Blockchain in Electronic Health Records: Increasing willingness to share health information through patient empowerment

Despite the potential benefit of sharing electronic health records, many patients hesitate to share their health data. Can blockchain-systems empower patients to share electronic health record information?

Introduction

Data is the beating heart of the digital transformation. Arguably, one of the most important sources of data in health care are electronic health records (EHR), offering improved disease management for individuals as well as Big Data for research, thus enabling better public health monitoring, increased quality of care, development of innovative treatments, or evaluation of health policy [1, 2]. Yet, resistance from providers, technical barriers, and legal issues still stifle full implementation in most health care systems across the globe [3]. Furthermore, most EHR systems have failed to convince a majority of patients to share their EHR [4; 5]. Attempts at tackling some of these hurdles could be made using Blockchain technology, ensuring secure exchange of healthcare data between actors [6]. However, beyond its ability to securely handle and store data [7], could it also empower patients in the use of their EHR and thereby facilitate broader adoption?

Examining the Impact of Blockchain Technology on Patient Empowerment and EHR Sharing Willingness

To find answers to this question, Hajian, Prytbutok & Chang (2023) conducted a vignette-based experiment, exploring how the use of blockchain systems may influence patients’ willingness to share EHR [8]. The theoretical foundations for the study were found in privacy calculus theory, which aims to explain individuals’ behaviour with respect to private information and when and how they might be willing to disclose it [9]. By linking the idea of empowerment, here understood as an individual’s involvement with and control over their data [8], to privacy calculus, the Authors aim to explain how a greater willingness to share EHR records could be achieved. With this in mind, the study tests the three hypotheses, (1) whether blockchain based electronic health records can increase patient empowerment, (2) whether patient empowerment can increase intention to share EHR, and finally, (3) whether patient empowerment has a mediating effect on willingness to share health information in blockchain-based systems.

Data was collected using the online platform Amazon Mechanical Turk, a crowdsourcing platform that allows researchers to recruit a workforce for selected tasks, such as participating in experimental surveys. After being presented with the research design, participants were given hypothetical scenarios, followed by Likert-scale evaluation questions regarding patient empowerment and patient intention to share health records. Once the data was gathered, it was checked for potential bias, focus and realism, as well as validity and reliability, before moving to its analysis.

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The study’s results were able to confirm all three hypotheses, with no significant effect coming from the control variables education, race, and sex. Specifically, it was shown, that blockchain-based systems are positively correlated with patient empowerment, which, in turn, has a significant impact on sharing health record information. Therefore, it was concluded that empowered patients are more willing to share their health records and blockchain systems can provide patients with such empowerment.

Patient Empowerment as a Mediator to Encourage EHR Sharing Willingness

By enhancing patient empowerment and trust through increased control over their health data, blockchain technology addresses critical challenges in data privacy and security. Its capacity for ensuring secure, decentralized data sharing also promotes interoperability among healthcare systems, facilitating seamless patient care continuity. Furthermore, blockchain can streamline administrative processes and assist in regulatory compliance, reducing costs and improving operational efficiency. In addition to these benefits, the study has shown how it can create empowerment in its users and thereby increase and support adoption of blockchain-driven systems.

It is never advisable to treat any one particular technology or innovation as the be-all end-all solution to any number of given problems. In the particular case of blockchain-systems, challenges ranging from difficulties in scalability, poor efficiencies, high transaction latencies or its high energy consumption remain [10]. Nonetheless, a certain level of excited curiosity for the application of blockchain-systems in healthcare data and EHR may very well be justified.

Further readings: Blockchain Technology in Healthcare: Paving the Way for Data Security and Privacy

References

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