The early 2000’s in healthcare was an important decade for large healthcare organizations such as Kaiser Permanente, UCLA Medical Centers—who were installing electronic medical records (EMR) software for patient charting. Kaiser had the goal to ensure that all 30,000 doctors, nurses, and healthcare support roles would have to use Epic EMR, dubbed HealthConnect, to schedule patients, room a patient, and then have doctors and nurses chart a patient’s visit. What drove the urgency to have an EMR in place? Why did the entire healthcare system undergo such a dramatic shift from paper charting to digital patient record keeping?
Kevin S. Little for Health Care Law tells us what drove the change: The Patient Protection and Affordable Care Act (PPACA), also known as Obama Care.
“Make no mistake about it,” Little asserted in 2013, “electronic medical records are the way of the future for medical practices of all sizes.”
Indeed, in 2009, the Patient Protection and Affordable Care Act (PPACA) was passed into law, and healthcare reform was on its way. Within this act, was a mandate that required electronic medical records for all providers and practitioners to take effect in 2014. And thus with the passage of this law—the race against time to implement and deploy this system was on. In many cases, mandates included in the Health Insurance Portability and Accountability Act (HIPAA) to meet the 2014 deadline.
Hospitals and clinics were frantically installing, testing, and deploying EMR systems like Epic Systems, the largest EMR system in the U.S. EMR’s use data base technology, which collects every bit of documentation entered by the doctor, the nurse, and by staff based on their roles.
Blockchain for EMR
Today, there is optimism in healthcare for the adoption of blockchain with EMR. A number of issues continue to plague how patient charting data and information is accessed, and by whom: privacy and Interoperability.
All patient records are deemed to be private. The Health Insurance Portability and Accountability Act, HIPAA is legislated law that protects the patient from people who want to look into their medical records. Hospitals and providers have a fiduciary responsibility to protect their patient’s EMR data.
Blockchain’s ability to provide a secured, immutable gateway is one area that healthcare executives are looking for answers. With blockchain, a token key can be given to the patient. This will allow the patient complete control over who sees their records.
#Interoperability is another advantage that #blockchain can offer companies. Many large corporations, #regulators, and #healthcare institutions such as the #NHS are insisting on this requirements. pic.twitter.com/oDIm1odGjg
— FarmaTrust (@FarmaTrust) October 16, 2019
A hospital will have many different systems for a patient’s information. Data may be collected by the primary care physician. Or image data is stored by the radiology department. And laboratory results are stored by yet another data system used to enter lab results. Patient data isn’t collected in just one medical center, but also across medical centers in different cities and states.
EMR data can contain volumes of data. In Health Care IT News, Miliard quotes industry experts that patient records contain: “Genomic data, hospital records, immunization records, lab results.”
It’s possible that all of a patient’s record could be put into the blockchain. This will allow the patient to manage their own medical records. With a token access, a patient can give permission to view records from another doctor in a different healthcare system.
Lucas Mearian, says in Computerworld that “blockchain’s interoperability could underpin data exchange, serving as an alternative to today’s health information exchanges.” It can act as a network for securely transmitting patient data for healthcare providers, pharmacies, insurance payers and clinical researchers in near real-time, continued Mearian.
Blockchain has the promise of interoperability to bring all the data pieces together.
Is Blockchain a Reality for EMR by 2020?
It’s apparent that healthcare has been slow to adopt blockchain. Mearian, says that “20% of healthcare organizations will have moved beyond pilot projects and be ‘using blockchain for operations management and patient identity,’” by 2020. Moreover, “even the U.S. Department of Veterans Affairs (VA),” known to be an early adopter of technology– has been slow to dip its toes into distributed ledger technology. This is in contrast to the VA being an early adopter of EMR.
Nonetheless, a “small number of healthcare providers are beginning to consider the technology as a way of leaving behind interoperability issues,” says Mearian.
Blockchain has the promise of being a solution for interoperability and protecting the patient’s privacy. That can now open the doors for a vastly different landscape in healthcare delivery.
With blockchain enabled EMRs, it may not be long before you will be able to see your doctor with virtual visits, and instead of seeing common HMO names like Cigna, Kaiser, or HealthCare Partners, you may begin to see names like Amazon, Apple, Google, IBM, and Microsoft. According to Mearian, these big tech players are “aggressively staking a claim in healthcare and in many cases how blockchain might be applied.”
Kaiser Permanente of Southern California has already pioneered basic doctor services at Walmart. When it comes to healthcare delivery, it’s a brave new world.