Blockchain in the health sector: great promise, but largely unproven

Today, Blockchain is in turmoil in health care, with providers, lenders and developers of digital technologies that promote their potential to increase work efficiency, transmit and share data securely and improve patient results.

Numerous examples of late shows capitalize on the trend.

In June, the US Patent and Trademark Office awarded Walmart a patent for a system that caches a person's medical information in a blockchain database and allows first responders to recover it in the event of a medical emergency . The wearable device in which the blockchain resides includes a biometric scanner that creates a unique signature for the user and an RFID scanner to scan the user's PHI.

And at the start of this year, Akiri of San Francisco launched a vendor-independent tool called Akiri Switch that uses blockchain to securely transmit information using codes, enabling organizations to share and verify data on heterogeneous systems. The company has financial support from the American Medical Association.

Meanwhile, Humana, UnitedHealthcare, Optum, MultiPlan and Quest Diagnostics have announced a blockchain-enabled initiative to increase the accuracy of health care network providers' directories.

There is additional evidence of blockchain being in the minds of many in the healthcare industry. According to a survey conducted in 2017 on Black Book Market Research, nearly 20% of hospital managers and 76% of health insurance executives are planning to implement some form of blockchain technology or are already implementing it. When asked about interoperability, 93% of managed care organizations and 70% of hospitals said the blockchain is very promising.

A more recent IDC report predicts that one in five health organizations will have passed the pilot phase to use blockchain technology in patient management and identity operations.

Because the volume of personal health data has exploded in recent years, it also has the challenge of interoperability and data security. "Blockchain essentially brings with it some properties that … could be able to unleash a lot of untapped value and the logic of these relatively stagnant and silted data reserves that we see in healthcare systems," says Mutaz Shegewi, an analyst IDC and author of the report. These properties are decentralization, better distribution and the ability to make data more immutable.

Possible use cases include encouraging patients to exchange data and improve the quality and management of administrative data. The advent of fast healthcare interoperability resources (FHIR) and open APIs could also give rise to blockchain grids for distributing and sharing clinical data, according to the report.

A lot of excitement surrounding technology ignores some difficult realities. Its development is still nascent, it may be difficult to identify users willing and the few cases of use usually do not involve work in the clinical setting. The future of the blockchain in the health sector is promising, but still largely unclear.

Blockchain in its early stages in the health sector

Despite all the interest and the clamor surrounding the blockchain, the technology remains largely untested in the health sector.

extremely early in the development cycle of this technology, "says Noah Zimmerman, director of the Mount Sinai Health and Data Center and its new Center for Biomedical Blockchain Research." We are really building the infrastructure and the plumbing right now, in the same way that the Internet protocols lay the groundwork for what would eventually become possible. "

What is exciting about the blockchain and what sets it apart from much technologies, is its focus on man, says Zimmerman.The technology – which was born as a safe vehicle for the transfer of cryptocurrencies – revolves around the construction of large-scale open networks and thus encourages people to participate in such networks.

"What blockchain was able to do is create markets in which a market did not work" existed previously, "says Zimmerman. "The question is: are there ways to exploit the same kind of behavior: involve and incentivize people to achieve an important goal, and do it in the health space?" he tells Healthcare Dive.

The fact that anyone can build on an open blockchain network contrasts sharply with the current situation where a limited number of interested parties control access to large amounts of health data. This could potentially lead to all types of applications in areas ranging from health administration to clinical trials and drug development, to population health and more.

The other side, by encouraging people to join the blockchain network, is more complicated. Suppliers, payers, pharmaceutical companies and medical devices all have incentives to do certain things, but there is little or no overlap in what they are.

Numbers are the key

The more numbers of people joining the network, the more robust the whole blockchain solution is. And the biggest challenge in this is trying to convince everyone to join the network because the incentives are not always aligned, says Bhooma Chutani, head of blockchain and ledger technologies distributed at LTI in Mumbai, India.

For example, some companies or organizations may earn more than others by participating in the blockchain, and some smaller ones may not have the necessary infrastructure.

Another challenge is information. There's a lot of academic work in basic cryptography and basic technology that supports the effective development of the blockchain, but when you look at the application areas, all of this information is driven by marketing departments, "says Zimmerman." And most likely it is … or oversizing what is possible or even misleading. "

The Center for Biomedical Research Blockchain hopes to answer some of the questions about what the blockchain can and can not solve in the health care field.It focuses on three types of projects: academic research, Zimmerman announced that the first partnership The center's business will be announced within a few weeks, explained Zimmerman.

Cases of early use in supply chain, management settings

While health care is still in the very early stages of the exploration of the blockchain in more than Righteous clinical and business processes, in terms of the ability to leverage technology and support the use of supply chain and operations management and patient identification, "is very much in the pipeline," says Shegewi.

LTI is working with a large insurance company on a wellness program that uses blockchain to track healthy behaviors at both the corporate level that individual and reward participants with discounted insurance rates, says Chutani. Similar programs are already used by car insurance companies to track and encourage safe driving habits.

Issue has developed a patient-driven blockchain network that allows patients to securely share their medical and PHI records, such as Fitbit data and establishes rules about who can view and access data. Users can revoke or change sharing permissions at any time.

"Patients can check in real time who has accessed their records and when, giving them a complete record of who has accessed their data," Robert Chu, CEO and founder of the Metuchen startup , in New Jersey, told Healthcare Dive via email. "Both mechanisms are codified in the blockchain as intelligent contracts, and therefore can not be falsified or tampered with."

Zimmerman sees the potential in creating these kinds of data markets and rewarding patient participation, but he thinks people will be able to their own PHI are oversold as a use case. There is no self-destruct mechanism that prevents people from using a person's data outside the blockchain even after that person has revoked access,

. However, Zimmerman sees opportunities for blockchain to incentivize patients with rare diseases to come together and collect data in collaboration with pharmaceutical companies for the development of new treatments and in areas such as behavioral health. Perhaps the blockchain could be harnessed in ways that not only encourage people to adopt healthy behaviors and avoid harmful ones, but also promote other social determinants of health, such as housing, which are known to be important predictors of health care expenditures and health.

ready for primetime

Some basic problems need to be solved before the blockchain can become mainstream in the health sector. The information and the incentive of people to participate is one. Scalability is another. The use of the most popular application on the Ethereum network, which is the biggest blockchain after Bitcoin, is Cryptokitties, in which users collect, breed and exchange virtual kittens. As the game counted more and more traffic on Ethereum (about 30%, according to Zimmerman), network performance slowed down considerably.

"If you have a game, and it was not even a very popular game, if that sort of thing can bring a network to its knees, then such a network is not really ready for primetime in the healthcare world today," says Zimmerman. It is expected that it will take at least a couple of years before the original capacity for comparison with consumers for the blockchain begins to be created in the health space.

"We are cautiously optimistic," he adds. "What we are really trying hard to do is not to contribute to the cycle of hype, but to be a little more balanced and systematic in the way we approach this technology and how it can adapt to the health systems of the future." [19659034] Source link