JMIR Publications

ABSTRACT

Background:

There are several challenges, such as information silos and lack of interoperability, with the current electronic medical records (EMR) infrastructure in the Canadian healthcare system. These challenges can be alleviated by implementing blockchain-based healthcare data management solution.

Objective:

The aim of this study was to provide a detailed overview of the current health data management infrastructure in British Columbia (BC) as a means of identifying some of the gaps and inefficiencies in the Canadian healthcare data management system. We explored whether blockchain is a viable option for the existing gaps in EMR solutions in BC’s healthcare system.

Methods:

We constructed BC’s healthcare data infrastructure and health information flow based on publicly available information, and in partnership with an industry expert who is very familiar with the health systems IT network of BC’s Provincial Health Services Authorities (PHSA). Information flow gaps, inconsistencies and inefficiencies were the target of our analyses.

Results:

We found that hospitals and clinics have several choices to manage electronic records of healthcare information, such as EMR softwares or cloud-based data management, and that the system development, implementation and operations for EMRs are carried out by the private sector. As of 2013, EMR adoption in BC was at 80% across all hospitals, and the process of entering medical information into EMR systems in BC could have a lag of up to 1 month. During this lag period, disease progression updates are continually written on physical paper charts and not immediately updated in the system, creating a continuous lag period and increasing the probability of errors and disjointed notes. The current major stumbling block for healthcare data management is interoperability, as different healthcare facilities use a wide range of unique information systems.

Conclusions:

Our analysis of BC’s healthcare data management revealed several challenges including information silos, potential for medical errors, general unwillingness of parties within the healthcare system to trust and share data with each other, and potential for security breaches and operational issues in the current EMR infrastructure. Blockchain-based solution has the highest potential in solving most of the challenges in managing healthcare data in BC and other Canadian provinces.