+ Data is increasing exponentially, at a very high rate, with modern advancements in technology
+ Privacy and security concerns. (i.e.: the European Union's (EU) recently adopted General Data Protection Regulation includes a “right to erasure” and places health data in a special category of personal data. This further raises additional questions about the intersection of blockchain, encrypted data, and patient privacy, particularly in the EU context)
+ Patient engagement (requires a lot of participants and meticulous steps)
+ Biggest limitation: incentives. Incentivizing institutions to build patient-facing data connections without financial motivation to do so will be challenging—the difference between compliance and true interoperability. 


Limitations of the patient-driven approach

This is where the technology of blockchains shines.

+ Data can subsequently assign access rules and permissions around their data, enabling easier sharing.
+ Data availability 
+ Rapid access to clinical information (Data liquidity)
+ Less complication in terms of patient identity
+ Immutability:  data is securely distributed across multiple entities, ensuring its integrity, lowering the risk of loss.



Advantages of the patient-driven approach

+ A patient's electronic health data is made available to them through standard mechanisms like traditional APIs.

+ Within this model, patients are the digital stewards of their health data, authorizing release and sharing to trusted entities.


Saint Olaf College

Implementing blockchain technology in healthcare systems.

Healthcare interoperability

+ Relies on different healthcare entities exchanging data based on business or regulatory incentives.
+ However, there has been a shift towards patient-driven interoperability due to the difficulties above.


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