The Iron Triangle of Healthcare in the Blockchain era

At every Healthcare delivery system there are three main concerns; Quality, Cost and Access or otherwise known as the Iron Triangle of Healthcare.

In an ideal world we could receive health care which is high quality, cheap and accessible. Unfortunately, this is not the case in the real world. You can’t change one edge of a triangle without affecting the other two. In a hospital for example, in order to improve access you must either get more resources and thus raise the costs or you can serve twice as many patients at the same time which will have as a result lower quality care. The same way goes with the other edges of the triangle, lower cost means lower access or reduced quality and improved quality means raised cost or limited access.

Digital technologies have introduced great advantages in the healthcare industry. Electronic Health Records systems, or EHR for short, have significantly improved hospital operations. Patient data are digital (no more handwriting and unreadability), easily searchable and by far more useful, processes and protocols are easier to keep track of and resources management is significantly more efficient. Access is improved, because digital systems reduce waiting times and enable more patients to be served, quality is improved because EHR systems make better use of medical data, reduce errors and enable to measure operations, resources, performance and other, but costs are higher because of complicated and demanding infrastructure.

EHR/EMR systems can work great, but within the walls of a single hospital. However patients visit multiple clinics, doctors or practices in their lives, so they don’t have always easy access to their health records. These systems are hospital-centered but Healthcare must be patient-centered and provider agnostic. Patient-centered health care is very difficult to be implemented because of the highly fragmented nature of Healthcare in general. The solution to that problem would be a decentralised, interconnected and secure system for sharing healthcare-related information.

Blockchain is the technology that is closely described by the sentence above. Very briefly, blockchain is a subset of Distributed Ledger Technologies (DLT) and is essentially a ledger of data and transactions, which is shared among multiple participating parties. Each transaction in the ledger is verified by consensus from the majority of the participants of the network.

So how Blockchain breaks the Iron Triangle of Healthcare by simultaneously improving access, improving quality and lowering the cost? Every patient can have easy and free access to their health data, by simply creating an account to the blockchain network. It is also faster to obtain care because doctors can collect easier and faster the complete records of a patient from multiple sources and thus consultations can take less time. At the same time quality is improved because a more complete and accurate health history means better consultations and diagnoses and less medical errors. Storing and sharing full patient records for millions of patients in a centralised way would be prohibitively expensive and unrealistic, so costs for the participants stay approximately in the same levels as with the EHR systems, because the vast volume of data and the costs of infrastructure are shared among the participants of the network.

The quadruple aim of healthcare is to improve population health, improve patient experience, reduce the per capita costs and also improve the provider satisfaction. Blockchain technology can help in all of these, so let’s improve Healthcare together.