The missing link: Where will blockchain help healthcare?

Blockchain has been touted as the next technology to revolutionize healthcare. It has been presented as the answer for everything, from interoperability to insurance processing.

But is it really? The current attitude is “blockchain is the answer…what’s the question?”

The truth is this technology is very early in its lifecycle. So, while many of the blockchain solutions being touted will likely go nowhere for obvious reasons, there are some that do hold promise and could make a real impact.

Most notably, there are two major opportunities where a patient’s interaction with his or her own health record could improve information quality. Simply put, the distributed ledger capabilities of blockchain could support processes that involve the patient more directly, and even puts him or her in control of where, when, and how health data is used and reused.

The key challenge blockchain could address is centered around the need to move critical functions out of the electronic health record (EHR) to improve management across the care continuum. The industry still has a focal point in the EHR, but patient data exists in many systems and other data sources. Blockchain-based solutions move the concept out of the EHR to more effectively manage the reality of a true patient data set. Trust, visibility and traceability across many EHRs and other system data are all things that are not possible with today’s technological approaches.

Implemented correctly, it could provide an important level of patient interaction with the health record that would improve how health information is managed.

So, let’s take a look at the two most promising areas.

Patient Identity Management
Managing patient identity can be a challenge. Physically identifying a patient is easy, but in a world where data and interactions are increasingly happening virtually, being able to find a way to manage and reconcile patient identity is no easy feat. Take, for example, a master patient index. As it stands, there is no universal approach in data entry or standardization.

This is one area where blockchain could help. Tamara St. Claire, Chief Operating Officer at BaseHealth, Inc., recently noted that “the very nature of blockchain incorporates the equivalent of a master patient identifier...and it uses private and public identifiers to create a singular, secure method for ensuring and protecting a patient’s digital identity.”

St. Claire brings up a good point. The idea that a healthcare blockchain could be incorporated into patient identity management, which helps to provide better information about a patient’s identity to anyone who needs it, is an interesting angle. A blockchain-based patient identifier that could be linked to hospital records as well as data from other sources, such as employee wellness programs and wearable health monitors, is an area worth focusing on.

Naturally involving patients in some level of curation of their data would involve much tighter means of coordination with patients and require evolved business models, but if we are willing to validate our credit reports, we need to be willing to do the same to help validate our healthcare identity.

Managing Consent
To fully realize the implication of digital health records, we have to figure out how best to use them. It is a balancing act between privacy, security and the ability to analyze patient information to improve medicine. Precision medicine is all about expanding our understanding of patient data to improve outcomes.

So, to make the most use of the ever-increasing stores of patient data, we have to find a way to manage how it is used. As the adage goes, “consumers want privacy; patients want research.” We need to manage how patient data can be shared and managed for research purposes. That means more effectively managing many of the consent processes across the healthcare landscape, among academic institutions, contract organizations, pharmaceutical and medical companies, and, of course, patients.

Blockchain presents an interesting technology to manage how patients consent to use their data for research opportunities. It can shift the paradigm from one of attempting to control and block how data is shared to informed surveillance and participation of the patient in the process.

The important criteria shared by these two ideas centers around the idea of getting patients involved in validation and access control over their health data. That is distinctly different and much more manageable than putting patients in total control of their health records whereby they become the full custodian and distributor.

The application of blockchain technology is fascinating and rapidly evolving. These two examples speak to the opportunity that lies within healthcare and how it could help reshape the landscape. I’ll be watching it with interest to see what takes shape.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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