Clinicians specializing in working with complex issues such as opioid addiction will be supported in previously unimagined ways by some of the newer technologies. The blockchain EHR is likely to be helpful in documenting and tracking the tendency for some opioid patients to “doctor shop” to get prescriptions from multiple doctors.
What is a Blockchain EHR?
Serving as a remedy for the problem-ridden EHR of today, the blockchain EHR is an immutable, centralized ledger that can be audited by prescribers and other professionals and other stakeholders, including the patient. As reported in 5 HIPAA Violation Fines for Failing to Grant the Right of Access, today’s professionals are challenged to make appropriate decisions regarding giving patients legal access to their own protected health information (PHI). While not a panacea, blockchain technology will solve many of these problems and put accurate information in the hands of people who need it to be most helpful to the patient.
The easy access to immutable information is particularly important now, when HIPAA has been relaxed and hackers are active. The promise of the blockchain EHR as a resource is of particular relevance now, when patient privacy is being compromised by the wholesale productizing of consumer-generated data related to health information: MITRE-Harris Poll Shows Dark Side of Insurance Privacy Practices.
With regard to the advantages of the blockchain EHR, in July of 2020, the Healthcare Information and Management Systems Society, Inc. (HIMSS), carried an article by Chrissa McFarlane, Chief Executive Officer, Patientory, Inc.; a HIMSS Digital Influencer, a Blockchain in Healthcare Task Force Member, and an Interoperability & HIE Committee Member. The article was entitled, Blockchain: Unlocking Health Data to Empower Patients and Improve Care and explained:
Blockchain technology could break the traditional siloes of medical record storage and make the process of sharing EHRs significantly easier. A blockchain is essentially an encrypted ledger of transactions, or blocks of data, that are immutable and linked chronologically together in a chain. Copies of the ledger are distributed across a specified network of users, and any additions to the chain are updated for all users in real-time. Putting this technology into practice not only provides security benefits above everything it provides the ability for individuals and healthcare stakeholders to gain access and track recorded health information.
In our imagined world, the transactions would consist of doctor’s appointments, surgical procedures, x-ray images, prescriptions, blood test results, patient-generated health data, etc. Individuals would be in charge of sharing the decryption key for their own associated blocks of data with their chosen healthcare provider(s). Both patients and providers would greatly benefit from accurate, up-to-date and comprehensive EHRs.
Patients in particular would benefit by controlling and perhaps even selling their own data, rather than passively standing by while a multi-billion dollar industry buys and sells their consumer-generated data (CGD) to insurance companies and other interested parties, and pockets the profits. The HIMSS article continues:
Blockchain has the ability to democratize data access in favor of the consumer, eliminating the need for a costly ‘middleman’ in transactions, i.e., a centralized, siloed database. Individuals could not only control access to their medical information but could sell it directly to data brokers themselves. Transparency when it comes to the collection and use of health data will be absolutely essential to maintaining trust in healthcare institutions.
An example of a company developing a promising blockchain application for opioid patients is EHR Data, which uses the Bitcoin network to process its data to enable auditable records for all prescriptions. Stressing the need for patients to own their own data, EHR Data explains that today’s available health apps only store and own a patient’s data or device that records it. This data is often “sold to third-party data brokers who analyze it or package it for other uses. Often, this information is combined with other publicly available data sources from marriage licenses to vehicle registration and even retail purchases and social media. This builds a personal data dossier that you never see or have access to, or have any control over how it’s used.”
The Bitcoin network has the ability and scalability to handle this kind of data. In a company update for September 2020, EHR Data said it is also in the testing phase of building a mobile application, that will give patients access to, and control of, their private health records. The processing and storage of key information in this way is still a few years into the future, but the promise of blockchain EHRs for opioid users is noteworthy.