Imagine a world where patients controlled their medical information and could determine what they share, with whom, and for what purpose. In this world, everyone could access their personal health data instantaneously via a digital healthcare passport. As a result, drug manufacturers could create more precise medications and establish more successful clinical trials through better recruitment of subjects. Patients could produce on-demand evidence of their blood type, surgical and medical history, allergies, and other clinical information to their numerous healthcare providers. Employers could verify health credentials such as vaccine status of employees.
This is but one component of the new data economy, where data is recognized as a critical tenant and treated as such. Now, it’s expanding to the healthcare space, where the impact is poised to take on a whole new meaning and identity.
What is a digital healthcare passport?
A digital healthcare passport is a mechanism to store and access all medical information and records online in one location. The data would be kept on a digital platform using blockchain and cloud technology for easy access and enhanced security and protection. It would have the ability to create separate, individual digital (online) accounts with each of their healthcare providers, including physicians, hospitals, healthcare groups, pharmacies, medical facilities, and specialists. These accounts would give patients the ability to retrieve and share their medical information. This ensures all medical information is in one place rather than scattered throughout numerous accounts.
Digital passports would be an improvement over what is used today. Currently, patients use distinct user IDs and passwords for each account within a medical network. Only providers within that network can view that medical data. Patients visiting providers outside that network must remember to bring copies of their medical records to those appointments. This approach is fragmented and fraught with errors. By increasing access to medical information, patients and healthcare providers benefit.
Benefits of digital healthcare passports
The biggest advantage of using a digital healthcare passport is keeping one’s entire medical history stored in one place. This would reduce the miscommunication that occurs among healthcare providers, in part due to limited or even restricted access to medical records, and costs the medical industry an estimated $11 billion yearly. Using an interconnected system to allow any medical provider access to pertinent medical information potentially can reduce medical errors and enhance medical care.
Another benefit or advantage is that digital healthcare passports can be designed with enhanced security and data masking features. Based on the security and accessibility levels, patients control both who can view their data and how much data they have access to using a rules-based system. Providers will not be able to view any medical information from other healthcare facilities without the patient’s permission. Some providers could be given carte blanche access, such as an oncologist who needs to see a patient’s entire medical history before determining a course of cancer treatment. Or providers could receive a one-time use code or pin, as per the patients’ approval, to view only specific medical data and upload pertinent information from the patient’s visit. Patients would be notified anytime their data was accessed and control the parameters on viewable medical records.
The majority (76.59%) of data breaches between 2015-2019 occurred in healthcare-related databases. To mitigate these data breaches with digital healthcare passports, companies storing medical information must take steps to ensure the safety of this information. Blockchain technology, currently used in cryptocurrency, may be a perfect fit for securing medical data. According to Reuters, “a blockchain is a database that is shared across a network of computers. Once a record has been added to the chain it is very difficult to change. To ensure all the copies of the database are the same, the network makes constant checks.” The security of blockchain technology makes it almost impossible to hack into or change the data. Additionally, using complex codes, blockchain can be used to conceal and protect any personally identifiable information, including medical data. The failure to securely access and share patient data will be mitigated by using blockchain technology.
The use of digital health passports could support clinical trials by providing better and easier access to patients and patient data. Clinical trial administrators can use this easy access to a person’s entire medical history data to quickly qualify individuals for trials. With continued access via digital health passports, they will be able to examine future medical data from a metrics perspective to ensure the trial is achieving its goals.
These passports also can simplify and assist with disease treatment, medication protocols and health maintenance. For example, remote monitoring tools, such as a glucose monitor, could be linked with the passport and configured to allow continuous uploading of data from these tools. This would make it easier for health care providers to review patients’ medical data to determine adherence to medical and drug regimens.
Digital healthcare passport concerns
Before a digital healthcare passport can garner widespread usage, several concerns need to be addressed. These include:
- HIPAA violations. It is important to ensure the data available through the digital healthcare passport is maintained according to HIPPA laws. Data mismanagement and misinterpretation can create havoc, privacy infringements, and medical mistakes. As the use of these passports increases, any data misuse must be regulated and prosecuted within the legal framework.
- Security and data breaches. Contingency plans must be created in case of security or data breaches. Investment into creating and maintaining strong security fixpoints where digital healthcare passports are stored needs to be a priority. Even blockchain technology, once deemed uncrackable, has experienced fraud in its cryptocurrency use due to broken blockchain keys. Regularly conducting security upgrades and updates is essential and backup and recovery procedures must be established in case of internet outages or other data failures.
- Lack of provider and patient commitment. There may be some hesitation from providers to comply with using these passports. One reason could center around the increased workload resulting from uploading medical data after each patient’s appointment. Incentives may be needed to encourage all providers to reliably participate inconsistent adherence to the protocols created in using and maintaining medical data in digital healthcare passports. Also, there may be some reluctance from patients to store all their medical information digitally. It is important to educate patients on the benefits and possible problems of using digital healthcare passports. The legal issues of how data is accessed and used must be clearly explained and patients must be informed about the privacy infringement if their data is leaked and any recourse that is available to them.
Once the theoretical concept of a digital healthcare passport becomes a reality, cost concerns must be considered. Expenses associated with this innovation include digital/cloud storage, security and encryption, and maintenance of the passports. The most likely solution is for patients to pay for these passports on a subscription-based model, based on the type of medical data stored, amount of storage needed, the desired level of security, and ease of accessibility. For example, there could be a basic level where only essential medial information is stored such as blood test results and prescription medications. Advanced levels could include storage of all medical information and varying degrees of accessibility where medical information could be masked and unmasked as per the patient’s request. Another possibility is for insurance companies to offer digital healthcare passports as part of their services, either included in the monthly insurance plan payment or as an added cost. Patients could provide access to their data for a fee, such as when being considered for a clinical trial. Incentives could be used to encourage patients to use these passports. Finally, mechanisms must be put in place to guarantee that patients who can no longer afford to pay for their digital healthcare passports do not lose access to their medical data.
Business opportunities evolve at any time, even during a pandemic. As a result of COVID-19, several enterprising organizations created digital health apps (vaccine passports), precursors to digital health passports. These apps provide digitally authenticated proof of COVID-19 vaccinations, and some also display COVID-19 test results. One concern with the use of these apps as digital vaccine passports is the lack of standardization across platforms. There are numerous apps in use worldwide, including state-specific ones used in the U.S, which mean different rules for uploading and accessing the medical data and various levels of security protection.
Digital healthcare passports build upon these new health apps by offering immediate access to a user’s entire medical history. Strong security and data-use protocols alleviate some of the concerns related to online storage of this private information. Yet, this may not be enough to overcome a reluctance to engage with this new technology. The adoption of these medical tools depends on the willingness of both patients and providers. Constructing a single system to easily store patient data which is quickly accessible by multiple medical providers can result in faster diagnosis and care. Many parties have a vested interest in this technology’s success, including digital healthcare passport creators, cloud storage companies, medical providers, health insurance organizations, clinical trial administrators and pharmaceutical companies. By removing barriers to using digital healthcare passports, creatively promoting the technology, and incentivizing patients and providers, stakeholders can proactively encourage patients to manage their health through digital healthcare passports.
Abhishek Sinha is a business and integration architect manager for Accenture, LLP with more than 16 years’ experience in pharmaceutical, automobile, and e-commerce digital enterprise solutions. He can be reached at [email protected] or on LinkedIn.