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What Are the Top Healthcare Blockchain Growing Pains?

Healthcare blockchain is going through a growth spurt and organizations need to know how future developments will affect health IT infrastructure.

healthcare blockchain

Source: Thinkstock

By Elizabeth O'Dowd

- Healthcare blockchain is expected to gain even more interest over the next year as implementations of the technology become a reality. However, understanding the point of the technology and its important aspects is critical to successful deployment.

A recent NIST publication pointed out some of the things organizations need to keep in mind when looking into adopting a healthcare blockchain solution.

There are several infrastructure challenges organizations need to be aware of, such as understanding the difficulty in modifying data that has already been stored, NIST stated. Entities may wonder what makes blockchain guarantee that it can’t be modified by other parties. Organizations don’t need to trust the parties with which they exchange data.

“On a blockchain, it is much more difficult to change data or update the ‘database’ software,” said the NIST report. “Organizations need to understand the extreme difficulty in changing anything that is already on the blockchain, and that changes to the blockchain software may cause forking of the blockchain.”

Entities also need to consider the protocol for participants to agree that the transaction in valid.

“New blockchain technologies are being developed constantly to enable new use cases and to improve the efficiency of existing systems,” report authors explained. “Some blockchain implementations are permissionless, meaning anyone can read and write to them.”

“Other implementations limit participation to specific people or companies, allow finer-grained controls, and may be managed by a central entity,” NIST continued. “Knowing these specifics allows an organization to understand what will be most applicable to its needs.”

Data exchange among healthcare organizations needs to be different than data exchange among organizations from other industries because of the nature of health information. Personal information is included in medical records as well as medical history and payment methods.

The concept of “permissionless” exchange can be intimidating to healthcare when it comes to HIPAA compliance and the potential of exposing patient information to the public.

Understanding that enterprise blockchain and consumer blockchain operate slightly differently is key to understanding how blockchain can be secure for enterprise.

The consumer blockchain ledger is shared with anyone. Enterprise blockchain operates within a private distributed ledger that is only accessible to organizations within the blockchain.

Despite different industries having different needs, most variations of blockchain use the same concept and the same type of open source build.

“Each technology used in a blockchain system takes existing, proven concepts and merges them together in a way that can address problems that were previously difficult,” said NIST.

Blockchain technology is developing and improving quickly, but there is still an immaturity to the technology.

Continuous uptime is one concern that the technology has yet to fully address, VMware Senior Healthcare Strategist Chris Logan told HITInfrastructure.com in a previous interview.

“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 first healthcare use cases for blockchain will most likely be financial transactions for insurance companies and the payer population.

For example, Change Healthcare released its first healthcare blockchain solution earlier this year for claims management.

While blockchain in healthcare is promising, there are still many kinks that need to be worked out before is becomes a standard health IT infrastructure technology.

“The use of blockchain technology is not a silver bullet, and there are issues that must be considered such as how to deal with malicious users, how controls are applied, and the limitations of any blockchain implementation,” NIST report authors concluded. “That said, blockchain technology is an important concept that will be a basis for many new solutions.”


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