How blockchain could revolutionise health

Rupert Spiegelberg, CEO of Doctorlink, writes about the technology he feels needs to be embraced in the future, as the COVID-19 pandemic triggered an embrace of digital technologies.

When a group of developers launched Bitcoin in 2009, it is unlikely they were thinking about whether or not they were on the cusp of a great medical discovery. After all, the promise of lower transactions fees than those that were on offer from traditional online payment methods at the time, was a concept rooted in finance.

The idea was simple. Bitcoin is a decentralised currency and therefore it can be traded without central banks. All that was required was a digital ledger that could distribute the currency. So not unlike many medical discoveries, when the developers were focusing on one area, they actually made a superior discovery in another. Once the furore around cryptocurrencies settled down, commentators were quick to point out that it might be the underlying ledger, blockchain, that could really have wider applications.

So, what does a public ledger have to do with healthcare and why is it relevant now, over a decade after blockchain was invented?

The question cannot be answered solely by referring to COVID-19 but it is important. The pandemic has created numerous obstacles in providing care, including concerns about viral spread within primary care, potential shortages in intensive care capacity, and challenges obtaining sufficient levels of personal protective equipment (PPE).

In less than two months, A&E attendance fell by half and there were concerns people with serious conditions were staying away and not getting access to the treatment they needed. In response, GP surgeries were advised by NHS England to move to a total online triage system. Now the NHS is undergoing a complete overhaul in how it delivers healthcare and physicians have embraced a rapid roll out of digital healthcare solutions that remove the need for face-to-face interactions with patients, but still enable treatment to be delivered.

It's therefore possible the healthcare sector is entering a new era, one that will see a digital explosion that almost every other industry has been enjoying over the last decade. We all knew for years that demand for healthcare was slowly outstripping existing clinical resource as populations aged and health provision became more expensive. COVID-19 has accelerated this problem by generating extraordinary demand on health systems in a very short space of time, making it clear that technology is the only way to meet these surges in demand.

This all starts with personal data. The more that can be collected and analysed, the better picture of an individual’s health a clinician is going to get. This will make it easier for healthcare professionals to draw more accurate assessments and potentially spot issues before they happen.

We are just at the start of this new era, where personal data becomes the basis of treatments and preventative care. However, despite its potential, data portability across multiple systems and services is a real issue. There is nothing more valuable to an individual than their personal medical records, so making data shareable across services will inevitably raise concerns around the spectre of data being misused.

Currently, data does not flow seamlessly across technology solutions within healthcare. For example, in the UK your hospital records do not form part of your GP records, but the advantages are clear in terms of treatment and preventative care were they to do so. Unfortunately, it is not likely a centralised storage and delivery system will get traction until there is one that can ensure the appropriate encryption and security.

Yet, it is an issue that a technology like blockchain can tackle. This is because the purpose of the chain is to store a series of transactions in a way that cannot be altered or changed. Each transaction is signed with a private key and then distributed amongst a peer to peer set of participants. Without a valid signature, new blocks created by data changes are ignored and not added to the chain. While it does then become a public artefact, inspection of blockchain does not reveal any data, only IDs and hash codes. That is why it becomes an incorruptible digital ledger.

In principle, blockchain might be useful in any situation where we currently trust someone to manage our data in ways that help us to interact. Instead of storing Bitcoin, blockchains could be used to store our medical records. In that way, we would resume ownership of our data, while also allowing others to interact with it at our convenience. Blockchain could therefore play a vital role in underpinning our digital progress and giving health professionals more access to vital data.

Of course, data is useless in itself and intelligence is required to interpret it and find patterns to generate benefits. For example, at Doctorlink we use patient data to assess, prioritise and direct patients to the right healthcare instantly at any time of day or night in a process known as triage. Our online triage algorithms in some GP surgeries have created up to 30% additional capacity in the system simply by making sure the right patients get to see the right healthcare provider at the right time.

Digital transformation is coming to healthcare. We have achieved great amounts in the last decade, but now we are looking ahead to a new phase where technology will be used to enhance clinician’s capabilities and enable them to operate at the top of their licence. Not just by handling more patients, but by handling them more effectively and treating their conditions more easily. Blockchain’s unique ability to both protect and flexibly hold our data could provide the crucial step to enable healthcare to advance with the times.

As a delivery system that can ensure appropriate encryption and security, blockchain could provide us with a platform to securely protect healthcare’s exciting future. With research already suggesting that 55% of all healthcare applications will have employed blockchain by 2025 and with the global healthcare market spend on blockchain expected to hit $5.61 billion per year by the same time, blockchain technologies are set  to become a major factor in future healthcare programs.