Transforming EHR/EMR Management to Next Level Using Blockchain

1. Transforming EHR/EMR Management to Next Level Using Blockchain Abstract: The management of EMR/EHR of patients in Healthcare industry under a conventional approach is well known. This follows a set of standards and compliances to better manage this area. HIPPA Compliance: This compliance, under several acts, ensures to protect patient's sensitive data and apply a number of protocols like if a provider want to update patient's record then that has to be done within specified number of days etc. HL7 Standards: This applies to ensure data interoperability of patient's records (EHR/EMR) between systems of different providers and it helps when patient move from one provider to another provider for a number of reasons say, for better treatment expectations/facilities or movement required from a speciality treatment to super speciality treatment due to unavoidable reasons etc. In any case, patient health records history always helps to new provider/s to look into patient's EHR/EMR containing past data, when patient moves from one to another provider. Challenges in conventional systems: •Even, it has been said that patient's EHR/EMR data is secure that who all can see patient's sensitive information in any health provider. In current approach, it usually managed with a user/role/access based admin level controls. But, role/access for a user to see patient's sensitive information varies from provider to provider organizations. It is not under control of patients, who are the main actor to decide

2. that who all can see their data or not. The patients just have to rely upon the systems and compliances to assume that their data is secure. •The healthcare systems with every provider are not HIPPA complaint or meet HL7 standards. The provider could be an organization say, hospital or could be a single doctor with some speciality or super speciality. This poses number of major challenges. 1.One, there is good amount of chance that patient's EHR/EMR could skip some very important information about patient health related parameters, which could be fatal in such cases. 2.HL7 being a standard to define technologies to bring data interoperability and in efforts to do so, they keep coming with advance standards with ever changing technologies. At times, there could be potential mismatch between systems of providers when it is required to transfer patient data from one provider to another. The reason is, all providers do not upgrade themselves to newer standards due to various reasons like cost etc. and this acts as an impediment to efficient data interoperability. Hence, technology itself become an hindrance in mankind. 3.Once again, patients have to assume that there health records are safe and secure under HIPPA but they are not sure if through some means researchers are using their health data to work on new innovative medicines/vaccines etc. Let's say, if it is ensured that researchers are not able to access patient's data without being authorized to do so, hence it becomes a major problem for them as researchers need it to carry on their research work and clinical trial etc. Assuming, if it is happening considering everything like patient's consent, providers consent and researchers access etc. but still it happens in good faith. Where is the technology to intervene to make sure that everything is controlled and acting in very interest of all concerned actors of the system. This means, system is controlled and intervened by many actors, while it should be the patients only to allow access to their sensitive information. Moreover, the system could error prone and healthcare industry face such problems time to time. The answers to above mentioned challenges are Blockchain, being introduced as path breaking technology. Blockchain Advantages: A. Using Blockchain the patients themselves can control their EHR/EMR and provide access to others by giving permissions to following. •Providers/caregivers/nursing staff, whom all they want to provide access. In this manner, they know that who all can view their sensitive information. •Once, written over Blockchain, the information can neither edited or deleted by anyone. After having authorized by patients, the providers can write their prescriptions, caregivers can write about therapy provided to patients as instructed by providers and patients can also add notes about their physical conditions to say how much they being benefited by induced therapy or feeling better etc. In Blockchain the data in blocks get added to Hyperledger and these blocks are highly secured with hashing/cryptography mechanism and cannot be hacked by any third party. The EMR/EHR records for a patient will keep on adding in blocks and always available to patients and authorized actors, in a very

3. secure manner. This will eliminate any errors as well as lose of any important data, which in turn, will work in mankind for betterment of patients and other actors like provider, caregiver, payer, researchers will also get their share of pie. •All the authorized entities can view, who have permission from patients, data as Blockchain keeps updating blocks for all who are on Blockchain network. Every user's device connected to Blockchain network, becomes a decentralized node and connected in a peer to peer environment. Hence, no separate user account management required by admin, what is required in case of centralized environments. •In existing centralized systems, researchers receive valuable patient’s data (EHR/EMR) from providers or by some other means to do research work or clinical trials etc. In such a case, data providers could be benefited by researchers. Why shouldn't patients be direct beneficiaries and to be paid by researchers as this data only related and associated to them. Blockchain empowers patients with such benefits and patients, on their will, can share their EHR/EMR records with those researchers, whom they give permissions and allowed access to view their data. Blockchain can also enable researchers to pay benefits to patients in small amounts/chunks of cryptocurrency against their contribution towards research. •Blockchain does not require any HL7 standard to implement for any kind of data interoperability, when patients move from one provider to another, as it has its own way to manage and secure data. This will reduce/might be able to remove providers headaches in future to keep themselves upgrading with new HL7 technology standards resulting into saving cost for them. •All HIPPA compliance related protocols can be implemented well in smart contracts written in Blockchain to maintain patient's data integrity. •Blockchain can also work as key factor in billing against patients health expenditures by secure transaction between provider and payers keeping patient in loop. •The Blockchain Hyperledger can also provide data to centralized controlled admin system so that admin can generate reports, perform data analytics etc. •For now, Blockchain is not going to replace EMR/EHR centralized systems completely, but indeed, it's going to complement existing EMR systems. One such reason is speed of transaction, what need to be well balanced by Blockchain and possibilities are there, but current centralized systems are quite faster in processing of thousands of records simultaneously. There are great opportunities for everyone to use Blockchain solutions in Healthcare industry as projected spending of healthcare entities using Blockchain transformed solution in healthcare by 2025 is $ 5.6 Billion. Healthcare industry in some countries have already started leveraging Blockchain capabilities in their healthcare systems, be it EHR/EMR, Pharmacy or Billings etc