What is Health Information Exchange (HIE) and how can blockchain transform it?

What is Health Information Exchange?

Electronic Health Information Exchange is a system that allows doctors, nurses, health care providers, pharmacists, and patients to access and share the patient’s medical information. This sharing mechanism undergoes greater efficiency and speed, high quality, cost of patient care, and safety.

Despite the conventional methods of storing the data on paper, the electronic health care information helps share the communication between the providers through mails, fax, or patients themselves, without any need to carry the information from appointment to appointment.

Although HIE (Healthcare-care Information Exchange) cannot replace provider and patient communication, it can help track medical records such as patient’s history, current medications, and other information during each visit.

The regular and timely sharing of medical information can improvise decision-making at the time of care and allow the providers to-.

• Improve diagnosis
• Reduce duplicate testing
• Avoid unnecessary medications
• Prevent readmissions

Electronic health information exchange cannot replace provider-patient communication. Therefore, it can help in improving the completeness of the record. This record may include the patient’s health history, current medications and other information during each visit to healthcare providers.

With the widespread availability of secured healthcare information exchange, the data gets standardized, and the transferred information gets updated in the recipient’s EHR.

Types of Health Information Exchange Apps

1. Direct exchange

This mode enables the primary healthcare providers to directly send the patient’s medical record to another healthcare professional. The medical records may include problems, ongoing medications, lab test reports, discharge records. The entire information sharing takes place in an encrypted and secured manner among the related healthcare professionals.

This information exchange is beneficial to patients and providers due to reduced routine medical procedures, testings and unnecessary visits. This form of information exchange is visible among the care providers who mutually know and trust each other and refer to patients for further treatment. This medium works best while sharing immunization data with public health organizations.

2. Query-based exchange

This form of healthcare information exchange helps to search and find accessible clinical sources on a patient. Healthcare professionals or providers make use of this form, usually in case of emergency or unplanned care.

3. Consumer Mediated Exchange

When it comes to accessing health information, the patients can manage their health care, similar to managing their finances through online banking. Patients can actively participate in healthcare by coordinating –

• providers or professionals to monitor any health issue
• identifying and rectifying any incorrect information
• making changes to correct billing details

As the technology continues to evolve, the adoption of healthcare information exchange has tremendously increased, realizing patient care benefits worldwide. According to the researchers at NYeC, admission, discharge, and transfer notifications displayed a 95% rise in healthcare information exchange utilization with query-based data exchange by 102 percent.

Challenges associated with Healthcare Information Exchange

Data privacy and security are the essential objectives in healthcare information exchange. Therefore, many healthcare units need to follow the regulations to maintain the security for the easy flow of data. Below are some of the significant challenges associated with HIE.

1. Difficulty in matching health records

   When exchanging health information, it is challenging to check patients with their precise health records due to similar names, birth year and locations.

2. Lack of standards and variations in rules

   There exists a necessity of adhering to specific standards of Electronic Health Records while exchanging information digitally. Most providers cannot comply with state regulations to exchange patients’ health information with other states’ providers.

3. High Cost

   HIE includes the costs of purchase, implementation, participation in local or state healthcare units, and vendors’ transaction charges.

4. Summary document

   Some HIE organizations comprise only a summary document. It could not give detailed information for further treatment of patients.

5. Patient Consent

   Patients authority and permission are significant challenges in exchanging health information on different platforms. There is always a legal threat if the information is shared without the patient’s consent.

These are some of the persisting challenges that have to overcome through – a technology that can record digital events and create immutable and distributable information with security against fraudulent cases.

Why choose blockchain technology to develop HIE systems?

Some of the blockchain features can be very effective in improving healthcare information exchange systems. They are as stated below:

• The decentralized nature and distributed ledger system of blockchain remove the need for a central authority. Therefore, blockchain can control patients’ records, verify the clinical tests, and update medical credentials and security to the medical supply chain.
• Blockchain-enabled HIE can understand the interoperability and integration steps for different health IT systems. It will reduce the cost of current intermediaries and improve efficiency in the flow of information.
• Blockchain prevents intermediation in the data sharing process. It will protect the data and be very useful while managing insurance claims, PHI, and other medical records.

With the scope of blockchain in healthcare being explored and experimented with by many companies, blockchain has been approved to be an irreplaceable healthcare platform tool.

Right from medications, enhanced payment options, and patient health history decentralization, blockchain can fortify healthcare information exchange governance most securely.

The HIE allows care providers to hit two targets at a time –

• Maintaining the privacy of public health records.
• Engaging the patients to take in-charge of their medical records.

Following are the key improvements in terms of security introduced by blockchain:

• Adequate protection with public/private key access.
• Enhanced data integrity through a distributed ledger.
• Allowing seamless integration of internal systems with APIs.
• Improved electronic prescriptions with decentralized, trust-based, secured information exchange.

Blockchain to overcome Healthcare Information Exchange Pain Points

Blockchain technology is not an elixir for data standardization or integration. Still, it provides a trustful distributed framework to magnify healthcare information exchange across various users and stakeholders.

Due to the multiple shortcomings of healthcare information exchange, a blockchain-based system ensures a more secure, efficient, and disintermediated flow of information exchange. Some of the pain points of HIE and their solutions using blockchain are mentioned below.

Pain Point 1: Building a secure network needs healthcare information exchange to act as an intermediary for point-point sharing and keep a paper record of exchanged data.

Blockchain Solution: Removes the need for an intermediary as all users have access to a distributed ledger for conducting secure information exchange, irrespective of brokered trust.

Pain Point 2: The synchronization of multiple patient identifiers gives rise to the Master Patient Index challenges while securing patient privacy.

Blockchain Solution: The distributed framework enables the use of public and private digital identifiers. Cryptography makes them more secure and authentic patient digital identifiers.

Pain Point 3: High cost per transaction with low volume channels minimize the business case for centralized systems.

Blockchain Solution: Disintermediation reduces the cost factor, and real-time operation makes the system more efficient.

Pain Point 4: -Variation in data standards affects interoperability as the records become incompatible in the system.

Blockchain Solution: Data sharing enables real-time updates throughout the network. Therefore, records remain compatible without affecting interoperability.

Pain Point 5: Healthcare information exchange incorporates very few integrated records sources, thereby providing limited access to population health data.

Blockchain Solution: Distributed ledger allows secure access to patient longitudinal health information.

Pain Point 6: Inconsistency in protocols prevents the proper health organization from accessing the correct patient data at the right time.

Blockchain Solution: The blockchain-based Smart contracts build consistency and regulations-based methods with consent to access the patient information for selected health organizations.

To be more precise, blockchain is a technology that shares, maintain immutable records and stores transaction records. It relies on cryptographic techniques to allow interaction (storage, exchange and viewing information) across the network. It gives a picture of how the blockchain functions as a technology.

How to develop a Health Information Exchange App on Blockchain?

For the organizations looking to develop blockchain solutions in healthcare information exchange, this four-step process will simplify the complex questions revolving in your mind. The following four processes will give a correct understanding of the blockchain framework.

Developing an HIE app on blockchain includes the following stages:

Step 1: Initiation

Step 2: Design

Step 3: Implementation

How does Blockchain work in Health Information Exchange?

Step 1: Make use of the Public hash key to replace the patient’s identity.

Step 2: Make the information to be HIPAA compliant.

Step 3: Store information on the blockchain and transactions get executed with Unique Identifier

Step 4: Healthcare organizations generate a query to the blockchain

Step 5: Patient shares the public /private key with Healthcare Units

When the medical information is directly stored, the blockchain ensures security and readability to permissioned access parties. Simultaneously, ample data file storage also hampers the block processing speeds and exhibits the challenges to scale up the system.

What to consider while building blockchain solutions for Healthcare Information Exchange?

Despite the various healthcare sector opportunities, it requires many factors to consider while building a blockchain solution. The technical, economic and behavioral challenges need to address before adopting blockchain in various organizations. Here are the technical constraints to consider :

1. Data Standardization

2. Adoption and Incentives for Participation

3. Balancing transaction volume and available computing power

4. Cost of Operation

Conclusion

A blockchain-based solution in Healthcare Information Exchange ensures trusted views of patients’ health, develops new insights, and supports the evolution towards value-based care. Due to enhanced transparency, security and easy access to information, blockchain can garner transformative changes for adequate safety, quality of vaccines, medicinal drugs, testing and treatment procedures.

Capitalizing on this technology will have widespread implications for stakeholders in healthcare ecosystems. However, the tremendous transformative changes with the nationwide blockchain network can connect fragmented HIE(Health-care Information Exchange) systems and generate insights for better health outcomes.

If you are looking to develop a health information exchange system on the blockchain, you can discuss your requirement with our blockchain experts and get started.