Even in today’s information age , there is no established network for health information. The current approach for implementing Electronic Health Records (EHR) is failing. The global expenditure for EHR will exceed $33.4 billion per year by 2025 for an approach that does not empower patients, alienates and frustrates physicians, and is prohibitively expensive.
Developing nations simply cannot afford to implement the current, enterprise-based EHR systems. The few advanced countries that have implemented EHR systems widely have severely flawed implementations that have significant problems and are economically unsustainable. As an example, studies have shown that physician burnout is affecting 50% of practicing doctors in the USA with EHR implementations taking the blame as the most significant factor. And this is for a system in which patients typically have to file manual requests and wait days or weeks to access their own health information. Physicians are struggling with administrative overhead, taking away from the time they can spend with patients, and getting burnt out working with EHR systems that don’t even come close to achieving the kind of patient experience required.
Healthcare organizations have traditionally implemented EHR software as enterprise systems for their organizations, or departments. They use different software packages (as many as 1000+ different products), and different versions of the same software packages that are tailored to implement the requirements of a specific enterprise, resulting in silo systems. Once implemented for each enterprise, organizations or consortia then spend enormous amounts of time, effort and money in trying to make these siloed enterprise systems communicate with each other, which is made enormously difficult due to differences in data structures, software, and also the complexity of the information that comprises EHRs. The major flaw in this approach is that health information for patients is not “enterprise information” such as, say sales data. It belongs to patients. It needs to be shared across departments, and healthcare organizations, and needs to be controlled by patients. In retrospect, this is a highly complex approach to collecting and managing health data for patients, that has in practice proven to be tremendously problematic, expensive, and infeasible. Patients do not have access to or control over their information, and physicians are frustrated and harassed with the overhead that EHR systems bring.

Unfortunately, the current state of health care is not patient centric. As an example, in the USA, only one state explicitly gives ownership of medical records to the patients, 20 give it to the physician, and 29 states leave the issues undefined. This shows how much patients are not viewed as collaborators rather are viewed as challengers. We must begin to realize the more access will reduce medical errors while improving patient safety.

The Universal Health Information Network (UNHIN) is taking a fresh approach to solve this problem, applying decentralized computing, including blockchain technology to establish an open, secure and universally available network for collecting, securing and managing health information. It overcomes the numerous challenges and high costs related to managing health information to transform the way Electronic Health Records (EHR) are implemented. It empowers patients and physicians, reduces physician overheads, reduces costs, makes EHR available globally to all geographical regions and economic levels, and provides managed access to health information that does not exist today. It facilitates advancing healthcare globally, providing improved outcomes, and services that are not possible with current infrastructure and technology.
We invite your inputs regarding the UNHIN project, your experience in implementing and interacting with EHR systems, and what would you like to see in an ideal EHR system.

Even in today’s information age , there is no established network for health information. The current approach for implementing Electronic Health Records (EHR) is failing. The global expenditure for EHR will exceed $33.4 billion per year by 2025 for an approach that does not empower patients, alienates and frustrates physicians, and is prohibitively expensive.
Developing nations simply cannot afford to implement the current, enterprise-based EHR systems. The few advanced countries that have implemented EHR systems widely have severely flawed implementations that have significant problems and are economically unsustainable. As an example, studies have shown that physician burnout is affecting 50% of practicing doctors in the USA with EHR implementations taking the blame as the most significant factor. And this is for a system in which patients typically have to file manual requests and wait days or weeks to access their own health information. Physicians are struggling with administrative overhead, taking away from the time they can spend with patients, and getting burnt out working with EHR systems that don’t even come close to achieving the kind of patient experience required.
Healthcare organizations have traditionally implemented EHR software as enterprise systems for their organizations, or departments. They use different software packages (as many as 1000+ different products), and different versions of the same software packages that are tailored to implement the requirements of a specific enterprise, resulting in silo systems. Once implemented for each enterprise, organizations or consortia then spend enormous amounts of time, effort and money in trying to make these siloed enterprise systems communicate with each other, which is made enormously difficult due to differences in data structures, software, and also the complexity of the information that comprises EHRs. The major flaw in this approach is that health information for patients is not “enterprise information” such as, say sales data. It belongs to patients. It needs to be shared across departments, and healthcare organizations, and needs to be controlled by patients. In retrospect, this is a highly complex approach to collecting and managing health data for patients, that has in practice proven to be tremendously problematic, expensive, and infeasible. Patients do not have access to or control over their information, and physicians are frustrated and harassed with the overhead that EHR systems bring.

Unfortunately, the current state of health care is not patient centric. As an example, in the USA, only one state explicitly gives ownership of medical records to the patients, 20 give it to the physician, and 29 states leave the issues undefined. This shows how much patients are not viewed as collaborators rather are viewed as challengers. We must begin to realize the more access will reduce medical errors while improving patient safety.

The Universal Health Information Network (UNHIN) is taking a fresh approach to solve this problem, applying decentralized computing, including blockchain technology to establish an open, secure and universally available network for collecting, securing and managing health information. It overcomes the numerous challenges and high costs related to managing health information to transform the way Electronic Health Records (EHR) are implemented. It empowers patients and physicians, reduces physician overheads, reduces costs, makes EHR available globally to all geographical regions and economic levels, and provides managed access to health information that does not exist today. It facilitates advancing healthcare globally, providing improved outcomes, and services that are not possible with current infrastructure and technology.
We invite your inputs regarding the UNHIN project, your experience in implementing and interacting with EHR systems, and what would you like to see in an ideal EHR system.

Establishing the Universal Health Information Network (UNHIN)

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8 replies, 5 voices Last updated by Shubh Singh 5 years, 4 months ago
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    • November 26, 2018 at 8:22 am #2756

      Ankit Monga
      Moderator
      @ankit

      Please review information on the UNHIN at http://www.unhin.org and share your thoughts, inputs, and any questions you have?
      We welcome inputs from people globally to establish a truly universal network.
      Please apply as an adviser on http://www.unhin.org to review and influence the design of the UNHIN, and work closely with our team.

    • December 2, 2018 at 5:26 pm #2764

      Kunal Khanna
      Participant
      @kunal

      Would UNHIN give medical info to enterprises who often ask the candidates to provide their medical checkup report at the time of joining? This could eliminate the problem of fake medical reports.

      • December 2, 2018 at 6:01 pm #2767

        Shubh Singh
        Participant
        @shubh

        Yes, UNHIN will absolutely handle this usecase. An individual who has their health record on UNHIN will be able to share the relevant test result or an appropriate summary of their record with an enterprise they are going to join. The UNHIN health wallet will make this very easy by giving an individual an option to share a specific test result, or an option for “share health record summary with employer”, which will pre-select appropriate information from their health record that is appropriate for an employer and share just that, so that they don’t share any sensitive information.

        • December 5, 2018 at 4:04 am #2857

          Mohit Kumar
          Participant
          @mohit.kumar

          UNHIN will gather the medical history of a patient and anyone who requires that info can use the info with the consent of the person. As Kunal mentioned that it can be used by enterprises who often ask the candidates to provide their medical checkup report at the time of joining. So the person cannot fake the report. But there is another use case: How UNHIN will make sure that whatever the data is on the network is also TRUE and note faked?

          • December 7, 2018 at 7:05 pm #2859

            Shubh Singh
            Participant
            @shubh

            The Blockchain will confirm healthcare transactions and make sure that the report is indeed provided by a physician or a lab that has conducted the test. What this means is that it will not be possible for someone to fake a physician’s identity and put data into a patient’s record. If a lab or physician fakes a result, there will be community processes to report that and the lab or physician making the false report will be identified. In this case the lab/physician will not just be penalized on the network by losing their staked tokens, the network will also provide immutable recorded information for taking legal action.

    • December 2, 2018 at 5:27 pm #2765

      Kunal Khanna
      Participant
      @kunal

      One of the target audiences for UNHIN is the developing world, with a very large population who are not fully aware of repercussions of sharing their medical data with people they are not supposed to be sharing it with,
      1 – how do we plan to make them aware?
      2 – how would a not so aware person know what level of data does the requesting doctor actually needs? He/she might give up his/her entire medical history access to a general physician

      • December 3, 2018 at 12:23 am #2769

        Shubh Singh
        Participant
        @shubh

        Good questions. We must in fact keep this in mind for all regions of the world, not just developing nations. The health wallets with which individuals interact with the UNHIN will have a very user friendly and easy to use design which we will test extensively. It will be designed so that it is highly intuitive for users and people should be able to use it without any training, user manuals, etc. This design will be supplemented with videos and other guides to make it still easier and also to help people with more advanced features where they may need information.

        The UNHIN will also be widely publicized to make people aware of its benefits and how they can use it.

        The health wallet and UNHIN will provide users with ready to use sharing modes so that they don’t have to think about what information to share and not to share. For example, they will have an option to share their record with a general physician, or a cardiologist, or even a nutritionist. Thsi will take them through a very simple user interface wizard which will allow them to choose the type of provider with whom they want to share their information. It will select the common parts of their health record that is normally shared with that type of provider.

        This can still be challenging in regions where there is a lack of education and people may not understand the app. In such scenarios, the UNHIN will still improve the conditions we have today wherein they can manage their health record with assistance from their physician. As an example, lets say if physicians are visiting a remote village to provide health services, if they put the information for patients in the UNHIN, it will be biometrically linked with the patient, and available for a different physician who may visit the village in the future. Also, it will maintain an electronic record of who has accessed the patient’s information to assist them in maintaining their record.

        In every situation, the UNHIN will improve things as compared to today even if it doesn’t solve the problem fully. This is in fact a very important point to understand. Healthcare is a complex domain and health information is hard to handle in the proper way, therefore it may not be possible to solve every problem fully, but the UNHIN will significantly improve the handling, management and security of information as compared to today.

    • December 6, 2018 at 9:26 am #2858

      Saransh Khanna
      Participant
      @SaranshKhanna

      UNHIN seems to be nothing less than revolutionary once achieved, but what I doubt is in developing nations we find a large chunk of people below poverty line or in other words who have no access to any sorts of technology, so how is UNHIN supposed to transform their health care ,will it be done with the collaboration with the government services or are we going with some other approach?

      • December 7, 2018 at 7:11 pm #2860

        Shubh Singh
        Participant
        @shubh

        Great question. The penetration of mobile devices and data networks have actually increased a lot in the last few years so that they are already used very widely. This is not just true in India but also in other countries. Additionally, for an initiative such as UNHIN we are designing for the future, and the penetration of mobile technology will only increase in the coming years. The apps on UNHIN< such as the health wallet will therefore take a mobile first design.

        Governments and corporations the world over are already undertaking large initiatives to increase the availability of mobile devices and data networks, so they are laying a foundation for the UNHIN.

        Even in cases where people in underprivileged areas do not have or cannot use mobile devices, there will be great benefits from the UNHIN. As an example a physician doing voluntary work in a remote area in Africa can create a UNHIN record on behalf of the patient, with the patient’s authorization. In future if a different vlunteer physician comes to provide services, they will find the full record created by previous physicians on the UNHIN.

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