The case for a Universal Patient Chart on Blockchain

In what I hope will be a series of posts where I freely share some ideas, I pondered what could make the most impact and transform healthcare worldwide.

The conclusion I came to, is a Universal Patient Chart on Blockchain. A chart that would belong to patients, who could then permit hospitals, clinics, labs, pharmacies and healthcare providers to access and contribute to.?A chart that patients would have complete control over, not a fragmented patchwork of health information which resides partly with your primary care provider, the hospital you got care from, the lab that did your tests or the pharmacy that dispenses your medications.

Logistically it would have to be cloud-based, abide by the highest standards of security and privacy and operate on blockchain technology with a low carbon footprint (think Ether’s ‘Proof of Stake’). The question arises who would operate and manage this endeavour? I believe it should be done by a non-profit, transparent and appropriately governed organization. This should not be an offshoot of a tech company but rather a healthcare-based entity to administer this Blockchain UPC as a public good.

There are several advantages to a Blockchain UPC, such as being patient-controlled, portable, standardized and accumulating over the patient’s lifetime enabling research on level not previously conceivable. In addition, standardization would enable all patients to access research, big data analysis and Artificial Intelligence not just those in developed countries. I see this as a means of achieving equitable healthcare worldwide. It would also enable us to utilize the promise of AI and population data on a scale never seen before.

In an era of precision medicine and individualized care, there will need to be repository of information including your genetic information, health chart and the inferences of AI to provide the best care possible. There have already been published examples of this Dubovitskaya et al. published an example of their experience with a blockchain EHR (ACTION-EHR) for cancer care. Others, including Amanat et al. contemplated the architecture and the importance of utilizing the information within and for a systematic review see Hussien et al.

So, if there is one thing that can transform medicine in the future, it is not just new therapies such as mRNA technology, immunotherapy, CAR-T therapy or new diagnostic techniques. Yes, AI will revolutionize medicine, but it will require a standardized means to access patient info on large scale and the only way I feel that can be possible is through the implementation of a worldwide blockchain based Universal Patient Chart.

Special thanks to Zain Ibrahim for proof reading and providing feedback.

References

Dubovitskaya A, Baig F, Xu Z, Shukla R, Zambani PS, Swaminathan A, Jahangir MM, Chowdhry K, Lachhani R, Idnani N, Schumacher M, Aberer K, Stoller SD, Ryu S, Wang F. ACTION-EHR: Patient-Centric Blockchain-Based Electronic Health Record Data Management for Cancer Care. J Med Internet Res. 2020 Aug 21;22(8):e13598. doi: 10.2196/13598. PMID: 32821064; PMCID: PMC7474412.

https://pubmed.ncbi.nlm.nih.gov/32821064/

Amanat A, Rizwan M, Maple C, Zikria YB, Almadhor AS, Kim SW. Blockchain and cloud computing-based secure electronic healthcare records storage and sharing. Front Public Health. 2022 Jul 19;10:938707. doi: 10.3389/fpubh.2022.938707. PMID: 35928494; PMCID: PMC9343689.

https://pubmed.ncbi.nlm.nih.gov/35928494/

Hussien HM, Yasin SM, Udzir SNI, Zaidan AA, Zaidan BB. A Systematic Review for Enabling of Develop a Blockchain Technology in Healthcare Application: Taxonomy, Substantially Analysis, Motivations, Challenges, Recommendations and Future Direction. J Med Syst. 2019 Sep 14;43(10):320. doi: 10.1007/s10916-019-1445-8. PMID: 31522262.

https://pubmed.ncbi.nlm.nih.gov/31522262/