Technological advancements have taken healthcare from a basic level to what, in comparison, seems sophisticated and state-of-the-art. For example, MRI, CT, PET and ultrasound technologies have drastically improved diagnostics and treatment in healthcare. Technology’s impact on communication has also radically changed healthcare. Images and information can be sent and received instantly, allowing medical professionals to consult and collaborate with each other regarding a patient’s diagnosis and treatment.
With digital means of recording and accessing patient medical history, continuity of care is easier than ever. With all of the changes technology has brought to the healthcare system, it would seem that patients and providers would be more than satisfied with the level of care and efficiency.
Unfortunately, reality says the contrary. According to a 2017 Gallup poll, over 70 percent of Americans think the healthcare system in the US is “’in a state of crisis”’. Patients, providers, and insurance companies face frustrations daily. Patients struggle to interpret their benefits and get approved for treatment. Denial of benefits and delayed payments plague patients and providers. The problem isn’t a lack of technology, as previously discussed. The problem is a lack of a mechanism to capitalize on existing technology. Information is already digital in the majority of medical offices, and a range of methods for electronic communication already exist. What the healthcare system needs now is a streamlined way of getting information where it needs to go in real time.
Blockchain to the Rescue
At first mention, it may seem far-fetched that blockchain technology would help the healthcare system. Most people know little about what blockchain technology, and if they are aware of it, it’s most often associated with cryptocurrency. Interestingly, the same blockchain technology that makes cryptocurrency possible is being applied in many arenas outside of cryptocurrency due to its ability to securely and efficiently verify and log transactions.
The blockchain is essentially a ledger of events that updates in real time. In cryptocurrency, for example, algorithms verify authenticity of coins, and coins are sent and received once verification is determined. The transaction is then stored in the blockchain. This is appealing to many people for many reasons. One reason is that quicker transfers of currencies are possible when the middle man is eliminated. Algorithms can do in seconds what banks take days to do. Another reason is that information is encrypted, which means privacy and security of information.
In terms of healthcare, a company called Solve.Care has undertaken the challenge of solving the existing problems in the healthcare system using the blockchain. The biggest plagues in healthcare are rooted in the administrative area. Many hours are spent tracking down information that should be easily and instantly available to relevant parties. For instance, it may take days or weeks to receive a letter denying an insurance claim.
According to the Office of Coordination of National Health Information, 50 percent of healthcare dollars are wasted on inefficient processes. Transformative innovation must not only change the current way things are done, it must be disruptive by having a meaningful impact on time, quality, cost and operational effectiveness – it must dramatically simplify and accelerate the process it enables.
There are very exciting ways in which digital technology is creating transformation across the entire healthcare system in areas such as connected health, artificial intelligence (AI), blockchain, mobile data gathering, analytics, digital therapeutics and remote patient monitoring. All of these technological developments will improve healthcare efficiency, but more importantly they will drive the delivery of individualized care and dramatically improve patient outcomes as follows:
Access to Care
Connected health, or telehealth, is enabling the delivery of care to rural areas, where access is often nonexistent or very limited. It is also being used to address growing medical staff and physician shortages by providing access to timely care through collaborative tools such as eConsults. Telehealth delivers faster, less expensive and more convenient healthcare and in doing so significantly improves patient outcomes.
Conventional patient engagement systems display information at the hospital bedside, which is only one of many relevant ways to connect with patients. Companies are now integrating artificial intelligence or ‘virtual’ health coaches into interactive educational platforms, resulting in higher utilization and engagement, and delivering more robust, actionable content.
Remote Patient Monitoring (RPM)
A vast array of innovative wearables and sensors such as the biosensor bra patch, implantable glucose sensor, electronic tattoos and the cardiac mapping vest are revolutionizing remote monitoring capabilities. These remote monitoring systems have the potential to help achieve triple aim goals by leveraging the latest advancements to collect and analyze patient data beyond the bedside. Patients and providers can use smart phones, tablets and apps to remotely assess, diagnose and monitor their patients. Electronic monitoring can be an effective solution to identifying issues as they happen while also enabling more effective tracking of patients post-discharge, improving compliance and adherence, and reducing the number of re-admissions.
Guest post by Fizzah Iqbal, content writer, Incubasys.
After a number of initial coin offerings being launched in the cryptocurrency market, blockchain development companies plan to introduce blockchain technology to the health records (EHR) industry. The Electronic Health Record (EHR) is a digitised version of patient’s medical history maintained by their doctors over a period of time. It includes information on demographics, diagnosis, vital signs, past medical history, progress over time, lab tests and more.
Owing to the de-centralised nature of blockchain system, it securely stores health records and maintains a single version of the truth that cannot be tampered with. This is of significant importance to different medical organisations and individuals like doctors, hospitals, labs, and insurers who can request permission to access a certain patient’s record from the blockchain without involving an intermediary. It offers two-way benefits; first, doctors and medical organisations get access to patients’ details and history without losing any precious time waiting for approvals from any intermediary and provide better patient care based on more accurate data, second, patients have more control over who sees their data.
The biggest challenge faced by healthcare systems throughout the world is how to share medical data with known and unknown parties for different reasons without violating patients’ rights and ensuring data security. Creating a trusted environment for decision-making regarding EHRs is challenging for medical community since each EHR stores data using different workflows which makes tracking data recording rather ambiguous. The growing focus on care coordination and EHR access across the care continuum has raised questions about ways to ensure that multiple providers can view, edit and share patient’s data without violating their rights and privacy in any way.
It’s not only about the problem of data sharing logistics in HER instead every solution that requires serious contemplation in a national healthcare system needs to put patient’s privacy and rights first in their list of priorities. And although laws have made health care data more accessible, vast majority of hospitals and doctors still cannot share data safely and securely. The time has arrived where solutions are needed in which patients themselves control whom to share their data with and where to remain pseudonymous.
Healthcare data is inherently sensitive in nature. Besides that the constant challenges of interoperability, patient record matching, and health information exchange have created opportunities for blockchain development companies to come up with a blockchain-based solution.
Once a blockchain solution is deployed to manage EHRs, it becomes a unified and common backbone for digital health. The biggest advantage of using this backbone is that each hospital or care provider no longer needs a specific version of databases or software to access patient data. Any information presented by EHR on the distributed ledger of a permissioned blockchain would be perfectly reconciled community-wide with the assured integrity throughout without any human intervention.
The use of blockchain technology to manage EHRs reduces the time it takes any medical representative to access patient’s information, enhance system interoperability and improve data quality. It also enables a reduction in overhead costs especially for development and maintenance of legacy health record systems. What blockchain does for everyone in healthcare system is that instead of relying on a designated intermediary for information exchange the de-centralised nature of blockchain allows any approved party to join in and either access information, share or exchange without the need to build data exchange channels between certain organisations.
According to a 2003 report by the World Health Organization (WHO) into medication adherence, about 50 percent of patients with chronic illness don’t take their medications as prescribed. This poor adherence to medication leads to wastage, disease progression, increased morbidity and death, increased burden on medical resources, and is estimated to cost approximately $100 billion per year.
Of course, it can be easy to write this issue off as the patient’s responsibility, and naturally they have a huge role to play in solving this issue. There are, however, myriad factors that contribute to non-adherence of the 4.45 billion prescriptions written in the US each year.
The medication-taking experience is a complex interaction that involves patient, physician and the broader healthcare system, and all of these protagonists need to be functioning together correctly if we are to reach a state where avoidable medical treatment is minimized.
Given that increased adherence would not only greatly improve patient outcomes, but also save the healthcare sector billions of dollars, addressing this pervasive issue should be a priority for the industry. But what really causes it, and how can we improve our approach?
The patient From the patient’s perspective, there are a number of factors that can contribute to the non-adherence of prescribed medication. One overarching theme for patients is patient activation and empowerment. The healthcare system isn’t constructed to ensure patients take on the role in self-management expected of them. Our paternalistic healthcare system can often make patients feel disempowered, and excluded from care decisions.
A poor understanding of both their condition and the medication that has been prescribed can lead to a lack of ownership of and accountability for the management of their condition. In numerous reports, patients are overly concerned about side effects, lack understanding on how to take the medicine safely, and may not understand why it is so important to continue to remain in therapy (especially in asymptomatic non-communicable diseases). Increasing the patient’s understanding of their condition, and the management thereof, can play a significant role in increasing adherence.
Sometimes, of course, non-adherence isn’t a deliberate decision by the patient, but an unintentional side effect due to capacity and resource limitations. For example, problems physically accessing prescriptions, a prohibitive cost, or competing demands on a patient’s time can all result in non-adherence.
Literacy is also a large contributing factor – in the US alone, close to 90 million adults have inadequate health literacy. The consequential lack of understanding puts them at greater risk of hospitalization and poorer clinical outcomes. Their beliefs about and attitudes toward health and treatment effectiveness, together with previous experiences with pharmacological treatments, also affect their level of adherence. Continue Reading