How to Approach Healthcare Blockchain Vendor Selection

June 11, 2018 - Blockchain is one of the most prominent buzzwords in health IT, but figuring out which vendors are experienced and healthcare oriented can be challenging when first looking into the technology. Knowing what to look for and what questions to ask potential vendors will ensure that the organization have confidence in their healthcare blockchain solution and full vendor support.

Blockchain is still in its pilot phase. The technology is new and there are many startups throwing their hats in the ring to become the go-to vendor for healthcare blockchain. While many of these vendors are capable of providing the required service, providers must come prepared to their initial meetings with these vendors.

The future of healthcare blockchain seems inevitable, but the buildout phase gives organizations time to recognize its infrastructure requirements. Vendors and providers are testing and coming up with various ideas about how blockchain will support emerging health IT trends.

Provider organizations need to map out a plan for their future blockchain endeavors. Establishing a timeline and where they anticipate blockchain being used in the comping years is crucial to knowing what questions to ask potential vendors. Blockchain works differently than other health IT systems because it is decentralized so meeting with vendors without a vision can lead to missed opportunities to ask the right questions.

Many organizations are first considering blockchain for financial transactions and eventually as a database system and a smart contract machine. Sharing the plan with vendors and making sure they can accommodate future ideas factor significantly into choosing the right vendor.

READ MORE: What Does Blockchain Mean for Health IT Infrastructure?

Vendors can pitch their solution as a “cloud-hosted, big data, machine learning, API-driven, mobile app with blockchain,” Harvard Medical School Professor of Innovation and Beth Israel Deaconess CIO John  Halamka, MD, MS, explained in his latest piece for Blockchain in Healthcare Today. While that sounds all-encompassing and promising for organizations who struggle with dated and disparate health IT solutions and tools, a closer look is needed to discover what vendors presently offer, and what they are building toward in the future.

Halamka warns that if organizations are not inquisitive and selective of their blockchain solutions, then blockchain will become a “meme for overpromising and underdelivering in healthcare IT.”

The first step is understanding what blockchain is and what it isn’t for healthcare organizations. Blockchain is useful for ensuring data integrity, consent management using smart contracts, and providing a decentralized ledger, according to Halamka.

Currently, blockchain is not a database, an analytics tool, a fast or scalable platform, a remedy for interoperability, nor user-friendly. Some of these uses are being worked on for future blockchain deployment models but are not current uses for the technology.

Blockchain will eventually be used as a database in some aspect, but organizations are not familiar enough with the technology to know what data should live on the blockchain and what data needs to be stored elsewhere.

READ MORE: Blockchain Vendor Efforts Center on IoT in IT Infrastructure

The way data is stored on blockchain is in small chunks of transactions. Blockchain has a two-layer architecture where the data being exchanged is still held in a database, but there is a layer of transactions, permissioning, and auditing layered on top of it.

Data storage will need to evolve to meet blockchain’s needs. The blockchain database is never deleted and once a transaction enters the blockchain, it’s there for as long as the blockchain lives. 

Storing data is a valuable potential use of healthcare blockchain. Providers and their potential vendors need to be on the same page about how the vendor’s blockchain solution is going to handle current and future data storage demands, and how it’s going be compatible with current storage infrastructure.

Interoperability is another potential use for healthcare blockchain that is still in its development phase. Most vendors and organizations intend to use blockchain for inter-health systems exchanges of patient records and other healthcare data.

Applying blockchain technology to interoperability efforts makes sense. Blockchain is a secure way to exchange information among different healthcare providers, but the kinks aren’t quite worked out yet. The two biggest obstacles blocking EHR interoperability is framework compatibility and the lack of a national patient identifier.

READ MORE: Why Blockchain May Not Be the Solution to EHR Interoperability

Most blockchain frameworks are meant to be interoperable, but there is a certain level of communication needed between health systems to know which framework is being used such as Hyperledger or Ethereum. There is no definitive answer to whether EHRs using one blockchain framework can consistently exchange data successfully with another health system using a different framework.

Many vendors and healthcare organizations are looking to blockchain to cure interoperability issues, but using it for EHRs can’t really work without a national patient identifier, VMware Senior Healthcare Strategist Chris Logan explained to HITInfrastructure.com in a previous interview.

“Until we have a national patient identifier, blockchain is worthless,” he maintained. “How am I supposed to know it’s your record at the end of the day, if I don’t know it’s you? One of the biggest problems healthcare organizations have is identifying the patient when they come into the organization.”

These issues need to be solved before blockchain can be effective in exchanging patient data. Organizations need to know if the vendor they choose is developing a solution for EHR interoperability before selecting them.

Organizations also need to inquire about how involved the vendor is in the healthcare space. A blockchain solution that works for other verticals can’t be retrofit for healthcare. The vendor needs to be either an exclusive healthcare blockchain vendor or have a dedicated healthcare specific solution.

Blockchain is also about collaboration. Selecting a vendor that will work with an organization and is also involved in consortiums and alliances is important.  Open source communities become more important to the development process as blockchain technology continues to develop. Open source communities and workgroups are an invaluable tool for new and innovative technology because it helps the technology develop faster.

Vendors that are involved in these communities will have better access and involvement with blockchain advancement and are committed to contributing to the community to improve healthcare blockchain overall.

Understanding what blockchain can offer now and what it can offer in the future is vital to choosing the correct vendor. Laying out a roadmap and working closely with a healthcare oriented blockchain vendor that understands current and future needs will increase chances of success and help organizations integrate blockchain into their health IT infrastructure.