The National Health Service (NHS) is a British legacy institution tasked with caring for 65 million people. Despite existing as a model for universal healthcare, the system is rife with challenges: a bloated bureaucracy, outdated systems, clinical failure, internal political squabbles and administrative burdens. These challenges are commonplace throughout the system and all factor into diminished health outcomes for citizens.
As the country’s population ages and deficiencies in the broader healthcare landscape become more apparent, thoughtful change is needed to right the ship in a manner that won’t place the nation’s health at risk.
Dr. Stewart Southey, a consultant anesthetist with the NHS, has some ideas. Southey is a ehealth and blockchain observer who is leveraging his medical practice and strategic consulting background to bring value to the new healthcare digital landscape. He spoke with The Distributed Ledger about where he sees, and hopes, the future of the system will head.
How did you become interested in the intersection between healthcare and technology?
As a working anesthesiologist, I have always been interested in technology in medicine. I also have a passion for the business of healthcare. After finishing my MBA, I decided to pursue new ways of delivering healthcare. The current models are outdated and unsustainable, with costs rising every year.
How did you first encounter blockchain technology?
In my exploration of a multitude of new technologies in medicine, including wearables, electronic health records, point-of-care diagnostics and many others, I stumbled across a TED talk on blockchain from Don Tapscott and the rest is history.
I also read Eric Topol's book, The Patient Will See You Now and his ideas of digitalization and democratization of medicine resonated with me. The blockchain offers the chance to do just that by empowering patients and making the business aspects transparent. The economic benefits are also staggering.
How do you think blockchain technology could be applied by the U.K.?
The government in the U.K. is currently investigating the blockchain for a number of applications, but is a long way from implementing it at scale. The NHS is a perfect example of where this technology might work best and I am certain there will be many startups wanting to get involved very soon.
The blockchain is useful in a number of ways. Nobody has yet solved the electronic health record interoperability issue, but MITs MedRec and several others are showing some promise via the blockchain.
Identity verification and supply chain management are other areas of potential, and prescribing via the blockchain could make accountability, transparency and medicine tracking a lot better too.
Are there specific areas that you think are poised for disruption?
The IBM Institute for Business Value Adoption identified nine areas where transformation and disruption are likely to emerge. They found that nine in 10 healthcare organizations plan to invest by 2018 in areas like medical device data integration, medical and health records, clinical trial records, adverse event safety monitoring, medication and treatment adherence, regulatory compliance, billings and claim management and contract management.
What countries have become early world leaders in blockchain technology adoption for healthcare?
Estonia is a great example, as more than a million healthcare records have been secured on the blockchain in that country. And NMC Health, the largest private sector healthcare provider in the United Arab Emirates (UAE), has announced a partnership with UAE-based telecom service provider Du to test Guardtime's KSI Blockchain technology in the country.
Are there other emerging blockchain solutions in the healthcare space?
Drug counterfeiting is a major problem in the pharmaceutical industry. Startups such as iSolve, Blockverify and Chronicled are engaged in projects related to blockchain and the pharmaceutical supply chain.
Gem, Capital One and Philips are all big players looking at the blockchain and the insurance industry may additionally be transformed by this technology.
What are some of the biggest barriers to blockchain adoption in medical care?
Making significant changes to, or indeed replacing, legacy systems may present a challenge. Trust in the blockchain ironically will also need to be established to allay control, security and privacy fears. And of course, the cultural shift from centralized to distributed networks will be a big leap for many.
What are some emerging trends you expect to see in the next 12 to 18 months?
I anticipate that health records, pharmaceutical supply chain management and insurance claims management will be the first and biggest targets for change. My personal hope is that eventually healthcare can be provided in the most efficient, cost-effective way where patients can trust their records and the medication they take. I'd particularly like to see fraud reduced and for administration to become largely automated so that healthcare expenditures can be directly targeted toward improving health and wellness and treating disease instead of being wasted.
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