Electronic Medical Records

Web3 in Plain English

Web 3 use cases in Plain English- Electronic Medical Records

The problem

When a patient visits the doctor, the doctor asks you questions about any health issues, then does an examination, and at the end gives you recommendations that could involve medications, treatments, and lifestyle changes.

At the same time, the doctor is making notes on a paper chart, which a nurse or the front desk will later enter into the computer. Sometimes the doctor will enter their notes and assessment directly into the computer.

Some doctors don’t even have electronic medical records. They have a paper chart. In those cases, Web3 and the blockchain won’t solve that issue. Yikes, but they would need to upgrade to go electronic. But that will improve in the future when dictation and AI get to the point where the doctor can speak into a microphone with their patient’s notes. The AI will record and correctly categorize those notes into an electronic medical record.

Okay, back to the problem. If the doctor’s office or hospital has a computer to store the patient’s health records, the patient will usually have access to those records online.

But what if the patient switches health providers because of a new job that uses different insurance. Or you may have moved out of state. Or you don’t like your doctor and wish to go somewhere else.

When that happens, the new doctor will ask for your health records from your previous doctors. And usually, the records are transferred by fax. Why? Because most doctor practices are old school. They may not have the same healthcare system as the other doctor. They may not even have email, strange but true. Doctor offices tend to be very low-tech outside of medical equipment.

Faxing has a lot of issues. Sometimes the fax fails to send, and the sender has to send it multiple times. Sometimes the receiver says they never received it, putting the burden on the patient to ensure the data gets over to the new doctor.

Sometimes the fax runs out of paper, so the new doctor only gets a partial set of the patient’s records.

Yikes, I won’t go through all the problems with faxing, but we can see the issues that arise with faxing medical records.

Not to mention the person receiving the fax could be the front desk. Should the folks at the front desk be able to view the patient’s medical records?

The other problem is that the patient doesn’t own their medical records. They can’t just switch doctors without telling their previous doctors that they must send their medical records to their new doctor.

Why can’t patients go to any doctor they choose and bring their medical records to the office?

The solution

This is where a Web3 and the blockchain could be a solution. The patient and the doctor can agree to enter the patient’s medical records.

How will it work

1. A Healthcare Web3 Patient medical record storage system would need to exist
   1. And there could be competing storage systems
2. The patient would sign up for this Web 3 storage system.
   1. A recurring payment would need to be involved. If the major health insurers agree to support the Healthcare Web3 Patient medical record storage system, the insurers can cover the expense.
3. The doctor would then enter the patient’s health medical records into the website.
4. The website backend would record the data into the blockchain
5. The patient’s identifying information would be stored in the blockchain
   1. The patient’s medical records would be encrypted and stored off-chain.
      1. Why off-chain? Storing on the blockchain can be expensive because of the gas fees, and the blockchain is not designed to store large amounts of data. That is where off-chain storage comes in.
6. If the doctor needs to review the patient’s medical health records, they will go onto the website and request access.
7. The patient will get a request that the doctor wants to access their records, and the patient will need to approve the request if the doctor wants to view the medical records.
   1. This could be tedious for the patient and the doctor. Especially if the patient is not near their phone and the doctor only has time right now to view the records.
      1. A potential solution would be that the patient would designate the doctor to view the records anytime they want for a specific period - a week, month, or forever in the future as long the patient is seeing the doctor.
8. The patient approves the request. The website then authenticates that request on the blockchain, redirecting the website to retrieve and decrypt the medical records stored off-chain.
9. The doctor can view and update the medical records, which will then be stored off-chain.
10. The website will notify patients that their medical records have new and updated information. The patient can view their records anytime.
11. If a patient changes doctor, they can give their ID to the new doctor.
12. The new doctor would use the patient’s ID on the website to request access.
13. The approval process with the patient and doctor would occur.

The Benefits

The benefit of having the patient’s data on the blockchain is that they can quickly bring their health records when they see a new doctor.

No more faxing. More privacy. The front desk and other personnel that work in the doctor’s office won’t be able to view your records even if it is not intentional.

The best benefit is that patient owns their medical records. Not the doctors. Not the insurance companies. And if the patient wishes to not share their medical records with the doctors or insurance companies, they can revoke access to the website.

I plan to do part 2 on this use case on how having the patient’s medical records stored on the blockchain and off-chain can be used for medical research.