Blockchain and Tokenization make EHR Interoperability Irrelevant, and more importantly, create a marketplace for healthcare innovation.
Compared to other industries, consumerization has not disrupted or transformed Healthcare.
Why is that?
Billions have been spent on Electronic Health Records in order to improve patient safety, as well as to improve the affordability and the accessibility of healthcare.
For millions of Americans, healthcare is still unaffordable, or in other ways not accessible.
The Problem is that although health data is widely generated, it is not widely shared or easily accessed when and where it is needed.
Individuals today often receive care at multiple locations, resulting in individual medical records at multiple facilities. Further, many generate health data on their own – none of which ends up in an EHR.
The information systems used by healthcare providers in the U.S. are not open (and only somewhat interoperable, and only if you stretch the meaning of the word). As a result, sharing data between healthcare providers, if it happens at all, is only accomplished at great expense and inconvenience.
So, billions more have been spent on Health Information Exchanges (HIEs) thinking that they would facilitate the sharing of patient data between providers. In other words, HIEs are intended to be a work-around for the lack of interoperability of EHRs.
HIEs have failed, and for a lot of good reasons. HIEs are like Blockbuster video stores in the era of Netflix streaming. No one wants a data storage middle-man that creates unnecessary overhead, is too expensive to be sustainable, and ultimately does not collect all the data that is needed. Further, physicians have refused to use them because their technology and their user experience is so poor.
When you get right down to it – HIEs and other Interoperability efforts are just fundamentally ill-conceived.
Think about it – Healthcare providers that have spent millions of dollars on an EHR are supposed to give patient data to a HIE that will be make that data available to competing organizations. And, pay the HIE to do that! It doesn’t make any sense.
So, what if EHRs were to eventually become interoperable? Okay, then the ability to share patient information between providers is easier. But, again, why would they want to do something that basically diminishes their efforts to create and retain loyal consumers. There really is no incentive for health care providers to push for interoperability or anything that makes it convenient for patients to use other organizations.
Most significantly, though, is this point – even if interoperability existed, patient data would still only in the hands of the providers and payers to be used how they see fit. That is just wrong.
The focus is on the wrong thing, and on the wrong place to really make an impact on the affordability and accessibility of healthcare.
CMS launched a new initiative in conjunction with the White House Office of American Innovation called “MyHealthEData.” This initiative sends a clear message to the health-care industry that patients should own and control their health-care records.
For the consumerization of healthcare to happen, for healthcare to actually become more affordable and more accessible, the consumer must have their data. Further, the consumer should be compensated for the use of their data.
If I had asked people what they wanted, they would have said faster horses.” Henry Ford
We do not need a better HIE.
And, EHR Interoperability standards are not going to make healthcare affordable or available to the millions of Americans who do not have health insurance.
It is fine to focus on ways to incentivize patient engagement in the hopes of keeping that patient with a chronic condition from becoming a patient with a catastrophic condition. But, that is not going to bring healthcare to the millions of Americans who can’t afford it today.
What we need is for every person to be able to possess, monetize, and distribute their health data as they see fit. We need to connect every healthcare organization, provider, payor, and individual in the U.S. to a nation-wide health data distribution utility. We need to monetize the use of health data. If you provide data, you get paid for it. We need to enable and facilitate the creation and connection of applications to this utility. We need a marketplace of innovative alternatives to traditional healthcare delivery and payment structures.
What if every person was able to possess, monetize, and distribute their health data as they see fit?
The need/burden/futility of transferring medical records among healthcare providers goes away.
And, most significantly, it would unleash a wave of innovation that will make health care more affordable, and available in ways that have not even been imagined at this point
If that happened, the need, and the futility of transferring medical records among healthcare providers goes away. More significantly, it would unleash a wave of innovation that will make healthcare more affordable and accessible in ways that have not even been imagined at this point.We are not looking to simply enable the existing entities in healthcare (hospitals, physician practices, health insurance companies, etc.) to do what they do more effectively (though we will do that, and that would be good thing). We are looking to enable alternatives – cost effective, convenient alternatives so that millions of people who cannot afford healthcare today will be able to in the future.
Blockchain technology and Tokenization make this a practical reality.
Electronic Medical Records designed for the individual, the consumer, stored in a blockchain make patient data an asset – an asset with value.
The blockchain network is economical and efficient because it eliminates duplication of effort and reduces the need for intermediaries. It’s also less vulnerable because it uses consensus models to validate information. Transactions are secure, authenticated, and verifiable.
We are coming to market with a technology that transforms the fundamental technical problem from a complicated one to a simple one; and with a business model that takes the simplified solution to market at a cost that requires no analysis.
TimiHealth and TimiCoin are poised to become the nation’s health data distribution Utility – a data distribution blockchain that protects and facilitates the monetization/tokenization of individual’s health data.
TimiHealth delivers a Consumer Medical Record, and a high trust blockchain infrastructure that decentralizes healthcare data making the data available to the appropriate parties while placing control of it in the hands of the individual to whom it belongs.
Interoperability, like Cloud Computing is a frequently misused term. There are companies with true multi-tenant, single instance, software as a service, cloud-computing based solutions. But, there are many, many more vendors that call anything running in a hosted data center a “cloud” solution. Interoperability is kind of like that. Interoperability is very different than Open. While the digital giants are all building more and more open systems, more true-interoperability, the HealthCare IT vendors are focused on limited-interoperability. Limited-Interoperability in this case means that other systems can interact with their system on their terms. True-interoperable systems create an environment that offer services which can be used in many different, unique, and interesting ways to create new solutions that may not have even been envisioned by the original service creator. Limited-Interoperability is a contractual relationship defining specific use-case and specific scenarios which may or may not be exercised. True-interoperable systems are enablers that allow consumers to create exponentially greater things as they piece together solutions.
Software has changed over the last 15 years from monolithic applications to ever shrinking in granularity services. The monolithic applications have “limited interoperability” and limit potential, whereas the “true interoperable” or “open” systems enable potential. So, while Healthcare IT vendors are unable or unwilling to move to true-interoperable in an effort to protect their value, the digital giants have long since realized that opening access to services more broadly is how they can protect your value.
Now apply this rationale to Blockchain. How do we avoid mistakes from the past? How do we make sure we do not limit potential? Some Blockchain platforms/frameworks are embracing what I would call True-interoperability, while some are going to prove to be very limiting.
On October 21, 1879 Thomas Edison created what no one else had before him – a long-lasting commercially viable electric light bulb. But, it did not make a difference until Edison created a Utility Companies to deliver electric power to towns and cities and homes throughout the United States. Once power was distributed to consumers, it not only illuminated their homes and business, it enabled a new era of innovation – heating, cooling, light, sound, entertainment, computation.
When we safely distribute patient data, the same thing will happen to health care. Health data is like electricity. Everything changed once we got power to the light bulb, once the Utility was created.
One can only imagine the innovations yet to come.