The healthcare industry has a wide range of use cases that can be explored, including the pharmaceutical supply chain, clinical trials, and electronic health records. We will focus on this last use case, as it is closer to our heart (literally).

The promise of electronic health records has always been appealing, and the benefits at first glance seem to be numerous:

• Complete view of the patient's history: By eliminating the inherent duplication of paper-based records, the patient should get more accurate diagnostics and receive more coherent long-term care, all in a timely fashion
• Reduction in duplication: Whether from duplicate tests being requested by different doctors or the fact that every clinic and hospital has to maintain its records, there is a potential waste of resources in the healthcare system
• Prevention of fraudulent actions: Whether it is double accounting by rogue clinics or the claiming of false prescriptions, there are many scenarios where the duplication of records creates the opportunity for abuse

While the benefits may seem obvious, the lessons from existing electronic health record projects would seem to hint at the fact that they are expensive and may not immediately deliver the expected benefits. Some research have found that:

• Digitally documenting patient/doctor session created additional work for the doctor
• Electronic health record systems were creating an increase in IT spending
• Additional effort had to be spent on change management and training

Since then, recent studies have shown that such solutions tend to have a positive return on investment in the long run (taking around five years to achieve a benefit).

Given that the value and benefits come from a wide/standardized adoption of the technology, and given the extent of the medical network of many countries, it is not hard to see how this type of endeavor is fraught with political complexities.

Can blockchain networks improve an area that has been long touted as a prime area of innovation for centralized technologies? While technically we can envision an elegant blockchain solution where clinics and hospitals join the network to get access to the patient's record, could the real challenge lie in governance?