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Blockchain Technology & Mental Health India

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Dr. Vihan Sanyal, Psychotherapist, Mumbai There is a lot of mixed feelings with the possible introduction of blockchain in the Indian market. A lot of research and development is currently being conducted and countless man hours being invested in making blockchain technology accessible and user friendly. The aim of this article is to understand the basic principles of the technology, the role it can play in the mental health arena and some of the perceived advantages and disadvantages of using the technology. It is important to mention that it is difficult to fully ascertain the benefits blockchain at this point in time. Until and unless the technology is widely accepted and used, we will not be able to come to a realistic conclusion of its effectiveness.

WHAT IS BLOCKCHAIN TECHNOLOGY?

Blockchain technology was conceptualized in 2008 by Satoshi Nakamoto, however, it gained recognition with the launch of Bitcoin. Blockchain is not a new technology, it is an amalgamation of three pre-existing technologies: the Internet, private key cryptography and a Peer-To-Peer network adhering to a protocol. A blockchain is a list of records (called blocks) which form a virtual chain using cryptography. This technology makes it easy for digital information to be distributed, but not copied. A blockchain provides a decentralized database, called a digital ledger, of transactions that anyone with an internet connection can view. It aims to make exchange of data secure and virtually impossible to hack. As there is only a single creator and owner of a particular data, the chances of data manipulation is eradicated and authenticity of data increases. There are owners of documents and no other authorized users. The unique cryptography key (a long string of numbers) is the only authentication required. Possession of this key is proof of ownership of the document.

The information on blockchain is accessible across multiple locations. As data is not stored in one particular location, it makes it difficult for hackers to hack into the system and therefore makes it a secure form of information sharing.
WHAT ARE SOME OF THE ADVANTAGES OF BLOCKCHAIN FOR THE MENTAL HEALTH CARE SECTOR?

UNIFORMATY – Data is stored in a single file format. This makes it easy for people to access and understand the data globally.
ACCESSABILITY – Data can be easily accessed across clinics, hospitals and insurance companies. It will prevent loss of historical and relevant data. It will improve diagnosing and treating of mental illness with point of reference available through the data.
CONTROL- The patient will remain in control of who can have access to the data at all times.


WHAT ARE SOME OF THE ADVANTAGES OF BLOCKCHAIN FOR THE MENTAL HEALTH CARE SECTOR ?


1. New Technology – Just like a new line of treatment, we cannot be certain of all of the advantages. There is bound to be a lot of trial and error before we can expect to reap the benefits.
2. High Start-Up Cost – The technology is expensive and requires high processing power leading to hefty electricity consumption. Not sure how many clinics and hospitals are likely to afford to use the technology.
3. Requires Joint Effort – Mass calibration is required within the health sector for blockchain to become successful in India. A movement which requires the support of major players within the health ecosystem is required for it to flourish.
4. Not able to handle large data sets – At present, the technology can handle personal data and prescriptions. It is likely to face challenges in storing large files like CT scans and x-rays.
5. Open To Human Error – The technology still relies upon manual entry of information. If a person makes an error while inputting the data into the system, the data will get stored and distributed

One of the main advantages of this technology is the decentralization of data. History of clients with accurate dates, diagnoses and prior treatment interventions are crucial in forming a plan of treatment. A few diligent clients carry with them thick files of prescriptions and notes left by mental health professionals they have visited in the past when they come to see me. While with others, I am often relying on their memory and interpretation of their condition as explained to them by other mental health professionals. It would be wonderful to be able to access accurate and relevant information at the click of a button.

I do, however, feel that the practicality of entering the data can pose certain challenges. Professionals with a busy practice may find it difficult to enter all the data into the system. If the professional has an assistant input the data, he not only breach’s confidentiality between him and his client, but, also limits control over the accuracy of the data.

In our country, doctor hopping has been a prevailing trend amongst people. If all mental health professionals could have access to a uniform system which was used across the board, it would save time and help the mental health professional to proceed with treatment options relevant to the person’s condition. If for example, a psychotherapist has been working with Cognitive Behavioral Therapy (CBT) with a client for years without much success and this record was available for the new therapist to access. The new therapist can then select a different line or modality of treatment instead of pursuing with CBT.

The stigma associated with any form of psychotherapy and mental health is one of lack of faith in its effectiveness. Access to therapeutic notes allow a client to have a visual representation of the progress they have made while in therapy and are of immense value to other mental health professionals when the client changes therapists.