Trust is essential to building and maintaining strong, healthy relationships, and the relationship between a patient and their healthcare provider is no exception. Patients with trust in their doctors are more likely to follow treatment plans and medical advice on lifestyle and family planning issues, reducing their lifetime cost of care and increasing their quality of life. A 1999 study found that sixty-two percent of patients with high levels of trust always take their prescribed medication and follow their doctor’s recommendations, but only fourteen percent of patients with low levels of trust do. As another example, for patients with H.I.V., trust in medical providers is associated with more clinic visits, fewer emergency room visits, increased use of antiretroviral drugs, and improved reported physical and mental health.

Mistrust, unfortunately, has been an increasing trend in healthcare. In 1966, almost three-fourths of Americans said they had great confidence in the leaders of the medical profession; by 2012 only one-third expressed this view. Combined with the overall decline in Americans’ trust in institutions the last few decades, the potential threats to public health become apparent. A lack of trust can lead to individual patients refusing vaccinations or forgoing the flu shot, which can have potentially deadly consequences for the greater population. During the 2014 Ebola outbreak, only thirty-one percent of the American public said they trusted public health officials to share complete and accurate information about the Ebola virus and a mere fourteen percent said they trusted the government to do the right thing. If these patterns of mistrust continue, future responses to public health emergencies could be drastically impaired.

So what can be done to rebuild trust in our healthcare systems? A recent report by Accenture reveals two clear steps that healthcare institutions can take: over ninety percent of health executives believe that treating customers as partners and ensuring the security of consumer data are both important or very important for gaining consumer trust. Consumer-centricity and data security are also two of the key benefits of blockchain technology, particularly when applied to electronic health records (EHRs). Traditional EHRs suffer from a lack of interoperability and cybersecurity due to varying practice standards and legacy IT systems. This makes sharing comprehensive health data securely across healthcare providers and institutions especially challenging and leaves consumers with little control over their own data.

Patientory is currently using the PTOYNet blockchain administered by the Patientory Association to shift this paradigm and empower patients to take control of their medical records. Blockchain, or distributed ledger technology, democratizes trust by removing the ‘middleman’ in transactions and allowing information to be recorded and shared by a community. Rather than relying on a central trust authority, blockchain relies on cryptography and a peer network for verification. All of the participants have a copy of the ledger updated in real time, providing a comprehensive, immutable record of information. Patientory’s blockchain-based distributed application allows patients to decide exactly who can access their health data and for what purpose. We believe improving consumer access to health data information is the first step to increasing trust in healthcare institutions.