The use of information and communications technology (ICT) in healthcare (eHealth) is intended to improve evidence and value-based health outcomes that demonstrate the net benefits over a full cycle of care. This includes the introduction of operational ICT systems as a source of data for the health information systems (HIS) to achieve a fully comprehensive care in the health sector. This is to provide the health professionals with an integrated view of patient health information (PHI) at the point of care. For this reason, a key source of data for outcome measurements evolves around the implementation of the national electronic health records (EHR) system.

However, the biggest problem to date is that the HIS does not retain data in the form of detailed individual patient record, which require more complex software and training. Instead, the patient data is aggregated into summary totals which obscure the individual patient link, making it difficult to follow patients over time. Similarly, Reda Chouffani at Biz Technology Solutions argues that the blockchain could be used to maintain the links to medical records without actually storing the data on the network. A research paper submitted to the Office of the National Coordinator for Health Information Technology’s (ONC) also makes a compelling argument thereby giving an insight on how the blockchain can be used to maintain the links where the medical record components are stored within the blockchain network.

The main challenge is that the systems that collect, manage and display individual patient data can be difficult to implement especially in low-resource settings, where health budgets are already strained. In the same way, the cutting-edge health services are delivered by organisations structured as they were centuries ago. As one could have expected, this is proving to be unsustainable in the current age of chronic diseases and ageing populations.

In order to address these challenges, the objective is to enable the sharing of patient data between the points of care and provide personalised care that is responsive to the individual needs of the patients. This includes easy tracking of the complete patient health outcomes to guide clinical decisions over the full cycle of care. While the medical practice has for many centuries struggled to fulfil the demands of individual patient rights, the use of electronic health records system is in several countries still in its infancy. To achieve a high-value delivery system in healthcare, there is no other reasonable alternative but to evaluate patient health outcomes and costs at the medical condition level. As such, in the realm of care for chronic conditions alone, IT provides enormous potential to improve care evaluation including self-monitoring.

Advances in IT are changing how individual healthcare is delivered and how health systems are run. The emphasis is on the value for patients driven by eHealth outcomes and cost measurements, followed by the required changes on HIS or the way in which patient care is delivered. Cloud computing has in recent years proved to be a technology of choice in medicine to enable an open digital health ecosystem for collaborative partnerships – breaking down the silos and advancing interoperability in healthcare. However, privacy and security issues have always been the biggest concern for the adoption of cloud computing, big data, internet of things, mobility, machine learning and artificial intelligence in medicine.

The emergence of the blockchain in creating a competitive currency of the 21st century has finally become a reality – thanks to the rise of the cryptocurrency and the prevailing success of the bitcoin. The success of the bitcoin business has strengthened the confidence of the blockchain ecosystem thereby providing insightful ‘unpacking’ of the important privacy and security issues around the use of information in support of healthcare delivery in communities. A strong case has been made by the blockchain technology developers for ‘leap-frogging’ the current impasses surrounding the data bridges in medicine and make use of the emerging technologies that show great promise. While blockchain is capable of revolutionizing many industries, it shows considerable promise within the healthcare industry, according to SANDY HATHAWAY at MedCity News. The blockchain has a potential to reduce the liability and accuracy concerns related to the exchange of medical data and further provides built-in levels of cryptographic security to protect patient identity. This includes addressing legislation, policy and compliance standard frameworks, which are all required to support the development of the national eHealth environment in medicine.

Therefore, the adoption of the blockchain gives a convincing argument in medicine due to its potential for the establishment of the effective IT ecosystem. With the convergence of the blockchain and big data in the cloud, the healthcare industry tends to benefit greatly towards strengthening the health system – thus improving the value for patients in medicine.

Key industry experts including Jennifer Bresnick at Health IT Analytics agree that the blockchain has the potential to unify disparate data sets, breaking down the silos that make it difficult for machine learning algorithms to access the standardized, comprehensive, high-integrity datasets required to perform advanced analytics. Blockchain transforms how businesses operate by decentralizing business models, creating more efficient processes, and providing a more secure and reliable way to exchange data.

Also noted by SANDY HATHAWAY at MedCity News, IBM in partnership with the FDA (Food and Drug Administration) plans to exchange medical data between devices connected to the Internet of Things, and wearables including mobile devices. According to the article by Shaun Sutner at Tech Target, Health IT giant – Philips has also launched a blockchain in healthcare lab and joined a new blockchain in healthcare network led by blockchain vendor Gem. These latest developments serve as a testimony that the blockchain has the potential to solve health IT’s most intractable problems – the lack of interoperability and securing the integrity, completeness and privacy of health records in medicine.

The blockchain is gaining momentum and becoming a common buzzword in health IT circles to overcome the data exchange and security challenges surrounding PHI. Just as in the case for Apache Hadoop for distributed IT ecosystem, the blockchain is also based on open source software, which has been developed to run on commodity hardware – distributed across network nodes. Furthermore, Kamaljit Behera, a transformational health industry analyst at Frost & Sullivan also attest that the blockchain technology may not be the panacea for healthcare industry challenges, but it holds the potential to save billions of dollars by optimizing current workflows and disintermediating some high-cost gatekeepers.

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