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Blockchain technology drives healthy patient behavior: Interview (Includes interview and first-hand account)

The way the MintHealth platform is designed to function is through the Vidamint token. Through this, MintHealth sets out to tackle two fundamental problems in healthcare today. First is the lack of a patient-controlled health record that can be seamlessly shared with key stakeholders. The second is the lack of an incentive model to promote proactive patient behaviors for the purpose of combatting the incessant global rise in chronic disease related healthcare costs.

The token is set to go on sale during the first quarter of 2018. To understand how this digital approach could influence health outcomes, Digital Journal caught up with Dr. Samir Damani.

Digital Journal: Thanks for the interview. What are the major challenges facing healthcare today?

Dr. Samir Damani: There exists today a global healthcare crisis, where 40 out of 56 million annual deaths occur from preventable, chronic conditions such as cardiovascular disease and cancer. Importantly, 80 percent of all heart disease, diabetes, and stroke can be prevented by modifiable risk factors including obesity, smoking, and a sedentary lifestyle. This is a global problem because in developed nations like the U.S., over 3.5 million seniors are turning 65 every year, with 90 percent having at least one chronic condition. In developing nations, the expanding middle class is a major contributor to the chronic disease epidemic.

The final linkage to the crisis is the fact that nearly 90 percent of all medical costs are spent on these chronic conditions. If we want to impact global healthcare outcomes and costs, we must address preventable, chronic conditions.

DJ: What are the complexities around health records?

Dr. Damani: Patient medical records are essentially siloed to a single provider or health system, with unwieldly access protocols making it difficult for patients and/or their families to obtain and transfer records across multiple providers. In other words, conventional approaches to data transfer require third party intermediaries, causing delays, higher costs, and potential for fraud and abuse.

Furthermore, even in the day of routine electronic health records (EHR), these proprietary systems store data differently, so it is not obvious who recorded what, where, and when. This results in EHR data that is essentially walled off from not only patients whose data it is, but caregivers, pharmacists, nurses, nursing homes, rehab facilities, social networks, devoted to their care.

These legacy software systems offer limited interoperability and house siloed and scattered data. Important clinical and behavioral data, generated from the home and work are absent, and vital health trends rarely addressed with the patient. The result is a vicious cycle of an uninformed, passive patient who waits until illness is upon him or her before taking action, if given permission to do so by the system.

Blockchain - a continuously growing list of records  called blocks  which are linked and secured usi...

Blockchain – a continuously growing list of records, called blocks, which are linked and secured using cryptography.
deavmi (CC BY-SA 4.0)

DJ: How can blockchain technology help?

Dr. Damani: Blockchain technology helps solve for existing healthcare challenges by enabling a self-sovereign, secure, and freely flowing health record We see blockchain as the solution for moving patients towards a more informed, proactive approach to their health. Blockchains can underpin the secure housing and immediate transfer of data to ecosystem participants without the need for intermediaries or clearinghouses to adjudicate permissions.

Smart blockchain contracts will allow for immediate data transfer to pre-determined entities, or in emergency situations, a durable power of attorney could add permissions to a smart contract. In short, blockchain eliminates middlemen and allows for seamless and secure transfer of data/information.

DJ: How can this change patient behavior?

Dr. Damani: The unifying thread to changing patient behaviors is engagement via: education, self-tracking of health metrics to improve awareness, social support, and financial incentives.

Fortunately, the rapid rise of mobile infrastructure and smartphones has made patient engagement scalable and cost-effective. Therefore, the MintHealth smartphone app will engage patients with daily messages reminding them to track metrics including blood pressure, glucose, pain, stress, sleep, weight, among other clinical and behavioral metrics. This messaging in the app will be tailored to personality types and key principles of behavior modification like “readiness for change” and “self-efficacy.”

It serves to increase patient awareness around key health trends – both good and bad. Data transfers, managed by smart contracts and the patient’s self-sovereign health record, allow physicians, clinical staff, family, friends, and caregivers to access patient information on a secure, controlled, and auditable basis, thereby informing overall patient health and building a patient-centered community for ongoing support.

Vegetables on sale in a market in Bohol  Philippines.

Vegetables on sale in a market in Bohol, Philippines.
Wikimedia Commons / Jasper Greek Golangco

DJ: What’s the idea behind Vidamints?

Dr. Damani: The Vidamint (VIDA) is a unique token incentive to help drive healthy behaviors. Upon completion of salutary behaviors patients will receive incentives for behavior change in the form of Vidamint tokens. Vidamint tokens will be managed and adjudicated through the blockchain and stored in a digital wallet. Vidamint tokens will be redeemable for certain benefits such as lower insurance premiums, discounts on prescriptions, health and wellness brands, and preventive services.

DJ: Do you think incentivizing patients will work?

Dr. Damani: The good news is that considerable data shows that incentivizing patients works well to change behaviors, for both patients and physicians.

In fact, numerous studies support the role of financial incentives in modifying chronic behaviors including weight-loss programs, smoking cessation and HIV risk. Healthcare providers also have been shown to change behavior in response to financial incentives and the U.S. Center for Medicare and Medicaid Services (has leveraged those findings to introduce the Quality Payment Program, paying physicians more for higher quality outcomes (value-based care), in contrast to traditional fee-for-service (volume-based care).

This is the same method used by the federal government successfully to increase the annual rate for EHR adoption by hospital Providers. Vidamint incentives will be used to motivate and reward providers to engage with their patients in developing actionable plans targeted towards patient involvement in achieving health. In short, both patients and providers respond positively to financial incentives and the introduction of the Vidamint is poised to become the gold standard currency for health promotion.

DJ: How have you addressed data security issues?

Dr. Damani: MintHealth’s platform will provide access to electronic protected health information, restricted based on roles and responsibilities, policies to govern the release or disclosure of protected health data, and secure data in transit via secure socket layer and data at rest via AES 256 encryption. Also, other security measures for IT disaster recovery, network safeguard, system access, and geo-redundant backups protect data that is not encrypted on the blockchain.

Comprehensive security governance will be created to manage security measures and perform routine audits as part of MintHealth’s policies and procedures. These functions will verify security controls are up-to-date and implemented on a timely basis for application security, access controls, storage security, infrastructure security, and network security.

Written By

Dr. Tim Sandle is Digital Journal's Editor-at-Large for science news. Tim specializes in science, technology, environmental, and health journalism. He is additionally a practising microbiologist; and an author. He is also interested in history, politics and current affairs.

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