The Impact of Blockchain on the Healthcare Industry

Key Takeaways

  • Healthcare facilities can decrease liabilities with digital identity solutions when patients hold their own identity.
  • Immediately secure transactions with millions of dollars of measurable proof for patients, providers, payors, and regulators.
  • Deterministic fees as low as $1.00 per four hundred thousand transactions
  • Dragonchain can implement blockchain solutions with traditional systems today without drastic changes to hospital infrastructures.

Over the last decade, the healthcare industry has been transitioning its systems into an interconnected environment. There have been some growing pains along the way. In the digital ecosystem, transparency and security are often at odds with one another. Blockchain makes it possible to satisfy both without compromise. Dragonchain makes it possible to use blockchain with the systems currently in use by healthcare facilities.

In the healthcare industry, a transaction can include events or supplies such as an injection, meal delivery, or distribution of crutches. Blockchain allows for each individual transaction to record specified data like name, billing codes, or credentials. When an event happens and it is placed on a blockchain, a timestamp and its origin is applied to that transaction. Once the transaction is on a blockchain it can not be altered and access to the information can only be accessed by specified parties.

From there, multiple providers may be permitted to access the data to view, update, and collaborate on the care of the patient. Validation of patient identity and the credentials of providers makes it possible for patients to control their own data and allow data access only to trusted providers. Patients and providers can further evaluate real-time updates made to the record.

Blockchain offers secure and complete access to a patient’s electronic medical records and protects the data included in Personally identifiable information (PII), Protected health information (PHI), and clinical research. This ecosystem provides real-time efficient workflows resulting in smarter healthcare decisions, validation, and confidence for all parties from patient to payor.

Blockchain does not solve all problems in the healthcare industry but can make an impact in several areas.

Blockchain in Healthcare

Electronic Records

An electronic medical record (EMR) is a digital version of the paper chart that patients have had in the past. The electronic medical record is a per doctor record of medical and treatment history with that doctor. The EMR is localized to a singular location, i.e. a single doctor’s office or the hospital.

The electronic health record (EHR) includes the EMR and all interactions associated with that patient across the continuum of care. It is an all-encompassing record of events and services tied to the patient including physician to physician. When a patient is referred to a specialist by their primary care physician, the treatment provided by the specialist as well as the primary care physician is contained within the EHR. The EHR contains vast amounts of information including imaging, labs, physical therapy services, dietary restrictions, consultations, medications, down to the disbursement of patient socks, and so much more.

The personal health record (PHR) contains the information from the EHR but the patient is in charge of the information. They can add and remove information on their own and they decide who has access to the record. The PHR is an important instrument in-home monitoring.

Electronic health records started in the 1970s at the VA but didn’t become mandatory until 2014 with the passage of the Patient Protection and Affordable Care Act (PPACA), otherwise known as Obamacare. The push for an electronic health record was to facilitate an interoperable network of healthcare institutions that would be able to freely exchange information to care for the patient. In practice, a few issues have been realized.

  1. The connection between multiple facilities is left wanting. Whether it is technology holding interconnected systems back or companies not working together, it has been difficult to get facilities to connect.
  2. Patients do not have control of their own data and as a result, can not disseminate their access. Most EHR systems such as Epic and Cerner will track when someone is in a patient’s chart, but the patient does not know who is accessing their record and why.
  3. Security holes. The repercussion from a hacker holding a facility's entire healthcare database hostage for a few bitcoins has long-reaching effects.

Dragonchain’s architecture provides secure solutions to these issues by connecting electronic health records and giving patients control of their personal health records. Blockchain can ease some of these issues and tackle some other healthcare related problems.

Data Protection

The Private/Public Blockchain Debate

Blockchain provides an optimal environment for the protection of data and aligns with regulations such as HIPAA and GDPR. Information placed on chain is immutable, secure, and transparent. There are, however, a couple of issues. Public blockchains are anonymous but they are not private. If the patient’s identity is linked to any one transaction, then the information is no longer private. Also, public blockchains have yet to provide the level of scalability necessary for the healthcare industry.

The use of a private blockchain may mitigate the public release of health information that is in direct opposition to regulations such as HIPAA. However, a private chain serves as an obstacle to interconnected healthcare systems and transparency. Private chains are centralized and as such have the same issues that plague traditional centralized systems such as storage capacity and security. Like public blockchains, private single database solutions are slow and unsuited to handle high transaction throughput necessary for the healthcare industry.

Dragonchain understands there may be large data sets or sensitive data that can’t be fully distributed. There may be current limitations in how systems are connected that require the data to remain in a controlled environment.

Dragonchain’s hybrid solution, Interchain, combines private and public blockchains to capitalize on the best aspects of both options. Interchain can connect traditional systems like Epic and Cerner to the healthcare facility’s private blockchain. By doing this, the sensitive patient data remains at the hospital level, and, through controlled transparency, only accessible by permissioned providers. The transactional data is then validated and secured to a public blockchain. Breaking up the sensitive data and the validation of that data creates an easily scalable environment.

Patient Controlled Consent

Most blockchains will facilitate a solution for restricted data access. The patient can let a specified doctor or nurse see the data they need when the patient is present and can give immediate and real-time consent.

One of the problems being voiced over patient controlled consent is what to do in cases where the patient is unconscious and unable to give consent or provide keys to their medical record. A possible future solution includes medical biometric bracelets.

Dragonchain’s solution could be implemented now without the need for additional technological advancement and expense.

Access control is where specified certified providers have access to information in the event of an emergency. For example, in the case of an unconscious patient, the certified EMS team would be able to access the records. The interesting thing about the records being in control of the patient and not the hospital is that the EMS team does not need access to the hospital’s EHR system and by extension the record’s for all the patients within the system. The EMS will only be able to see the records of their current patient. In addition, they will only be able to see the data that is pertinent to the EMS team at that time. So they wouldn’t be able to access images from the patient’s OB ultrasound if they are picking them up for a heart attack.

In the event there was some incident of mismanaged data or the EMS team looked at the patient’s data without the patient in the back of the ambulance, at the very least, the patient has the transparency that somebody looked at their records and it can be reported. If something like that happens now, the patient would not be aware of the breach unless it was reported to them by the facility. The facility may not be aware of the breach until an audit revealed unauthorized access. The resulting penalties, fines, and possible lawsuits for the facility don’t go away because the facility was unaware of the breach.

Security

Beyond the fact that consent management and access control facilitate a secure environment for accessing individual records, blockchain is instrumental in securing every transaction with the entire EHR. Every node in the blockchain network must verify and record any changes to the medical record. To tamper with the record someone would need to tamper with every node in the network. In a decentralized public network that can mean hundreds to thousands of nodes and not easily done. Compared to the security of a public decentralized blockchain, a private centralized blockchain does not have the same level of security from bad actors.

The primary goal of Drgaonchain’s architecture since its inception at Disney has always been the protection of business data with blockchain technology. When the architecture was being built there was no way for businesses to benefit from the security that a public blockchain provided because businesses would have never put their own data, let alone its customer’s data on a public chain. The same can be said for healthcare data. Putting sensitive data on a public chain, even if it is encrypted is risky. The hybrid solution that the architecture supports brings these two areas to consensus.

Ransomware Attacks in Healthcare

Modern healthcare systems are not immune to hackers. There have been a plethora of reports of data hacking where someone commandeers the facility’s systems, takes its data, and holds it for ransom. Medical records are valuable due to the vast amounts of information.

To combat the risk from these phishing scams, most healthcare facilities institute education and punitive policies directed at staff. Repercussions for the staff who unknowingly release a virus may help mitigate the problem as the staff may be more aware, but human error and fallibility are still issues and still put EHR at risk.

When you don't have to pay a ransom and you have a lot more power.

The question of to pay or not to pay for the healthcare facility is literally life and death. Dragonchain’s solution involves controlled and secure decentralization of data that can be but doesn’t have to be, dispersed across different cloud environments. The more decentralization you can make data, the harder it is for someone to attack it because they have to attack all of the multiple places. As an added layer backups of traditional systems are in place to recover entire systems with little downtime. Lowering the risk to the facility of storing data in one centralized location will help thwart those attacks.

If the hacker does get some piece of data from the facility none of the acquired data would be visible without consent making the data unusable and therefore of no value. Dragonchain provides a solution that allows for healthcare businesses to protect data the way they already do, but by instituting Dragonchain’s platform, broad access to that data is controlled. Dragonchain leverages Interchain to connect the systems a facility uses now with its own blockchain to provide immense security value without exposing any customer data.

The proof of that data is aggregated into Bitcoin, Ethereum, and any other current interchain. A single system would be able to leverage millions of dollars of security in a day and billions of dollars worth of energy and security in just a few months, per transaction. A business would never think to or couldn’t afford to provide that much security for one single transaction. The fee for this security is deterministic and a healthcare institution can run 400,000 transactions for as low as $1.00.

Consumer Identity

For the Individual

Decentralized Identity and the control of data is a crucial part of the personal health record (PHR). With a decentralized identity, patients can own their own data and identity. Clashes of security protocol across different systems can be alleviated when the patient, not the facility, is the owner of the data. The patient decides who gets access to which personal data and for how long. The data can be incentivized by the healthcare facility and the patient can be compensated.

Dragonchain takes a unique approach to decentralized digital identity solutions. In operation since 2018, Factor is extremely flexible and powerful. By breaking up people's identity into individual factors, the person can release only what is necessary to only who needs it. A factor includes things like your first name, your full name, your birth date, etc. Dragonchain takes it one step further with derived factors. Derived factors can attest that you are a certain age, 21 for example, without revealing your birth date.

For Healthcare Organization

Factor goes beyond CCPA, HIPAA, and GDPR compliance. Healthcare organizations can mitigate their risk of storing patient identity information with a decentralized identity. Data is a valuable resource that bad actors will attack when accessible. When data is stored by the healthcare facility, the facility is vulnerable to data breaches. With Factor, a person's individual identity components are not stored within the organization, but with the patient, decreasing the liability for the organization.

Factor is used with third party identity providers to certify identity to the level that a facility requests. In some cases, a facility employee can act as that third-party and verify that the individual is as they claimed. For instance, a hospital registrar can attest that they have seen a driver's license or some other form of ID. The registrar then becomes the third party as the hospital has protocols in place for verification.

Dragonchain can implement Factor into any user-friendly application through a RESTful API integration to make it easy to use for the non-technical individual. The most important part of a decentralized identity is it has to be usable by the patient and by the healthcare worker. Patients should not worry about private keys or mismanaging data.

Research and Development

Research and development is an area of the healthcare industry that can benefit greatly from blockchain. To replicate clinical studies, researchers have very specific bookkeeping requirements. Every aspect of a study from the participants and their characteristics to results and statistics must be meticulously ledgered. Clinical research includes more than actual trials. Recruitment, screening trials, and reviews all must be documented. By putting it all on chain, you can prove every step of the entire process was connected as outlined and has not been tampered with.

With the entire process on chain, it now becomes cheaper to replicate the study for review. The peer-review process checks for validity and can be incentivized to increase peer review pools. A reputation score for reviewers can further ensure research is reviewed by reputable peers with knowledge in specified areas.

Another advantage of having everything on chain is in situations where there is a lot of “red tape” to adjust processes. In these cases, if any part of a process is changed, it can be a massive expense as the entire process has to be reevaluated, not just the part that is adjusted. Blockchain can allow you to prove that nothing has been altered throughout except the part that is intended.

Enhanced Monetization

Blockchain brings the ability for incentivized enhanced monetization via micropayments and/or tokenization.

If a patient has a certain characteristic that matches criteria for a research study, the provider can ask the patient if they may use their anonymized data, exposing only what is agreed upon. Agreed upon terms can be defined by the provider and the patient and in turn, the patient can be paid for that data.

Incentivizing patient behavior to be more healthy, to be more accurate in the way they're taking their medicines, or to arrive at an appointment on time will benefit the provider as well as the patient.

Monetization for tasks or access can be in the form of a deduction on a service like an imaging scan, VIP service, or premium parking for repeat patients. The possibilities are endless and can assist is better engagement and better outcomes.

Value-Based Healthcare

The recent shift from fee-for-service type reimbursements to value-based reimbursements has thrown some providers for a loop, especially given the push for the transparency of the chargemaster, which is a fee table. The chargemaster doesn’t often align with what is charged and reimbursed.

The value-based payments model is based on patient satisfaction scores and outcomes and has created an environment where healthcare providers throughout the entire hospital and third-party vendors must provide a cohesive experience for the patient. All parties must also now share in the financial responsibility.

“While these relationships are appealing, there is the risk that they will be unprofitable if not structured properly,” said Layna Cook Rush, Shareholder, Baker, Donelson, Bearman, Caldwell & Berkowitz, PC, in a recent survey from Managed Healthcare Executive.

The lack of interoperability within the healthcare industry is apparent as a single patient now has multiple partners responsible for improving their outcomes. There is a critical need for frictionless coordination in all aspects of patient care.

In the same survey Kim Bell, senior vice president of health services, NFP, an insurance broker and consulting firm explains how to meet these challenges facilities must, “Consider what can be done differently to enhance efficiency and effectiveness, both in terms of improving what is working and fixing what’s not.”

Dragonchain would be instrumental in providing the interoperability necessary for the systems currently being used now. The need for coordination in the collection, analyzing, and sharing of medical data can be accomplished within the regulatory environment of HIPAA and maintain privacy.

The transition to a value-based payment schedule doesn’t have to be daunting. With the inclusion of blockchain-based interop along with a decentralized identity in Factor, Dragonchain creates an environment where the patient, the provider, and the payor are all working together, resulting in a cohesive relationship and better scores.

Supply Chain

Tracking and traceability for supplies such as ventilators, pharmaceuticals, and masks provide a chain of custody. Detailed information on the source, where the product has been, and who interacted with the product can all be ledgered to a blockchain. For the medical industry, a supply chain secured by blockchain can be instrumental in swift recalls as detailed reports will show where that drug or equipment is at that current moment.

Proof of Shipping

Identifying counterfeits will be easier as authentic supplies are identified with a serial number that is recorded on chain. The chain of custody will show when those supplies are shipped, where they are going, and the signature of the entity that shipped them. Proof of shipping is auditable and trackable from supply production to use.

Proof of Inventory

Supply chains can be automated with smart contracts for inventory and reordering capabilities to keep supplies at par levels. Dragonchain smart contracts can be written in any coding language so that healthcare facilities can benefit today.

Emergency management systems can benefit from a blockchain-based supply chain. Facilities are good at getting equipment when needed however some breakdowns occur with proving equipment or supplies are available and if they got to the desired location. Provable tracking of inventory levels, such as test kits, ventilators, generators, and usage rates, delivers a clear picture of all available emergency supplies, and how these supplies should be distributed based on priority Actual proof of what is available on the shelf at all facilities can save time and money and ultimately lives.

Interoperability

One of the biggest problems facing blockchain’s inclusion in healthcare is a lack of interoperability. This is a problem between traditional systems like Cerner and Epic, not just blockchain systems. In our hyper-connected environment, this is an area where the healthcare industry can’t afford to fail.

The biggest benefit of an interoperable system with Dragonchain is the integration with those traditional systems right now without the need for any system to change processes. Dragonchain can interop traditional systems to each other which is something that the healthcare industry is struggling with.

Interoperability includes more than EHR connectivity. IoMT devices that plug into the Internet or devices that are monitored at the hospital like cardiac monitors need to be able to connect to hospital systems as well.

Dragonchain can integrate with those systems as well as at-home devices, including ones that are not networked at all such as a pulse oximeter to provide proof that the patient took their vitals and these are the results.

People often consider proof to be a purely legal term. For Dragonchain, the term proof can simply mean there is proof of an event. For instance, if a patient enters a blood glucose level into an application from home the doctor can see that the patient entered the level, everything looks good, and can accept the results. With this ability, self-monitoring is now provable. This potentially helps a lot with telemedicine, which is finally seeing some progress in recent months.

Telemedicine

Not unlike the inclusion of blockchain for the EHR, telemedicine can also see great benefits from blockchain. Blockchain-based digital storage can accommodate the largest audio and video files associated with telemedicine visits. Cloud storage can provide the infrastructure needed as EHRs are not equipped to handle increased data stores.

Smart contracts can also be used for managing the revenue cycle, verifying data, and insurance coverage. Claims can be reimbursed in real-time at the end of the call, resulting in lower costs and reduced time.

Insurance Providers

Interoperability with the insurance companies to directly interface with providers will have a direct effect on reimbursements.

The possibility exists for real-time pre-verification of services per patient, saving the provider time on the front end and money on the back end. It is also possible to consider treatment options that are best for the patient from a health cost standpoint. For example, maybe the provider prescribes a specific medication. In a normal environment, the patient would then go to the pharmacy only to be told the medication is not covered by their insurance company. If the provider knew at the time the prescription was written that it would not be covered, an alternate medication could be used without delay or increased expense.

Insurance companies can stay ahead of the game with micropayment payments. They may choose to pay upfront in real-time for preventive services to mitigate the need to pay for a more serious outcome down the road. The improved medical adherence based on compliance or general health helps not only the insurance company but the patient and provider as well.

Before blockchain, providers would have to wait for reimbursements on medical services rendered which could take 60-90 days or more. With the advent of smart contracts, information stored on a blockchain, likely in an automated fashion, can be processed in real-time. If conditions specified in the smart contract are met, events are triggered and payment can be disbursed.

Blockchain makes the healthcare experience more secure and efficient. With Dragonchain’s Proof Systems, healthcare organizations can prove that an event happened, when it happened, who it happened to, and who provided that service. On top of that, Proof Systems make it possible to prove compliance in the copious amounts of regulations that face the industry.

Healthcare Regulation

In the United States, the Department of Health and Human Services (HHS) oversees regulations on healthcare. Several regulatory bodies fall under the HHS including Centers for Medicare & Medicaid Services (CMS), the Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control (CDC), and the Food and Drug Administration (FDA), just to name a few. Those regulatory bodies are responsible for some healthcare regulations including the Patient Protection and Affordable Care Act (PPACA), Consolidated Omnibus Budget Reconciliation Act (COBRA), Employee Retirement Income Security Act (ERISA), Health Information Technology for Economic and Clinical Health Act (HITECH), and Health Insurance Portability and Accountability Act (HIPAA).

In addition to the above, state and local regulations apply to healthcare facilities as well as non-government agencies such as The Joint Commission (TJC) and the Institute of Medicine (IOM).

Healthcare facilities also need to adhere to workplace regulations such as those from the Occupational Safety and Health Administration (OSHA) and the Equal Employment Opportunity Commission (EEOC).

As if all that is not enough, each department such as imaging, nursing, physicians, and laboratory clinicians have their own accreditation that comes with criteria for continuing education and code of conduct.

Healthcare remains one of the highest regulated industries. According to a report from the American Hospital Association (AHA) on the burden of healthcare regulations, 629 distinct regulatory requirements come from just four agencies including the Office of Inspector General (OIG), the Office for Civil Rights (OCR), the Office of the National Coordinator for Health Information Technology (ONC), and CMS.

The report specifically analyzed data from nine areas including:

  1. Quality
  2. Value-based payment models
  3. EHRs
  4. Hospital conditions of participation (CoPs)
  5. Program integrity
  6. Fraud and abuse
  7. Privacy and security
  8. Post-acute care
  9. Billing and coverage verification requirements

Also in that same report, it is noted that health systems, hospitals, and post acute care (PAC) providers alone spend nearly $39 billion a year solely on the administrative activities related to regulatory compliance. That’s nearly $7.6 million annually for an average-sized community hospital of 161 beds. That averaged sized hospital will allocate 59 full-time equivalents (FTEs) to meet the requirements to regulatory compliance.

Providers dedicate the largest proportion of resources to documenting Medicare conditions of participation (CoP) adherence. CoPs are federal regulations with which healthcare facilities must comply to receive funding from Medicare and Medicaid programs. The Centers for Medicare & Medicaid Services (CMS) is responsible for 80% of reimbursements to healthcare facilities and providers. Also, CMS determines the rate of reimbursements, meaning they decide what a facility is allowed to receive for services. Even in the case where a patient is not using Medicare or Medicaid and is using a different insurance company, charges for services fall under what is usual and customary. The healthcare facility does have the ability to turn around and recoup what Medicare or Medicaid did not payout for those patients.

For physicians and compliance professionals, understanding these regulations is crucial, as violations can result in criminal charges, fines, and, for physicians, possibly the loss of their medical license.

False Claims Act

According to the Department of Justice, of the $3.5 billion recovered from False Claims Act cases in 2015, $1.9 billion came from healthcare organizations.

The False Claims Act imposes liability on persons and companies (typically federal contractors) who defraud governmental programs such as CMS. The law includes a qui tam provision that allows people who are not affiliated with the government to file actions on behalf of the government. This is where the term whistleblower comes from. Typically a whistleblower will be associated, not with the government but with the organizations accused of wrongdoing. As of 2019, over 71 percent of all FCA actions were initiated by whistleblowers.

Federal Anti-Kickback Statute

The federal Anti-Kickback Statute prohibits healthcare professionals from accepting money, contracts, or products as rewards for referrals or provider's recommendations to patients on federally covered medical programs. The statute pertains to both payers and recipients of the “kickbacks” with penalties of up to $50,000 per kickback.

Dragonchain makes it possible for the healthcare facility or physician to prove there were no conflicts of interest when dealing with vendors thus proving they were compliant with anti-kickback rules.

Stark Law

The Stark Law prohibits physicians from referring patients covered by Medicare or Medicaid for treatments or services that the physician has a financial relationship with or stands to profit from.

Interestingly, the Stark Law and the Affordable Care Act’s creation of Accountable Care Organizations (ACOs), which manages and coordinates care, are contradictory. The Law specifies that healthcare services must be at fair-market prices. The ACO incentivizes payments based on value and quality over a fee-based payment scenario for services, which puts the two laws squarely at odds.

In a report to Congress, the HHS observed that current “fraud and abuse laws may serve as an impediment to innovative programs that align providers by using financial incentives to achieve quality standards, generate cost savings and reduce waste.”

Healthcare Compliance

Healthcare compliance programs became necessary with the passage of HIPAA in 1996. Finally implemented in 2003, HIPAA mandates industry-wide standards and processes for the protection and confidential handling of patient health information. The new requirement prompted the formation of compliance programs across the industry.

Compliance programs are tasked with ensuring that all areas of healthcare including patient care, billing, and research are meeting the requirements set forth from all regulatory bodies not just HIPAA. Effective compliance programs will minimize liabilities and foster safe, high-quality patient care.

The ever-changing regulatory environment makes it difficult to develop a consistent program. Organizations must constantly review policies and procedures, offer staff training, and monitor adherence and should feel empowered to initiate processes and programs.

According to Compliancy Group HIPAA has outlined 7 key elements used to build a compliance program.

  1. Written policies, procedures, and standards of conduct.
  2. Designating a compliance officer and compliance committee.
  3. Training and education.
  4. Effective lines of communication.
  5. Internal monitoring and auditing.
  6. Enforcing standards through well-publicized disciplinary guidelines.
  7. Responding promptly to detected offenses and undertaking corrective action.

These standards require an annual review and “...organization-wide enforcement and documentation”. The most successful compliance program will be integrated into the everyday practices of providers. When it becomes part of the standard of care it is easier to track and report on the ways the facility is being compliant. Ultimately the facility and the compliance program must provide proof.

  • Tracking the changing regulations
  • Proving regulations are being adhered to
  • Proving employees are trained
  • Proving changes have not been made- forgery, fraud
  • Providing proof of program effectiveness- Is it working?
  • Identifying gaps in the program
  • Is the data verifiable?

Regulatory Compliance

Many regulations exist for consumer privacy. HIPAA, GDPR, PII, PHI, the CCPA among others require businesses and by extension healthcare providers to inform consumers about the information they collect and how it can be used. In addition to federal privacy laws, state privacy laws must also be taken into consideration with how all data is used and disseminated.

Dragonchain allows for proof of compliance with all applicable regulations. A compliance dashboard is available to offer reports in real-time. Automated audits with data coming in constantly as transactions are processed will show every single action taken is provable with millions to billions of dollars of proof. The compliance officer can look at the dashboard before they go home and know instantly everything's in order.

Healthcare Risk Management

Risk is anything that can result in an unexpected outcome or a loss. Blockchain can help companies manage their risks.

Risk management is the process of analyzing processes and practices that are in place, identifying risk factors, and implementing procedures to address those risks.

In healthcare, risks can involve any area of the healthcare ecosystem and includes faulty equipment, hazardous situations, medical malpractice, and even keeping patients compliant in their medical care for events like:

  • Not filling expired prescriptions to prevent abuse
  • Following up on missing test results to increase consultations
  • Tracking missed appointments
  • Increasing communication with patients
  • Preventing falls

Minimizing risks and implementing management strategies will keep people safe and secure as well as keep costs down.

Medical Malpractice

One of the biggest areas of risk is medical malpractice. The increase in medical malpractice insurance has led some physicians to the difficult decision to stop practicing altogether. The surges in premiums are the result of several factors including rising healthcare costs and higher jury settlements in malpractice lawsuits.

The use of a proactive risk management process can reduce liability and cost but will only be as effective as those who use the program. The process must include properly training employees to recognize anything that would present an increased risk to avoid losses and expenses that could impact an organization's bottom line.

Risk Mitigation in Healthcare

Role credential based access is the process by which only certain credentialed personnel are allowed to perform a certain service. Take for instance medication administration. Every year hundreds of thousands of patients are injured from medication errors at a cost of $40 billion. In the US alone 6,000-9,000 patients die every year from medication errors.

Parallel Verification

Role credential access would allow for much tighter controls to decrease wrong dosages, wrong medications, or administering medications to the wrong patient. Parallel verification is the process by which a second check is performed either manually or automated. The check would flag unusual situations. For instance, let’s say a medication dosage ordered was for a male of 180 pounds but the patient was a child of 75 pounds the parallel verification check would send an alert of the wrong dose.

Another area where this would be helpful is in the case of controlled substance administration. A secondary check on who is receiving the medication and what other medications that the patient already has could be made and signed off by a second credentialed party.

For both of these scenarios, a Dragonchain proof report would show why it was flagged, who flagged it, who looked into the discrepancy, and ultimately who signed off on administering the medication.

What Dragonchain brings to the process is controlled transparency. Blockchain transparency doesn’t have to mean everything is transparent even to the patient. It’s more about proving that an event happened. It’s the ability to prove the order was placed and all events surrounding the order. You can further prove what time decisions were executed and you can prove what information was known at that time. Did they inform the physician they had some other condition? All of this geared towards lowering operational administrative costs and risks for the healthcare facility and providing proof.

Dragonchain Brings Blockchain to Healthcare Today

With the ability to integrate with any system, Dragonchain can handle large amounts of data with proven scalability of at least 250 million transactions over 24 hours on a single business system.

A few big names are working on programs to implement blockchain into the healthcare facilities. These solutions typically include specific blockchain solutions that have yet to tackle the scaling issue that constrains blockchains in general. The increased volume on these blockchains from integrating with a healthcare facility would bog down the blockchain system and would result in increased fees across the whole blockchain ecosystem.

Dragonchain provides deterministic fees that won’t shock the healthcare facility nor its blockchains platform. The hybrid architecture consists of individual blockchains, both private and public. With Dragonchain, every business or healthcare facility has its own system that is private where no sensitive data is released for public consumption. Validation and security of the transactions are realized in the subsequent blockchain verifications providing proof, transparency, and traceability. This independence is what gives Dragonchain a lot of scalability.

Dragonchain is Excited about the Future Impact of Blockchain in Healthcare

There is an immediate need for the healthcare ecosystem to adopt blockchain solutions for interoperability, security, and privacy. Today, Dragonchain can put any and all healthcare data on chain to provide proof. Proof, not only for regulators but for patients and providers that is accessible for years to come. It is very simple and easy to leverage blockchain for this purpose.

The most powerful implementation of Dragonchain for the healthcare industry is medication error reduction. Knowing the implementation of a Dragonchain Proof System would actually save lives with extra checks and a well-defined workflow on chain all without an added burden to medical staff and patients brings home why this technology is poised to change systems across all industries.

Learn more about Dragonchain’s Proof Systems or contact us directly to discuss how Dragonchain can implement solutions for your healthcare needs.