Blockchain in Healthcare Could Be “Game Changer” for EHR Interoperability

October 23, 2018 - Blockchain in healthcare is a potential game changer for the way providers exchange data. However, understanding the potential of blockchain and how to realistically implement it are not always clear.

According to a recent Deloitte report, blockchain provides a specific set of capabilities: transparency, trust, disintermediation, auditability, and smart contracts. Because of these capabilities, the healthcare industry has begun to see how blockchain can be used in healthcare-specific implementations.

“Blockchain has evolved from capturing cryptocurrency transactions (e.g., bitcoin) where entries are financial transactions, to a medium that can enable decentralized information sharing and application operations,” said the report. “In this new evolution, information on the blockchain can represent contracts, assets, records, transactions, identities, or practically anything else that can be described in digital form.”

One of the most significant ways blockchain can potentially help the healthcare industry is by solving the data donation issue, according to Deloitte.

“Blockchain may offer a solution to more easily aggregate health data in a secure, trusted, automated, and error-free way,” said the report. “A solution which enforces rules, privacy, and regulations in a mutually agreed upon manner, resulting in a smart contract between patient and healthcare stakeholders can be an important enabler to clinical research.”

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“This can allow patients to more easily aggregate their data from different sources and share what they choose to with their physicians and researchers,” the report continued. “All this puts the patient in the driver seat of health and well-being, rather than being along for the ride.”

While this use for blockchain would simplify data collection among patients, there are still a few challenges blocking organizations from embracing blockchain right away.

Lack of EHR interoperability is one of the major blockchain obstacles facing healthcare organizations today.

“A patient’s medical information can be scattered across medical centers, physicians, health plans and others,” the report explained. “Often these healthcare organizations store this data in different digital formats and EHR systems, which can make the task to aggregate and analyze patient data on common terms very difficult and can result in inconsistent formats in the way data holders may make health data available to patients. The lack of continuity that surrounds medical data and EHRs is a major concern for patients.”

Open standards projects like Fast Healthcare Interoperability Resources (FHIR) have been working to solve these issues, but they are still being developed and aren’t mature enough to fully support interoperability. Organizations are hopeful that blockchain will be the game changer that will help provide interoperability.

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“Traditional solutions and technologies have not been able to completely solve these issues, leaving patients in a position where they face challenges taking advantage of their own medical information to accelerate new cures. A game changer is needed,” said the report.

Blockchain can potentially help solve interoperability challenges in healthcare because of the way it’s built. There is no centralized owner of information so each participant in the blockchain owns and maintains their own copy of the information. This concept could allow patients to oversee their own identity and health record.

“Although this blockchain would require standards and agreements from various stakeholders, its distributed nature and capabilities (e.g., smart contracts that autonomously and consistently execute rules) can better facilitate widescale adoption among groups that do not inherently share information with one another when compared to other traditional technologies,” said the report.

Giving patients control of their own records has potential, but the standards and motivation must be present for it to be successful. Patients may not be interested in being in control of their own records.

“The healthcare organization is just a holder for that data, we don’t own it,” VMware Senior Healthcare Strategist Chris Logan told HITInfrastructure.com. “At the end of the day ownership is back on the patient to request that information or store the information as they see fit. From a compliance perspective including certain mandates healthcare providers have to conform to, this is where blockchain falls a little flat.”

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“People don’t want to own their records and that has been proven time and time again if you think about the personal health records that were available to people many years ago,” he continued. “How many people actually took advantage of it?”

This is an important question to ask when it comes to blockchain implementation and how it will be used in the future.

Provider organizations may not be at the point where they can realistically implement blockchain, but keeping an eye on what other organizations are doing and the development of standards can help them see a realistic blockchain timeline.