TMUH has partnered with more than 100 community-based clinics and has launched Healthcare Blockchain Platform in full compliance with government policy. Guests present at the announcement included the Director General of National Health Insurance Administration (NHIA), Po-Chang Lee from Ministry of Health and Welfare, and President of the Taiwan Medical Association and Dean of the Community Primary Clinics, Tai-Yuan Chiu.
Ray-Jade Chen, Superintendent of TMUH, remarked that current health care system model and medical record storage is a centralized system. He believes the strengthened collaboration between hospitals and clinics would naturally move towards a decentralized system like blockchain to store and transfer medical records efficiently and securely. The other available option, My Health Bank, is a NHIA-promoted patient portal that only allows patients to view an aggregate of their medical information collected based on claims data uploaded from different medical institutes. However, blockchain technology can combine not only electronic medical records (EMR) with electronic health records (EHR) from different hospitals and clinics, but also add an additional security feature of patient notification and consent before any transfer even takes place.
In support of the government’s Hierarchical Medical System (分級醫療) policy, TMUH has been developing the platform as a one-stop referral window for referral and long-term care services. TMUH’s Director of the Department of Preventive and Community Medicine, Shy-Shin Chang has reported more than 500 referrals per month at TMUH. Currently, nurses at specified referral counters around the hospital assist people who want a referral; however, with Healthcare Blockchain Platform, patients could simply log in with their personal key through the mobile application and accomplish the same task. Shortening the EMR delivery time between clinics and hospitals will not only enhance data transparency but also provide patients with better tools to drive their own medical treatment.
Superintendent Ray-Jade Chen emphasized the benefit of a distributed ledger in healthcare. “If links between different hospitals and clinics are compromised or hacked, the decentralized nature of blockchain allows for the other links to still function. Medical records are automatically encrypted before being uploaded and the encrypted medical records are not stored directly on the Internet, but instead converted into an unreadable index. Only before use will the data download, be decrypted, and become a readable document again. The patient's privacy and record security are then ensured. More importantly, patients who undergo inter-hospital transfers no longer need to go through the tedious, complicated applications process. Patients and institutes can now share medical records by giving consent via smart contracts. Healthcare’s move towards blockchain is a move towards greater patient autonomy and empowerment."
Connie Kang, Director of the Department of Medical Information, TMUH, explained that data on the blockchain are chronologically sorted by date of visit. For patients who have visited TMUH before, their EMR could be combined with previous records including the medical summary, medication, images, labs, surgical operations, as well as self-financed health exams. New data collected during a patient's visit to the hospital are automatically uploaded to the hospital’s cloud system.
In Superintendent Chen’s view, blockchain technology in healthcare can be used for more than patient referrals and may have opportunities for more cross sector applications. For patients who file claims with private insurance companies, the time from request to reimbursement typically takes 2-3 months. If all three parties of hospital, patient and insurance company are connected by the blockchain via smart contracts, then patients could authorize the medical records sharing with the insurance company and automatically start the claims process - possibly shortening the wait time dramatically.
Facing a Hierarchical Medical System and the rising need for long-term care, Superintendent Chen expects that the launch of the Healthcare Blockchain Platform will significantly increase the number of patient referrals at TMUH. Through data safety, transparency and ease of sharing of medical records, people may better understand their own health conditions and can then choose the most appropriate medical course for themselves. Only when trust and data security are established between different levels of institute will a smart and healthy ecosystem be established.