Blockchain-Powered Free Basic Public Healthcare – The Time Has Come

Opinion, Regulation | August 6, 2018 By:

In the global healthcare industry today, medical care access remains the most pressing challenge. Many patients, especially those in underserved markets, often need immediate care yet lack access to a physician or hospital because they either live too far away or are not in a position to pay for services. For these patients, there is no convenient, immediate way to access the healthcare system. Physicians, for their part, want to help patients yet are often not in a position to travel beyond their immediate location to provide care.

Currently, there are more than 100 countries without universal or free healthcare. To make matters more challenging, managing healthcare and patient data within and across multiple healthcare providers is complex, error-prone, expensive and time consuming. So data from thousands even millions of patient visits is fragmented across disparate systems, making it difficult to conduct effective research and ultimately bring better and more effective healthcare solutions to market. And as many of us are aware, unfortunately, most large healthcare institutions simply cannot keep up with the speed of technological innovation. New solutions are needed, and they can bridge the data gap between providers as well as level the playing field and democratize healthcare for all.  This presents an opportunity for blockchain-powered telemedicine.

Telemedicine is a reality in some countries and regions. What has not yet been accomplished is to provide basic healthcare via telemedicine, and without numerous patient obligations, free of charge. By “basic” we are referring to initial diagnosis and/or referral by primary care doctors to specialists — or simply answering basic health questions (e.g., Is this a skin disease or an allergic rash due to laundry soap?).  There are companies that appear to port the traditional, paid, in-person healthcare model over to telemedicine, and while it’s potentially viable, the paid model won’t lead to the widespread uptake in the service needed for it to really “take off.”

Reducing user obligations to a bare minimum and removing the payment component can help increase adoption, but blockchain is the key to incentivizing the other critical stakeholders — physicians, institutions and even government entities — to participate. Blockchain, and more specifically the creation of a universally accessible, public healthcare blockchain, would be the key to driving toward success and creating broader value.

Beyond the immediate benefit of improved patient health, telemedicine with anonymized data automatically captured and stored on the blockchain can drive greater insight that leads to improvements in the medical services, including a dramatic increase in publicly available data healthcare and medical knowledge. At a basic level, a blockchain-based storage solution could deliver:

  • Better Health — With a single, public decentralized database of “borderless” medical knowledge based on real-time and real-world data sets, research could improve and ultimately help bring more effective healthcare solutions to market.
  • Better Data Management — A public healthcare blockchain would empower patients, doctors, hospitals and other healthcare providers to manage industry and highly confidential patient data in a more cost-effective, transparent and secure way than the current standard. Healthcare and related service providers would be able to develop decentralized apps (dApps) on top of the public blockchain to better access and integrate health data into their systems.
  • Full Patient Control and Transparency of Data The public blockchain would give patients complete permission, control and transparency over who has access to their personally-identifiable encrypted medical data. This puts patients in control of the data rather than large healthcare organizations with potentially conflicting business interests.

There are a number of telemedicine solutions on the market today in multiple countries. Many telemedicine companies sell their service, and some have even closed significant funding rounds recently. The free service model based on the blockchain data sharing is more disruptive than anything paid and available today. It also allows for the buildup of a massive amount of anonymized patient data on the public healthcare blockchain, for the benefit of all.

Other telemedicine services require the patient to take the active role of uploading and managing the majority of the data to be shared. This tends to be an obstacle to adoption and hinders the full potential of where telemedicine might go if easier to use and derive useful insights from industry research and patient data.

Finally, incentives for physicians to participate such as access to unique tools (e.g., integrating artificial intelligence tools that automatically update clinical guides with the latest diagnostic and treatment developments),  leading industry journals free of charge, or even new patient referrals would also need to be part of enabling the model.

In the environment of a well-established medical community firmly steeped in tradition, what are challenges to developing this public healthcare blockchain and populating it with patient data that would make it truly useful?  Some commonly voiced initial concerns are legitimate, and our organization and others are working to overcome these challenges.

Initial concerns we typically hear from different parties include:

  • Patient data security – How secure is the technology to protect sensitive patient data, and do the data security standards meet GDPR and HIPAA requirements? Blockchain technology has proven to be highly secure, reliable way of protecting patient data due to its decentralized and tamper-proof, immutability of each data entry. The data security standards of blockchain are capable of meeting HIPAA requirements, and many companies like us are working diligently towards GDPR compliance for even better security.
  • Internet access and technology reliability – Access to not only healthcare but a reliable Internet connection is sometimes a concern; there are a number of companies working on delivering reliable Internet connectivity to underserved communities and populations, some even based on the blockchain, and we stand fully behind them in their efforts.
  • Physician training and licensing for telemedicine – Although we are focused on basic healthcare rather than specialized care, this remains a comparatively new channel for physicians. As the most widely deployed free basic telemedicine network today, one possibility we are working toward is the development of a broadly accepted curriculum and standard physician certification, combining traditional healthcare norms with telemedicine best practices.
  • Cost and billing for services – As we see it, professional basic healthcare is a human right not a privilege, and as such, there should not be a cost. In order to support the free model, the patient’s anonymized data could be leveraged for research purposes. Based on work we are currently doing, there is a clear market for insights from this data in both the private and public sectors. Again, with data encryption, storage on a decentralized  blockchain network, and personally identifiable data choices in the hands of individual patients, security is not a concern. The only way anyone can access an individual patient’s identity is if the patient actively chooses to grant access with his/her encrypted private key.

Finally, private healthcare providers, governments, and medical research and educational institutions could also spend traditional money or cryptocurrency in order to access anonymous patient and/or healthcare data. (This is key to enabling a free model for basic care and is analogous to how Facebook is able to offer a free service supported by ad revenue).

Perhaps the disruptive nature of a blockchain-based solution would offend healthcare establishment to the extent that it is shunned or ignored? That’s not likely. As an organization with more than 50,000 telemedicine patients in over 20 countries, those types of resistance are not what Docademic is seeing. What we are seeing is physicians and healthcare organizations of all sizes, not to mention public entities, becoming supportive of what can now finally be done both in terms of patient care and public health data insights..

What are the next steps in truly getting the free basic healthcare off the ground, in the form of blockchain-based telemedicine? Based on current industry progress, we expect a good portion of most medical facilities to have some aspect of telemedicine in their offerings in the next five years.

We feel strongly that both the need and the technology are there for even quicker adoption, and as that happens, first and foremost the healthcare service needs to be easy to use from both the patient and the physician’s perspective. Patient data must be secure and private, and the service needs to be attractive to not only those in extreme rural settings, but consumers and citizens everywhere in order to drive broad adoption and a robust, rapidly growing data set. Based on the value of insights from the data set, and the fact that institutions and government entities are willing to pay for those insights, the service could be provided free of charge to users.

It is our hope that we can be part of an industry solution to offer free basic healthcare to anyone, regardless of location or economic status, and that we can help transition the world to a better, decentralized and universal healthcare system.