Blockchain Technology for a Patient-Centred Clinical Pathway Feasibility Study

“NHS在利用新兴技术改变商业实践方面落后于其他行业。人们一致认为，数字技术有潜力改变患者参与服务的方式，提高护理的效率和协调，并帮助人们管理自己的健康。采用数字技术改变护理的速度一直是最近政策和讨论的焦点。NHS英格兰五年展望描述了一个数字愿景，以缩小护理和质量，资金和效率以及健康和福祉方面的差距。从NPfIT吸取的经验教训导致对中央授权的解决方案持谨慎态度。国家信息委员会PHC 2020描述了制定本地数字路线图的实际步骤，2016年Wachter报告呼吁将更大的临床领导力和互操作性作为数字化NHS的核心目标。技术合作模式我们为特定人群开发和部署了综合护理路径，由于采用临床驱动的解决方案，这些路径已在全国范围内推广。网络，在一个中央平台上托管核心临床流程，而不会干扰完善的本地服务交付模式。我们相信，这种跨组织数字化整体护理路径的方法支持社会和临床网络，并为转型变革提供了机会。这项可行性研究将测试使用新兴区块链技术构建的并行系统，使用分布式账本而不是集中托管的信息，是否可以在整个系统中提供更高的成本效率，特别是围绕通过捕获患者级别的交易进行调试，以及从人群中提取大量数据以进行高级分析的能力，由于当前的数据仓库实践，这些数据目前不可用组织内。我们计划通过在两个系统上并行建模患者流程和交易来测试区块链技术的可行性;一个系统使用托管在共享中央平台上的开源技术，另一个系统使用区块链开发相同的临床流程，在定义和充分理解的人群中。可以根据目前的状况分析成本效益，病人水平的数据在当地输入国家数据库，通过回顾性的年度活动分析，根据与关税有关的人口风险简单分层，为委托提供信息。比较将在两个系统中进行建模，其中一个系统可以从基于Web的动态临床过程中提取真实的时间数据，另一个系统可以使用分布式区块链方法对同一临床过程进行交易分析。"

"The NHS trails behind other industries in use of new and emerging technologies to transform business practice. It is agreed that digital technology holds the potential to transform the way patients engage with services and improve the efficiency and co-ordination of care and to assist people in managing their own health.The speed of adoption of digital technologies to transform care has been the focus of recent policy and discussion. The NHS England five year forward describes a digital vision to close gaps in care and quality, funding and efficiency and health and wellbeing. Lessons learned from NPfIT resulted in caution around centrally mandated solutions. The National Information Board PHC2020 describes practical steps in development of local digital roadmaps and the 2016 Wachter report calls for greater clinical leadership and interoperability as core goals of a digitised NHS.With a unique clinical-technical collaborative model we have developed and deployed integrated care pathways for specific populations that have been diffused nationally due to an approach of clinically driven solutions across networks, on a central platform that hosts the core clinical process without interfering with well-established local service delivery models. We believe this approach to digitised whole-care pathways across organisations supports social and clinical networks and provides opportunity for transformational change. This feasibility study will test whether a parallel system built using emerging blockchain technology, with a distributed ledger rather than centrally hosted information, could deliver greater cost efficiencies across the system, specifically around commissioning through capture of transactions at patient level and the ability to pull large volumes of data from populations for advanced analytics that are currently not available due to current practice of data warehousing within organisations. We plan to test the feasibility of blockchain technology by modelling patient flow and transactions on two systems in parallel; one using open source technology hosted on a shared central platform, and the same clinical process developed using blockchain, within a defined and well understood population. Cost-benefits can be analysed against current status, where patient level data is entered locally into a national database that informs commissioning through retrospective annual analysis of activity based on simple stratification of risk across the population linked to a tariff. Comparison will be modelled across two systems, one where real time data can be extracted from a web-based dynamic clinical process versus the potential for transactional analysis using distributed blockchain approach for the same clinical process.?"