Like any map, this resource lays out key landmarks across the blockchain in healthcare ecosystem. This landscape is rapidly evolving, with new developments unfolding on a daily basis. This roadmap serves as a high-level tool in relation to blockchain and its application to healthcare. It is not intended to serve as a heavily detailed and/or exhaustive list of the subject.
Organizations must assess their point of origin on an individualized roadmap towards blockchain in healthcare. Some organizations may experiment with blockchain technology, even in a mode of trial and error, while others may select a specific use case category and pilot in a known area. Others may opt to engage in the “new economy” of cryptocurrency with intent to benefit from newly emerging opportunities in this area of blockchain. Still, others may take a hybrid approach, mixing any of the aforementioned methods.
Before embarking on the path towards a blockchain technology implementation project, review the following key considerations:
Blockchain as a Journey and a Destination
Organizations should understand their desired outcomes as a result of the implementation of a blockchain technology project. Moreover, serendipitous discoveries may unfold on their journey into blockchain technology that may lead to modifications of the original desired outcomes. A good starting point is to assess whether the proposed use case would benefit from implementation of blockchain technology. There are a few resources available that attempt to address this step:
- Explore the HIMSS resource “Strategies to Identify Use Cases for Blockchain in Healthcare”
- “Do I need a Blockchain?” proposes a decision flowchart to determine what type of blockchain to use, if any.
- The ACT-IAC Blockchain Playbook proposes a 5-phase process that takes the user from assessment of the business problem to integration of a blockchain-based solution within the organization’s infrastructure.
Before departure, organizations must assess their capacity to participate in the healthcare blockchain landscape.
- Skill sets: Working with blockchain technology requires new skills that should be layered on a foundation of network and data administration, governance, application integration, security and privacy, support, maintenance, and change management. New business skills that are focused on decentralizing authority across organizations participating in blockchain networks or alliances will also be required.
- Collaboration is essential: The “chain” in a blockchain necessitates interdependency among blocks or “links” in a “chain.” Whether a trusted network versus a zero-trust system, or private versus public blockchain, the use of blockchain technology pulls organizations from self-sovereignty into a broader ecosystem without a central authority. These new partnerships are now dependent on valid, shared data derived from all of participants within the network.
- Risk Tolerance: With the partnership inherent in blockchain solutions, a perceived loss of control of certain aspects of the business will be shifted to the blockchain network. Therefore, there is a potential for detours and the corresponding need for resources in reserve to compensate for unanticipated outcomes or interim costs when entering into blockchain project initiatives.
Resources for the Journey
In addition to readiness, organizations will require several types of resources in order to embark on their blockchain journey:
- Data: Organizations must identify a minimum set of data of sufficient quality and of mutual benefit to add to the blockchain database. Additionally, organizations have to abide by regulatory and compliance laws, such as HIPAA and GDPR.
- Finance: Monetary or in-kind resources must be financially accounted for, particularly if cryptocurrency or fiat currency incentives are a part of the project’s scope.
- Capacity to Scale: Blockchain initiatives will grow and organizations will need to have available materials (e.g. physical or virtual hardware) and human resources to respond to blockchain network growth.
- Throughput: Resource contention is a reality that is both within and outside the ability of an organization to control. Organizations will need to plan for potential bottlenecks and have strategies at the onset to mitigate obstacles and/or leverage more efficient pathways.
- Time: Commitment to an implementation schedule that anticipates and allows for flexibility to handle unanticipated, new, or better discoveries along the way to the intended destination is essential.
Roadmap Steps to Determine if Implementing Blockchain Technology Makes Sense for Your Organization
Blockchain is a unique type of distributed ledger, in which a network of transactional participants can share a single copy of the ledger. The importance of blockchain technology for healthcare is that it solves the reconciliation problem as all partners share the same ledger information. When one transaction is made, all participants will receive the information. Therefore, it removes the inefficient process of checking and validating data in order to determine which party has the correct data set.
Past attempts to solve for the large amounts of transactional data amassed in healthcare are usually focused on data unreliability and storing and/or moving data in a secure fashion. It is customary to utilize an intermediary system to transport data. Example use cases within the space are also available for review.
The technical architecture of blockchain can help to solve many common problems with transactional inefficiencies in healthcare, such as interoperability for clinical outcomes, revenue cycle on the payment side and issues with the pharmaceutical supply chain.
With blockchain technology initiatives already begun, organizations will need to identify key milestones to assess progress. Below are questions that may need to be considered at critical points during the project roll-out.
- Has the core business expanded?
- Do you take on the expanded scope or do you separate the new initiative and return to the original scope?
- Is the blockchain initiative a candidate for spinning off as a new venture?
- Does the organization need to make the difficult decision to terminate the effort, recognize the lack of meaningful progress or gain, and cut the initiative before the investment turns into a significant loss?
- What processes and workflows would need to be re-designed?
Undertaking a blockchain technology implementation in a healthcare organization may appear to be a daunting endeavor. Organizations need to employ project management, change management and strategic planning akin to any other type of IT initiative. This roadmap serves as a tool to help guide organizations through the pre-planning and implementation process to facilitate a successful journey.