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Blockchain not only has the potential to impact the health sector – it could even transform the industry one day. But it is still early in the adoption process. And as with other industries, the real influence of the blockchain on the way health services are provided, invoiced, paid and managed has yet to be determined.
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Defined as a "single version of the truth" made possible by an immutable and safe ledger with timestamp, whose copies are held by many, Blockchain is seen by many as a revolutionary method for conducting transactions.
An industry that deals with digital transactions involving medical records, patient data and other sensitive information certainly needs ways to better protect the integrity and security of such transactions. Blockchain is the answer?
How the blockchain could impact health care
Blockchain technology can potentially transform health care, putting the patient at the center of the health care ecosystem and increasing safety, privacy and interoperability of health data, according to a report from the consulting firm Deloitte Consulting LLP.
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This technology "could provide a new model for health information exchange by making electronic medical records more efficient, disintermediate and secure," the report said. "Although it is not a panacea, this new rapidly evolving field provides fertile ground for experimentation, investment and proof-of-concept testing."
Blockchain-based tools can reduce or eliminate the friction and costs of current intermediaries, according to Deloitte's study. They can help connect fragmented systems to generate insights and better assess the value of care. In the long term, a national blockchain network for electronic health records could improve efficiency and support better health outcomes for patients, the company said.
Some experts are skeptical about the role of blockchain in the health sector.
"There are still a few real test points," said Martha Bennett, principal analyst at Forrester Research. "We talk a lot about the" thing ", very little about" how ", particularly when we look at resized and operational processes and almost no one talks about key management, which will be a challenge".
For many of the proposed cases of use of blockchain health care, "the real problems have nothing to do with technology, and all with the market structure, vested interests and politics," says Bennett. Projects are in the very early stages, mostly proof of concept], she said. There are some limited distributions, the most promising of which increases existing processes.
Promising cases of use
Adding transparency to processes, whether it's complaints, prescriptions, etc., is a key area in which blockchain could apply, Bennett said. "Clearly, for this to happen successfully, you need ecosystem partners willing to work together," he said. "It is also necessary to face the challenge of balancing transparency with confidentiality."
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A good use case, and one that has less problems with confidentiality, is any type of reference data such as health care provider information.
Monitoring of returned medicines is also a promising use case, particularly if regulation prevents the sector from managing a centralized system.
There are two health data challenges that the blockchain can help solve, said RJ Krawie, manager, customer strategy and design applied to Deloitte. One is that health data is often sensitive and must be kept private and shared only under certain circumstances. The other thing is that there are advantages in having more data when evaluating a problem or a current state of health.
"Blockchain can help by creating a secure way to keep health data electronically and allow a person to control who sees it and who does not," Krawie said. "It also facilitates the tracking of health data and of every moor interaction in the whole life of that person, giving them the benefit of the maximum possible amount of data when making a health determination".
Blockchain provides a safer method for storing data, and in a sense it is a better "block", "said Krawie." Many of the information security techniques are put in place to prevent humans from sharing unintentionally data, "he said." People will still be forced to give wrong access to the wrong people. "
Can the blockchain allow interoperability at national level?
The Deloitte report found that the office of the National Coordinator for Health Information Technology, a division of the Secretary's Office within the United States Department of Health and Human Services ( HHS), issued a nationwide shared interoperability roadmap that defines the critical policy and technical components necessary for interoperability at the national level.
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These components include a secure and ubiquitous network infrastructure; verifiable identity and authentication of all participants; and a coherent representation of the authorization to access electronic health information. But current technologies do not fully meet these requirements, the Deloitte report said, because they face limitations related to security, privacy and interoperability of the entire ecosystem.
Blockchain could help to address these limitations, but today it is not fully mature, the report states. Several technical, organizational and behavioral challenges need to be addressed before a health blockchain can be adopted by organizations at national level.
The future of blockchain in health care
Blockchain technology creates unique opportunities to reduce complexity, enable trustless collaboration, and create secure and unchanging information, according to the Deloitte report.
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"HHS is right to keep track of this rapidly changing industry to identify trends and areas of detection where government support may be needed for technology to realize its full potential in the healthcare sector," the report said. "To shape the future of the blockchain, HHS should consider mapping and convening the blockchain ecosystem, establishing a blockchain structure to coordinate early adopters and supporting a consortium for dialogue and discovery."
While there is not yet an existing technology solution to protect all medical data, allowing for an efficient and secure data exchange, it is possible and likely to arrive, Krawie said. "I will also say that the blockchain is not a magic remedy," he said. "Blockchain can help with the secure transfer of medical data, but it will not solve any of the other interoperability problems, such as quality and data integrity, by itself."
In the end, it remains to be seen if the blockchain dramatically interrupts health care. "No technology can do it," Bennett said. "But blockchain-based networks can help shake the industry if ecosystems decide to collaborate and change the way things are done, while obviously maintaining regulatory compliance."
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