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Part 2: Healthcare Blockchain – A Path to Success in 2018

Most healthcare data today exists in healthcare organizations within various data silos. Information sharing is either absent or extremely limited.

There exists vast, unlocked value in sharing healthcare data in a targeted, secure manner to help enable improved quality of patient care and reduced healthcare costs.

In our first blog post, the HIMSS Blockchain Work Group set out on a course to provide thought leadership, best practices and key use cases for how blockchain technology might affect the healthcare ecosystem in the future. For this post, we leverage our work group’s experts from across all healthcare sectors with deep collective knowledge of blockchain and its potential value to healthcare for guidance on next steps.

Blockchain Work Group Goal Setting and Alignment

To start, we examine our group’s goal setting and alignment to improve focus on key deliverables of greatest value to the healthcare industry. Since HIMSS formed the Blockchain Work Group in August 2017, it has been highly goal-oriented, “…focusing on defining the potential role of blockchain and distributed ledger technology within the health information and technology ecosystem… [as] well as educating the community on the clinical, business, technical, and financial implications the technology may have on the healthcare landscape.”

As activities have matured, and the work group has expanded incrementally to better represent the many categories of healthcare stakeholders, the work group has and will continue to conduct iterative reviews and alignment of our goals to refine HIMSS’s short-term strategy for blockchain and distributed ledger technology, and provide our members with the resources they need to assess this technology’s application in the healthcare setting.

 

A Layered Approach and High-Level Roadmap for Blockchain

To help understand the potential of blockchain, it is useful to first analyze where we are today in Layer 0: Healthcare Data Mostly in Silos, Little Sharing, Massive Untapped Potential. The majority of healthcare data today is stored within various enterprise system data silos with healthcare providers, payers, pharmaceuticals, life sciences, or business associates/data processors. With only limited sharing of such data, there remains vast, untapped potential to improve the quality of patient care and reduce healthcare costs by sharing this data in a targeted and secure manner.

 

Figure 1 Source: Blockchain, Cryptocurrencies, Smart Contracts, Artificial Intelligence, and Machine Learning in Healthcare  

This provides fertile ground for blockchain in Layer 1: Blockchain Enables Secure Sharing of Healthcare Data Across B2B Networks to enable targeted, secure sharing of data across healthcare organizations participating in blockchain networks. Existing healthcare B2B networks have been identified as near-term opportunities for blockchain to add value. These range from clearinghouse networks, health information exchanges, drug and medical device supply chains, provider credentialing networks, clinical data sharing networks and many others.

Layer 2: Smart Contracts Increasingly Automate Transactions, Improving Efficiency can be built upon blockchains and introduce executable code that can trigger on matching blockchain transactions, automate processing, and output results onto the blockchain. Smart contracts will enable more code to be executed directly on blockchains, versus only within healthcare organizations enterprise systems as is done today. This will further improve efficiencies with blockchains and in turn help both improve patient care and reduce healthcare costs.

Layer 3: Cryptocurrencies and Tokens Enable New Commerce and Incentive Systems may be built upon blockchains and smart contracts. Blockchains, even without cryptocurrencies and tokens, provide value to healthcare in enabling targeted, secure sharing of healthcare data, independent of cryptocurrencies and tokens. That said, cryptocurrencies and tokens may make sense for some healthcare blockchain use cases and enable new commerce and incentive systems. For example, patients may earn cryptocurrency or tokens by participating in clinical research studies using blockchain, and redeem this value to help offset their healthcare costs.

Artificial Intelligence (AI) and Machine Learning (ML) show incredible potential to improve patient care and reduce costs as shown in Layer 4: Artificial Intelligence and Machine Learning Enable Major New Insights, Value. For example, AI early diagnosis could save heart and cancer patients where AI and ML can help analyze various types of scans for heart disease and lung cancer, enabling earlier detection and improving patient care options, while also estimated to save the UK NHS more than £300m annually.

 

A Checklist for Blockchain in Healthcare

Success with blockchain in healthcare will depend on many business and technical factors. The HIMSS Blockchain Work Group is working to identify and analyze these factors.

We share below an initial 10-point, high-level checklist of key factors you can use to crosscheck with your blockchain initiatives. These can help identify potential additional factors you need to cover to help improve your organization’s success with blockchain:

1. Clear definition of use case(s), and identification of existing or new B2B networks of healthcare organizations

2. Identification of which healthcare organizations will participate, and why: their business models, incentives, ROI, etc.

3. Privacy, security and compliance considerations

4. Performance, throughput and scalability – ensuring your use case is realistic given blockchain constraints in these areas

5. Types of data stored on the blockchain vs. data remaining off blockchains in enterprise systems, and possibly referenced by metadata on blockchains

6. Deployment architecture: public vs. private, permissioned, on-premises vs. cloud-based deployment of blockchain nodes

7. Integration with enterprise systems, identity and interoperability

8. Technology selection: blockchain platform and related technologies

9. Prototyping, piloting, incremental and iterative refinement, case studies

10. Production deployments and scale out to enable improved quality of patient care and reduce healthcare costs

 

Paving the Way for Future Interactive Blockchain Tools

As its many activities continue and benefit from newly refined goals, the work group sees opportunities to provide tools in the form of guidance documentation, such as the high-level checklist above, and also as interactive tools.

As healthcare decision makers advance their use case evaluation within their organizations and business networks, drive toward early and significant architectural decisions, and seek to financially model costs and benefits, this work group can contribute unbiased, detailed, high-value guidance to HIMSS membership.

Potential interactive tools for blockchain-related technical and business decision support will be one area considered by the work group. Various concepts for such tools are under discussion and will continue to be explored within the context of, and in alignment with, the newly refined goals.

As the Blockchain Work Group continues its efforts, please be on the lookout for updates on refined goals, much more detail on business and technical roadmaps, key business and technical factors, decision-support, educational resources and more.

 

What kinds of questions and thoughts on blockchain does the HIMSS community have? We want to hear from you! Contact interop@himss.org to share your idea or to learn more about getting involved in future HIMSS blockchain activities.

 

New at the 2018 HIMSS Global Conference & Exhibition, blockchain solutions and education will occur at the Interoperability Showcase and the Innovation LIVE areas within the exhibition hall.