Can Blockchain-Enabled Telehealth Uphold the Sovereignty of Physicians?

Pradeep Goel, CEO and Founder of Solve.Care 

The COVID-19 pandemic has highlighted yet again the immensely important role played by healthcare professionals across the globe, but it has also presented immeasurable challenges to physicians themselves. As frontline workers, they are placing their lives at risk day in, day out, to ensure the health of their patients. Face-to-face assessments during a pandemic can be a perilous situation for both physicians and patients alike: a study undertaken by the University of Pennsylvania Medical Centre found that among healthcare workers, family and primary care doctors may have been at the highest risk of dying from COVID-19, above those that work in hospital settings. 

There are also additional concerns wrought by the demands of in-person assessments that have been exacerbated by the pandemic. Physicians must adhere to the guidelines of their place of work. For example, if a hospital or clinic opening hours are 9 am until 5 pm, a physician would be restricted by only being able to work within this time frame, and with children out of school due to the pandemic, this may cause unnecessary inconveniences. And should a physician decide to start up their own practice, they would need to employ a receptionist, rent an office space, employ cleaners to maintain that space, pay for electricity bills; not only is this costly for the physician, but the costs of running such a practice have the consequence of driving the cost on the patient upwards. This pandemic has highlighted the immense need for a better way to deliver healthcare.

Throughout the pandemic, workers in many fields have pivoted towards the utilization of applications such as Zoom, Google Hangouts, and Microsoft Teams, in order to ensure the smooth transition to remote work. The medical profession has also seen an uptake of remote delivery for healthcare services. According to a CDC report, telehealth visits saw a 154% increase in March 2020, compared to the corresponding period the year before. Nevertheless, while a sizable portion of the medical profession is still needed working on the frontlines of the pandemic dealing with COVID-19 patients, other physicians are still needlessly putting their lives in danger by continuing to practice as normal while assessing patients for non-COVID related illnesses or injuries, despite having telehealth as a viable option. 

Telehealth allows physicians to maintain their safety by eliminating the need for close, physical contact with their patients, thus breaking down geographical barriers between doctors and patients. It is also most cost-effective to set up, without having to invest in a brick-and-mortar healthcare office facility. For patients, the benefits and convenience of telehealth are far superior to those wrought with in-person appointments, notably for the same reason as the physicians themselves: patients no longer have to put themselves at risk of contracting COVID-19 in a waiting room. And those living in rural areas where specialists are scarce and would normally have to travel long distances can have easier access to medical care.

All that said, telehealth is a tool, not a panacea, and does not come without its own challenges. Should physicians choose to adapt their practices and utilize the various telehealth service providers in the market instead of in-person consultations, they would still be beholden to the terms and conditions of these services, which leave much to be desired. Many of these platforms specify the hours within which physicians can practice, reducing their flexibility and the overall attractiveness of using these platforms. Many also incur significant fees, as well as control the rates which physicians can charge, reducing the economic viability of using such platforms, especially when physicians can earn comparatively more from in-person consultations. 

An alternative approach for physicians would be to independently utilize the many video conferencing tools that have gain popularity in recent times, setting up appointments manually and dictating their own working hours. However, these platforms also incur a range of issues. Firstly, they may not be entirely secure and would have trouble maintaining HIPAA compliance. In addition, they will not be equipped to facilitate proper continuity of care, with challenges in integrating Electronic Medical Records. In essence, they are simply not designed for medical consultations. 

However, there is a solution to these problems: by integrating telehealth with blockchain technology, we can facilitate the best possible interaction between physicians and their patients, ensuring the privacy and security of all patient data, and most importantly, uphold the sovereignty of physicians

With current technologies, we can achieve many things, but it is more important that we first have a fundamental shift in our approach to healthcare when designing telehealth solutions. First and foremost, the industry needs to bring the focus of the healthcare journey back to the patient. And secondly, design solutions that offer the greatest flexibility for healthcare providers to facilitate better delivery of care.

Using telehealth, physicians should be allowed to assess and diagnose patients from all over the world in different time zones at any time of the day or night that suits them best. This allows for increased flexibility for both doctors and patients alike. It also widens the pool of potential patients that they can work with, ensuring that more people across the world are receiving the medical attention they need at a time when non-essential medical visits are significantly lower than before. 

Additionally, physicians should be able to accept or deny any appointments as they wish while scheduling appointments with just a couple of clicks. These solutions should allow for the full automation of all administrative procedures, ensuring that medical professionals can put their much-needed skills to use all from the comfort and safety of their own homes. 

The implementation of emerging technologies in the space such as blockchain will be a gamechanger for the medical field. We can further develop telehealth solutions that allow for the provision of functionalities and services that uphold the autonomy of healthcare providers and their work. All patient and doctor records and transactions, when stored on the blockchain, ensure privacy and reduce the security concerns for both the healthcare professional and the patient. With patient consent, doctors can immediately access a patient’s past medical records, eliminating the time-wasted conducting repeat assessments and unnecessary medical tests. 

For patients, such platforms respect and enforce patient rights and privacy, giving them complete control over their sensitive healthcare data. At a time when data is becoming of increasing concern to individuals across the globe, this is of utmost importance. 

The integration of blockchain technology with telehealth services gives us the opportunity to provide a much-needed real-world solution that breaks down barriers in our healthcare systems, increasing accessibility, and reducing inequality. These solutions should be designed to meet the needs of physicians and patients alike, whilst minimizing paperwork and bureaucracy and respecting the rights and privacy of both parties. The need for greater patient empowerment and respect for the sovereignty of physicians has never been more pronounced. Access to quality healthcare should not be restricted by geographical, societal, or administrative barriers. This is one of the great opportunities of our time, and it is up to the medical profession and those of us that depend on them to ensure it reaches its full potential. 


About Pradeep Goel

Pradeep Goel is the Chief Executive Officer of Solve.Care, and he has more than 25 years of healthcare experience, developing groundbreaking software for the insurance industry, and co-founding four healthcare IT businesses where he has served in a number of management roles including CEO, COO, CIO, and CTO.  Pradeep was previously the Founder and CEO of health software firm EngagePoint, where he was deeply involved in implementing the Affordable Care Act across multiple states. Pradeep Co-founded Dakota Imaging in 1990, where he served as Senior Vice President and Chief Operating Officer before the company was subsequently acquired by WebMD. He holds a B.E. in Systems Engineering from the University of Punjab in India.