In this article, I discuss the details of my proposal by using a case example of the private insurance market in the United States. First, I describe the unmet needs in this private insurance market. Then, I discuss the idea of a new bitcoin-enabled, patient-centric health plan structured as a public good and a new electronic health-record system where patients own their data. The Bitcoin network creates an opportunity for pA NEW EHR SYSTEM
Healthcare is the practice of data-driven science. The Centers for Disease Control and Prevention (CDC) categorizes the factors that influence health into: genetics, behavior, environmental and physical influences, medical care and social.
A traditional EHR contains patients’ medical information such as administrative and billing data, patient demographics, medical histories, medications, labs, etc. Most of this information is only a part of the factors that influence health.
Instead, a new EHR system can be designed to capture data on all factors that influence health. For instance, data can be captured via the healthcare providers, patients, caregivers, wearable devices, travel and food apps. Health can be entered by various parties including the patients, caregivers, wearable devices and the various types of apps such as for diet, weight management, travel, women’s health, etc.
This EHR system will be based in Web5, which is a decentralized web platform that uses bitcoin to revolutionize the commerce of the internet. Within Web5, the decentralized identifiers (DIDs) built on Bitcoin (e.g., via ION) can empower the patients to own their digital identity and secure their own data. The decentralized web nodes (DWNs) in Web5 can be the new standard for storing the health data and relaying that data enables entities of any type (patients, providers, etc.) to send and store HIPAA-compliant messages and information.
Through Fast Healthcare Interoperability Resource (FHIR), developers can build applications that can transcend the current document-based environment and enable access to data no matter what EHR operating system underpins the user’s infrastructure. This also means that the existing EHRs of the patients can be used as a foundation for the proposed system, hence significantly lowering the barrier to entry.atient-centric healthcare.The main benefits of such a new EHR system are:
Patient-centric healthcare system: Patients should own their data in any patient-centric healthcare system.
Seamless patient care: A patient having the ability to seamlessly share their data with any healthcare provider of their choice will ensure continuity of care.
Data on all determinants of health will drive higher-quality care: Having access to data on all factors that influence health can help enable and improve the quality of evidence-based medicine for each patient.
Acceleration of development of new health technologies: Value-add services can be built atop this EHR system to promote research efforts for innovative, life-changing health technologies. The purpose of such services should always be to maximize patients’ health and optimize system efficiencies. Such services can also create new revenue streams for the key participating stakeholders.
Waste reduction: Overall, it is estimated that about 25% of healthcare spending in the U.S. is wasted. Data-driven, value-add services can drive waste reduction by increasing system efficiency and cutting fraud.
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