Inside Medicalchain Issue #24

Welcome to the twenty-fourth issue of Inside Medicalchain, our newsletter to keep our community up to date. If you missed the twenty-third issue, you can catch up by clicking here.


We want to start this issue by firstly apologising to the community for being quiet for the past few months. As with every organisation, COVID-19 has been a difficult challenge and has disrupted how we work with all of the team now working remotely for the past year.

We reflected on areas where we could be more efficient within the company and how we could focus all our efforts and resources on delivering on our projects. That being said, ‘Inside Medicalchain’ will be switched to a quarterly publication instead starting from now. This gives us the opportunity to have enough time to prepare these newsletters as well as have enough significant progress to report on.

We will always do our best to update the community and hope to do this quarterly going forward.

Product development

Our upcoming Medicalchain Health Passport features and updates include:

  • Patient reported outcomes;
  • Health questionnaires;
  • Auditing on the blockchain;
  • Access to the largest primary care record source in the world;

We are also in the final rounds of discussions with two large pharmaceutical companies to run some trials using our technology.

Our upcoming MyClinic features include:

  • Multi-party consultations to facilitate Multidisciplinary Team discussions.
  • Health questionnaires.
  • Receptionist tool.

For users of MyClinic, if you have any questions, do check out our Help Centre and don’t hesitate to get in touch at [email protected] if you have any suggestions.

We are looking forward to sharing with the community our developments for electronic health records. We will be releasing more information soon, stay tuned!

New announcement: Further NHS Digital Framework goals

We continue to work closely with the UK National Health Service (NHS) digital service and will hopefully have some good news in the next edition of Inside Medicalchain about joining the dominant and ‘future-proof’ framework which the NHS has unveiled recently.


Dr Abdullah Albeyatti was an invited guest with Professor Tony Young to speak about the NHS and entrepreneurship on the The Voice of Healthcare podcast, hosted by Dr Cybulsky (Founder, IONIA) and Dr Maclellan (CEO, Cortina Health).

You can listen to that podcast here.

Dr Abdullah Albeyatti has also continued to contribute to the life sciences by speaking at several universities and institutions and was recently awarded by Imperial College London, the Emerging Alumni 2021 Award.

You can read more about the award and his journey by clicking here.

Inside perspective

This section aims to provide an insight into the project, including the people behind the scenes who are working extremely hard to make our vision a reality. In this edition of Inside Medicalchain, Behzad Hosseini, our Lead React Developer, gives you an update on our work and some invaluable advice for those wishing to enter the health technology space.

We hope you enjoy this inside perspective!

Behzad Hosseini — Lead React Developer, Medicalchain

What is a typical day like as a developer?

I like to start my days as early as possible and get most tasks done by noon time. I call these my golden hours of the day where I see myself most productive, especially when there’s a problem to solve or a new solution to create.

I typically first check on Slack, where our development team is, to see the latest updates. That’s followed by doing commit reviews on GitHub. Before I start or resume my previous day’s activities, I may have a short chat with my colleagues to either request something that I contemplated the night before or update them on a certain topic that has been discussed previously.

During the afternoon I mostly do refactoring, tests, and enhancements to our newly created solutions, and as we approach the evening time, I make sure my day’s work is saved or committed to GitHub for everyone to access, and I usually leave myself a sticky note describing the latest state where I left my work and what needs to be done the following day, and if needed, I update my tasks on Jira too.

I almost forgot to add that I usually go for a run in my neighbourhood park just before lunchtime as I feel more refreshed right after that for the rest of the day. I’ve been doing this ritualistically in the last 2 years.

What are the main features of the Medicalchain/MyClinic products that you have been working on?

I have been primarily working on MyClinic’s front-end. My job involves designing and implementing user-facing components using the React framework. However, the biggest portion of my work is related to the video call feature that we have within the MyClinic web solution, which enables the clinicians to interact with their patients over voice and video sessions as part of the appointment they had already set up using the same web-based app.

In our latest effort, we are working on a questionnaire feature that enables the clinician to have the patient answer a set of predefined questions before a consultation to gain insight into patients’ current condition, and therefore, hold a more efficient session once the patient is connected. This will be an important step in patient-reported outcomes in our Medicalchain Health Passport.

What are the main challenges that you find yourself facing when developing?

The main challenge most developers face is time management as there are many tasks in the backlog and we have to maintain a sustainable pace while approaching them. As a solution, I generally try to simplify tasks and break them into smaller pieces to better estimate what is absolutely necessary to be delivered to be able to mark the task complete. Then I move on to the next one, and when there’s less work, I can always go back and add improvements in small increments to our existing features.

What is it like working on healthcare technology? How is it different to other projects you have worked on?

It is always satisfying to think about how your solution or what you are building with your team as a developer can be beneficial to others in society. Working in a MedTech company is a great opportunity to reach a large user base and provide solutions that transform the way we used to approach healthcare traditionally while making sure no one is left behind.

Do you have any advice for any aspiring developers out there interested in this area?

Yes! That is “if I can do it, you can do it too”. That’s what I always say to let everyone know the only limit is their imagination. As developers with hands-on experience in the industry, we should feel the obligation to empower the brilliant minds who yet haven’t figured out their true potential, and pave the way for better collaboration in an ever-connected world as we approach new horizons in technological breakthroughs.

Social Media

Thank you to everyone who has taken the time to ask us questions and engage with our communications team. We do try our best to answer all of your questions.

· Twitter

· Facebook

· Instagram

· Medium

· Youtube

· Linkedin

Don’t forget to promote MyClinic to your local health providers

MyClinic is available for free to anyone providing a health service, of any kind.

Please promote this free solution to your friends, family and network.

Inside Medicalchain Issue #23

Welcome to the twenty-third issue of Inside Medicalchain, our regular newsletter to keep our community up to date. If you missed the twenty-second issue, you can catch up by clicking here.

Product development

Our upcoming MyClinic features include:

  • Screen sharing between clinicians and patients.
  • SMS and email invitations to be expanded, beyond links alone.
  • The enabling of image and file uploading.

If you have any questions, do check out our Help Centre and don’t hesitate to get in touch at [email protected] if you have any suggestions.

We are looking forward to sharing with the community our blockchain developments for electronic health records. We will be releasing more information soon, stay tuned!

Read more

Inside Medicalchain Issue #22

Inside Medicalchain Issue #22

Welcome to the twenty-second issue of Inside Medicalchain, our regular newsletter to keep our community up to date. If you missed the twenty-first issue, you can catch up by clicking here.

Product development

We are still busy in developing our blockchain-based EHR and products. 

We’re looking forward to sharing upcoming exciting developments soon! Hold on tight. Update

The increasing adoption of Rooms has been fantastic, and we thank all of you who have helped share and increase awareness about it. We are now operating across the globe. NHS users are the most prolific users of Further, we are being used by wide-reaching medical specialities, from Dermatology to Physiotherapy to Mental Health. 

Read more

Inside Medicalchain Issue #21

Welcome to the twenty-first issue of Inside Medicalchain, our monthly newsletter to keep our community up to date. If you missed the twentieth issue, you can catch up by clicking here. Rooms is still going strong!

We released Rooms in response to the current coronavirus pandemic. Rooms is a simple tool designed by us to allow for a virtual waiting room where patients can be directed to ‘check into’ whilst they wait for their doctor to begin the video consultation. We are now being used by several NHS hospital trusts in the UK to support the delivery of their secondary care clinics and research activities.

We are proud to share with you some updated numbers about our usage globally. We have now been used in over 78 countries worldwide! Check out a heatmap of all the countries below.

Read more

Inside Medicalchain Issue #9

(February 2019)

Welcome to the ninth issue of Inside Medicalchain, our monthly newsletter to keep our community up to date.

If you missed the eighth issue you can catch up by clicking here.

Product Development

Want to help? Give us feedback!

Please continue to download the iOS version of the application, and let us know your feedback on version 1.0 by sending us your comments to — [email protected]

You will be excited to hear that V2 of the application is almost ready for release, and we will be sharing this with you very shortly! Read more

Lifestyle Intervention

Whenever you hear the word “intervention” you may automatically think of an ‘addiction intervention’’, or a ‘surgical intervention’, as these terms have almost become synonymous with the word. But how about a lifestyle intervention?

Currently, the NHS England spends around 10% of its budget on treating diabetes, with recent projections showing that the growing number of people with the condition could result in nearly 39,000 people suffering a heart attack and over 50,000 people suffering a stroke by 2035.

There is progress within the sector to redress the prevalence of type 2 diabetes (T2DM) in particular, through a prescription of- lifestyle changes.

There are plans proposed by the NHS to roll out a national Diabetes Prevention Programme (DPP) in the form of ‘lifestyle interventions’ to curb the demand the health service is under. The evidence shows that diabetes prevention programmes significantly reduce progression to T2DM compared to traditional care by ~26%.

The approach will involve GPs prescribing a liquid diet of just over 800 kilocalories a day for three months, then a period of follow-up support to ultimately help achieve remission of their Type 2 diabetes. NHS England’s chief executive, Simon Stevens, announced the program on 30th November. It will first be offered to 5000 patients before being rolled out nationally.

The announcement followed a series of recent studies that have overturned the widely held view that type 2 diabetes is incurable and must be managed with medication.

Large population-based studies in China, Finland and the USA have recently demonstrated the feasibility of preventing, or delaying, the onset of diabetes in overweight subjects with mild glucose intolerance (IGT). With these studies leading to the conclusion that even moderate reduction in weight and only half an hour of brisk walking each day reduces the incidence of diabetes by more than fifty percent.

The objectives for the DPP are:

  • To support more people at high risk of developing diabetes to receive lifestyle
    interventions to help them lower that risk.
  • To slow down the increase in the incidence of type 2 diabetes compared with current predictions.
  • To reduce the incidence of heart disease, strokes, kidney, eye and foot problems (and associated
    mortality) related to diabetes compared with current predictions.

The benefits include not only saving the NHS money by alleviating the demand diabetes puts on numerous services within the sector, but the money and resources will then be reallocated and reinvested into providing more essential frontline care.

Chris Askew, the Chief Executive of Diabetes UK states:
“Plans to double the size of the NHS Diabetes Prevention Programme is excellent news. The programme is already the largest of its kind globally and shows England to be a world leader in this area. The ambition being shown by the NHS needs to be matched across all government policy — we need stronger action on marketing to children, and clearer nutritional labelling to support people to make healthy choices.”

There are even plans for online versions of the DPP, involving wearable technologies and apps to help those at risk of Type 2 Diabetes better self-manage. These will also be provided to those who find it difficult to attend regular sessions due to work or family commitments.

The aim is to better integrate the available solutions and help patients feel more in control of their treatment. This will hopefully stop the chance of patients withdrawing from their therapy and in feeling more accomplished with short-term goals- by achieving a certain number of steps for instance. This move by the NHS brings us one step closer to achieving a patient-centric health service, a more integrated solution.

By Medicalchain’s Tim Robinson

Curiosity killed the…Trust?

Salford Royal NHS Foundation Trust

Trust is a valuable commodity and in the words of American business magnate, Warren Buffett — “It takes 20 years to build a reputation and five minutes to ruin it.” The greatest issue is not so much the fact that you have been lied to, but that it then becomes so much more difficult to trust.

Trust is especially valuable when it comes to our privacy, and what is more private than our most intimate data — our personal medical records. In May, Sir Alex Ferguson, Britain’s most successful football manager was admitted to Salford Royal hospital after suffering a brain haemorrhage. After emergency treatment and less than a month in the hospital, Sir Alex made a good recovery.

After an audit of the Trust’s computer systems however, it became evident that a number of staff members- Two doctors, a senior consultant, and two nurses allegedly gained unauthorised access to Sir Alex’s private data.

Doctor Chris Brookes, chief medical officer for the Northern Care Alliance NHS Group, which runs Salford Royal, said of the incident- “We can confirm that a number of staff who work at Salford Royal are currently subject to investigation in relation to an information governance breach… All of our patients have the right to expect that their information will be looked after securely and accessed appropriately. We take patient confidentiality extremely seriously.”

Human error is not the issue here, curiosity shouldn’t be a variable in the privacy of our data since ideally, this shouldn’t even be a possibility. The Information Commissioner’s Office (ICO) is the UK’s regulatory body charged with enforcing data protection legislation and bringing regulatory action against those found to have breached data laws. It regularly deals with health-related cases and states that within its figures for Q2 of 2018/19 alone, there were a total of 4,056 data security incident reports within the sector.

What can Hospital Trusts do to earn our trust? Doctor Chris Brookes, chief medical officer at the site responsible for Sir Alex’s breach also stated — “We take patient confidentiality extremely seriously and will take the appropriate action to ensure staff understand the seriousness of unauthorised access.” Does that mean staff were not previously aware of the seriousness of unauthorised access? Does that statement guarantee this won’t happen again?

If hospital sites and CMOs wish to redress the issue they should reconsider their solutions, since trust is built through actions, not words. Successful relationships, including doctor-patient relationships, are built on the foundation of trust. This isn’t automatically awarded to someone due to a title, but earned, and as each Doctor and healthcare professional represents the sector as a whole, their reputation affects the NHS’s reputation.

Advising someone not to be curious is not enough, we should have firm and robust measures to protect patient data. Around the world, companies are considering using blockchain technology to help with privacy and data safety as they have done for the financial sector. it is time to block unwarranted access so that we can rebuild some trust.

By Medicalchain’s Tim Robinson

E-Prescribing for NHS Trusts

E-Prescribing for NHS Trusts

The UK’s Department for Health and Social Care has announced this week, that it will be providing £78 million to establish electronic prescribing and medicines administration (ePMA) systems in NHS Trust sites. There will be an initial share distributed to 13 selected NHS trusts, with a total of £16 million funding for 2018/2019 between them.

The reason for this decision is to move away from handwritten prescriptions which cause many issues within the system. Health Minister Stephen Hammond said, “As part of the long-term plan for the NHS, we not only want to harness technology to make it one of the most advanced healthcare systems in the world but crucially to improve patient care… The funding provided for these trusts will help to drive these changes to the patient experience, but will also aid our hard-working and dedicated staff… The introduction of electronic prescribing is not only known to reduce medication errors but also frees up time for staff by moving away from archaic systems.”

The benefits of ePMA systems include:

  • The reduction in potentially deadly medication errors by up to 50% when compared with the old paper systems.
  • The creation of a more complete electronic health record.
  • Dispensers can reduce use of paper, have improved stock control, and provide a more efficient service to patients.
  • Patients can collect repeat prescriptions from a pharmacy without visiting their GP, and won’t have a paper prescription to lose. In turn, freeing up GP time.

This is a great move to advance the UK’s health system for the benefit of service providers and patients alike.

A research body conducted by university academics from Manchester, Sheffield and York, identified more than 230 million medication errors a year that took place in the NHS. The report also stated that an estimated 712 deaths result from avoidable adverse drug reactions (ADRs). Furthermore, these ADRs could be a contributory factor to between 1,700 and 22,303 deaths a year.

Fiona Campbell, Research Fellow from the University of Sheffield’s School of Health and Related Research, said: “Measuring harm to patients from medication errors is difficult for several reasons, one being that harm can sometimes occur when medicines are used correctly, but now that we have more understanding of the number of errors that occur we have an opportunity to do more to improve NHS systems.”

A personal case in point occurred recently. On a weekend away within the UK, I became aware that I’d forgotten to bring my inhaler with me. Usually, the asthma is not a problem, but there was a lot of heavy walking and a log fire involved which seemed to exacerbate the issue.

Upon attending a local pharmacy I came to an abrupt roadblock as the pharmacist refused to sell me an inhaler over the counter, instead insisting I give her a paper copy of my prescription.

If I didn’t have my inhaler I certainly wasn’t going to have my prescription with me, so I asked if she could make a discretionary judgment as I had no means of providing the prescription and I mentioned the NHS website, which says:

“If you urgently need medication, contact your prescriber immediately to arrange a prescription. If this isn’t possible, you may be able to get medicine from a pharmacist in an emergency, subject to certain conditions.”

This is when she also quoted the NHS website and relayed to me:

“You must have been prescribed the medicine before by a doctor, dentist, nurse independent prescriber, optometrist independent prescriber or other healthcare professional, who is registered in the UK.”

Here was the alleged issue – I had no evidence that I had been prescribed Salbutamol previously, other than knowing what it is and wheezing at her over the counter.

The next step was to call up my home GP and ask them to send evidence of my repeat prescription to the pharmacy. The GP uses a system called EMIS, the Pharmacy I attended used a rival software, TPP. Therefore both could not communicate with each other to verify my need for this inhaler whilst I became more breathless and wheezy as time went on.

The solution to the issue? (although it is perfectly legal for the Pharmacist to make a judgment call on a solitary inhaler to a wheezing patient, they are registered health professionals for a reason you know):

  1. I needed to register with the local medical practice
  2. Meaning I needed to consent to the medical practice obtaining all my previous medical records
  3. To then book an appointment to see the doctor
  4. To then wait another 2 hours to get to see the doctor- taking up her lunch time
  5. To obtain a prescription I already have on repeat
  6. To go back to the pharmacist that turned me away to get an inhaler

The entire process took over 3 hours all the while physically no better off, which proves the point even though anecdotally. The current system is archaic and not in harmony with the times we live. Almost everything is digital – even the local old man I bought wood to build a fence from accepts online purchases and Google Pay.

The utilisation of electronic prescribing will streamline the present health system and save the NHS financially, by limiting cases of litigation as a result of ADRs and wasted appointments at GP practices (inhaler). Patients will benefit by being able to avoid unnecessary trips to their GP and in having quick access to their medication upon a visit to any cooperative pharmacy.

By Medicalchain’s Tim Robinson

Youth Turning to Apps for Mental Health Needs.

Youth Turning to Apps for Mental Health Needs.

According to the Office for National Statistics (ONS), in 2014, a total of 6,122 suicides were recorded in the UK for people aged 10 and older (10.8 deaths per 100,000 population), with suicide being the leading cause of death among young people aged 20-34 years of age. This equates to approximately one death every two hours, with around 75% of these being male.

Suicide is not a mental illness in itself, but rather a desperate attempt to control the overwhelming symptoms of the underlying mental health disease; making it the ultimate consequence for many mental illnesses. The Adult Psychiatric Morbidity Survey found that young people aged 16–24 were more likely to report suicidal thoughts than any other age group, with females in this age group having the highest levels of suicidal thoughts than any other demographic.

It is easy to rattle off a long list of statistics to prove a point, but there is a greater issue involved here, 72% of people who died from suicide between 2002 and 2012 had not contacted their GP or a healthcare professional about these feelings in the year leading up to the event.

There are a multitude of reasons to why patients are not reaching out for help. Severe depression and anxiety can make simple tasks such as going outside or calling your doctor too difficult. Simple everyday processes become a barrier to accessing help. It may be difficult to get access to a GP or a Doctor they trust, they may lack faith in the system to help them or are poorly informed about the help available, and the general stigma associated with mental health.

Although society and the media is trying very hard to change perceptions of mental health and the stigma associated with it, it remains a part of the problem. Stigma comes from multiple fronts. There is the social stigma inherent in a society, which can be localised due to the demographic disparity. Then there is a self-imposed stigma from the perception of the sufferer, at the possibility of being labelled as perhaps self-absorbed, their symptoms self-inflicted or unimportant. Either way, the fact that stigma exists around mental health compounds the suffering. Sufferers may feel it is a personal weakness or failure on their part, but the reality is that it is a disease that needs treatment and is ultimately not their fault.

If stigma, isolation and lack of availability of help compound the issue, the converse must also be true. People who receive support from caring friends and family, and who have access to mental health services are less likely to act on their impulses, however those impulses manifest.

According to the Care Quality Commission, evidence suggests that the number of children visiting A&E for mental health treatment has more than doubled since 2010. Many services are even failing to meet NHS guidelines for an out-of-hours crisis service.

Dr Nick Waggett, Chief Executive of the Association of Child Psychotherapists commented on the current state of the sector – “We do hear stories of children and young people having to have attempted suicide on a number of occasions actually before they are seen within the service… The problem is that then they’re very ill and it actually becomes increasingly difficult to offer them an effective treatment.”

I started this article to break the ice, stating the worst case scenario, but these points are just facts. Just as it is a fact that mental health is a continuum, the extremes are quite distinct, but the variations in between are gradual. If the number of fatalities represent one extreme, even though so prevalent, there will be so many more who are affected along the scale.

Everyone has mental health and just as everyone has different states of physical fitness, everyone has varying states of mental health. The two should not be thought of as separate since mental health plays a major role in your ability to maintain good physical health. Mental illnesses, such as depression and anxiety for example, affect your ability to participate in healthy behaviors.

Clearly there is a need for mental well-being to have the same prominence as physical well-being. Not to compare mental health disease with physical disease, but to appreciate that they coincide. Clinical depression is an illness that should be treated by a health care professional or a mental health professional, in as much as diabetes, arthritis or hypertension needs treatment.

Since the openness and access to sources of care and support can mitigate the risks associated with mental health issues, especially the prevalence at which these issues affect the young, we should publicise any available resources.

Tom Madders, Director of Communications, Campaigns and Participation at Young Minds, an organisation dedicated to tackling the issues around mental health in youth states- “Most young people spend much of their time online, and it can feel easier for them to communicate through messaging and online services than face-to-face”, this is where services such as Kooth come in. Kooth is a platform which offers online counselling and emotional well-being support for children and young people through a community of peers and a team of experienced counsellors.

It would seem that the use of health apps is an indispensable convenience and even preference which should be more widely adopted by local health organisations, including the greater health and social care system as a whole.

Many services are failing to meet the demands of those in need and the last thing which should happen if they have been able to reach out; is for young people to be rejected from a service they believed could help them. Whether there be a top-down, or bottom-up dissemination of these resources, it doesn’t matter, so long as access is made available. Anyone can download an app.

A helpful summary of available apps to support mental health well-being can be found here:

By Medicalchain’s Tim Robinson