That's burning down your house to kill a spider. Even in a closed system infinite replay-ability is a big headache, and adding "blockchain" adds a hundred new problems. There's already legal system which is a direct dependency, and it is more efficient and manageable. (Yes, that's right, the US legal system actually looks sane by comparison.)
Instead, make a legal requirement that patients (and sometimes other stakeholders) can demand the data/logic behind the company decisions.
If you still want very tamper-proof write-only records, that can be done way more easily/quickly/cheaply with an old-school distributed database with fixed trusted nodes, run by multiple institutions that are not likely to conspire together.
> make a legal requirement that patients (and sometimes other stakeholders) can demand the data/logic behind the company decisions.
Huh. This is already available, and it never works in the interest of the patient. Unless one has expensive attorneys, no individual has the time and patience to jump through all the hoops needed to get it to work. The point is to eliminate friction completely.
I do reiterate that scheduled data+logic exports from the government would alternatively also help, allowing the execution to similarly be replayed. A problem with a scheduled export, however, is that a corrupt state government will gladly change your records for you (in their favor) when you go to court. This is more difficult to do with a blockchain.
If someone receives a letter in the mail with a claim rejection that never contradicts whatever blockchain says, they will not win in court.
Somehow you assume that data on blockchain was entered correctly and truthfully just because it's blockchain. Somehow you assume that no one will need expensive attorneys and expertise to sift through data just because it's on blockchain. Somehow you assume that there's some magic "execution" on blockchain that you can somehow easily "replay".
You obviously don't know much about how a blockchain works, haven't spent a minute thinking about the answers to your questions, and think no one else has either. Your concerns are unoriginal as far as blockchain technology is concerned, and solutions easily exist to each issue.
I know how blockchain works. For the purposes of this discussion it's an append-only distributed log.
However, blockchain proponents en masse have no idea how blockchain works or how real world works. That's why they always assign these magical properties to it: that all information added to blockchain is true and correct. That it's trivially easy for anyone to "replay" any number of any complex events containing any arbitrarily complex data to do something or reach some conclusion.
When challenged on this assumptions the answer is, inevitably, "you don't know how blockchains work" (everyone does) and "solutions to these challenges exist" (they don't).
Literally nothing in blockchain can prevent entry of bad/incorrect/falsified data. Literally nothing in blockchains makes it easy to navigate complex medical decisions without the help of experts (and in the US, lawyers) to untangle and understand the data and decisions.
I am sick and tired of the inept comment, but let's take your points, one at a time:
> Somehow you assume that data on blockchain was entered correctly and truthfully just because it's blockchain.
If the information on the blockchain contradicts a denial communication e/mailed to the patient, it will be an easy win in court. And if it's a simple data entry error, it will be fixed when reported.
Somehow you assume that no one will need expensive attorneys and expertise to sift through data just because it's on blockchain.
> There are numerous blockchain explorer websites that catalog the data and conveniently query+format it for display. These days even LLMs can write queries.
> Somehow you assume that there's some magic "execution" on blockchain that you can somehow easily "replay".
Yes, that's how it works, and there is no magic in it. The rules and claims and diagnosis codes both go on the blockchain. The client software executes the rules against the claims and diagnosis. Again, even a website can assist in it.
It is obvious that you're operating 100% in bad faith. Also, your experience of having to deal with experts and attorneys has ruined you from seeing beyond it.
> If the information on the blockchain contradicts a denial communication e/mailed to the patient, it will be an easy win in court.
And you will understand that how? As a person who is no an expert in medicine.
> There are numerous blockchain explorer websites that catalog the data and conveniently query+format it for display.
So you've got yourself hundreds of pages of medical data and decisions. Now what?
> The rules and claims and diagnosis codes both go on the blockchain. The client software executes the rules
Ah yes. The magical rules that exists just because there's blockchain. And there's magical software that can easily execute those rules just because blockchain. Because as we all know, all medical data and decisions are input into systems in easily digestible machine-readable formats and all the machine-executable rules are there.
Funny how none of that exists now, but will somehow magically appear the moment you say "blockchain".
> It is obvious that you're operating 100% in bad faith.
The only thing that's obvious is that the vast majority of blockchain proponents assume their opponents operates in bad faith the moment their opponents ask questions rooted in reality, and not in wishful thinking.
> your experience of having to deal with experts and attorneys has ruined you from seeing beyond it.
I've never dealt with experts or attorneys when it comes to medicine.
I've read enough of simple non-complicated descriptions of such simple things done to me like routine dental checkups and removal of a non-malignant tumor to see through any of the fairy tales you're trying to sell.
> More than half of the physicians in this study reported engaging in some questionable hospital chart documentation practices. Many of the physicians reported using charting practices that would be considered unacceptable (e.g. charting prior to seeing the patient or without seeing the patient on the day of charting).
> The pressures that may influence physicians to engage in questionable documentation practices are numerous, including reimbursement regulations, time-constraints, fear of litigation, and quality audits.
> ... fear of litigation and the threat of malpractice liability have been cited as reasons why physicians alter their clinical behavior and practice defensive medicine
lol good luck with your "blockchain is the source of all truth and it's easy to run the rules on some client software"
I'm definitely not interested to continue this conversation, as it devolves into a well know pattern of blockchain-related delusions.
It is clear when someone is spreading FUD such as in your comment. As for blockchain, it is demonstrably used millions if not billions of times daily to do all the things I noted. Your limited mind can hardly comprehend the rule-based contracts that execute on Ethereum.
If left to you, civilization would never have progressed out of the stone age, and I mean the stone-throwing age, not the stone-tooling age.
That's burning down your house to kill a spider. Even in a closed system infinite replay-ability is a big headache, and adding "blockchain" adds a hundred new problems. There's already legal system which is a direct dependency, and it is more efficient and manageable. (Yes, that's right, the US legal system actually looks sane by comparison.)
Instead, make a legal requirement that patients (and sometimes other stakeholders) can demand the data/logic behind the company decisions.
If you still want very tamper-proof write-only records, that can be done way more easily/quickly/cheaply with an old-school distributed database with fixed trusted nodes, run by multiple institutions that are not likely to conspire together.