Science and Business Program, Faculty of Science, University of Waterloo, Waterloo, ON, Canada.
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
J Med Internet Res. 2020 Oct 23;22(10):e20897. doi: 10.2196/20897.
There are several challenges such as information silos and lack of interoperability with the current electronic medical record (EMR) infrastructure in the Canadian health care system. These challenges can be alleviated by implementing a blockchain-based health care data management solution.
This study aims to provide a detailed overview of the current health data management infrastructure in British Columbia for identifying some of the gaps and inefficiencies in the Canadian health care data management system. We explored whether blockchain is a viable option for bridging the existing gaps in EMR solutions in British Columbia's health care system.
We constructed the British Columbia health care data infrastructure and health information flow based on publicly available information and in partnership with an industry expert familiar with the health systems information technology network of British Columbia's Provincial Health Services Authorities. Information flow gaps, inconsistencies, and inefficiencies were the target of our analyses.
We found that hospitals and clinics have several choices for managing electronic records of health care information, such as different EMR software 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 British Columbia was at 80% across all hospitals and the process of entering medical information into EMR systems in British Columbia 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 health care data management is interoperability resulting from the use of a wide range of unique information systems by different health care facilities.
Our analysis of British Columbia's health care data management revealed several challenges, including information silos, the potential for medical errors, the general unwillingness of parties within the health care system to trust and share data, and the potential for security breaches and operational issues in the current EMR infrastructure. A blockchain-based solution has the highest potential in solving most of the challenges in managing health care data in British Columbia and other Canadian provinces.
加拿大医疗保健系统目前存在信息孤岛和与电子病历（EMR）基础设施缺乏互操作性等挑战。通过实施基于区块链的医疗保健数据管理解决方案可以缓解这些挑战。
本研究旨在提供不列颠哥伦比亚省当前医疗数据管理基础设施的详细概述，以确定加拿大医疗保健数据管理系统中的一些差距和效率低下问题。我们探讨了区块链是否是弥合不列颠哥伦比亚省医疗保健系统中现有 EMR 解决方案差距的可行选择。
我们根据公开信息并与熟悉不列颠哥伦比亚省省级卫生服务局医疗系统信息技术网络的行业专家合作，构建了不列颠哥伦比亚省医疗保健数据基础设施和信息流。我们的分析目标是信息流差距、不一致和效率低下问题。
我们发现医院和诊所可以选择多种方式来管理医疗保健信息的电子记录，例如不同的 EMR 软件或基于云的数据管理，并且 EMR 的系统开发、实施和运营由私营部门负责。截至 2013 年，不列颠哥伦比亚省所有医院的 EMR 采用率达到 80%，在不列颠哥伦比亚省将医疗信息输入 EMR 系统的过程可能会有长达 1 个月的延迟。在此延迟期间，疾病进展更新会不断记录在纸质图表上，而不会立即在系统中更新，从而导致持续的延迟，并增加错误和不连贯记录的可能性。医疗保健数据管理目前的主要障碍是互操作性，这是由于不同医疗保健设施使用广泛的独特信息系统造成的。
我们对不列颠哥伦比亚省医疗保健数据管理的分析揭示了一些挑战，包括信息孤岛、医疗错误的可能性、医疗保健系统内各方不愿信任和共享数据，以及当前 EMR 基础设施中的安全漏洞和运营问题。基于区块链的解决方案在解决不列颠哥伦比亚省和其他加拿大省份管理医疗保健数据方面的大多数挑战方面具有最大的潜力。
