Proposed Implementation of Blockchain in British Columbia’s Health Care Data Management

Abstract

Background There are several challenges such as information silos and lack of interoperability with the current electronic medical record (EMR) infrastructure in the Canadian health care system. These challenges can be alleviated by implementing a blockchain-based health care data management solution. Objective This study aims to provide a detailed overview of the current health data management infrastructure in British Columbia for identifying some of the gaps and inefficiencies in the Canadian health care data management system. We explored whether blockchain is a viable option for bridging the existing gaps in EMR solutions in British Columbia’s health care system. Methods We constructed the British Columbia health care data infrastructure and health information flow based on publicly available information and in partnership with an industry expert familiar with the health systems information technology network of British Columbia’s Provincial Health Services Authorities. Information flow gaps, inconsistencies, and inefficiencies were the target of our analyses. Results We found that hospitals and clinics have several choices for managing electronic records of health care information, such as different EMR software or cloud-based data management, and that the system development, implementation, and operations for EMRs are carried out by the private sector. As of 2013, EMR adoption in British Columbia was at 80% across all hospitals and the process of entering medical information into EMR systems in British Columbia could have a lag of up to 1 month. During this lag period, disease progression updates are continually written on physical paper charts and not immediately updated in the system, creating a continuous lag period and increasing the probability of errors and disjointed notes. The current major stumbling block for health care data management is interoperability resulting from the use of a wide range of unique information systems by different health care facilities. Conclusions Our analysis of British Columbia’s health care data management revealed several challenges, including information silos, the potential for medical errors, the general unwillingness of parties within the health care system to trust and share data, and the potential for security breaches and operational issues in the current EMR infrastructure. A blockchain-based solution has the highest potential in solving most of the challenges in managing health care data in British Columbia and other Canadian provinces.

The Development History and Research Tendency of Medical Informatics: Topic Evolution Analysis

“…Derived from topics in stage 2, the purpose of medical informatics research always took user needs into account, including the needs of patients [ 44 ] and doctors [ 45 ]. Meanwhile, studies in this period also paid more attention to applying new emerging technologies in health data analysis, such as deep learning [ 46 ], blockchain [ 47 ], and artificial intelligence [ 48 ]. Furthermore, with the growing use of smartphones and wearables, a variety of health tools have enabled users to generate their own private health logs and manage their health conditions, such as weight control [ 49 ], chronic disease treatment [ 50 ], and mental health management [ 51 ].…”

Distributed Solutions for a Reliable Data-Driven Transformation of Healthcare Management and Research

“…Plenty of literature suggests that one of the biggest benefits of employing DLT techniques in healthcare, is the enhancement of the so-called patient-centric healthcare. This approach improves the patients' understanding of their condition, increasing concordance and adherence, while improving health outcomes (21)(22)(23).…”

“…Flipping the current infrastructure around to accommodate patient-centric healthcare would require systems' redesigns. At this end, DLT techniques could allow patients to access their records whenever and to whomever they want ( 23 ).…”

“…Another major issue for healthcare management is the one related to data fragmentation and interoperability: patients visit many healthcare institutions during their lives and each one of these institutions registers their EHR. This leads to data fragmentation that limits the information available to practitioners and service providers ( 23 ). That, in turn, hinders a good quality of care.…”

Harmonizing sensitive data exchange and double-spending prevention through blockchain and digital wallets: The case of e-prescription management

“…Similarly, while Ying et al [2019] propose an architecture that ensures privacy throughout the process of dispensing drugs, they omit the integration of central stakeholders such as the users in their considerations. Cadoret et al [2020] suggest storing prescription data in private, permissioned blockchains or using ZKP for addressing privacy challenges, but do not provide details how the associated access management would work or on which layer the sensitive data could be exchanged.…”