Blockchain in healthcare: three words igniting excitement in the hearts of health information and technology professionals everywhere. Blockchain may very well be the official health tech buzzword of 2018. And when words catch a buzz, confusion over definition and application are inevitable.
When faced with unveiling the potential of promising innovation, HIMSS does what we do best: convening industry subject matter experts that can break through the noise, get the facts and disseminate them to amplify awareness.
This was integral in the formation of HIMSS’s Blockchain in Healthcare Task Force. Its leaders and members represent industry expertise from around the globe in diverse topic areas including interoperability and security.
The launch of the task force was championed by Mari Greenberger, MPPA; director of Informatics at HIMSS. An interoperability subject matter expert, Greenberger has dedicated the last 12 years of her career to the strategic direction of programs within healthcare associations.
The HIMSS Blockchain in Healthcare Task Force chair, David Houlding, CISSP, CIPP, brings forth a background rooted in security and compliance expertise, accompanied by over two decades in healthcare. The current principal healthcare lead at Microsoft, Houlding defines blockchain’s potential on not only on what it is, but what it isn’t – a necessary part of distilling the hype.
Blockchain should be considered one tool among many in your digital health toolbox, Houlding emphasized. “In the early days of blockchain, it was really asserted as a security technology,” Houlding explained. “Some people kind of asserted it as a ‘silver bullet’ for security – which it’s not – but it definitely has security strengths.”
Though Houlding entered the world of blockchain from a privacy, security and compliance angle, he quickly dove deep into many of the healthcare use cases driving much of the interest in blockchain. Sharing his expertise across the industry, he learned quickly what boxes needed to be checked for blockchain technology to make sense within an organization.
Is it grounded in business values?
In order for blockchain technology to work for your organization, its use must be grounded in business values first, Houlding emphasized. This is integral to measuring success with new technologies.
Are there multiple organizations involved?
If your systems aren’t interoperable, it won’t make sense to start thinking ahead on blockchain, Houlding and Greenberger agreed. “The hardest part about building blockchain is building the consortiums of healthcare organizations: building buy-in, building trust and getting organizations to the point where they’re willing to connect their systems and transact on blockchain,” Houlding explained. “Blockchain makes sense in terms of a network of healthcare organizations wanting to collaborate around a target use case, with defined business value, and to do that targeted secure sharing of data.”
Does it work well with other enterprise systems?
“How does blockchain sit with other enterprise systems?” Houlding asked. “If it’s providers, it’s electronic health records. For payers, it’s eligibility, membership, claims management. Whatever the consortium is, whatever the network, they’ll have different enterprise systems they’re going to want to connect to the blockchain and do this targeted, secured sharing.
Is it a complement to your current processes?
Keep in mind, blockchain is not necessarily the winning solution to all of your organization’s challenges. It works most effectively as a complement to integrated, interoperable systems. “Blockchain is just another tool among many in our toolbox, as David explained,” Greenberger added. “It’s not a stand-alone, isolated piece of technology.”
“Our strong recommendation from the task force is to target existing business to business networks or consortiums where you already have organizations collaborating,” Houlding said. “You have the trust, you have the buy-in, and blockchain can prove itself (at that point) and not hit that major hurdle that stalls so many blockchain efforts; that being said, how do you build a consortium of trust if you start from scratch?”
Watch Kamal Obbad, co-founder and CEO of Nebula Genomics, talk with, talk with HIMSS TV about understanding the risks to consider before giving someone access to their data based on a blockchain model.
When looking at the big picture, HIMSS keeps a close eye on how innovations are developing worldwide. The Blockchain in Healthcare Task Force brings global expertise spanning from members located across three continents.
So where are we at globally on our journey to blockchain? From a European standpoint, there’s additional layering to consider in an organization’s strategic approach, based on the recent GDPR regulations for citizens of the European Union (EU).
“Best practices to learn from, especially from the privacy and compliance side … they really inform blockchain in terms of what data to keep on or off blockchain,” Houlding explained, citing the potential storage of EU citizens’ personally identifiable information on blockchain nodes.
“It could flow to the other node, which could be in a different country with different regulations. That sort of data sovereignty and trans-border data flow issue is very important to identify and can influence what types of information you put on the blockchain, and conversely what types of information you keep off the blockchain in secure enterprise systems and reference from the blockchain. If you start local, and then go international at some point, all of the information in the shared ledger of the blockchain will flow wherever you stand up new nodes. The privacy and compliance things are definitely things to learn from, from the European standpoint, and it is critical to a blockchain’s success to consider these factors up front in your initiative.”
Various ventures underway are rapidly outpacing other nations as they dive deep into the production phases of blockchain implementation, Houlding said. For instance, a hospital in Taiwan recently developed a healthcare blockchain-powered platform focused on health data exchange between medical establishments and patient portals. Additionally, a South Korean biotech enterprise is teaming up with a technology firm to develop a medical big data ecosystem, which would make possible the storage and transfer of vast amounts of sensitive genomic and personal information.
“With fast-movers like this company reaching production stages in Taiwan, maybe because they’re less regulated, they’re able to deploy faster. And maybe we could learn from their production use and deployment. Healthcare organizations love to see what other healthcare organizations are doing, and the values they attest to,” said Houlding.
“I think 2019’s going to be really interesting, in terms of some of those pilots wrapping up, case studies being published, and obtaining attestations from healthcare organizations as to what worked well. I think that is going to be a watershed moment for blockchain – because as you get more providers, payers, etc., standing up and saying, ‘Hey, we did blockchain for this use case, this is the business value we saw,’ you’ll see more organizations gravitate towards those use cases, join those consortiums and grow those networks. Blockchain, again, is very much a network technology, so it benefits from the network effect. The more organizations that connect, the more value there is for the network.”
Like most great innovations, it is clear that blockchain’s maximum potential can be exercised most effectively through collaboration and leveraging a consortia – from a technical standpoint, from an organizational standpoint and from a global standpoint. Although many healthcare organizations may not be ready just yet, the promise of this technology should motivate organizations to move forward in their efforts to become interoperable.
Blockchain and distributed ledger technology are taking hold in healthcare as the industry learns more about the potential to improve patient care and reduce costs.