Abstract
This chapter explores how Blockchain might be used in support of both elevated patient engagement in the co-production of care and improved coordination among actors in the care ecosystem. Blockchain is a relatively new technology for sharing information much more widely and securely than in the past. Integrated Care Ecosystems, require both unique levels of cooperation between a great number of actors (relationship holders) and significantly greater patient engagement to advance the quadruple aims of healthcare. Current designs of cross boundary care processes in traditional organizations or networks rely on multiple centralized IT systems that are not well suited to support the decentralized and tenuous relationships that are typical of care ecosystems. Patients, hospitals, physicians and insurers and other relationship holders within an ecosystem typically all use separate patient electronic file systems that do not communicate well with each other. The limitations of current information systems has impeded the possibilities of care model innovations at the ecosystem level. The chapter discusses: whether, through the use of blockchain, personal data can be recorded and managed in a more secure way than with centralized un-interoperable systems, allowing patients to better manage their data over their life-time; whether the decentralized setting of blockchains incentivizes users with very different interests to start sharing data and information; and whether digital currencies can be used to provide incentives to support behavior of participants in ecosystems. We conclude that blockchain not only registers data forever and in a safe way, the decentralized structure of the system and the features of the software are adaptable to the continuously evolving way ecosystems work and that patient self-management of care requires. The future will show if such technology helps us care for each other, and therefore improve the quality of integrated care in the ecosystem at large.
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This chapter has been written with support from the Belgian CORTEXS-research grant (project number: 130020) and the Dutch TNO-SMO funding Smart Working.
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Dhondt, S. (2019). Blockchain: A Necessary Building Block for Integrated Care Ecosystems?. In: Mohr, B., Dessers, E. (eds) Designing Integrated Care Ecosystems. Springer, Cham. https://doi.org/10.1007/978-3-030-31121-6_19
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DOI: https://doi.org/10.1007/978-3-030-31121-6_19
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