- Why Blockchain May Not Be the Solution to EHR Interoperability
- What Does Blockchain Mean for Health IT Infrastructure?
Blockchain is the exchange of information between nodes (e.g., users, organizations) via a shared database without the regulation of a third party controlling the data through a single silo. This leads to the creation of a trusted history of transactions between organizations sharing data.
Data storage is currently being considered as a future use for healthcare blockchain, according to the latest edition of Blockchain in Healthcare Today, which the HIMSS Blockchain Work Group contributed to.
Blockchain can potentially be used as a means of data storage to retrieve information such as lab results, medications, and other patient information that may have been collected by another department of outside specialist.
The use of blockchain for health data storage is still not fully fleshed out because of privacy and security regulations.
“Where personal data and PII are concerned, the privacy rules are applicable,” said report authors. “If more sensitive data are also processed e.g., health data or citizen service numbers) more stringent requirements apply.”
“Health data combined with PII are commonly referred to as protected health information (PHI) and is strictly regulated by HIPAA and data protection laws abroad, which can vary by Location.”
These compliance issues are a concern, but healthcare blockchain could enhance PII and PHI protection if the issues are overcome. The inherent design of blockchain, how it handles data exchange, and its encryption methods could provide a more secure environment.
Availability is another potential infrastructure benefit of blockchain in healthcare. Organizations cannot afford to lose the ability to access tools and data because of the risk to patients.
Blockchain is a decentralized ledger, meaning that there is no single point of failure. Some data will be stored on the chain while other data will remain in the data center.
Report authors suggested that not every organization should use the same method to decide which data is stored on the chain. A single blockchain design pattern will not work for every individual entity when it comes to data availability and should be addressed on a case-by-case basis.
Using blockchain to enhance other technology to overcome challenges is another potential benefit. Interoperability is the most common chronic health IT infrastructure challenge for which blockchain is currently being developed.
“To achieve the trusted interoperability that would match blockchain’s data integrity premise, the structure, semantic integrity, reference terminologies and code sets employed, and status of data stored on the blockchain should be defined and enforced,” said report authors. “In cases where a blockchain contains pointers to off chain data, metadata associated with such pointers can include information required to support interoperability. This approach enables interoperability not just for the data stored on the blockchain, but also for the data stored off the blockchain.”
Hyperledger is working on developing blockchain to enhance interoperability. Hyperledger Executive Director Brian Belendorf spoke positively of healthcare blockchain for interoperability in a previous interview with HITInfrastructure.com.
Behlendorf believes blockchain can take advantage of the healthcare standards community, including FHIR and HL7, to contribute to building a mechanism to keep track of a discovery process. Records relating to a patient will be accessible to all parties involved, attesting to the truthfulness and accuracy of the data.
Healthcare blockchain still needs time to develop, but there are many promising use cases for it within health IT infrastructure. As development continues, organizations will have more options to leverage healthcare blockchain in the coming years.