- Healthcare blockchain is expected to emerge as a valuable tool to add to health IT infrastructure in 2018. However, healthcare blockchain is still so new that the practical applications of the technology are unclear .
The first healthcare blockchain solution was just released for claims management, but there’s talk of using blockchain for EHRs and medical imaging as well. The concept of secure, decentralized ledgers for data exchange is promising for healthcare. Practically applying the technology in its infancy may be challenging in the industry.
VMware Senior Healthcare Strategist Chris Logan sees healthcare blockchain potential but doesn’t completely see the technology’s full utility in the healthcare industry yet.
“When you think about what blockchain actually is, it’s just a decentralized ledger,” explained Logan. “At the end of the day, if we’re decentralizing a database it’s not groundbreaking at all even though there are operational benefits that come with that.”
“There is still an immaturity about blockchain in general,” Logan continued. “Healthcare organizations aren’t going to be quick to adopt blockchain, especially if it’s a public-facing chain because it’s relying on the resources that they don’t control.”
Publicly controlled blockchain for healthcare data exchange can be dangerous and takes the industry back to the same hesitations entities felt towards public cloud adoption a few years ago. When public cloud first emerged, healthcare organizations did not want to put their data where it was stored alongside data from other enterprises across many verticals with different regulation and security requirements.
Logan said this is a problem that vendors are going to need to solve by offering blockchain solutions that are more private.
“I think we’ll start to see the emergence of more ‘controlled chains’ that you’re buying into so that you’re guaranteeing continuous uptime,” said Logan. “You’re guaranteeing the non-repudiation of the information that’s going in because you’re going to partner with a vendor to provide the actual chain.”
The healthcare space is currently lacking the applications that will drive data to the blockchain.
Interoperability has been a major health IT issue for over a decade. The interoperability challenge has yet to be resolved universally across healthcare and will be an obstacle for healthcare blockchain.
“Interoperability started off with needing application software, which is fine inside the walls of a hospital,” Logan explained. “As we’re expanding out, interoperability is really focused around patients.”
“The ONC is starting to publish a lot of information about interoperability and their protocol that they developed, FHIR, to be able to share that data seamlessly and securely across the continuum,” he added. “But, that still doesn’t put the data in the hands of the actual owner, who is the patient.”
One of the biggest challenges of patients being at the center of their EHR is the lack of a national patient identifier, Logan stated in a previous interview. A national patient identifier is crucial to blockchain because if an organization cannot correctly identify a patient, then the patient can’t be in control of their EHR.
Patient record ownership isn’t the only use blockchain has in healthcare. Logan sees potential in clinical trial management and disease management as potential future uses for blockchain.
“Blockchain could really play a role in healthcare is with the CDC,” said Logan. “The federal government could use disease tracking in the blockchain because it gives that unfettered access to the information, to whom it needs to be given to at that point in time where they need it. The data becomes more actionable, because it can’t be tampered with. It’s a true source of truth at the end of the day.”
Healthcare blockchain also has potential for financial transactions for insurance companies for the payer population.
“Insurance claims and the payer population are using their own patient identifier,” Logan stated. For example, an organization could gather information from a provider that is contracting for them. Following that patient-through-care continuum to insure the proper payments or smart contracts is a great blockchain use, he said.
Healthcare blockchain is going to require a dedicated infrastructure from providers, Logan added. Currently blockchain is using resources that are spread across the internet that may or may not be trusted. The nature of the encryption being used is secure, but that may not always be the case.
“Organizations may start to look at their data that’s going to be on the chain and say, ‘We need a dedicated infrastructure for this if we’re really going take advantage of it,’” said Logan. “That infrastructure is going to require the application development to actually have the interface stack in to make it simple and seamless.”
“What will happen, just like it’s happening today, you have miners out there mining for Bitcoin and other forms of cryptocurrencies,” he continued. “Who’s to say that those miners then can’t mine for other pieces of data? It’s going to have to be privatized infrastructure to really run the chains, and people are going have to actually buy into it.”
Blockchain has potential in healthcare, but organizations need to look at successful use cases and consider how they want to handle a new infrastructure technology.
Blockchain is still in its early phases and may change as it becomes more popular and as more dedicated infrastructure is needed. Entities need to consider these potential infrastructure changes before committing to a blockchain solution in the near future.