Blockchain Technology: Efficiently Managing Medical Information in the Pain Management Field

Abstract

Dear Editor, We read the recently published article “Can Blockchain Technologies Help Tackle the Opioid Epidemic: A Narrative Review” by Raghavendra [1]. The article states that blockchain technology can make it possible to collect robust epidemiological data on opioid overuse in real time. Based on this statement, it can be expected that blockchain technology could help reduce opioid abuse. We are grateful for the author’s effort in introducing the possible usefulness of blockchain technology in reducing opioid overuse, which inspired us to conceptually apply the same technology to the management of medical information in the pain management field. The processes of diagnosing and treating patients who present with pain are as follows: 1) recording of a detailed history on the location, nature, onset, duration, severity, and aggravating/alleviating factors of pain; 2) physical examination; 3) imaging studies such as x-rays, ultrasonography, magnetic resonance imaging (MRI), conventional tomography (CT), and, in some cases, an electrodiagnostic evaluation (electromyogram/nerve conduction study) if deemed necessary; 4) diagnostic injection(s) (because lesions identified with radiological examinations are frequently asymptomatic, and diagnostic injections with anesthetics can be performed to confirm clinicians’ diagnoses); and 5) treatment (after confirming the pain source, various treatments such as oral medication, physical therapy, injections, and radiofrequency treatments can be used to control pain). Therefore, during pain treatment, it is crucial for clinicians to be fully aware of patients’ medical information and for the information to be accurate. Moreover, clinicians being aware of patients’ medical information concerning the presence of diseases such as diabetes, allergies, and the use of anticoagulants could prevent adverse effects in various procedures implemented for pain management. In the current medical system, medical data are the property of hospitals where electronic medical records are kept, even though such data contain patients’ personal information. The private medical information of individual patients is often shared among several hospitals, with the different hospitals managing the data in their care. Therefore, despite the importance of medical information in pain management, the current data management system presents a number of difficulties when a patient with pain visits a new hospital. First, when a patient visits a new hospital, the previous hospital provides printed reports of the patient’s medical information and only provides imaging data—such as x-rays, ultrasonography, MRI, and CT—on compact discs upon request by the patient. The patient then personally submits these data to the new hospital. This process is not only inconvenient for the patients, but also promotes the possibility of vital medical information being omitted. Second, if the volume of information contained in these paper reports is expansive, it becomes difficult for the new physician to fully and accurately identify the information provided by the patient. Third, patients often do not bring their existing medical information when visiting a new hospital or did not ask for it where they initially received care. In such cases, the patients might be required to undergo radiological tests or other diagnostic investigations already performed for the same condition, which would generate significant expenses from a cost perspective. Blockchain is a ledger management technology based on distributed computing that is resistant to the arbitrary modification of data. It stores data in a distributed data storage environment based on peer-to-peer (P2P) technology [2]. In contrast to the traditional method of storing data in a central server, each individual is responsible for recording and managing the data, which increases the stability, reliability, transparency, and integrity of the data. When medical information is decentralized in a blockchain system, it becomes the property of individual patients, rather than hospitals. This allows patients to easily submit their medical information without having their existing data printed on paper or copied to compact discs, as they can handily access it on their smartphone or tablet [3]. Clinicians will then be able to spend less time on inquiries and establish diagnosis and treatment plans by identifying the patient’s condition based on the data provided by the patient without repetitive examinations. Moreover, medical costs associated with duplicate examinations can be reduced, and complications that could occur during treatment can also be prevented. Furthermore, using blockchain will make it easier to collect data from patients with pain, enabling large-scale studies to be conducted [3]. Although there are many expected benefits to using blockchain technology for managing patients’ medical information, certain potential difficulties need to be resolved beforehand. Current legislation is based on a centralized management system. Therefore, the legal system needs to be updated to address, for example, the establishment of new guidelines regarding issues that may arise when implementing blockchain technology. Also, the ownership and the right of management for medical data uploaded on the blockchain system should be clarified. Moreover, as conflict with the existing medical ecosystem and cost-sharing issues could occur when implementing blockchain technology, social discussion among all the actors involved will also be necessary. Despite these barriers, we envision blockchain technology finally overcoming these practical difficulties and being applied to clinical practice in the pain management field, which will benefit many patients with pain as well as clinicians. Funding sources: No funding was received. Conflicts of interest: The authors report no conflicts of interest related to this work.