Electronic Health Reporter

By Chrissa McFarlane, CEO, Patientory, and Jonathan Fuchs, FACHE, member of the board, Patientory Association.

As we approach a new decade, there are a plethora of predictions being made around the future of the healthcare industry. Healthcare’s journey to value will, of course, continue, however, industry challenges and boundaries (i.e. competitive pressure, lack of transparency, limited patient access and erosion of trust) are still areas of concern and opportunity as the industry progresses.

My education, experience, and journey as an entrepreneur led me to create Patientory to empower consumers with an application they can use to improve their overall health and well-being. We are the world’s first healthcare cryptocurrency and HIPAA-compliant blockchain network, with more than 50 nodes registered worldwide.

I recently sat down with Jonathan Fuchs, FACHE, veteran healthcare executive, who also serves as a board member for the Patientory Association. With more than four decades of experience in healthcare management and operations, Jonathan’s expertise in health information technology, data analytics has allowed him to focus on assisting healthcare startup companies on reimbursement strategies, the impact of data and analytics on value-based care.

Chrissa McFarlane: Jonathan, thank you so much for sitting down with me to talk about Healthcare 2030. Taking a look back at how the healthcare industry has advanced over the past two decades is astounding. However, as we look ten years ahead, I believe a consumer-centric healthcare system will be crucial for industry growth. What do you say to this and how do you believe technologies such as blockchain will lead the way in advancing this mission?

Jonathan Fuchs: Chrissa, of course. To your question, health information exchange will be critical in advancing the healthcare industry and honing in on the consumer-centric approach over the next decade. Blockchain will essentially help with interoperability by streamlining efficiencies, making health care an achievable and cost-efficient reality for all. The ability to transmit patient records safely and securely will, in turn, allow patient data to be viewed by hospitals and other providers in any participating region, city or country meaning the potential of blockchain will be boundary and boundless.  In addition to this, the issues of cybersecurity are also top of mind. The ability to encrypt data (specifically on a healthcare blockchain) prevents unauthorized parties from accessing and reading patient data, even if they are able to access the blockchain itself.

Blockchain technology will help create better privacy standards within the industry.

Chrissa: What would you say are some of the roadblocks to Blockchain adoption?

Johnathan: Until the ability for various healthcare information technology systems to exchange, interpret and use data cohesively occur,  we will continue to see latency in the adoption of Blockchain. The very structure of the technology enables data exchange to happen at a higher level of transfer. Which, currently, electronic servers and EHR systems are not set up to handle the volume or power requirements.  Another roadblock is scalability, blockchain is expensive (for now)and at this point requires more power resources to handle the speed at which it operates. That’s not to say this will always be the case, but it’s definitely true today.

Chrissa: Historically, healthcare has been slow to change. Many would argue that healthcare should be more realistic than futuristic. What do you say to this?

Johnathan: Any industry should always seek innovation. Our industry is doing this slowly but surely. Healthcare is a complicated, interrelated industry that requires multiple aspects to change and evolve before it’s completely “fixed”. Currently, patients don’t have access to data (or the ability to accurately interpret) in order to make the best decisions for their care, especially in emergency situations. The accuracy of the information is also a recurring conversation happening on both the patient and the provider side. While the ability to view data down to the individual patient, physician and procedural level is better than it’s ever been before, there is still a lack of transparency.

What has to happen is to change the way healthcare is paid for and how insurance and providers are reimbursed. I believe if the industry focuses on increasing patient access, implementing better data analytics and addressing aspects outside of the hospital–such as social determinants of health–that impact the clinical and provider positively, it will help the industry advance. Further, the use of data analytics in population health and provider credentialing will improve provider performance in terms of quality, costs, and outcomes of services.  In addition, this should have a major impact on medical malpractice premiums and litigation.  Until these are addressed,  advancement will be incremental and not at the speed that is warranted or expected.

Chrissa: According to Gartner, by 2030, blockchain is predicted to generate $3.1 trillion in new business value globally. However, organizations must avoid missteps that could leave them out of capitalizing fully on Blockchain. Do you agree and if so, what do you believe these missteps are?

Jonathan:  It starts with organizations being cautious of overpromising and under-delivering on what the blockchain technology can do for their organization. They can avoid missteps such as:

1. Having adequate funding,  organization and energy resources   to make it work
2. Implementing then failing (saying you will do something and it doesn’t work)
3. Maintenance cost (it’s expensive and people must understand what it’s going to cost and figure out how to reduce those costs and enhance scalability).

Chrissa: So Jonathan, with this, how would you define healthcare in 2030?

Jonathan: I’ve been watching this evolve for the last 20+ years and I believe when “big business” says “we can’t afford to pay for healthcare anymore” is when the industry will change. Historically, businesses provided health insurance in the era of wage and price controls to attract quality employees. With an expanding economy, workforce requirements demand higher salaries, but at some point, businesses will have to say “enough.” There are initial rumblings on this within the U.S. Chamber of Commerce and its small business constituency.  And JP Morgan, Google and Apple are creating a joint insurance coverage entity to tackle the rising cost of healthcare.

Currently, the GDP for healthcare is hovering around 18% which accounts for almost a fifth of our economy being devoted to the healthcare sphere. This is virtually unprecedented for one sector of the economy to have such a large impact on the GDP. I can’t believe we’ll be able to afford to operate the current system as is much longer without significant modifications to address the multiple issues that confront health care providers and institutions . The present political discussion, when focused on healthcare, provides a window into the complications of modifying the healthcare eco-system. Unless something dramatic happens in 2020, I believe this is the course of the industry as we approach 2030.