During the 20th edition of the Electronic Commerce Platform (ECP) Annual Congress on November 16th, the building blocks of the digital society were discussed. This year’s theme was: ‘Building the digital society together’. Along that thread, 28 in-depth sessions were organized around the building blocks: digital trends, (big) data, e-skills, trust, infrastructure and healthcare. Two sessions on healthcare are here described in more detail.
Blockchain in healthcare: the Care Lab
During this session, various blockchain solutions were presented that ensure safe handling of patient data. To this day, for example, patient data from several hospital laboratories are sent by post to other hospitals to be manually entered into the computer of the receiving hospital. Blockchain is established to digitally connect hospital laboratories. Through a network of small boxes that run a ‘full’ blockchain node, patient information is encrypted and registered, so it can be retrieved from other hospitals in a safe and decentralized manner. At first, only blood values will be transferred from laboratory to laboratory this way. The ultimate goal is to provide a platform for safer communication of electronic patient data.
A second example was the application in home care where people in the Netherlands now use a writing pad on their kitchen table where their care providers can leave notes for each other, the patient, and his/her caregiver. The National Health Care Institute (Zorginstituut Nederland) has developed a blockchain for this purpose, in which both the care providers and the social network of those in need of care all have access to. Moreover, this is shaped as an app that needs to be retrieved by every care provider on his/ her phone, which he/ she is intuitively guided through. The blockchain is shaped in such a way that it complies with all laws and regulations, such as those under the Dutch Personal Data Protection Act (Wet bescherming persoonsgegevens) and the Dutch Social Support Act (Wet Maatschappelijke Ondersteuning). The blockchain has been tested against all applicable laws and regulations and the first legal blockchain certificate has been issued.
Digitizing healthcare and privacy
Healthcare is a pre-eminent sector where many different forms and types of data have been collected for a long time. All kinds of digitization seem promising when it comes to booking health and financial profit. However, digitization can also entail risks with regard to the protection of personal and health data. The legal frameworks often take a dominant position within a debate about digitization in healthcare. That is why the group of legal counsellors is playing an important role in the current debate around digital healthcare. In this ECP-session different perspectives with a diverse group of healthcare providers, IT professionals, data privacy experts, and patients were explored. Topics such as ownership of data, developments in data access and aggregation, and the way how data can be used for research in a meaningful and safe way were discussed. The content of this session was comparable with a recent seminar on big data in healthcare. In short, stakeholders provide different challenges and opportunities when it comes to healthcare digitization. New legal, technical, educational, and ethical frameworks are needed which require a joint approach from all stakeholders to get ready for tomorrow.
The ECP 2017 congress clearly showed that the building of digital healthcare is already happening and that there is no turning back. It also made clear that many hurdles still need to be overcome, including legal issues as mentioned above. Other challenges that need to be addressed when designing and delivering digital health at scale, as we have seen in the UK, are:
- The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare;
- The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments;
- The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale;
- The effects of branding and marketing issues in consumer healthcare settings; and
- The challenge of interoperability and information governance, when commercial proprietary models are dominant.
At Panaxea, we believe it would be most helpful for stakeholders in digital healthcare to share implementation lessons learned. Notwithstanding, the evaluation of individual projects for specific groups, we argue for a synthesis of implementation lessons to further guide the national and local agenda. It is time to better understand ‘what works in which circumstances and for whom?’.
Anam Ahmed & Bert Vrijhoef