Blockchain is set to alter the course of many industries, and healthcare is no exception.
A new report by PwC’s Health Research Institute, A prescription for blockchain and healthcare, contains a stark but timely warning – it’s time for health to reinvent itself, or face being reinvented from the outside. In particular, the report looks at six healthcare uses, and details three use cases, that could be overhauled with the use of blockchain, the distributed database that engenders trust with its tamperproof construction.
While blockchain could be the key to improving operations and increasing trust, it will take trust in the technology itself – and ecosystem partners – to realise its effects. Health providers who overcome this obstacle, however, face a future of substantial opportunity. Those that don’t will likely lose out to those that do.
The report identifies six areas where healthcare institutions could benefit from blockchain. Even more so than many other industries, healthcare organisations run on complex, data-intensive and laborious, manual processes. As any patient can can tell you, the gears often grind slowly. In part this is because of the many trusted intermediaries needed to handle often-sensitive data.
Back office functions, such as payments, audit and contracts could occur via smart contracts which self-execute on the blockchain, eliminating manual reconciliation and oversight. Patient data, which is spread throughout multiple systems – and often inaccessible between them – could, with blockchain, be pooled and accessed by the necessary entities as decided by the patient. And with R&D, such as in clinical drug trials, data and payments could be automatically processed after upload to the blockchain, eliminating processing delays.
For organisations dealing with third party providers, blockchain could fast track the extensive background and eligibility checks by providing immutable and easily accessed information of trusted information on all parties. For example, hospitals or physician groups hiring a clinician must check their numerous credentials, which can take months and involve contacting dozens of separate entities (such as universities, prior employers, licensing boards etc) all of whom also spend significant time verifying credentials for multiple clinicians.
This delay, where doctors could be treating patients, also causes significant revenue loss for the physician and clinic. Keeping registries up to date is also costly to the healthcare provider, and combined with the added complexity of insurance, burdensome. With an updated record of credentials and insurance information on a blockchain that could be updated in real-time and accessed by multiple players, the process could be accomplished in days.
PwC estimates that US$163 billion to US$217 billion in counterfeit drugs were sold worldwide in 2015. Tracking drugs across the supply chain, from pharmaceutical manufacturers to packagers, distributors, wholesalers, dispensers and regulators is a complicated business. Each part of the process often happens on different systems, with numerous processes and manual handoffs. Given the lack of evidence that a drug that left one part of the supply chain is the same that is received at another and, given the amount of money involved in counterfeit operations, the system is prone to malfeasance.
With blockchain, pharmaceutical packages of drugs could be tracked through each node of the supply chain via identifiable serial numbers. Each company in the supply chain could record transactions as the package passes through, greatly increasing the ability to validate the provenance of the package – and identify at which point things may have gone awry.
Not only would this give pharmacists confidence around the authenticity of their prescriptions and the patient getting their intended medication, regulators would have the added benefit of ensuring that recalled products or warnings can be instantly updated on the blockchain, stopping them from being dispensed to a patient.
As the report notes, citing the previous PwC Global Blockchain Survey, while blockchain intends to overcome issues of trust, it is a lack trust in the technology and its collaborative nature that is hindering its adoption. Blockchain solutions involve multiple parties, and building and governing the blockchain takes collaboration, time and effort.
For healthcare companies there are additional difficulties. Data sharing is fraught with danger – both from a privacy point of view, and a security one. That data needs to be handled, shared and structured very carefully to ensure that all parties have the access they need.
Further hampering trust is the nature of blockchain itself. Its emergent status means that expertise to implement blockchain projects is scarce, and 61% of healthcare companies surveyed reported challenges in a lack of blockchain skills in their teams.
The technology is also one that should be thought of in terms of a larger digital transformation strategy. As the report suggests, “companies shouldn’t just have a hammer – blockchain – and be in search of a nail”. Instead, they need to think about blockchain holistically – about the overall motivation, the business case, infrastructure needs, what their competitors are doing, and ultimately, build trusted networks of partners to begin implementation.
While it is just the beginning of the blockchain revolution, it is important for the health industry to embrace its use in order to effect a revolution of its own. If they don’t, they may find themselves taking someone else’s disruptive medicine.
For further information on the use of blockchain in healthcare, including additional use cases and implementation advice, download the full report, A prescription for blockchain and healthcare.
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