Usability and Performance of a Blockchain-based Care-Management Platform in Kenya

Abstract

The inherent complexities of Africa’s healthcare landscape make it difficult for practitioners to ascertain a deep under-standing of a patient’s condition and effectively coordinate efforts to deliver high quality care. To address these critical challenges, we are developing a platform with three core capabilities. First, the care management platform, a Blockchain-enabled platform that enables patient-controlled exchange of health data and coordinated care between primary and referral organizations and adheres to the Fast Healthcare Interoperability Resources (FHIR) v3.0 standard. Second, the patient-care wallet, a mobile application where patients view their health records, who accessed their records, and consent to share their health data. Finally, a clinical encounters application that marshals care providers through workflows and enables requests for patient consent to share health data between providers. We conducted preliminary investigations of the system usability and performance to identify critical usability and reliability issues. Care providers found the application satisfactory and easy to use for supporting clinical documentation and data sharing. Performance test findings suggest that the platform can be deployed in resource-constrained settings, though its performance is affected by the number of concurrent users, transaction loads, round-trip delay time for accessing cloud-hosted services, and local network bandwidth. The platform has the potential to transform care coordination and delivery by providing deeper visibility of patient histories during referrals, reducing unnecessary paperwork, minimizing duplicative services, and promoting data privacy and access transparency.