Informed Patients, Shared Decisions and Immutable Records

Informed Patients, Shared Decisions and Immutable Records
Alexandra Eavis
Alexandra Eavis
May 15th 2018

The world of healthcare is changing. From a generic, top down model where the doctor was the expert and knew what treatment was best for the patient, and a pharmaceutical industry that thrived on a one drug for all model; to a world of patient-driven self-service and personalised treatments.

Informed Patients

While highly trained medics are obviously a fantastic and extremely valuable source of clinical information, the Internet and data about the availability of treatments and outcomes data have democratised health knowledge. The number one source for medical data for patients and practitioners alike is Google. Patients are increasingly using online forums and communities (like HealthUnlocked with 2.5m shared patient experiences and counting) to discuss their health conditions and learn from their peers’ experience. And they aren’t just going online to understand their health better. The proliferation of self-care apps shows patients are increasingly turning to technology to manage their conditions. From self-diagnosis to self-medication, patients are taking healthcare into their own hands and becoming increasingly savvy.

Shared Decisions

The younger, digital generation are transitioning away from traditional, patriarchal healthcare systems; as evidenced by the take up of mobile, self-serve offers like Babylon Health, Push Doctor and on a far greater scale, WeDoctor in Asia. Choice is proliferating as technology and pharmacology develop. We are moving from a one size fits all to an n=1 treatment model, with personalised treatments tailored to our specific genetic make-up not far off on the horizon. Informed patients are being asked to make decisions in collaboration and cooperation with their healthcare teams, rather than being told what’s best for them.

Immutable Records

With more information being provided and more options to choose from, healthcare systems and the trained professionals working within them need (more than ever) to have robust ways of recording what information was provided, by whom and what decision was made. Every personal decision needs to be matched with personal outcome data to form the basis for learning about what decisions, for whom, led to the best outcomes. You can call this artificial intelligence or machine learning but it’s really just unbiased wisdom. What we’ve traditionally relied on doctors for. Only it’s actually really hard to find an unbiased human. Michael Lewis’s highly readable book, The Undoing Project, has some great examples of the role subconscious biases and heuristics play in healthcare and every other industry and discipline out there.

The infrastructure for this revolution in healthcare requires a secure and common form of data sharing; and an indelible way of recording decisions. That’s what we are working on at Dovetail and why, starting from the problem, we chose to use distributed ledger technology. If we’d created the technology from scratch, we’d be looking for some sort of append-only database that creates permanent records which are always available. One that is distributed mirroring the distributed healthcare system itself; and one that can help circumvent issues around trust that always exist between organisations handling sensitive data. So, if you’re interested in empowering patients to share in their healthcare decisions or have a technology that you think is doing exactly that, we’d love to hear from you.