The situation in the United States serves as an ideal case study of health care coordination challenges, which even high-income countries with some of the highest standards of living face. In these countries, at least 1 out of every 4 patients are referred to specialists who rely on data provided to them by referring physicians to diagnose and treat them. Yet, 70% of specialists rate the information they receive from other physicians as fair or poor.
The current health care system – from its arduous processes to its lack of coherency – prevents doctors from providing patients with the best care and negatively impacts the care they already deliver. Medical professionals are burdened with attempting to coordinate health care in a system that simply isn’t designed for it.
Around the world, physicians and their staff struggle to coordinate care through antiquated methods – frequently by face-to-face, fax, phone or courier – that may lead to dangerous miscommunication.
Such miscommunication between caregivers accounts for as much as 80% of serious medical errors. In addition, medical records and diagnostic results are often lost somewhere in the care continuum, either during the transfer from labs to providers and to external practices or even within hospital departments, resulting in the inability to coordinate timely and accurate medical care from the providers.
For patients, this persistent lack of care coordination leaves them facing a poor continuity of care, unnecessary testing, delayed diagnoses, inappropriate treatment, and preventable injuries or death. Without coordinated care, patients are less likely to follow treatment plans. This goes doubly for people with chronic conditions who require complex care plans, continuous monitoring and communication. When providers aren’t able to ensure that their patients can understand and follow care plans, patients are less likely to do so, leading to 20–30% of prescriptions for chronic health conditions never being filled, and about half of them not taken as prescribed.
In 2011, the cost associated with poor care coordination was estimated at $25–$45 billion a year in the U.S. alone, and it continues to rise. In general, Americans spent $3.65 trillion – $11,212 per person – on health care in 2018, according to data from the Organization for Economic Co-operation and Development.
The data also shows:
- The level of health care spending, in all respects, is by far the highest in the world. High spending hasn’t, however, equated to the best health outcomes.
- The average life expectancy in the U.S. is almost three years shorter than in other high-income countries.
- Infant mortality is the highest with 5.8 deaths per 1,000 live births compared to 3.6 per 1,000.
Throwing more money at the problem of poor patient care coordination, then, is not the solution.
How blockchain will change the way health care is delivered
Blockchain has the potential to make it easier to put the patient in the center of care, while also making health care more affordable, accessible and user-friendly for all. The technology’s value stems largely from its inherent qualities as a store of immutable data that permits collaboration with instant, secure information sharing. Because of these qualities, care coordination on a blockchain would result in effectively putting control of health care into the hands of patients and their providers, leading to faster care delivery and improved care outcomes.
A proper blockchain-based care coordination model would create an environment that connects patients, family members, care coordinators, providers and other permissioned parties in coordinating care in real time, securely synchronizing all those involved in a patient’s health care journey.
At its most basic level, blockchain-based care coordination enables authorized parties to instantly access medical data whenever and wherever for timely health care delivery. All parties in the health care process can access the data they need without relying on the disclosure of this information by a separate entity. Information is available without delay and updated for all users as soon as changes are made by any user.
The decentralized nature of blockchain means that there is traceability, accountability and transparency in the storage, and the retrieval of patients’ medical data, simplifying the process of planning and executing the health care experience.
The benefits of a blockchain-based care coordination model
When they can be directly involved in their medical care, people are more empowered to be proactive about their health. Blockchain-based care coordination allows patients to interact with medical providers, report on their health conditions and share health data, including from wearable and non-wearable devices – all in real time. Those on a patient’s team, in turn, can continuously track and monitor the patient’s health, deliver treatment recommendations faster (including prescription management and appointment setting), better coordinate care and provide other health care-related services, especially those that benefit from multiparty synchronization.
In addition, since patients have control over access, they can select to authorize family or friends to participate in their care coordination, such as helping to schedule medical appointments, monitor medication compliance or provide feedback on health progress.
Having patient data on a blockchain – a crucial element of a complete blockchain-based care coordination model – ensures that primary care providers and specialists have the resources they need to work together to deliver synchronized patient care.
To make sure specialists receive the patient information that is vital for decision-making, the Taipei Medical University Hospital has introduced a blockchain solution to give patients “a complete set of all their medical records, including high-resolution medical images, lab results, and clinical and health exam information.” Although this is a good start, access to records does not automatically translate into better synchronized patient care.
An ideal care coordination system on a blockchain could go significantly further and provide an ecosystem for secure communication, real-time treatment monitoring and aggregated data sharing among providers, care coordinators, patients and other parties in the health care chain. Providers receive diagnostics, lab results and other data as soon as they’re inputted – accessibility that dramatically improves efficiency – allowing them to synchronize care more rapidly with other medical professionals and work with patients to develop practicable treatment plans.
Providers can use a blockchain-based system to get immediate feedback on whether their interventions are improving patient health, without needing to wait for the patient’s next appointment. They would have more ability to identify and mitigate total risks to patients, to avert health crises and the need for urgent care. With this insight, providers and all those involved in bettering a patient’s health can more proactively deliver care.
Overall, a successful blockchain-based care coordination model will facilitate continuous care oversight, timely interventions and, ultimately, better care outcomes throughout its entire continuum of care, from primary and preventative care to specialist and long-term care.
During the course of our lives, all of us will need care – some of us more urgently than others. What a shame it would be to see technology successfully connect the world but fail to come to our aid when we need it the most.
A blockchain-based care coordination system will help doctors be more effective at providing care, allow patients to control their data and be proactively involved in the treatment they deserve, and enable both the provider and the patient alike to lead more vibrant, fulfilled lives. Blockchain technology is already redefining the entire health care ecosystem, creating a coordinated care network on which the patients control the process. In 10 years, we’ll be asking ourselves how we ever lived without it.