Introduction: Despite a rapidly advancing healthcare information technology (Health IT) landscape over the past several decades, there are still many barriers to effective technological adoption and implementation in the United States. Based on the current U.S. Health IT infrastructure, implementing a patient-centric focus in healthcare is daunting. However, novel technological systems are emerging that alter the concepts of information exchange, data ownership, and security. Blockchain-based systems and distributed ledger technologies have the potential to shift focus to more patient-centric medicine, and significantly improve data transfer, cost efficacy, and security in healthcare.
Methods: We examined the role of blockchain and distributed-ledger technologies in healthcare globally, and within neurosurgery specifically. We present the theoretical impacts of blockchain technology in healthcare, so as to inform the neurosurgical practitioner and educate on its future roles in neurosurgery.
Results: At its most elemental level, a “blockchain” is a decentralized, distributed leger of digital transactions that allows a trustless exchange of money or data. While initially developed for financial transactions (Bitcoin, 2009), this technology has evolved to generally store and access sensitive data, for which a publically auditable log of data edits is maintained and distributed securely throughout the network. In health care, these intrinsic properties can be applied to enhance patient privacy, encrypted data sharing, and value-based payment schemes. Using blockchain-based records would allow more effective record sharing for medical research, and even allow patients to monetize their data as incentive for participating in clinical trials. For the medical device industry, product development would benefit from a tightly regulated patent network, and distributed ledger technology would automate and vastly simplify the medical supply chain.
Conclusions: Neurosurgeons have always integrated technology into practice. Blockchain and distributed ledger technologies have emerged into the mainstream, and given the intrinsic benefits of enhanced security, protected data sharing, and device and supply chain efficiencies over incumbent technology, they will likely continue to broadly foray into healthcare. As this occurs, it is essential that the neurosurgeon understands this technology and is open to adoption for use cases in healthcare generally and neurosurgery specifically.
Patient Care: Blockchain technology will facilitate a patient-centric focus in healthcare, by emphasizing security, data integrity, and value-based care.
Learning Objectives: Understand blockchain technology as it applies in healthcare and in neurosurgery, specifically