The following was originally published in the October 2019 special print edition of Medical Tourism Magazine, which was initially available at the 12th annual World Medical Tourism & Global Healthcare Congress in Abu Dhabi.
The medical tourism industry is experiencing a rapid revolution as healthcare becomes more patient-centric. Despite being a relatively new concept, blockchain technology is one of the catalysts of the evolving paradigm shift in healthcare delivery.
Stakeholders are beginning to make huge investments in this innovative technology in order to push it to its vast potential. Blockchain is a decentralized digital ledger made of chronologically-arranged, immutable, distributive data between connected devices in a blockchain system.
Records and transactions are stored in the blockchain system as blocks of data that are connected to previous records in the system to form a blockchain.
The big advantage of blockchain is its decentralized system of data control, as well as its validity, authenticity, transparency, and security.
The records and transactions in a blockchain system are encrypted with cryptographic keys, with each user having a shareable key and a private key. This secures the data and ensures it cannot be accessed or used by unauthorized persons. This stored data is shared with each participant’sidentity undisclosed.
How Can Blockchain Help Medical Tourism?
Blockchain technology is permeating healthcare rapidly, bringing healthcare solutions to promote better patient experience for medical travelers.
Blockchain technology offers solutions to several barriers in medical tourism and health tourism, such as poor pre-travel logistics, record exchange between healthcare providers, and loss of patient visibility in a tourist destination country. These problems often lead to a waste of money and potential health risks for the patient, as well as reduced destination attractiveness for the medical tourist destination.
Healthcare Mobility and Interoperability of Healthcare Systems
Healthcare has gone global. Today, for example, patients who live in the United States can travel to Singapore for cosmetic treatment. One important factor that drives and promotes health tourism is mobility of a patient’s health data.
A lack of access to a patient’s health records can slow down the care process, lead to healthcare mishaps, and, ultimately, ruin the reputation and attractiveness of a hospital or health travel destination. With blockchain, a patient’s health data is made accessible to providers (and anyone else) to whom the patient grants authorization.
This ensures a free-flow of health information between local and international healthcare providers.
Geographical barriers are a major limitation in health travel and often impede the continuum of care. Because of the interoperability of systems blockchain offers, patients are able to access their health history and records through the decentralized record system. Similarly, healthcare providers can share details concerning a patient to maintain the continuum of care. Patients can also make smart contracts, allowing them to access quality healthcare providers anywhere in the world.
Authentication of Medical Research Data
The quality of healthcare services is a key driver of health tourism, often tied to the volume and quality of medical research and clinical trials conducted in the destination country. Blockchain technology can help reduce the incidence of errors and fraud in clinical trial records by providing verifiable records of clinical trials and results.
Additionally, blockchain-enabled technology can address outcome switching and selective reporting in clinical trials. A recent study by researchers in Cambridge University showed that modified or incorrect clinical trial data can be detected by using a unique code generated by the blockchain system.
Modifying data stored in a blockchain system generates a ‘hash’ which can be identified by other users. This action prevents data theft and, with the help of the cryptographic keys which help to secure data, blockchain also helps to prevent data spying.
Claims and Billing Management
Health insurance and billings are plagued by fraud and scams, which account for 5-10 percent of healthcare costs every year.
Examples of these scams plaguing medical insurance programs include patient billing scams, phantom billing scams, and upcoding scheme. Billing errors also cost insurance programs a lot of money.
Patient billing scams involve both patients and providers. In this case, patients provide their insurance number to the provider who bills the insurer for a treatment the patient did not receive. This is often done with the patient receiving kickbacks from the provider at the end of the transaction.
Phantom billing scams are somewhat similar but do not involve the patient participating in the scam. In a phantom billing scam, the provider bills the insurer for unnecessary procedures or medical tests, procedures or tests that were never done, as well as the cost of unnecessary equipment.
In an upcoding scheme, the provider inflates bills made to the insurer by using a billing code that suggests that the patient requires more (often unnecessary and expensive) procedures.
Blockchain technology can automate many claim payments and adjudications, eliminating middlemen who may manipulate the process. In addition, its decentralized control of data provides transparency and ease of tracking billing and payment records, allowing auditors to detect any discrepancies and billing errors.
Blockchain can also provide an advantageous environment for smart contracts in healthcare between patients and providers and providers and payers. In an overall system where contracting and payments necessarily requires a financial transaction, the security of the transaction and the elimination of the costly intermediary presents a very attractive proposition.
Some governments are requiring healthcare organizations to implement Blockchain technology. With this technology changing all of the time, it should be very interesting to consider the financial impact for healthcare systems to keep up to date and for these systems to integrate with existing healthcare information systems.
Blockchain technology is still in its developing stages and rapidly revolutionizing many industries, particularly the healthcare industry. As more research is being done to establish a sustainable mechanism for wider application of this technology in health tourism, there is no doubt healthcare will become more simplified, secure, and patient-centric in the future.