Every winter the NHS is in crisis – in fact, you could argue that the NHS is constantly in crisis; the situation simply becomes more acute in winter due to higher demands on the system. In a nutshell, this problem happens because the ongoing and rising demand for healthcare is greater than our system’s ability to provide it.
Growing demands on the NHS come from a myriad of sources: Europe currently is undergoing a demographic shift towards fewer babies being born and we also have a greater proportion of elderly people with more complex health needs; advances in healthcare also mean we expect access to the latest (often very expensive) medicines and treatments and yet, at the same time, public budgets in Europe are being squeezed by austerity measures. Meanwhile, medical professionals are dissatisfied with their working conditions, patients feel powerless to get their needs met and unable to effect change and the overall effect is a lot of suffering – despite the very best intentions of our free-at-the-point of entry system.
So what can technologies like blockchain do to help? The NHS’s problems include not just the structural changes already described but also old-fashioned and inefficient processes which stem in part from the lack of long-term financial investment in the system and the slow-moving process of top-down political decision-making. Typical problems faced by doctors and patients alike include excess paperwork and bureaucracy; frequently lost test results; lack of interoperability between different parts of the system; the burden of compliance with regulation; and perhaps most importantly, not much empowerment or agency for patients when things don’t work.
The properties of blockchain technology make it well suited to fixing some of these challenges. Put simply, a blockchain is just a way of securely keeping track - in chronological order - of all the transactions happening on a decentralised network. This network may be distributed in multiple places – for example, in different parts of the health system like GP surgeries, hospitals or clinics – yet all the people involved in the network can see the same information at the same time. Participants all have access to an identical, shared history of events that cannot subsequently be changed.
Imagine what impact this could have on healthcare. Blockchain is already beginning to bring in significant changes to healthcare systems around the world. In the US, it is being used to speed up compliance with healthcare regulations like HIPAA. Further afield, companies like Iryo are using it to provide healthcare IDs to refugees and migrants who would otherwise not have any way to keep track of their own history of health treatment.
Blockchain can do this because it creates a kind of 'trust layer' where government service providers and citizens can interact more directly and keep track of the status of key activities. One example could be tracking medical test results so they can be shared in real time or sharing medical data between professionals for research purposes. Blockchain could also help with workforce issues like not having to keep re-doing compliance documentation for staff. A huge amount of time and resources are wasted by HR departments on compiling documentation for short-term staff who then move on after a few months in the job. These cost savings alone could be huge.
Other blockchain-based services may help keep patients out of hospital in the first place by allowing them to upload their personal health data from wearable devices so that, for example, a diabetic patient could keep in touch with their doctor to monitor blood sugar levels and modify lifestyles accordingly.
The era of blockchain in healthcare is just beginning and it is certainly not a universal panacea for all the NHS’s ills but the technology already offers the potential for huge changes in the way we organise and look at healthcare.
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