For many of us, blockchain technology exists in our consciousness merely as a companion concept for cryptocurrency transactions. We understand that it has revolutionary capability because of this, but we know little else about the wider capability of blockchain to improve other industries. This article will outline the potential of blockchain to overcome existing and emerging challenges presented by the modern medtech and healthcare ecosystem.
Let’s start by defining the concept:
‘Blockchain is a decentralised, distributed ledger for maintaining a permanent and tamper-proof record of transactional data. The distributed ledger ensures the simultaneous recording of updates to the ledger in multiple places (i.e. the individual members of the community or stakeholders), the ledger record is updated based on the establishment of consensus among users within the network, be it public or private.’
(Investopedia & SearchCIO)
A device traceability solution:
The new EU Medical Device Regulation which enters into force next year is placing new obligations on manufacturers to improve individual device traceability (Articles 25 & 27) and supply chain effectiveness. The European Commission is seeking, through the MDR, to make vital product lifecycle information visible and accessible, with the intention of improving standards of care and more effectively isolating specific issues which lead to product recall and defectiveness.
In the supply chain
Through the distributed ledger system blockchain could be utilised by each supply chain stakeholder to independently log their phase of the product journey in real time. Any issue arising around defectiveness can be traced to the source quickly and resolved, minimising negative outcomes and overall disruption to continuity of supply.
Where fines and reprimands are necessary accredited bodies will look to ascertain the direct source of a malfunction to establish blame, accurate record keeping via the supply chain ledger would greatly streamline this discovery process.
Towards outcomes-based payment:
Outcomes-based payment has long been seen as the next phase of development in the way in which cost to the patient is calculated for healthcare treatments and services. In the US system cost is based on metrics such as the number of doctor visits or the number of drugs taken rather than outcome, leaving life science companies in a position where delivering innovation and improved treatment effectiveness is not necessarily synonymous with financial gain.
Tracking the outcome and therefore the value of a round of treatments at the individual level is not currently viable, the administrative burdens are too great and no functionality exists which can allow the different stakeholders in the treatment process to interact effectively. Contracts, invoicing, patient group data are all generated manually at a great time and resource cost.
Blockchain technology has the potential to make outcomes-based payment a scalable reality by streamlining and automating the administrative and contractual processes of establishing the value of treatment at this individual level.
How can blockchain deliver this?
Blockchain has the functionality to facilitate ‘Smart Contracts’ which are conditional agreements coded into a private platform. A 3rd party interlocutor provides access to the platform, contractual criteria are agreed by the healthcare stakeholders and fed into the system. Data is then run through and invoicing is triggered when conditions of the contract are met. The bureaucratic legwork does not increase if a contract increases in complexity.
When healthcare systems have the technology available to base payment on outcomes, innovation and treatment improvement will become intrinsically linked to financial success for manufacturers, competition will go hand in hand with continued increases in patient choice and quality of care.
To the future
Blockchain technology can empower the individual and erode some of our innately held beliefs on the supremacy of centralised, traditional institutions to connect us with our peers. The rise of connected devices and the Healthcare Internet of Things means patients can look to a future in which organisations with access to their information such as diet, sleeping, exercise, genetics, etc. can interact with other companies which may be monitoring blood pressure or heart rate. The resulting cocktail of information has the potential to deliver holistic healthcare solutions, where patients can be certain each aspect of their health has been taken into account.