Healthcare in India and Disorders of the Central Nervous System: A Blockchain Solution

Posted on 26 June 2020

Authored by Tanya Varshney

Introduction

Medical institutions face difficulties with interoperability of healthcare records and complexities of data[1]. Aside from that, there is a problem of effective communication between various institutions such as hospitals, research centers, pharmacies and insurance companies. Concerns of patient confidentiality are also raised while addressing these issues. In India, there is an institutional divide in the healthcare system between the Government hospitals and private hospitals. This article addresses the shortcomings in the Indian healthcare system with a particular emphasis on neurological diseases and provides a solution to it through a blockchain model.

Indian Healthcare System: Conversation with a Neurologist

In an interview conducted with Dr. Manjari Tripathi[2] (Neurologist), she highlighted the difficulties in the healthcare domain. With respect to diseases of the central nervous system, Dr. Tripathi pointed out that MRI scan machines manufactured by different companies could lead to different diagnosis. This becomes a major problem because this often leads to misdiagnosis and incorrect treatment across different hospitals using different machines. This is an ongoing problem because of the interoperability of healthcare records to compare and study complex data essential to diseases of the central nervous system.[3] Upon further questions regarding diseases of the central nervous system, Dr. Tripathi pointed out that there is a lack of data regarding the population of people suffering with these diseases, and the extent of their disabilities.

This problem is further heightened due to the lack of cooperation between Government hospitals and private hospitals. Lack of funding and the increasing demand for healthcare has put a burden on the Government hospitals and they are unable to provide adequate services or effectively organize healthcare records. Dr. Tripathi shared that Government hospitals such as AIIMS, New Delhi have thousands of patients on a daily basis who don’t have proper prior medical records. Doctors are not able to understand patient history and diagnose diseases efficiently. Research amongst these diseases is halted as doctors and researchers don’t have the required statistics and data. General practitioners are often unable to identify the clinical characteristics and patterns of healthcare utilization in neuropathic disorders[4].

A Blockchain Solution

Blockchain is a peer to peer distributed ledger technology (“DLT”). Blockchain supports the use of “smart contracts” through which changes in records are updated and can be tracked through an automated decentralized system[5]. In simple terms, each member of the blockchain stores identical copy of the data contributing to certifying and validating transactions as well as updating the data.[6] Thus, DLT removes the need for intermediaries and provides a decentralized system for data storage. There are various advantages to implementing DLT in the Indian healthcare system particularly for neuropathic disorders.

Firstly, it makes access to health records and statistics amongst medical and research institutions across India easier. Due to its decentralized nature, there is one storage space for medical data. There is no single source that claims authority over the true data and all members by consensus hold the data identically.[7] This removes all obstacles to patients acquiring copies of their healthcare records or transferring them to another healthcare provider.[8] This allows for improvements and advancements in the medical field as doctors now have access to the nature, types and extent of diseases in the country. This data may help them reach conclusions as to causation of diseases and possibly their cures. This also prevents misdiagnosis as doctors now have access to prior medical records of the patient and other patients who may have been diagnosed with the same disease. Thus, a DLT model in healthcare can help in creating a higher level of organization, accessibility, and amenability to time-saving digital tools while also further engaging the patient in their own care.

Secondly, with respect to diseases of the central nervous system, obtaining disability certificates and consequently disability benefits are slightly more challenging due to the non-visual nature of the disabilities. The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Rules, 1996 provide the broad guidelines for issue of the disability certificates. As per a 2018 notification providing for the ‘Guidelines for Assessment of Extent of Disability and Certification of Specified Disabilities’, assessment of disability for neurological diseases largely depends upon the effects and fulfillment of certain functional impairments for different types of neurological disorders. Through a blockchain model, obtaining a disability certificate can be an automated procedure based upon the fulfillment of certain criteria which would be uploaded by the registered medical practitioners or institutions on the blockchain network. Once the required conditions are met and reflected in the patient’s health-records, they automatically become eligible for a disability certificate and the disability benefits.

Thirdly, blockchain further provides a solution for efficiency in claiming medical insurance. In claiming medical insurance, the insurance companies require the insured to provide multiple documents regarding the health records, spending records, reports of scans, tests, etc. Blockchain can provide a solution to this by storing encrypted information about the insured’s age, residence, family income, and family composition, as well as medical information, such as disabilities.[9] Further, the blockchain model can also implement a digital signature or verification key to verify the authenticity of medical records. These speeds the process of claiming insurance and reduces costs for both the insurance companies and the insured persons. There may also be additional services such as notifying the owner of the profile when their insurance/disability/ medical status changes and automatically reapplying for benefits or insurance options[10].

Conclusion

In this paper, we looked at the unique challenges of neurological disorders and disabilities. A blockchain model can engage healthcare providers, medical researchers, practitioners, medical institutions and help in understanding the impact of contributing factors to the patient’s health. The healthcare sector, in particular, would benefit from DLT as it would allow availability of ‘real-time data’ which would improve clinical care coordination, medical treatments in emergency situations, and aid researchers to detect those conditions which impact public health.[11] Implementation of a blockchain model in the Indian healthcare system will not only be beneficial for the organization and interoperability of data, but it would be extremely beneficial for the study, organization and cures of the diseases/disorders which are slightly more complex.


[1] Mead, C. N. (2006). Data Interchange Standards in Healthcare-Computable Semantic Interoperability: Now Possible but Still Difficult. Do we really need a better Mousetrap?. Journal of Healthcare Information Management, 20(1), 71.

[2] Dr. Manjari Tripathi, Professor Neurology, Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi.

[3] Peterson, K., Deeduvanu, R., Kanjamala, P., & Boles, K. (2016). A blockchain-based approach to health information exchange networks. In Proc. NIST Workshop Blockchain Healthcare (Vol. 1, pp. 1-10).

[4] Berger, A., Sadosky, A., Dukes, E., Edelsberg, J., & Oster, G. (2012). Clinical Characteristics and Patterns of Healthcare Utilization in Patients with Painful Neuropathic Disorders in UK General Practice: a Retrospective Cohort Study. BMC Neurology, 12(1), 8.

[5] Ekblaw, A., Azaria, A., Halamka, J. D., & Lippman, A. (2016, August). A Case Study for Blockchain in Healthcare: “MedRec” Prototype for Electronic Health Records and Medical Research Data. In Proceedings of IEEE Open & Big Data Conference (Vol. 13, p. 13).

[6] Linn, L. A., & Koo, M. B. (2016). Blockchain for health data and its potential use in health it and health care related research. In ONC/NIST Use of Blockchain for Healthcare and Research Workshop. Gaithersburg, Maryland, United States: ONC/NIST.

[7] Engelhardt, M. A. (2017). Hitching healthcare to the chain: An introduction to blockchain technology in the healthcare sector. Technology Innovation Management Review, 7(10).

[8] Ivan D . Moving Toward a Blockchain-based Method for the Secure Storage of Patient Records. ONC/NIST Use of Blockchain for Healthcare and Research Workshop.  ONC/NIST; 2016.

[9] Vian, K., Voto, A., & Haynes-Sanstead, K. (2016). A blockchain profile for medicaid applicants and recipients. Institute for the Future August, 8, 1.

[10] Ibid. (n 5)

[11] Ibid. (n 6)

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