Can blockchain bring interoperability to health care?
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The distributed ledger technology may be able to manage and secure health information that flows back and forth among patients, doctors, insurance companies and federal agencies.
Blockchain, the technology that powers the digital currency Bitcoin, is getting some attention as a potential way to improve the nation’s health care system.
The current health care industry infrastructure was not designed to manage information in a connected society where data flows back and forth from patients’ wearables, home computers, doctor’s offices, hospitals, insurance companies and federal agencies. Blockchain can provide technology solutions to the infrastructure challenges, according to a Frost and Sullivan report, because it can provide “interoperability, integrity and security and portable user-owned data,”
As a record or ledger of digital events that is shared among many different parties, blockchain requires each party in the chain to digitally sign a hash of a transaction and the public key of the next party in the chain before passing it along. No blockchain record can be updated without the agreement of a majority of the entities involved, and none of the historical information contained in a ledger can be altered because any attempt would change the old hash.
In essence, a blockchain-based system combines decentralized authentication with a fully auditable sequence of digital events enclosed in a highly secure environment.
The Department of Health and Human Services is taking a look the blockchain distributed ledger system to address privacy, security and scalability challenges of managing electronic health records and resources.
Currently there is very little actual use case data on blockchain in health care, but earlier this year Phillips Healthcare announced it opened a lab specifically to test the use of blockchain technology in the healthcare sector. The MIT Enigma project also is testing using the technology to selectively store and share patient health information for research, and the government of Estonia is integrating the technology with Oracle to improve security and auditing of patient health records.
HHS recently wrapped up an ideation challenge that solicited papers on using blockchain to advance health data interoperability, as well as for Patient Centered Outcomes Research (PCOR), the Precision Medicine Initiative, delivery system reform and other healthcare delivery needs. The challenge generated 77 submissions from respondents such as MIT, the Mayo Clinic, Deloitte, IBM, and the National Quality Forum. Fifteen papers were selected as winners.
The suggested healthcare uses for the blockchain covered a wide range – from creating a private peer-to-peer network for clinical trials to securing patient health records to improving claims processing and payments.
Winners “identif[ied] potential gaps in standards created and/or resolved by the use of blockchain, and examine[d] how blockchain links to the stated objectives in the Nationwide Interoperability Roadmap, PCOR, precision medicine and other national health care delivery priorities,” challenge officials said.
The winning submissions show blockchain’s “exciting potential for new, innovative uses in health care,” National Coordinator for Health IT Dr. Vindell Washington said.