Blockchain Technology Application: Improving Electronic Medical Record System

American doctors have a love-hate feeling about electronic health record (EHR). On the one hand, doctors can't provide the best medical services to patients without electronic medical records. But on the other hand, the current electronic medical records are more cumbersome and cumbersome, and the efficiency of the physician is also reduced.

In fact, there are a lot of things that can be told about EHR love and hate, and EHR has also led to many problems. There is now a way to solve these problems, namely the blockchain technology behind Bitcoin.

Blockchain Technology Application: Improving Electronic Medical Record System

First of all, why do physicians prefer EHR?

Information is the driving force. Electronic medical records allow doctors to access patient cases quickly, reliably, and safely, and view prescription records and past inspection results. With this data, the quality of several comprehensive professional medical groups such as Mayo Clinic, Intermountain Healthcare and Kaiser Permanente has improved significantly. A comprehensive EHR helps them reduce medical errors, shorten patient stays, and make clinical outcomes better.

In short, if every American can get the quality of care provided by these EHR systems, hundreds of thousands of people can be prevented from dying every year from heart attacks, strokes and cancer.

So why do physicians hate EHR?

The first "electronic medical record system" was born in 1972. In the following decades, electronic medical records were mainly used for billing. The structure and application flow of electronic medical records are neither intuitive nor friendly. for example. Below is an example of searching the EHR interface on Google.

The electronic medical record is some of the necessary information, of course, it seems dizzying.

Due to design flaws in the EHR, the time required to enter and access patient data is longer than the paper medical record. In addition, due to the lack of interoperability in most systems, the important function of connecting an EHR to another EHR makes it difficult for doctors to access patient information from other offices or hospitals.

Electronic medical records are not necessarily very complicated. Application developers around the world can use a complex database to build easy-to-use consumer tools for mobile devices, simplifying every aspect of our lives. Obviously, in terms of necessity, the application of medicine can and must be the next one.

How do we need to improve the current EHR system?

Have you ever asked yourself:

• "Who has my medical record information?”

• "Who is it controlled by who?"

If your medical data is stored on a local doctor's office computer, the answer is that the doctor owns and controls it. In this case, your medical records are not comprehensive and can be accessed immediately by anyone outside your doctor's office.

Now imagine that you have a heart attack or a stroke when you visit a loved one outside the city. Of course, the hospital or emergency department (ED) will call your doctor to ask for your medical records because they don't want to (a) give you a drug that will negatively interact with another drug you are taking. , or (b) You already have the drugs tested in this laboratory. Such an inquiry process, one after another, will obviously delay the treatment and delay the time.

Often, what happens next is shocking: because the life-saving information stored on your doctor's computer is likely to be sent to the hospital by fax. So, when another doctor or emergency center needs your medical information, they are usually obtained by printing. But what if a group of doctors need to treat you? Does the medical team need to share EHR? In this case, your medical data is useful to all doctors in the group.

Often, what happens next is shocking: because the life-saving information stored on your doctor's computer is likely to be sent to the hospital by fax. So, when another doctor or emergency center needs your medical information, they are usually obtained by printing. But what if a group of doctors need to treat you? Does the medical team need to share EHR? In this case, your medical data is useful to all doctors in the group. However, in fact, they are unable to access and share your medical information in a timely manner.

If the patient is going to go elsewhere to treat the disease, the same problem occurs. Even doctors in other hospitals or emergency centers using the same EHR system can't see the patient's medical data without going through the process and without spending hours. At present, there is no easy way to send a patient's medical record to a doctor who needs attention.

It is hard to imagine any consumer giving up their financial control and giving control to the banker or broker. This is your money, you should manage it the way you think fit. But in medicine, even if it is your life, your health, your information does not belong to you, you can not control.

At present, the main beneficiaries of the structure and process of the EHR system are manufacturers and buyers, not patients. EHR providers can open up software and connect software to the system to ensure the comprehensiveness of patient information, so that more doctors can easily access the patient's medical records. But they will not voluntarily do this. Why is this? Please allow us to quote a passage from the book "Mistreated" that I published in 2017:

“Manufacturers of large EHR systems do not want doctors to use integrated systems unless they only use the applications provided by the manufacturer. They are concerned about the impact of interoperability between systems on their business.”

If an EHR vendor allows third-party developers to access their application interface (also known as an API), all of the patient's medical information can be combined into a single integrated system. This is very beneficial for both the patient and the doctor. But doing so will make it easier for doctors and hospitals to switch from one manufacturer to another, thereby reducing the software revenue of these companies.

A solution with the possibility of implementation: blockchain technology

In order to avoid the occurrence of medical malpractice and improve the quality of treatment, all doctors who treat patients should obtain medical information from patients, provided that the medical information is confidential and safe. Blockchain technology can fulfill these needs. The term "blockchain" combines two key elements of its technology: "blocks" are transaction records, or interactive records, using encryption techniques (similar to code-based encryption that is common in medical practice). This block may be a person selling a cryptocurrency to another person at a specific price, just like bitcoin, thus forming a "chain."

In order to understand how blockchain technology can be applied to health care, it is necessary to understand if this technology is used to simplify the transaction of funds.

Research on blockchain technology began in the early 1990s. In 2008, Nakamoto became an extension of the technology in creating (and trading) the current cryptocurrency, Bitcoin. In essence, Bitcoin was born to eliminate the cost, user reliance, and transaction delays of banks as intermediaries. Now, whether you believe Bitcoin is a great investment or a Ponzi scheme, its underlying technology (blockchain) is proprietary, secure, and reliable. Its foundation is equivalent to an electronic public ledger with date and time stamps that can be used to create ownership without the need for an intermediary such as a bank. Therefore, blockchain does not allow an organization to control your financial data. It is an open system in which hackers cannot invade, destroy, or erase recorded data.

Of course, the treatment of patients and the trading of digital currencies are clearly different. The former involves a lot of personal health information. As a result, the patient chain may date back several decades, involving hundreds of visits and tens of thousands of data. It is impossible for doctors to search the entire chain in time for timely access to specific information. But this is precisely a clinically-oriented application that independent developers can create, making the EHR system easier to use and more friendly.

Since the protocol of the blockchain is universal, applications in the healthcare field are compatible and do not distort the data itself. As a result, all providers have secure access to this information, regardless of whether you change your insurance company, doctor or health system. It is important to remember that the underlying blockchain technology ensures the security of information. Today, a hacker who breaks into the emergency room of a hospital can extract information about millions of people, including their medical data, as well as their social security numbers and private information.

A blockchain data node for a single patient is protected with a digital public key or a more complex private key. Therefore, if someone invades the EHR system based on blockchain technology, they are not sure who the data is and cannot manipulate the information as it is now. Similarly, physicians who can see your medical records cannot see information from other patients in the same EHR system, unless otherwise permitted by other patients.

This complex, intuitive technology can eventually be used to replace the current EHR system.

Why is blockchain technology replacing the current EHR system?

A single nationwide blockchain-based approach allows patients to regain control of their own medical information and gain control. Where the patient is going, where the medical data will go, the patient will be assured and the data will be safe as the patient arrives at the new emergency center, doctor's office or hospital. Once new data is entered, the system will be updated in a timely manner. There are currently no similar things for commercial use. This goes back to the chicken and egg problem: if there is no blockchain-based data, developers are less likely to create a solution, unless it can be used in clinical practice, otherwise no one is willing to get information in this form. .

To some extent, patients and doctors are reluctant to tolerate these shortcomings of the current EHR system. Once they ask to change the system, a third party will appear. They need to connect the application to the patient's comprehensive information in a safe and reliable manner. When they mastered the technology, they will develop an electronic medical record that meets the needs of patients in the 21st century.

As a patient, wherever we go, our medical information should go where. Whether it is forcing today's EHR vendors to open their application processing interfaces (APIs) to developers, or requiring all systems to follow the same design standards, it can be done.

One day, blockchain technology will become a catalyst to accelerate large-scale changes in the US healthcare sector. I hope that this day will come soon.