Blockchain- the technology that took the world by storm by its revolutionary work in data management and exchange, especially in the financial sector. Its immense success across different industries has left the healthcare world rattling with questions too. People are calling it the ‘answer to interoperability,’ and the ‘technology that can solve healthcare’s looming problems,’- but if the confusion looms, blockchain will take double the time to make a difference in healthcare.
Let’s try to unpack blockchain, one question at a time and understand its implications for the healthcare industry.
What is blockchain?
Blockchain was developed in 2008 by Satoshi Nakamoto, “unknown,” or rather a pseudonymous person (or a group) and was used as a core component of the digital currency, ‘bitcoin.’ Keeping the technical jargon aside, blockchain is simply a distributed and a write-once-read-only record of digital events in a chronological order that is shared in a peer-to-peer network.
It records exchanges and transactions in a database that can be distributed and shared across authorized users that can add to it, when needed. Sounds simple, right? But here’s what makes blockchain different- these authorized users can neither delete nor alter any record and no transaction can take place unless validated by all users.
How does blockchain work?
Blockchain is a peer-to-peer distributed ledger technology and has three major components:
1. Distributed network: The decentralized P2P architecture has nodes consisting of network participants, where each member stores an identical copy of the blockchain and is authorized to validate and certify digital transactions for the network.
2. Shared ledger: The members in the network record the ongoing digital transactions into a shared ledger. They run algorithms and verify the proposed transaction, and once a majority of members validate the transaction, it is added to the shared ledger.
3. Digital transaction: Any information or digital asset that could be stored in a blockchain could qualify as a digital transaction. Each transaction is structured into a ‘block,’ and each block contains a cryptographic hash to add the transactions in a linear, chronological order.
Imagining blockchain in healthcare
In healthcare, critical information is scattered across multiple systems and sometimes, it may not be accessible when needed the most. The current healthcare infrastructure has often been called inadequate to handle information exchange and requires certain tweaks. Blockchain has gone beyond the “innovation trigger” and is just at the “peak of inflated expectations” according to most recent Gartner Hype Cycle and could perhaps transform how we view healthcare and data together.
Why should blockchain be incorporated in healthcare?
In my opinion, one of the biggest things that make the use of blockchain revolutionary in healthcare is the lack of a central administrator. Why? Because a database is still a tangible thing- consisting of bits and bytes. If the contents of the database are stored in the physical memory of a particular system, anyone who has access to that system could corrupt the data within.
With blockchain, there will be no need for a central administrator- eliminated by clever cryptography. Plus, all the users are in control of all their information and transactions. Since healthcare deals with confidential patient information and requires quick access to information, blockchain can streamline these medical records and enable their sharing in a secure way. Blockchain, in a single go, offers access security, scalability, and data privacy.
The concept of blockchain in healthcare is absolutely disruptive- but it won’t be an elixir to drown down the issues of data management. Rather, it would be an evolutionary journey where blockchain is implemented step-by-step.
How will blockchain technology be used in healthcare?
Fewer than 5% CIOs and only 12% of the payer industry executives have blockchain figured out in their roadmaps. That’s why, keeping aside the hype, we need to understand the realistic applications of blockchain in healthcare.
Here are five ways blockchain can benefit healthcare:
1.) Single, longitudinal patient records
Longitudinal patient records- compiling episodes, disease registries, lab results, treatments- can be achieved through blockchain, including inpatient, ambulatory and wearable data- assisting providers in coming up with better ways of delivering care.
2.) Master patient indices
Often when dealing with healthcare data, records get mismatched or duplicated. Also, different EHRs have a different schema for every single field- coming up with different ways of entering and manipulating the simplest of data sets. With blockchain, the entire data set is hashed to a ledger, and not just the primary key. The user would look for the address- there can be multiple addresses and multiple keys, but they will all yield to a single patient identification.
3.) Claims adjudication
Since blockchain works on a validation-based exchange, the claims can be automatically verified where the network agrees upon the way a contract is executed. Also, since there is no central authority, there would be fewer errors or frauds.
4.) Supply chain management
Blockchain-based contracts can assist healthcare organizations in monitoring supply-demand cycles through its entire lifecycle- how is the transaction taking place, whether the contract is successful, or if there are any delays.
Interoperability, the very promise of blockchain, can be realized by the use of sophisticated APIs to make EHR interoperability and data storage a reliable process. With blockchain network being shared with authorized providers in a secure and standardized way, that would eliminate the cost and burden associated with data reconciliation.
Other than these, blockchain can transform revenue cycle management, drug supply management, clinical trials and prevent frauds.
The road ahead
Majorly, blockchain’s potential for healthcare depends on how willing healthcare organizations are to create the required technical infrastructure. Blockchain is costly, there are some concerns regarding its integration with the existing technology, and there certainly is speculation about its cultural adoption.
But one thing is for sure- blockchain has taken healthcare by storm over the past year, and there are significant investments for blockchain. With such wide-ranging possibilities, it is no surprise blockchain seems poised to one of the key pillars in the digital world. And maybe someday, it will transform the big data landscape.
Abhinav Shashank is the CEO & Co-founder at Innovaccer Inc., a datashop integrating complex data across multiple distributed sources to give healthcare organizations greater insights to provider better care.