Challenges & barriers to blockchain adoption in healthcare: Q&A with CTG Health Solutions principal consultant

Kumar Madurai, delivery manager and principal consultant at health IT support company CTG Health Solutions in Buffalo, N.Y., discusses his predictions on the most significant blockchain applications in healthcare over the next five years.

Responses have been lightly edited for clarity and length.

Question: Where is blockchain in healthcare now and how will it develop in 2019?

Kumar Madurai: Healthcare entities today are approaching blockchain with guarded optimism. Many acknowledge that there is a huge potential for it in healthcare but are still cautious about the challenge, such as health data privacy, performance and lack of standards. There are still barriers to the adoption of public blockchains in healthcare because of the need to protect health data and new regulations such as general data protection regulations.

With that, the number of startup companies in healthcare will continue to grow in 2019, and many of them are specifically trying to address these challenges. Blockchain-based consortiums should also grow in number as they find common use cases in the area of data exchange — such as hospitals in a health system or health plans in a specific region.

Q: What do you think will be the most significant blockchain applications in healthcare over the next five years?

KM: Earlier adoption will be in private or consortium-based blockchain, where a trusted network of providers or health systems can create and share data in a secure manner, such as for provider directories and provider credentialing information.

Another potential application that benefits all the stakeholders in the healthcare system — payers, providers and patients — is the use of smart contracts to record the insurance policy coverages and pre-authorizations to expedite the approval process for covered services and drugs. A more powerful extension of these smart contracts will be to integrate them with the provider billing systems, clearinghouses and/or payer systems so that the payments to providers can be automated once the services are performed, and thus reduce the administrative burden of claims processing.

The pharmaceutical industry is another promising area for blockchain. To mitigate the problem of counterfeit drugs, for example, a consortium of pharmaceutical companies, distribution networks and retail pharmacies can track and record the movement of legitimate drugs on the blockchain using product identifiers such as radio frequency identification or barcodes.

Patient access to records is yet another opportunity. Given the privacy challenges of protecting new types of healthcare data such as genomic data or data from home-health monitoring devices, a patient-centered blockchain envisions that the patient controls who has access to this information. Once the access rights as determined by the patients are recorded in smart contracts, the designated providers can access them for treatment purposes or permissioned researchers can use them in their studies.

Q: What do health IT leaders at hospitals and health systems need to know about block chain today?

KM: Understand the key concepts of blockchain: distributed ledger of transactions, disintermediation of trust, data immutability, etc., and how they can lead to innovative solutions in healthcare. Know what barriers exist today for adoption of blockchain in healthcare, especially related to protection of patient data and privacy, and how they are being addressed by the technology vendors and new research. Learn about specific healthcare blockchain applications that have already been launched by startups in this area and how some of the major health systems are partnering with them.

Also, become aware of local collaborative efforts in blockchain involving payers and providers and explore potential for participation in proof-of-concept and consortium-based projects.

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