Your medical record grows longer with each visit to your doctor. Your weight, blood pressure, symptoms, and other data gradually builds up in your electronic medical records, or EMRs. It’s a neat, tidy term, but EMRs are messy. Every hospital and every doctor’s office has a different way of storing them, which means it’s not always easy for healthcare providers to obtain your medical history.
This situation, coupled with a medical emergency, can have potentially disastrous consequences. Luckily, there’s a research group at MIT that aims to bring order to the chaotic world of EMRs, with a little help from the blockchain.
Before we talk about the potential solution, let’s talk about the problem. Electronic medical records (EMRs) — also known as electronic health records (EHRs) — are the backbone of every modern healthcare system. They’re the reason your doctor is always seated in front of a computer during a general checkup. They’re filling out information about the visit, their recommendations, your condition, and adding notes. Entering data in your records during visits has, as recently deposed Secretary of Health and Human Services Tom Price stated, turned medical professionals into data entry clerks.
“A prescription refill used to take five seconds of the doctor’s time. Today, it can take 20 to 200 seconds of clicking through boxes, reviewing chart notes and entering orders, depending on the workflow and any questions that arise,” writes Dr. Paul Dechant. “Doctors and nurses spend less time talking to each other these days. Rather than calling a colleague regarding a consult, we enter the referral order. Rather than discuss the patient with the nurse, we type in our orders.”
That problem, according to a Mayo Clinic study, is a factor contributing to professional burnout. Managing records is time-intensive, and not only during patient visits. Healthcare professionals need to catalogue personal notes, procedures ordered, procedures performed, and prescriptions. Every tiny detail that exists in your medical record was put there by a healthcare professional — and not always for your benefit.
These systems aren’t designed to streamline medical record storage and access for healthcare providers and patients. They’re primarily designed for billing. Overworked healthcare professionals end up spending hours at home or during the weekend, catching up on data entry not for your health, but for your insurance company. It’s an inefficient system. The Canadian Medical Association Journal speculates it could be less effective than old paper-based systems.
“The systems are also designed to make billing easier, not to make clinical care more efficient, so tasks such as refilling prescriptions actually take longer than before EHRs,” the CMAJ reports.
And remember, these meticulously maintained records aren’t interchangeable. Changing doctors, providers, or facilities can complicate your medical records. The city of Boston, Massachusetts has at least 26 different medical record systems currently in use. As MIT reports, of those systems has its own language for sharing, representing, and sorting data. Moving your medical records from one facility to another is complicated. They must be translated into the new system, and that can mean added strain on already overstressed medical professionals.
Added, and unnecessary. It could all be as simple as sending an email.
Here’s where the blockchain comes in. If you’re unfamiliar, blockchain forms the literal backbone of cryptocurrencies like bitcoin, Litecoin, and Ethereum. They work by keeping track of transactions in a distributed ledger, a log where hundreds, thousands, even millions of computers all hold a piece of and validate with one another. When one computer (a node) adds a piece of data (a block) to the ledger (the chain), other nearby nodes start talking to each other, distributing the updated ledger.
