Health IT

Here are 5 ways that blockchain can disrupt healthcare

Blockchain and Bitcoin have a bad rap for their connections to data heists and ransomware, but public and private efforts are ongoing to encourage it to be a force for good in the healthcare industry.

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When it comes to healthcare, it’s more common to hear the terms “Bitcoin” and “blockchain” as they relate to heists of hospital data, patient records and ransomware. You can just imagine the hackers demanding “Pay us the Bitcoins, or your data is toast” as hospital CIOs hit the panic button. 

But, perhaps surprisingly, blockchain technology can be a force for good in healthcare IT, and there are private and public efforts to harness it for that very purpose.

As we wrote in July, in healthcare, something like the blockchain — the underlying technology for bitcoin and other crypto-currencies — could be used in setting up vaccine registries or transactional histories for patients. During clinical trials, the blockchain could be used to share blood test information; for, say, five different trials, only one blood test would then be needed. The blockchain could also be paired with a patient’s current electronic medical record to provide a new level of data integrity and interoperability, meaning patient data could be shared across organizations and people without compromising the security of the information that’s stored.

Now the blockchain is getting the attention of the federal Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology. This month, the ONC revealed the 15 winners of its Use of Blockchain in Health IT and Health-related Research Challenge.

“We have a focus on looking ahead to see where on the horizon the health IT space may be going,” said Steven Posnack, director of business and technology at the ONC. “So that was the point of the challenge—to look at what are the area that people are focused on and have the greatest potential.”

The summer contest brought in more than 70 submissions. White papers came from a variety of research groups, each proposing different ways to use the blockchain in healthcare and health IT to secure, store, and manage different healthcare data. 

Part of the impetus for issuing the challenge was to have the winning papers available to read in the run-up to the two-day “Use of Blockchain for Healthcare and Research” workshop. The event is co-hosted by ONC and the National Institute of Standards and Technology and kicks off at NIST headquarters in Gaithersburg, Maryland, on Sept. 26. But the other rationale was to get ahead of the future.

“The healthcare industry and market is moving in the direction of newer technologies. Whether blockchain is the winner is still to be determined,” said Debbie Bucci, an ONC IT architect who researches the intersection of new technology and healthcare privacy and security.

“I believe [blockchain] is going to be an underlying technology that’s just going to happen,” Bucci continued. “You may not know you’re using blockchain, but it has the potential to be that pervasive.”

Here is a look at the five most interesting potential applications of blockchain technology gathered from the 15 white paper finalists.

  • Blockchain and alternative payment models: What type of alternative payment method could be used in healthcare to rein in spending and bring some control over the fee-for-service model? We’re not talking about paying in Bitcoin. But this paper argues that blockchain tech could disrupt something like the typical way for processing claims in a positive way. Put claims data on a private blockchain, accessible to the organizations that exchange the data, and have it update in real-time. By allowing claims data to be processed more quickly, this could potentially cut down on incorrect reporting and make sure the final payment or bill is correct.

(Author: King Yip, senior manager at Audacious Inquiry in Catonsville, Maryland, although he submitted the paper as unaffiliated with any institution.)

  • A blockchain profile for Medicaid applicants and recipients: Use the blockchain to create what this paper calls a “smart health profile,” and then tie that profile to an individual patient. The profile will enable financial and patient information to be securely stored and accessed, and could alleviate one of the persistent problems in Medicaid. Namely, since Medicaid is a means-tested program, how beneficiaries enroll and re-qualify for health services and keep their information up to date. By storing patient health data and personal profile securely on the blockchain, that information can be kept up to date and made easily accessible should the need to re-qualify for Medicaid benefits arise.

(Authors: Kathi Vian, Alessandro Voto, and Katherine Haynes Sanstad, all affiliated with the Blockchain Futures Lab at the Institute for the Future in Palo Alto, California)

  • MedRec: Using blockchain for medical data access and permission management: How to secure, store, and exchange Electronic Health Records using new technology might be the biggest topic when it comes to the blockchain. This paper offers a prototype. The MedRec is a decentralized, modular record management system that could work with healthcare providers’ existing local data storage and takes advantage of some of the blockchain’s advantages such as authentication for stored information and accountability on the part of people accessing that information.

(Authors: Ariel Ekblaw, Asaph Azaria, and Andrew Lippman affiliated with the MIT Media Lab in Cambridge, Massachusetts.; and Dr. John D. Halamka, from Beth Israel Deaconess Medical Center in Boston, Massachusetts)

  • Blockchain and health IT: Algorithms, privacy, and data: A central growing tension in the healthcare field is that between data-sharing and privacy, as this paper illustrates. Organizations in a health IT ecosystem—providers, patients, and now the government—need information on patients. Generally that’s done with a centralized IT system, the type that’s vulnerable to hacking. Make it so that the blockchain is the backbone of newer distribution technologies, and an “auditable record of actions” will follow that information wherever it goes. 

(Authors: Allison Ackerman Shrier, Anne Chang, Nadia Diakun-thibault, Luca Forni, Fernando Landa, Jerry Mayo, and Raul van Riezen, affiliated with Project PharmOrchard of MIT’s Experimental Learning “MIT Fintech: Future Commerce“; and Thomas Hardjono of MIT Connection Science)

  • The Use of a Blockchain to Foster the Development of Patient-Reported Outcome Measures: The Internet of Things has only made personalized medicine that much more personal. Health readings taken from people’s Fitbit, Jawbone wristband, and Apple Watch get stored in the cloud, but there’s a risk in storing health data there. As this paper noted: “In cloud-based architecture, data is replicated and moved frequently so the risks of unauthorized data use increases.” So this paper argues if blockchain tech becomes the basis for the way personal health data is recorded and stored, it would bring greater security to private data even when they are carrying around personal health devices and other mobile devices every day.

(Author: Jason C. Goldwater, MA, MPA, affiliated with the National Quality Forum in Washington, D.C.)

And if the federal department’s efforts in encouraging blockchain applications doesn’t impress you, it’s worth noting that life science companies are getting into the game as well. At MedCity’s CONVERGE conference in July, Merck’s Nishan Kulatilaka talked about how Merck is exploring the use of blockchain in healthcare.

The private and public efforts underscore the fact that blockchain is something that we will hear about more in the future.

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