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​Last sector to embrace the cloud – healthcare – could benefit from blockchain


Clinisent's team

By Emily McDaid

Clinisent, a healthcare startup located on Belfast’s Waring Street, has raised a total of £1.65m in the last 18 months. Investors saw the company’s promise as one of the few to be focused on blockchain in health.

Clinisent is revolutionising the use of digital tools in the management of healthcare, examining the innovative potential of blockchain.

Founder and CEO, Andrew Cuthbert, is challenging the status quo in his market. He said, “Healthcare is perhaps the last industry people would think the blockchain should be applied. In general, technology adoption tends to be slower in the healthcare industry, and we believe we can change that.”

One of the areas that Clinisent is trying to transform is the secure flow of health information between providers and patients. Clinisent reported that 100m patient records are soon to be processed by their system.

“A classic argument for the deployment of blockchain might be medical tourism,” said Andrew. “Many regions of the world are known for attracting medical tourists who travel for procedures, for example, hip replacements. The doctor back in the patient’s home country need to access the clinical information or the health record after the replacement. Yet there are no inter-jurisdictional digital solutions that hold data in an effective way across borders. Our product fills this requirement and does so securely.”

I wondered whether this was about empowering the patient to have more control over their own information. Are there privacy implications to letting people hold their own medical notes?

“Data needs to be open and yet anonymous. Data like personal health records needs to be visible to the right people and invisible to others who might have malicious purposes,” said Andrew.

He discussed how blockchain factors in this.

“Public blockchains like Ethereum and Bitcoin are a permanent record – we know data in the chain is accurate, we know who supplied it, and which healthcare provider originated the information. We just have to be careful of size and cost – both important factors when identifying how a blockchain solution might be deployed,” Andrew said.

In some respects the blockchain offers greater transparency -- so I wondered how this affects such a sensitive area as your health records.

“The lack of anonymity has historically been a major sticking point for health care. Private health care networks are jurisdictionally controlled. Some reconciliation needs to happen with that data across territories,” he said.

I asked Andrew to define other use cases for blockchain in healthcare, beyond medical tourism?

“Imagine a scenario where an individual visits A&E within a closed private market, but they have a DNR (do not resuscitate) as a wish,” said Andrew. “The patient has no family present, and being unconscious, has no one to voice their wishes. The blockchain lets us store related advanced care planning data in a way that could be organisationally independent, in theory.”

He continued, “We’ve worked in this area as a key use case and deployed our technology as part of a hackathon on a project entitled ‘Clear Call’. Unfortunately we need to evolve new methods of accessing the chain for the non-technical person, before the use of the technology in this case becomes real.”

If blockchain is to transform healthcare, who would be the winners and losers?

Andrew said, “Those who benefit from high processing costs, the intermediaries – of whom there are plenty – would suffer. For instance I’d expect HMOs to suffer – those who manage payments for insurance companies. As processing costs dramatically reduce, and the cost of analysis would decrease as information became easier to validate, so margins would decrease.”

Andrew continued, “According to the World Health Organization, Americans spend $8,362 per capita on healthcare annually, where Brits spend $3,480.* In my opinion that’s mainly due to the number of intermediaries existing in the payment structures. I believe that HMOs would have to completely change their business models in a world of blockchain. That’s why many of them have called blockchain untested and unsafe.”

Source *http://uk.businessinsider.com/comparison-uk-nhs-v-us-private-heathcare-2015-1

This has been an interesting perspective to see that sometimes, there are barriers to innovation beyond the technical.

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