Blockchain. Most people have an inkling that it is some sort of technology behind Bitcoin and other “cryptocurrencies”. But it still sounds more like science fiction. It looks like it is soon to become science fact for healthcare in a way that could transform the industry as we know it today. Will blockchain technology actually work in healthcare? Some companies with very deep pockets, like Google and others, believe it will and are betting time and money on it.
“Decentralized databases promise to revolutionize medical records, but not until the health-care industry buys in to the idea and gets to work.” — MIT Technology Review
But what is blockchain and how might it be used in healthcare? Deloitte has done research and analysis on this and sums up the case for it in an article entitled “Blockchain: Trust Economy”. The article dubs the technology a “digital ledger” and explains, “The technology behind digital contracts transforms reputation into a useful, manageable attribute.”
To visualize what blockchain technology does, Deloitte created this infographic:
In one word, blockchain is about trust. But it also involves being able to use the trusted data in applications ranging from medical devices to health research. And, the Deloitte analysts behind the article that carries the graphic above see far-ranging consequences for its use. “The blockchain/trust economy trend represents a remarkable power shift from large, centralized trust agents to the individual. And while its broader implications may not be fully understood for years to come, it is hardly a death knell for banks, credit agencies, and other transactional intermediaries. It may mean, however, that with blockchain as the gatekeeper of identity and trust, business and government will have to create new ways to engage the individual—and to add value and utility in the rapidly evolving trust economy.”
A recent overview article in MIT Technology Review puts a fair amount of responsibility on hospitals and other providers: “Either way, blockchain’s potential for the health-care industry depends on whether hospitals, clinics, and other organizations are willing to help create the technical infrastructure required. Right now, that means prototyping and testing fundamental concepts, says Emily Vaughn”, head of accounts at Gem, a startup that helps companies adopt blockchain technology. For example, the health-care blockchain will “need a way to provide unassailable information about a patient’s identity to anyone who needs it, anywhere.”
Imagine if all medical devices were connected through a healthcare blockchain too. The article explains that “To that end, Gem is working with clients to prototype a global, blockchain-based patient identifier that could be linked to hospital records as well as data from other sources like employee wellness programs and wearable health monitors. It could be just the thing to sew together the maddening patchwork of digital systems available now.”
Helen Disney, writing for PharmaPhorum, lays out the case for use of blockchain technology in healthcare like this: “Healthcare systems are drowning in data – updating patient medical records, processing clinical trials, interpreting cancer treatment outcomes, analyzing reams of new genomic information, and so on. But securely managing and sharing such data in a manner fit for the 21st century is a hard problem to solve. Indeed, writing in the Japan Medical Association Journal about ‘Healthcare and the Roles of the Medical Profession in the Big Data Era’, Yuji Yamamoto argues that, when it comes to clinical trials research, the amount of data being handled already exceeds our human capacity for processing it. This gap is only likely to widen.”
Then there’s Forbes with a recent article entitled, “Is Blockchain Coming Of Age?” Their take is that blockchain is a solution whose time has come. Writing about its overall potential, they are most certain of its value in healthcare. “The potential is arguably greatest in healthcare however, where a number of projects have emerged that utilize the technology. For instance, earlier this year Alphabet’s AI division DeepMind announced the launch of a blockchain like a ledger for managing healthcare data. The aim is to automatically record every interaction with patient data in a secure manner.” They continue, “or you have healthcare startup Patientory. Their mission is to connect digital medical records without compromising privacy. They recently announced the first token sale of its kind in the industry.”
DeepMind’s possible impact is intriguing because the deep pockets of Google (changed its name to Alphabet recently) are behind it. According to Silicon.co.uk (DeepMind is based in the United Kingdom), “Deepmind said its working title for this project is “Verifiable Data Audit” for DeepMind Health. It said its effort was to provide the health service with technology that can help clinicians predict, diagnose and prevent serious illnesses.” And the potential goes way beyond simply securing healthcare records:
“For example, an organization holding health data can’t simply decide to start carrying out research on patient records being used to provide care, or re purpose a research dataset for some other unapproved use,” it said. “In other words: it’s not just where the data is stored, it’s what’s being done with it that counts. We want to make that verifiable and auditable, in real-time, for the first time.” — from “Google’s Deepmind Promises Auditable Healthcare Data Tracking” in Silicon.co.uk
If you noticed that the article seems to be quoting DeepMind as though it were a person to be interviewed — there’s some validity to that. DeepMind is an AI — Artificial Intelligence — this time being deployed in healthcare after Google already has developed an AI that now manages its SEO algorithm.
Already in the UK, there are hospitals participating with Deepmind (the company has real people in it too) in their work. The hospitals (five total currently) are part of the Imperial College Healthcare NHS Trust, and together form part of an academic health science center.
Back in the US, a Healthcare IT article quotes Tamara StClaire, a health IT advisor who previously worked as chief innovation officer at Conduent Health, observing that, “When it comes to a master patient index, for instance, hospitals currently have as many as 20 different ways to enter a simple date-of-birth and no real way to standardize that once it’s been done. Blockchain could ease that by tying patients to their data, rather than identity.” The article is favorable to the idea, “blockchain’s interoperability and security potential, of course, could enable the Holy Grail of a longitudinal health record by securing data as it’s exchanged among organizations in a format that is usable for various clinicians across the care continuum.”
But, are key stakeholders in the game yet? According to research by Deloitte studying the deployment of blockchain technology across all industries, “healthcare is planning the most aggressive deployments, with 35 percent of health and life sciences respondents saying their company plans to deploy it within the next year. And some organizations are putting big money behind the projects. Deloitte found that 28 percent of respondents across all industries said they’d already invested $5 million or more, while 10 percent have invested $10 million or more.”
And Deloitte is very optimistic about the prospects of a healthcare blockchain. Their analysts write, “Blockchain technology has the potential to transform healthcare, placing the patient at the center of the healthcare ecosystem and increasing the security, privacy, and interoperability of health data. This technology could provide a new model for health information exchanges (HIE) by making electronic medical records more efficient, disintermediated, and secure. While it is not a panacea, this new, rapidly evolving field provides fertile ground for experimentation, investment, and proof-of-concept testing.”