• in drug trials;

• manufacturing of fake drugs and the use of poor quality or the wrong ingredients;

• allowing unqualified staff to perform procedures and examinations; 

• invoicing medically unnecessary services; 

• billing for services not performed; 

• charging for branded drugs and using simple generic medication instead;

• charging for more drugs than were used.

Source: Science Direct

According to the Fortune Business Insights publication: “The global fraud detection and prevention market is exhibited to grow from USD 30.65 billion in 2022 to USD 129.17 billion in 2029, exhibiting a CAGR of 22.8%”. Such levels of fraud lead to a lack of trust in the healthcare industry and are often a result of an absence of transparency. And this is what the use of blockchain-powered platforms is able to alleviate. Alongside being a catalyst for the utmost accountability, the use of Blockchain technology can ensure that data is more secure, accurate, and tamper-resistant in nature whereby making it almost impossible to mimic, falsify or manipulate data.

Application of blockchain in the medical industry

The uses of Blockchain technology in the medical sector are many and varied and it uses to tackle fraud is just but one. Other such examples are:

• safety and transparency - ensuring a simple and easy exchange of data among providers of medical solutions can contribute to diagnostic precision, productive therapies and cost-effective ecosystems. Blockchain enables different health organisations to connect and exchange information on a commonly distributed ledger for better safety and transparency whilst still maintaining integrity and confidentiality. 

• health record keeping - in most cases, patients’ data exists in silos that are not connected. For instance, your primary care physician has access to some of your medical data but not to data that specialists such as an endocrinologist, general surgeon or obstetrician can access, and vice versa. This hinders treatment and can impede the care management of a patient. Blockchain technology could solve this problem by making available an application that enables connecting to existing medical record (EMR) systems from different healthcare providers. Whenever a piece of new information is lodged into any of the EMRs, the blockchain would receive encrypted data regarding the information. This unifies all details and provides the patient and health providers with historical access, thereby making it easy and possible for healthcare providers to obtain a complete view of the patient's health status at any point in time.

• digital identity - it is claimed that: “Stolen health information is 20 to 50 times more valuable on the black market than financial data. This stolen data is used for medical identity theft, an insidious crime that can lead to devastating consequences for individuals and billions of dollars lost industry-wide”. Blockchains can enable a transparent, auditable means for individuals (using their peculiar credentials and encryption key) to allow other parties to access their personal health data. This includes granting authority for health professionals, service providers and other relevant actors to access their medical records and other information for direct health care delivery, or to permit statistical, research or other secondary uses of their data. This means that no one has access to your data without your consent.

• clinical trials - the use of Blockchain technology can help to strengthen trust in clinical trials by addressing the problems of false results and data disintegration that do not match the purposes and objectives of the research. Providing more clarity and identification of false content brings credibility to clinical trials.

• display information – given that it is properly used, Blockchain technology provides better protection than ever for sensitive data. For example, it will display information about the origins of a medication to ensure high quality and also confirm details about that manufacturer supplying the approved medicine.

• monitoring of patients - Blockchain technology can be used in conjunction with other technologies to help monitor patients, store information about an individual patient, analyse the effects of a particular procedure, validate transactions, create research initiatives, maintain financial statements in hospitals and minimise data transformation time and cost. 

How blockchain technology can be used in the medical sector.

Source: Science Direct

In 2021, US healthcare spending was over $4trillion, i.e. almost 20% of the county’s GDP, whereby attracting a number of companies such as Akiri, BurstIQ, Factom, Chronicled, Embleema, RoboMed and Curisium to develop and promote a wide range of blockchain-powered solutions. However, although change in the medical sector is understandably not going to happen immediately, there have potentially been valuable lessons to be learnt from the way in which medical treatments and drugs were developed to address the COVID-19 pandemic. Indeed, in the report ‘Blockchain applications in health care for COVID-19 and beyond’, by The Lancet, was included that: “Blockchain technology has numerous potential COVID-19-related and non-COVID-19-related applications in health care”.

Challenges of using blockchain in the medical industry

Being a new concept, challenges have been plaguing the adoption and use of blockchain in the medical industry, and the adoption of Blockchain technology in healthcare has been slow for many reasons - the fear of litigation, the perception of blockchain as new technology and often a lack of funds to implement new processes, procedures and the technology itself. Some healthcare organisations are concerned about the scalability of blockchain, with the fear that blockchain-powered platforms systems will be unable to scale to support their needs. 

Well, they perform in the same way as credit card companies, but without the interests and commitments. Because of the problems they tackle, BNPL platforms have a younger demographic (Gen Z and younger millennials) as their audience. However, this is not to say BNPL platforms do not enjoy patronage from the older demography. In a survey by The Ascent, over 37% of Americans had used BNPL at one point in time. 2021 drove that number to almost 56%. In another report by Accenture, the number of BNPL platforms was found to have reached 45 million people. Furthermore, a survey by Ascent found that 62% of users think BNPL could replace credit cards. According to Insider Intelligence, in 2025 the BNPL offering will account for an impressive $680 billion in transaction volume worldwide. This projected growth will occur as a result of the expanding number of e-commerce platforms and increasing adoption of BNPL services to meet the needs of other markets.

There are a number of firms which use Blockchain technology and digital assets that use this technology with the best known being PayPal (now offering BNPL in over 600,000 stores globally). XRPayNet, built on the XRP ledger, is another company which uses cryptocurrencies and launched its app in January 2022 offering a BNPL option. XRPayNet works at capturing and overcoming the current needs of real-life and on-demand crypto payment systems required by people and businesses all over the world. XRPayNet’s approach aims to address cryptocurrency problems that could let users trade cryptocurrencies from their savings accounts. 

BNPL firms in the DeFi sector

Source: BNPL.io

@Pay is a DeFi platform with a different approach to implementing BNPL in the blockchain industry. It is a Defi protocol, integrating Blockchain technology with its cryptocurrency to power its BNPL approach. The platform also offers significant cost savings to its users by utilising smart contracts and Blockchain technology. This is very helpful when offering DeFi e-commerce and other solutions to buyers and sellers. Another firm in the DeFi sector is Uquid which has teamed up with Binance to offer its ‘Pay in 3’ feature - spreading crypto payments on everyday purchases across three instalments. The increasing number of e-commerce and FinTech firms are driving the BNPL-crypto innovations forward because e-commerce stores are partnering with BNPL stores to meet the demand from the growing number of digital assets and crypto owners - many of whom are also their customers. One of the perks of the competitiveness of the e-commerce space is that it drives e-commerce platforms to implement innovations that are stress free for their customers. In addition, the increasing number of crypto wallet owners is prompting e-commerce platforms to optimise their checkout experience to remain relevant and competitive.

Many other companies are likely to join in building and strengthening these innovations, given the success these pioneering companies are set to enjoy. This is not to say there will not be challenges on the way in order to achieve these solutions. The most notable of these challenges is that of regulators scrutinising BNPL plans, labelling them loans since customers could become debtors from using them. This is somewhat technical because loans have interests attached to them and BNPL plans do not. However, when they apply the service, BNPL users typically have to pay back in four instalments - late payments attract extra payments. In a survey conducted in 2021, Credit Karma (a financial services company and indeed the largest Fintech firm in Europe) found that a third of the users of BNPL platforms reported defaulting on their payments. This has become a source of concern in some jurisdictions and a bone of contention with BNPL companies. BNPL firms are usually not regulated although they are in some countries heeding warnings from regulators to alter their terms and conditions with their clients ,such as in the UK. Some companies have been required to refund their BNPL customers while others  are putting mechanisms in place to make debts on their platforms almost impossible. One such company, Afterpay, intends to resolve the debt issue by allowing the maximum charge of $8 in late fees payment with the cost being capped at 25% of the individual order amount. Afterpay customers are banned from using the platform when they default on their payments until they pay their debts. 

Innovative BNPL FinTech platforms will create challenges and potential problems which require modern solutions, but do they need to be regulated? These FinTech providers are presenting stiff competition for the credit card providers and banks which have traditionally offered consumer credit services and by using a range of digital applications are doing so potentially cheaper, and faster.