Healthcare is one industry where records are of utmost importance as they help in preventing and reducing medical error. According to the article “Medication Dispensing Errors and Prevention” published by the National Library of Medicine in May 2023, 7,000 to 9,000 patients die each year in the United States due to medication error. And the cost of treating over 7seven million patients due to medication errors amount to a total of $40 billion annually.
The article further states that “medication errors may be due to human errors, but it often results from a flawed system with inadequate backup to detect mistakes.” For instance, a completely paper-based system would have a doctor handing a written order for a patient to a nurse. The nurse then executes the order, but might make a mistake in the type of medication or dosage due to illegible handwriting.
Although this could be considered human error, it ultimately points to a flawed paper-based or analog system that can be easily resolved by establishing an electronic health records (EHR) system. With this kind of digital system, all clinic or hospital staff will enter orders, prescriptions and other health information to an EHR application or platform. Everyone is logged in with their own user ID and password in order to ensure information security and veracity.
Everything is clear as it is not handwritten or verbal, and there is an electronic trace of the entire process. This not only makes the system more efficient, but also strengthens accountability and error mitigation and correction. Furthermore, an EHR system can not only organize and store health records, but also flag possible negative drug interactions and reactions.
It can also result in improved and more accurate patient diagnoses, treatments and outcomes; enhanced coordination between healthcare professionals and other stakeholders; more efficient handling and compilation of patient information for other purposes like research and medicine development; and bigger cost savings due to general improved efficiency of healthcare delivery.
Blockchain as Technological Foundation for EHR Platforms
The crucial question to ask now is what technology can be used so that EHR systems can be developed and used in a way that is both efficient and economical. Recording each entry should be seamless and instantaneous, and there should be sufficient storage to accommodate past, present and future health records.
As awareness and education about blockchain technology spread to both the private and public sectors of business, it has been eyed by many EHR system providers and startups to act as a foundation for their platforms. This is because blockchain enables the immutable and chronological recording and storage of data.
Each entry on the blockchain is processed as a transaction and collected in a data block. Once a block is full, it is linked to a previously completed block to form a chain. Bigger blocks allow for more space for transactions and a higher throughput as calculated in transactions per second (TPS).
Blockchain transactions are processed by nodes or miners on the network. A blockchain is both decentralized and distributed. It is decentralized because there is no central authority figure in control of the network. Any kind of change on transaction data must be agreed upon by all nodes, which makes data immutable and tamper-proof.
On the other hand, a blockchain is called a distributed ledger because each miner on the network has a master copy of all transactions updated in near real time. In this way, even if a miner decides to halt its operations, there is no data loss as all other miners have a master copy of its transaction history.
These capabilities of blockchain make it the ideal technological foundation for an EHR platform. There will be no risk of data loss unlike when a server crashes. Each entry can be recorded instantly and immutably, and there will be no downtime. Data integrity is ensured because it would be nearly impossible to manipulate data.
Transparency is also guaranteed as a complete transaction history can be immediately accessed when needed. With blockchain, verification of each transaction is made easier, and each detail regarding the transaction can be viewed. This means that healthcare practitioners can refer to it at any given time.
Healthcare administrators can also easily trace where and how a medication error was committed, who can be held accountable, and what to do so that it does not happen again. Many in the healthcare industry are already digitizing records and digitalizing their processes and systems. Significant to this is choosing which technology to use when it comes to upgrading to an EHR system.
Factors to Consider when Choosing a Blockchain
An EHR platform would necessitate an enterprise blockchain, which is especially geared towards catering to the needs of large-scale businesses and governments. Enterprise blockchains can handle the high number of transactions and massive amount of data needed by companies and organizations.
Efficiency and affordability are two of the most decisive factors when choosing which enterprise blockchain to build an EHR platform on. Network latencies and crashes, as well as surges in transaction fees during busy hours, will definitely cause more problems than provide solutions.
Scalability is crucial, not only to the ability of a blockchain to complete transactions instantly and accommodate big data, but also to the lowering down and stabilizing of fees. Scaling makes a blockchain an efficient yet affordable solution to digital system deficiencies.
For instance, the BSV Blockchain has unlocked its ability to scale unbounded after restoring the original Bitcoin design as close as possible to how it was stated in the white paper written by Satoshi Nakamoto. The pseudonymous creator of Bitcoin, the first functional implementation of blockchain technology, has always maintained that his invention was built to scale.
Compare unscalable Ethereum (ETH) and BSV Blockchain. ETH, launched in July 2015, has completed a total of 1.1 billion transactions at a current average throughput of 14.5 TPS and a fee of $5.37 per transaction. Its transaction processing time ranges from 15 seconds to five minutes.
On the other hand, BSV Blockchain, established in November 2018, has already processed a total of 1.3 billion transactions, even setting a world record of 128 million transactions in 24 hours. It has scaled to 4GB data blocks and a throughput of 50,000 TPS at an average fee of $0.000003 and transaction time of less than two seconds. And these numbers will only improve as the network continues to scale.
Imagine a hospital writing 1,000 records on a blockchain-based EHR platform in a day and paying over $5 for each record. Spending more than $5,000 on a daily basis just to record and store information is definitely not practical for any hospital or clinic.
And what if there is a surge in transaction fees and it reaches over $10 per transaction? Just last May, ETH transaction fees reached $14. Will the hospital just stop recording patient information because it cannot afford the fees? And can the hospital sustain waiting minutes for each data entry?
What if the network crashes due to low throughput, can the hospital suspend its operations and wait for the system to go back online? How can an EHR platform designed to prevent and reduce medication errors achieve its goal when the system itself is disrupted by latencies and downtimes?
Getting the answers to these questions is critical when choosing which blockchain to build an EHR platform on. With the right blockchain, an EHR platform can definitely produce real results—not only in mitigating medication errors, but also in improving healthcare systems and processes.
