ONC Blockchain Winners Target Health IT Interoperability

August 30, 2016 - The Office of the National Coordinator for Health Information Technology (ONC) has named the final winners of its healthcare blockchain challenge, several with a focus on advancing health IT interoperability.

“We are thrilled by the incredible amount of interest in this challenge,” National Coordinator Vindell Washington, MD, MHCM, said in a public statement. “While many know about Blockchain technology’s uses for digital currency purposes, the challenge submissions show its exciting potential for new, innovative uses in health care.”

At its most basic, blockchain technology organizes data into a series of blocks containing transactions verified by a predetermined set of stakeholders. Its decentralized approach to protecting and ensuring the integrity of information is what drew the attention of ONC.  

Here's an overview of blockchain challenge winners focused on advancing health IT interoperability.

Blockchain: Securing a New Health Interoperability Experience

READ MORE: NIH Grant Funds Machine Learning Tool for Chronic Disease Detection

Researchers from Accenture have claimed that blockchain technology has the potential to increase the scalability of health IT interoperability in three ways:

1. Creating secured and trusted care records: Securing healthcare records created by healthcare professionals and patients into an electronic chain of events, while preserving the inherent provenance and integrity of those records

2. Linking identities: Supporting strong identity proofing by preserving an immutable record of the declared identities of both patients and healthcare professionals

3. Recording patient consent: Empowering patients through the recording of consent decisions and patient directives within the secured healthcare record

Key to the authors' argument is the idea that blockchain technology can sit on top of existing health IT investments.

READ MORE: Hartford Healthcare Partnership Focuses on Digital Health Innovation

The Use of a Blockchain to Foster the Development of Patient-Reported Outcome Measures

Patient-generated health data such as outcomes will have an important part to play in determining provider success in value-based care programs such as the Merit-based Incentive Payment System.

Researchers from the National Quality Forum have made the case for using blockchain technology for reporting patient-related outcome measures (PROMS) by providers.

The IoT [Internet of Things] cannot be the panacea to all of the barriers to PROM development and use, but the information generated from wearables, smartphone applications and other patient-centered technology, can provide a basis for understanding what types of measures can and should be developed. Combining that data with the patient information found within an EMR is robust enough to populate these measures without the reliance on validated instrument. Studies of wearable technologies for conditions such as osteoarthritis have shown that the generated data provides information on items such as functional activity level, treatment compliance and the development of individualized exercise regimens that has high comparability with reference tools such as surveys.

Powering the Physician Patient Relationship with ‘HIE of One’ Blockchain Health IT

READ MORE: Nuvance Health Pilots At-Home Remote Patient Monitoring Program

Health information exchange stands to benefit from blockchain, according Adrian Gropper, MD, who detailed a project known as the HIE of One is leveraging the technology to bring providers and patients together electronically:

In the current health IT architecture, the hospital is responsible for both credentialing the individuals and securing the protected health information (PHI). In the HIE of One architecture, credentialing is done by institutions such as medical societies or state agencies that do not have or want access to PHI. Identity of physicians and of patients is managed on the blockchain without placing any PHI on the blockchain…Finally, in the HIE of One model, the PHI stays in place wherever it was generated or is most convenient. HIE of One works with PHI in institutional EHRs, PHRs, regional health information databases, cloud wellness services, or the Precision Medicine Initiative.

A Blockchain-Based Approach to Health Information Exchange Network

Also on the subject of health information exchange, researchers from Mayo Clinic described the use of blockchain technology to overcome the limitations of current HIE infrastructure — having to choose between a centralized data source and the exchange of bulk data. Assuming the patient is ultimately in control of their medical record, he grants users access and controls when that information is accessible:

Simply sharing data is not enough — we’ve shown that effective data sharing networks require consensus on data syntax, meaning, and security. We’ve proposed that a blockchain can play a fundamental role in enabling data sharing within a network, and have defined the high level structures and protocols necessary to apply this new technology to healthcare. Building on techniques used successfully by other blockchain applications, we’ve introduced a new consensus algorithm designed to facilitate data interoperability. Finally, we have applied extra measures of security on the blockchain such as network-wide keys and smart contracts, keeping security a top priority. Ultimately, we believe that a blockchain-based data sharing network is a tenable solution for the complex problem of sharing healthcare data.

A full list of final winners is available here.

Dig Deeper:

• How Health IT Standards Enable Patient Access to Health Data
• 3 Programs Supporting Health IT Standard FHIR Development