A blockchain powered health information exchange can unlock the true value of interoperability. Blockchain-based systems have the potential to reduce or eliminate the friction and costs of current intermediaries.
The promise of blockchain has widespread implications for stakeholders in the healthcare ecosystem. Capitalizing on this technology has the potential to connect fragmented systems to generate insights and better assess the value of care. In the long term, a nationwide blockchain network for electronic medical records will improve efficiencies and support better health outcomes for patients.
At its core, blockchain is a distributed system recording and storing transaction records.
More specifically, blockchain is a shared, constant record of peer-to-peer transactions built from linked transaction blocks and stored in a digital ledger. Blockchain relies on established cryptographic techniques to allow each participant in a network to interact (e.g., store, exchange and view information), without preexisting trust between the parties. In a blockchain system, there is no central authority; instead, transaction records are stored and distributed across all network participants. Interactions with the blockchain become known to all participants and require verification by the network before the information is added. Blockchain distributes trust between network participants in the system while recording a constant audit trail of all interactions with the rules defined by the protocol.
Blockchain, the national standard of interoperability.
ONC has issued a shared nationwide interoperability roadmap, which defines critical policy and technical components needed for nationwide interoperability, including:
1. Constant, continuing & secure network infrastructure
2. Verifiable identity and authentication of all participants
3. Consistent representation of authorization to access electronic health information and multiple other requirements.
Current technologies do not adequately address these requirements because they face limitations related to security, privacy, and full ecosystem interoperability.
Reducing Frictions via Blockchain
A study by IBM identified the nine frictions holding back healthcare organizations categorized in the areas of information, interaction and innovation. The effortless working together of the three information frictions provides meaningful outcomes in the healthcare industry. The lack of nationwide interoperability standards puts costly constraints on the information friction.
Blockchain technology presents numerous opportunities for healthcare to address these issues; however, its maturity as a standard is still developing. Several technical, organizational, and behavioral economic challenges are being addressed to ensure that healthcare blockchain can be adopted by organizations nationwide.
The future of blockchain in healthcare
We at Rural Health IT (RHITC) see many immediate uses for blockchain especially in creating interoperability to address the easy, seamless, two-way flow of data between payers and providers to deliver better, more efficient care to dual eligibles of Medicare & Medicaid.
Blockchain technology creates unique opportunities to reduce complexity, enable trustworthy collaboration, and create secure and immutable information. Human Health & Services (HHS) is right to track this rapidly evolving field to identify trends and determine areas where government support through HIT grants may be needed for the technology to realize its full potential in healthcare. By shaping blockchain’s future, our ability through grant funding at RHITC is assisting with mapping and convening the blockchain ecosystem, establishing a blockchain framework to coordinate early-adopters, creating pilot projects nationwide, and supporting a consortium for dialogue and discovery.
RHITC has secured over 20 million dollars in funding since winning our first grants in 2004 for Mt Ascutney HealthCare Consortium. New grants are available now to assist in funding the blockchain technology. These grant opportunities are readily obtainable and support the mission of accomplishing technological growth in the healthcare industry nationwide.
