Blockchain. This new technology is driving a profound shift in the financial sector, and Humana Chief Executive Officer (CEO) Bruce Broussard recently wrote that it’s “positioned to be the next dramatic innovation in health care” (see Blockchain: Transformational Technology for Health Care).
So what is it, exactly?
A technical explanation would involve throwing around IT jargon like “distributed databases” and “nonce values.” To put it in simpler terms, it’s a virtual ledger that houses connected data nodes, or a “chain of blocks,” that allows multiple parties to exchange sensitive, fixed information and coordinate important processes (such as financial transactions). Within the system, each network participant can view and share data; but there is no central administrator managing the data. All data and transactions are shared across the network participants. The idea behind it is to make these kinds of interactions more efficient and secure. Additionally, it creates and stores a long, unalterable paper trail — minus the actual paper — for all of the organizations and individuals involved. (You may know blockchain and not know it – it is the driving technology behind the alternate currency system, Bitcoin.)
I see two important implications for how blockchain could affect the health care market – improved interoperability and more consumer control of their health information. First, the ability to organize and exchange data. We know that the ability to share data is essential to integrated care coordination and population health management. We also know that many provider organizations are currently struggling with sharing consumer health information, with reporting performance metrics to payers, and with using their data for clinical decision support tools (see The Dismal State Of Data Exchange and Are We There Yet? A Look At Three State Health Information Exchange Initiatives). To do this, the Office of the National Coordinator for Health Information Technology’s (ONCHIT) plan for A Shared Nationwide Interoperability Roadmap calls for the establishment of a national, consumer-centered data exchange that will “continuously improve care, public health, and science through real-time data access” by 2024.
Blockchain offers a new way to think about this interoperability challenge. Without a single authority establishing a network and managing the data, the exchange of information could be more easily shared across multiple systems. This opens up a whole new world of interoperability for health care payer and provider organizations. (For an in-depth analysis of its potential impact, see the recent report from Deloitte, Blockchain: Opportunities for Health Care.)
Second, with blockchain, consumers could conceivably have much more agency in accessing and controlling their health care information. Because blockchain technology exchanges fixed data across a wide range of network participants, there is a potential to use it to more readily share information with consumers and allow consumers to control their own health records.
We’re seeing the first application of blockchain technology in clinical trials. Blockchain Health Company is developing solutions using blockchain for identity verification, consent management, and record management for use in clinical trials. Ryan Singer, chief executive officer of Blockchain Health Company, envisions consumers controlling their medical treatment through Facebook-like online networks that bring providers and payers together on a single dashboard. The use of the technology creates a fundamentally different role for consumers. Mr. Singer noted that “The concern is that right now in the health care industry, people try as hard as they can to keep consumers from being actors. Payers pay, providers provide, and the patient is the product that moves through the funnel.”
At this point, the impact of blockchain is still almost entirely theoretical, in health care and in general. But like other technology innovations, the impact of blockchain will likely take a while, but will be indelible. I am reminded of the Bill Gates quote, “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don’t let yourself be lulled into inaction….”
Want more insights into the present and future impact of technology on the health and human service field? Don’t miss our upcoming 2016 OPEN MINDS Technology & Informatics Institute, taking place November 10-11 at the Marriott Wardman Park Hotel in Washington, D.C. Join us for over 20 sessions led by leading-edge faculty including Andrey Ostrovsky, M.D., Chief Medical Officer, Center for Medicaid and CHIP Services; Craig Rhinehart, Director, IBM Watson Health Innovation and Market Development, IBM Watson Health; Seth D. Feuerstein, M.D., Chief Medical Officer, Medical and Digital Innovation, Magellan Healthcare; and many more.