Before getting to implementing a DApp, one should start with the business problem by asking questions such as What are the challenges or the pain points? In the case of healthcare data, examples of challenges are as follows:
- Digitization: Many patients' medical records are available only on paper. This is particularly true for family physician offices, which are usually small. When a patient visits a physician's office, it is still a common scene for a doctor's office receptionist to search the file cabinets and pull out a folder with the patient's medical history. The records are then handed over to the physician. The physician reads the records while talking to the patient. This approach is not scalable and risky. A natural disaster such as flooding or fire can easily destroy these records. When a patient changes physician, the old records are not transferred. The new physician's office will set up a new folder and start to accumulate the medical history for the patient. Due to the loss of old records, some medical tests may need to be redone, resulting in additional costs and inconvenience to the patient. More importantly, the loss of history could lead to losing precious time that could be used for curing a disease.
- Timeliness: Since a patient's medical records are physically maintained at multiple offices, sharing the records, for example between the patient's family physician and a specialist, is difficult and time-consuming. To facilitate sharing the records, the patient first gives his/her physician's contact information to the specialist's office. Then, a specialist's office receptionist contacts the physician's office. The physician's office makes an arrangement to send the information via fax or regular mail. This approach is slow, expensive, and insecure. A patient's medical information can potentially be seen by unauthorized parties during the information transfer and the stolen insurance information can be used for malicious purposes.
- Ownership: Medical records are the health history of a patient. The patient should be the owner of the medical data. A doctor's office is merely the custodian. In reality, this is rarely the case. Whoever maintains the medical records becomes the de facto owner and makes decisions on how the data is used or accessed.
- Transparency: Since medical records are on paper and scattered at doctors' offices, individual and institutional users such as medical researchers, government agencies, and insurance companies do not have a convenient way to access aggregated medical information for legislative and other purposes. Access to the aggregated medical information, which does not involve confidential information about individuals, can be beneficial for the advancement of medical research, prioritizing medicine development, or making government health policies.