As the coronavirus continues to ravage the world in what the UN chief calls an “unprecedented global health crisis” since the Second World War, the healthcare industry is finding more and more new uses for the blockchain in the pandemic war.
The immutability and transparency of the blockchain could help track the virus that causes Covid-19. As the global medical industry faces the growing challenge of overcrowded hospitals, faulty tests and inconsistent data, technology is also used to help make payments more efficiently to infected people and to better monitor the spread of the disease through data.
See related article: As coronavirus infections soar, blockchain accelerates demands for health care and maps epidemic
A shortage of equipment such as face masks and ventilators has also increased the risks for health workers. Blockchain could be used to guarantee the integrity of the supply chain, to reduce the problem of counterfeit protective gear and equipment.
Forkast.News interviewed Dr. David Hanekom, Surgeon General and President of Solve.Care in North America, to find out how blockchain technology is being used to fight the pandemic and improve health care in general. Solve.Care is a global healthcare information technology company that uses blockchain to reduce fraud and costs to consumers.
The following interview has been edited and condensed.
See related article: Long-term coronavirus prevention tips: face masks, social distancing, hand wipes and more
The high cost of health care was already a big problem in the United States before the coronavirus crisis. How can blockchain technology help reduce costs for patients and the healthcare industry as Covid-19 spreads?
Blockchain technology has the power to give patients the ability to better understand their symptoms compared to the coronavirus. Telemedicine platforms with secure and reliable data systems can be exploited to connect potential patients with qualified health practitioners where they can provide them with clinical advice remotely. This action alone will reduce the number of people exposed to the virus. If fewer people are exposed, less are likely to have a severe reaction and therefore there will be a reduction in the volume of those requiring emergency care in hospitals. This is to encourage people to stay out of health facilities until necessary.
How else is blockchain used in the fight against coronavirus?
Blockchain has the ability to transfer data transparently and securely between different parties and stakeholders. This technology can be leveraged to share vital clinical information from verified practitioners to patients in a confidential manner. In a pandemic like this, it is necessary to reduce the number of people exposed to the virus. By switching to telemedicine platforms, those with mild symptoms of the disease can access practitioners remotely, reducing the number of people entering hospitals and health care facilities.
The second area where blockchain can be leveraged is supply chain management. It’s no secret that current suppliers of personal protective equipment, such as face masks, are struggling to keep up with growing global demand. The traditional global distribution of supply chain networks also makes quality and supply control particularly difficult in times of global crisis. However, blockchain can greatly assist in the verification of products to ensure that they come from legitimate suppliers.
The United States has a unique healthcare system compared to the rest of the developed world. In what ways can blockchain be used to improve the healthcare and insurance system in the United States in general?
Unlike other healthcare systems around the world, it is the hallmark of the U.S. healthcare delivery system to deploy all the resources necessary to save a life. The United States is perfectly geared towards providing intensive care to individual patients with very serious illnesses, which is why the cost of care is extremely high.
However, the volume of people who may require this level of medical care will increase due to the rapid spread of Covid-19. In addition to distributing already limited resources even more finely, the government is now beginning to understand the risk that this represents for those who work specifically on the front lines. These workers are included in the high risk category, which means that more extreme measures will have to be taken outside of social distancing. Distributed ledger (DLT) technologies such as blockchain can help in this regard, ensuring safer and more efficient deployment of resources. For example, the implementation of telemedicine platforms would help reduce the number of patients to whom health workers are exposed and allow them to continue treating patients.
Is the coronavirus easier or more difficult to fight in the United States compared to other places? What do you think are the strengths and weaknesses of the United States in the fight against this pandemic, compared to other countries or regions?
The fight against coronavirus will be a challenge, regardless of the strengths or weaknesses of individual health systems. The main priority globally is to reduce the number of people exposed to the disease at any given time. It is important that those who are mildly infected are able to manage their symptoms remotely to allow those in need of urgent care to access hospitals and health care facilities.
We have seen reports of the CDC’s botched test kits and a lack of tests available to people in the United States. Could blockchain be used to prevent such situations in the future?
Blockchain has the ability to monitor and manage flawless supply chain systems, using real-time tracking technology from supplier to consumer. It also has the ability to verify the legitimate vendors of these test kits as well as reduce the overall costs associated with moving the product through the supply chain. Taking advantage of this technology could help ensure the quality of test kits as well as ensuring that they are distributed in the right quantities, based on regional demand.
Some CDC scenarios predict that there could be between 2.4 and 21 million patients with coronavirus in the United States who should be hospitalized. But the United States has 925,000 staffed hospital beds. How could blockchain be used to track infected people and link them to available beds?
Although this is the expected number of people requiring hospitalization, not everyone who requires this level of care will arrive on the same day. In retrospect, there were hotspots where the number of people affected increased and eventually decreased again, resulting in varied and distributed demand at different times.
We have seen in recent weeks that many resources have been allocated to this cause with all the healthcare workers waiting to treat anyone affected by the disease. By using secure telemedicine platforms, infected people are more likely to provide more specific information about who they have been in contact with and where they have been for some time. Healthcare providers can then use the blockchain to create a continuous record of the number of beds available in the hospital in which they work. Those infected and presenting with severe symptoms can be matched with the beds available in their region via the telemedicine platform.
We have seen how information on coronaviruses from the ground in China was censored and manipulated by state actors. How could blockchain improve the way doctors and medical staff submit data and verify the accuracy of information?
The main question here is whether or not we can trust a central authority with our information when we have no idea what it does with our information. It is important that citizens have the power to decide with whom they share their information. With blockchain, users have authority over their own information – where they can choose to share the information, to what extent and under what conditions. This would give healthcare workers the ability to share information without the risk of being deleted or changed and with the immutable blockchain as a guarantee of its veracity.
What are the limits of this technology?
Blockchain technology has two obvious limitations: it is still very new and cannot do everything.
First, blockchain technology is just over a decade old. As a result, we are still in the phase where healthcare professionals are exploring its potential and developing proof of concept before proceeding with a full deployment. Over time, once the mass adoption is completed, we will be able to look back and truly assess its impact.
The other thing to keep in mind is that blockchain is not a panacea for all the problems affecting modern healthcare systems. This works very well in favor of managing personal health records which contain all the essential information that a person and their circle of care may need to manage their health journey.
What do you think of President Trump’s emergency policies to prevent the spread of the virus and support the health care system?
I believe that Congress has acted appropriately to prevent the further spread of the virus and to make community well-being a priority. The United States government has implemented a number of measures to protect their citizens during this time, particularly with regard to funding those who cannot work due to the virus. They really stepped up by rewarding the companies that closed and those that follow the protocol. Loans have been made by the government and they have agreed to pay for tests and provide assistance with hospital bills related to Covid-19. Initiatives like this show a clear understanding of the gravity of the situation and the critical need to provide financial relief to citizens and businesses, to keep the ecosystem alive during this uncertain time.
It is important to find infected people and the people they have been in contact with to prevent the spread of the virus. How can blockchain facilitate tracking?
In the same way that blockchain is leveraged in the supply chain, we can use a similar approach to track those who have been infected with the disease and with whom they may have been in contact.
There have been reports of people seeking tests and receive huge bills to do this. What can be done about uninsured and underinsured people in the United States who may delay the test or ignore precautions such as social distancing due to fear of economic backsliding (this is i.e. deliverers, cashiers, Uber drivers)?
The government has committed to cover all medical costs incurred as a result of the coronavirus, whether or not the person is insured. It is a necessary step they must take to reduce death rates in the weeks and months to come by ensuring that people get the medical help they need, regardless of their financial situation.
Social distancing measures should be taken into account for those who can. Telemedicine platforms can be used for those who do not wish to visit the health care facilities to be tested or for those who deem it unnecessary due to mild symptoms. The fewer people exposed to the infected, the better we can manage this situation.
According to the CDC, the the prevalence of obesity in the United States was 42.4% in 2017 to 2018. Add to that other common preexisting conditions such as diabetes, what impact could this have on the death rate of people infected with a coronavirus in the United States?
The coronavirus presents a great risk for those who suffer from preexisting chronic diseases. Although other countries do not specifically have a high level of these diseases, they may have other diseases or factors such as poverty that contribute to the number of people at high risk. Governments will have a tailor-made approach to manage this pandemic according to the contributing factors present in their country.
What role can blockchain play in future public health crises?
Blockchain has the ability to significantly reduce some of the anxiety and fear of being infected with the virus. Providing a channel for individuals to connect with qualified practitioners, giving them details of their risks and symptoms and receiving instant feedback, will reduce the number of people going directly to the ER when they have some of the symptoms associated with sickness. Most importantly, healthcare professionals will be able to monitor their condition remotely and provide individuals with information to help them better understand their condition.
As mentioned earlier, blockchain can be used in the management of supply chains for medical equipment. Monitoring supply chains in terms of supply, demand and stock distribution is very important in times of crisis, as we are currently witnessing the lack of personal protective equipment available for medical workers worldwide. Rising prices are also a major problem when certain items are in high demand. A better managed supply chain would completely avoid this scenario.
Do you see any differences between the way healthcare uses (or doesn’t use) the blockchain in different parts of the world?
Unfortunately, blockchain is such a new technology that it is still too early to determine the impact it would have on any healthcare system in the world today. However, its potential for good is enormous, so I hope we will see health systems around the world benefit from it soon.
What are the most effective ways to use blockchain in healthcare now?
In the United States, the current payment system is based on fee-for-service, where doctors are compensated for the number of people they see and the number of procedures they perform. With the blockchain, this will evolve towards a values-based model of care where the rewards are based on the patient’s results. This will divert attention from the quantity of patients who are seen and towards the quality of care the patient receives.
Blockchain also allows people to be more open in sharing their data and information. Once they control who they share their information with and to what extent, people are more likely to provide all the details they need to get the care they need to get better results.
The current pandemic is likely to fundamentally change the way information is accessed and distributed to trusted stakeholders in the future. I can imagine a time when individuals control their health information, choosing to share it with the stakeholders they trust, in circumstances where such sharing is beneficial for each person and society in general.