Blockchain Technology (“BCT”) has come a long way since its inception, in this article we will be discussing and evaluating used cases of smart contracts in more detail. We will primarily focus on the applications of such contracts in the health-care industry.
Smart Contracts have been increasingly accepted throughout all jurisdictions across the world. They empower parties to encode variables such as quantities, price, timings, and flow of funds making the performance of contracts efficient, speedy and hassle-free.
Estonia’s adoption of blockchain-based electronic health records is a case in point. The Government of Estonia was among the first governments in the world to have embraced the blockchain technology in its live production systems with the help of Guartime, founded in Tallinn, Estonia in 2007. Guardtime was initially established to support the Estonian Government to design and build a system that would allow information to be validated without centralized trust authorities. Estonian government and Guardtime began formal cooperation in 2011, when select government organizations started deploying the Keyless Signature Infrastructure (“KSI”) blockchain technology to secure both public and internal records as well as logs to combat insider threat and indemnify the information systems operators.
In early 2016 Guardtime announced a partnership with the Estonian e-Government e-Health Foundation to accelerate blockchain-based management for patient healthcare records. The smart contract technology ensured data integrity, mitigated internal data threats, and allowed various public and private sector organizations to exchange information in a seamless manner.
Functioning like a centralized, national database, the e-health record retrieves data from various providers, who may be using different systems, and presents it in a standard format through the e-patient portal. To trigger the smart contract transaction, the patient (or the initiator) uses his or her electronic ID card to send an initiating message, encrypted with his or her private key, to the other participants (i.e. governments, hospitals, and insurers). The message is then picked up by the participants’ computers.
Each person in Estonia that visits a doctor has an online e-Health record that can be tracked through their electronic ID-card. All health information is accessible only to authorized individuals and is kept completely secure. Patients have access to their own records, as well as those of their underaged children and people who have given them authorization for access.
One of the key innovations in Estonia’s e-Healthcare system is the e-Prescription, a centralized paperless system for issuing and handling medical prescriptions. When a doctor prescribes medicine using the system, he or she does so electronically, with the aid of an online form. Because the e-Prescription system draws on data from the national health insurance fund, any state medical subsidies that the patient is entitled to, also appear, and the medicine is discounted accordingly. Another major advantage of the system is that doctor visits are no longer needed for repeat prescriptions.
In conclusion, the e-health care system allows individuals not only to own and control personal data (e.g. able to securely disclose personal data to various counterparties) but also facilitating frictionless KYC. Government authorities, hospitals, and insurance companies are able to stay compliant and increase resiliency and interoperability in a speedy and efficient manner. Now, more than ever, during the current global pandemic, the Estonian Government’s investment in BCT has paid off as digital health records and e-prescription services have freed up Estonian doctors, nurses, and administrators for the fight against Covid-19. The KSI BCT has helped all stakeholders thus far to optimize end-to-end workflows whilst ensuring the security and integrity of data through the distributed ledger system. The KSI BCT has helped the Estonian Government to reduce administrative costs due to error correction by 80% and the time spent on repeated prescriptions by doctors by 2 times. The liability claims to doctors for mistakenly erroneous prescriptions have also dropped close to zero.