Moving beyond the hype? Blockchain in healthcare

31 July 2018

Last week, the new Health and Social Care Secretary, Matt Hancock, said that technology could achieve the ‘holy trinity’ of healthcare. That is, better care for patients, easier service provision for clinicians and lower costs for the taxpayer. Some technology, such as AI, has been adopted by many in the health service to solve specific challenges. In comparison, other technologies have not been used widely but, arguably, have as much potential for answering some of the Service’s biggest challenges.

Blockchain is one such technology. Blockchain is a database distributed across a series of computers that each keep an identical record of the data stored in that database, rather than all data being held centrally. Blockchain has a number of other unique attributes – highly secure, tamper-proof and transparent – making it a reliable and efficient storage of data. These benefits have led to much hype around its possible applications in public services, from supply chains to identity management. Hype, however, has not always lived up to reality. People have looked for something to apply blockchain to rather than finding a specific problem the technology can solve.

One problem that blockchain technology could solve in healthcare is data sharing. This is a priority for government. If the NHS wants to become an integrated, outcomes-focused service, providing holistic care, it needs to link up datasets. In the current system, different organisations each hold their own data. These, more often than not, are stored in siloes leading to inefficiency and inaccuracy. Siloed data storage can have serious implications for care, such as misdiagnosis, which is estimated at between 10 and 20 per cent. It is also highly inefficient, causing delays in surgical procedures if medical history cannot be verified. Furthermore, this type of data storage is frustrating for professionals. A cancer consultant might have to ask for data from CAT scan labs, radiologists, GPs and pharmacists before they can form an accurate picture of a patient’s condition.

There is optimism around the role blockchain could play in addressing this challenge. In a recent poll, over 70 per cent of hospital executives said that blockchain technology holds great promise for tackling data sharing. In practice, this could mean transferring electronic patient records on to a blockchain network. This network could be built across local health areas so that GPs, hospitals and care services could all have access to one, identical version of a patient’s medical records. Blockchain’s distributed nature would mean that when one organisation updated data about a patient this would automatically update all other records held on that patient. A permissioned network could be used with only authorised parties granted access. This, along with  encryption, would keep health records secure, answering one of the biggest concerns when it comes to sharing healthcare data.

A blockchain network for medical records is not science fiction. Countries, such as Estonia, are already using this. In Matt Hancock’s holy trinity, patient care could be significantly improved. All professionals would have access to the same information and because of blockchain’s immutability (once something is added to the blockchain it cannot be changed or removed) patients could trust that professionals know their whole health history. For clinicians, some blockchain-enabled apps for data sharing are showing how much easier service provision could be. Doctors could securely share information with patients, and manage electronic orders and referrals on their phone.

Arguably, blockchain technology use is nascent in the NHS because the NHS is not digitally ready. A recent poll by Royal College of Surgeons found that nearly 9,000 fax machines were still in use across the NHS. The previous health secretary’s ambition to move the NHS to paperless by this year has now moved back to 2023 and electronic health records are not in place in many hospitals. Evidently, the NHS has catching up to do before it can utilise the benefits of such a transformative technology. This does not mean, however, that the Government should not be considering the role this technology could play in their long-term plan for the NHS or start trialling the technology to understand the problems it could solve.

The new Health Secretary has rightly argued that technology presents significant opportunities for improving healthcare. Although in its infancy, blockchain could be one of those technologies. Policymakers should use blockchain to address a specific challenge in the NHS rather than apply the technology for technology’s sake. This blog has considered data sharing. In the coming weeks, Reform will be releasing a series of blogs looking at other healthcare challenges blockchain technology could help resolve.

Maisie Borrows, Senior Researcher, Reform



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