We must discover blockchain as a brand new method to organise healthcare companies.
The potential of blockchain and distributed ledger expertise (DLT) within the healthcare area has been recognised by a number of stakeholders all over the world. Blockchain functions within the healthcare industry span from well being information change and id administration to drug provide chain, from insurance coverage to personalised medicine.1
The European healthcare ecosystems face troublesome challenges, such because the growing old inhabitants, multimorbidity, healthcare workforce shortages, and the rising burden of preventable noncommunicable illnesses.2 Therefore, it’s key to discover blockchain as a brand new method to organise healthcare companies and as such develop extra resilient, accessible and efficient high quality care to European residents.
In this context, healthcare companies can use blockchain-based instruments to enhance well being outcomes, and are broadly recognised as a necessary, not disruptive component to realize sustainable healthcare programs that optimises nurses’ time in help of affected person care wants.3
Health information typically lies inside applied sciences that aren’t interoperable as we speak, thus hindering its wider use.4 More considerably, the usage of people-centred well being information continues to be under-developed throughout the EU.5 The information is commonly untraceable and fragmented throughout totally different areas and programs, with potential antagonistic impacts on prognosis, therapy and follow-up in major care and group care settings. Therefore, a continuity of care strategy turns into essential for healthcare ecosystems as up to date residents well being information are lifesaving for residents, primarily based on knowledgeable choices made by the healthcare professionals.
Healthcare companies and blockchain: advantages for person-centred care
Rather than having one central administrator that acts as a gatekeeper to information, a community of clinicians must have entry to synchronised residents’ well being information, seen to anybody with credentialled entry, giving unprecedented advantages for person-centred care fashions within the EU.
Given the precise options of blockchain in establishing belief, accountability, traceability, and integrity of knowledge,6one of many key functions envisioned is digital well being document administration and change. Blockchain gives attention-grabbing options in well being document administration, because it introduces a decentralised mechanism for controlling and accessing information, whereas additionally introducing a timestamp to the information, in addition to a sturdy audit trails mechanism.7
Compared to conventional databases in biomedical and healthcare functions, blockchain gives clear advantages, together with extra sturdy information provenance fashions (enhancing each possession management and traceability of the origin of a selected information asset); elevated robustness and availability (due to the excessive degree of redundancy offered by the expertise); and improved privateness and safety (due to cryptographic algorithms).8
Blockchain can help the event of person-centred care fashions with particular concentrate on continuity of care, permitting nurses to course of lifetime private well being information. Blockchain’s potential to safe residents’ well being information may give EU cross-border care a brand new dimension of deployment. These developments could cut back the workload of nurses’ frontline, thereby making major and group care extra accessible.9
The European Commission has revealed a suggestion10 on a European Electronic Health Record (EHR) change format that can facilitate residents’ entry to their well being data electronically and securely throughout all EU Member States.
The creation of the International Association for Trusted Blockchain Applications (INATBA) gives a chance for stakeholders to concentrate on the well being agenda and discover sensible blockchain options which might be match for objective, supporting the frontline professionals and delivering higher well being outcomes for residents all through Europe. Blockchain represents a chance to make healthcare ecosystems extra environment friendly, enhancing the standard and security of deliberate and delivered care, and empowering residents and sufferers to raised handle their very own well being.
Added worth for continuity of care
Blockchain has many distinctive traits, three of which make it notably helpful for continuity of care.11 These are:
- Full traceability of any data on the blockchain;
- The potential to make sure information has not been tampered with; and
- Increased safety.
But the benefits of blockchain ought to go approach past traceability and safety. Blockchain ought to construct belief and help frontline employees in planning nursing care throughout medical pathways, ensuring outcomes are recorded with out being an administrative burden, in order that the nurses’ workload might be lowered considerably, particularly taking away the burdensome administrative duties allotted and delegated to nurses. For continuity of care it’s key that blockchain helps the holistic view of nursing care and serves as a single supply of reality – which means that every one healthcare stakeholders can see the identical data to which they’ve been granted entry by the residents and sufferers.
There are blockchain options which at the moment are able to be adopted in routine, actual world eventualities; and most significantly, that are in a position to present an actual return on funding, each in monetary phrases and in precise enchancment within the current workflow. Within this context, it’s important that INATBA Healthcare Working Group explores the actual wants in numerous well being service provision eventualities, and of the environments and workflows through which healthcare professionals operates every day.
The true problem is that the business wants to satisfy with all related stakeholders to raised perceive the prevailing workflows and related shortcomings, to finally co-create and co-design blockchain options in collaboration with the top customers, to affect the way in which through which nursing care is offered in numerous actual world eventualities.
The Research Data Alliance working group on blockchain in well being information administration12 just lately offered a fundamental framework for designing distributed ledger expertise options,13 which may assist innovation and deployment when digitalising the healthcare sector.
Bringing innovation into follow
As a primary step it is very important begin growing the use case by figuring out the issue or alternative the top customers are in search of to handle via the answer and formulate clearly the anticipated outcomes, focusing – when potential – on tangible outcomes to be reached within the brief or medium time period.
Furthermore, it is very important set up benchmarks for future reference, by defining some key metrics to evaluate the outcomes of the brand new blockchain-based system compared with current programs and workflows. For this purpose, it’s of paramount significance to analyse intimately what’s the present workflow for that particular operation and determine the related key efficiency indicator (KPI). This will function the bottom reality for assessing the efficiency of the blockchain-based system, offering proof of its efficacy or additional steering for enchancment or redesign.
Use case: blockchain improves planning of major and group care
Optimising medical pathways via blockchain and synthetic intelligence (AI) are nice alternatives for the nursing career to course of and to retailer nurses’ actions and actions, in addition to monitoring the information that constantly feed into the nursing care course of, and as such higher plan every day actions.
A European society the place a rising variety of folks reside with comorbidities and non-communicable illnesses in want of extra advanced nursing care interventions in group care settings, because the length of hospital visits is compelled to turn out to be shorter and shorter, and in want of extra tailor-made care to handle the unmet wants, can profit from blockchain instruments for group care.
The use case situation helps the design of tailor-made continuity of care pathways, enabling a bidirectional movement of knowledge between sufferers and authorised care actors, making information accessible throughout group care primarily based healthcare networks, and permitting credentialed customers to securely add, with the residents’ consent, to the nodes of knowledge wanted to make the continuity of care operational and efficient.
In the case of power sufferers’ administration, some attention-grabbing initiatives have been launched, combining DLT with novel medical IoT gadgets (IoMT) to facilitate affected person distant administration, self-management, and steady monitoring. Surely the adoption of IoMT might help enhance the standard of care and cut back the prevalence of extreme occasions which could in any other case result in hospitalisation, whereas on the similar time lowering pointless visits to emergency rooms.
Furthermore, the information coming from these gadgets want to answer fundamental high quality and security standards, which DLTs might help obtain by offering components for proving information provenance and integrity, in addition to – and never much less importantly – the authenticity and id of the IoMT system itself.
The present programs of knowledge entry by frontline nurses, who at the moment are spending extra useful time in elevated administration and information assortment moderately than caring for sufferers, is an actual barrier to handle the unmet wants. This provides additional obligations that distract frontline nurses away from the affected person’s bedside.
Blockchain expertise has nice potential to spice up continuity of care with out being disruptive. Healthcare, particularly now we’re going via the COVID-19 pandemic, is in itself already disruptive sufficient!
Blockchain generally is a useful help for the already overwhelmed healthcare sector frontline employees, and notably for the nurses who co-ordinate continuity of care 24 hours a day, seven days per week, 365 days a 12 months. It is due to this fact key that blockchain options improve the interplay between the citizen or affected person and the healthcare supplier, making certain entry to extra correct, full, and reliable well being information, thus positively impacting the supply of extra people-centred and personalised healthcare.
Blockchain options ought to have a optimistic and measurable affect on the nurses’ workloads with a quantifiable rebalancing of duties from administrative help in the direction of care supply. In consideration of the pertinent position that nurses play in major and group care, it’s essential to make sure that frontline nurses can independently ship top quality and secure care by growing (all through the EU) superior capabilities in managing the chain of care.
- Frost & Sullivan Report: Blockchain Technology in Global Healthcare, 2017–2025 – Healthcare Industry Assesses Blockchain Potential to Optimize Healthcare Workflows and Improve Outcome-based Care Delivery Models, June 2017, p.34.
- Communication on Digital Transformation of Health and Care within the Digital Single Market
- eHealth Action Plan 2012-2020
- eHealth Interoperability Framework Study
- Communication on Digital Transformation of Health and Care within the Digital Single Market
- Ribitzky, R., Clair, J. S., Houlding, D. I., McFarlane, C. T., Ahier, B., Gould, M., … & Clauson, Okay. A. (2018). Pragmatic, Interdisciplinary Perspectives on Blockchain and Distributed Ledger Technology: Paving the Future for Healthcare. Blockchain in Healthcare Today.
- Halamka, J. D., & Ekblaw, A. (2017). The potential for blockchain to rework digital well being information. Harvard Business Review, 3.
- Kuo, T. T., Kim, H. E., & Ohno-Machado, L. (2017). Blockchain distributed ledger applied sciences for biomedical and well being care functions. Journal of the American Medical Informatics Association, 24(6), 1211-1220.
- European Social Pillar
- European Commission (2018) Communication from the Commission to the European Parliament, The Council, The European Economic, and Social Committee and The Committee of the Regions on enabling the digital transformation of well being and care within the Digital Single Market; empowering residents and constructing a more healthy society. European Commission, Brussels. (Online) Available from: https://ec.europa.eu/digital-single-market/en/news/communication-enabling-digital-transformation-healthand-care-digital-single-market-empowering
- World Economic Forum, 2019, Building Value with Blockchain Technology: How to Evaluate Blockchain’s Benefits. White paper (p.9).
- The full RDA WG is offered right here: https://www.rd-alliance.org/system/files/documents/Blockchain%20adoption%20evaluation%20framework_0.pdf
Danny van Roijen
Digital Health Director, COCIR
Co-chair Health WG, INATBA
Mirko De Malde
Italian Ambassador, Blockchain In Healthcare Today journal
Co-chair, Health WG INATBA
Executive Director, INATBA
Professor Dr Paul De Raeve, RN, MSc, MStat, PhD
General Secretary, European Federation of Nurses Associations
Member of Healthcare Working Group, International Association for Trusted Blockchain Applications (INATBA)
This article is from concern 14 of Health Europa. Click here to get your free subscription as we speak.