you may ask? Well, it’s not the cryptocurrency, per se, but the blockchain technology it’s built upon.
What’s a Blockchain?
The first known blockchain was devised by an anonymous person or group pseudonymously known as Satoshi Nakamoto in 2008, when it was implemented to serve as the public ledger for all Bitcoin transactions. Continuously expanding lists of records, called blocks, are linked together and cryptographically secured.
The Harvard Business Review describes blockchain as "an open, distributed ledger that can record transactions between two parties efficiently and in a verifiable and permanent way.”
It’s thus far been nearly impossible to hack into most blockchains, so they are ideal media for not only currency systems but also medical records. Just as Bitcoin is evolving into a globally universal currency, new blockchain technologies for the distribution of medical records could finally get everyone on board the same ship – saving time, costs and lives in the meantime.
Specialized blockchain software, such as that used by Embleema, can not only track who can access which aspects of a patient’s medical history, but also safeguard who can view and who can alter or made additions to it. Meanwhile, it could also perform continuous data integrity tests to detect and immediately deter any hacking attempts.
Therefore, anything a doctor logs on the blockchain would become part of a patient’s universal record, no matter which electronic system the doctor uses. Thus, any other authorized doctor, nurse, pharmacist or caregiver could also access it without concern for incompatible systems.
Plus, any updates about medications, problems, and allergies would be universally connected to an open-source, community-wide trusted ledger. Instead of just displaying information from a single database, the record could display data from the entire ledger.
If a patient had an allergic reaction to penicillin in Milwaukee at age 2, that reaction would be recorded for a clinic in Tampa to reference when the same patient quits breathing at age 42. And if a person is prescribed Vicodin at a pain clinic in Reno, then tries to fill a similar prescription two days later at a pharmacy in Santa Fe, the pharmacist will immediately know.
The adoption of blockchain ledger recordings of medical records could mean medical staff won’t have to treat cancer patients the same as drug addicts. And really, won’t it be comforting to know that everyone is finally on the same page?
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