Coding a healthcare application for Blockchain

I usually have to dive right in if I'm going to understand something.  So I found some sample code via IBM BlueMix to read through.

Here is the first application I will try to create:

1.) Identify a patient using a cryptographic entity identifier.  Imagine that I have an application on my phone. I used it to connect to the Blockchain Healthcare Network (BHN).  The first time I did this, it issued me my cryptographic identifier that I stored on an application on my phone.  We won't bother talking about how this is kept secure. That's for a later discussion.

2.) In the case of this example, the identifier I discussed above will simply be a hard-coded key that is provided by BlueMix.

3.) I pretend I am a healthcare primary care provider that has co-identified me when I came to the practice (e.g., I log into my phone, open my BHN key application, and show them my QR code and they scan it in.)

4.) They prescribe/order me to take 1 Ibuprofen

5.) I leave and the practice submits this new medical information to the BHN

And, it's a transaction for the ledger.

So, here are the steps I believe will happen:

1.) Practice entity identifier is submitted to the blockchain.
2.) My patient entity identifier is submitted to the blockchain
3.) The transaction is this:

• Credit Patient's ledger with an Active Medication called Ibuprofen, quantity 1
• Debit Provider's ledger which indicates the practice has issued the unfilled prescription
• Verify the transaction is legitimate (not sure how this part works but it uses hundreds of "volunteer" computers around the world who get a micro-fee for providing their infrastructure)
• Close the transaction for these entities

Simple, right?

Hypothesizing on applying Blockchain to healthcare

Okay, so it’s a ledger that's "secure" and "transparent". hmm. http://blogs.wsj.com/cio/2016/02/02/cio-explainer-what-is-blockchain/

I must come up with a transaction that adds from one side of the ledger to the other and/or subtracts from one side to the other.

Once the transaction is complete, I must make sure the ledger is reconciled and auditable.

How would we put this to use in healthcare?

I assume, possibly wrongly, that the transaction for healthcare would add to a person’s healthcare record or subtract from it.

In other words, I am adding healthcare information to Person A’s record and taking it from the provider that Person A saw?

I’m not sure that is correct but let’s try a use case.

Person A goes to Practice Z and is administered drug Ibuprofen.  My blockchain transaction would look like this: Add drug Ibuprofen to drug list ledger of Person A and subtract drug Ibuprofen from drug order list of Practice Z.

This doesn’t make sense to me unless the ledger already has a record of Practice Z’s drug orders. I think I may be hung up on my far distant knowledge of double-ledger bookkeeping. In double-ledger bookkeeping, every addition to one account must correspond to a subtraction from another account. This doesn’t seem like a starter.  Time to go back and do more reading.