The health ecosystem continues to undergo massive transformation and innovative technology like blockchain are a big part of what’s driving it.
Despite the endless innovations illustrating the digital health landscape, at times it can feel like we’re always stuck in traffic. The hype factor, like smog blanketing the air on a crowded road, can make it difficult to see what’s ahead and navigate the impending terrain.
It’s natural to feel impatient to move forward with the latest technology, but it’s also a waste of time to do so when the roads to your destination are blocked off, or if you are on the wrong road. Often we seek shortcuts that end up delaying our journey to our desired destination entirely.
Wherever we are on that road, each driver shares a common goal: we are all trying to get somewhere. Generally, that direction is forward, to what we believe is the right path ahead. Being stuck in traffic is only temporary. You might as well sit back and enjoy the journey – and, perhaps, plan a different route for your next adventure.
Watch David Kho, chief medical information and chief digital officer of ChenMed, talk with HIMSSTV about data governance projects and why it’s critical to consider data quality, consistency, standards and lineage.
“I think of blockchain as a superhighway for secure, targeted health data exchange. The on-ramps and off-ramps to that superhighway are the blockchain nodes,” said David Houlding, CISSP, CIPP; chair of the HIMSS Blockchain in Healthcare Task Force and principal healthcare lead at Microsoft. Houlding has been following blockchain technology closely for many years and brings vast healthcare experience to the task force rooted in compliance, privacy and security expertise.
“Each healthcare organization would have at least one blockchain node,” said Houlding. “That node could live on-premise inside the data center of a healthcare organization, or within the cloud.”
In other words, healthcare enterprise systems use those nodes to access the blockchain superhighway, and data from enterprise systems connected to blockchain nodes is the fuel that powers the blockchain in health.
If blockchain is a superhighway for health data exchange, organizations like HIMSS are the GPS systems that help get you where you want to go next in healthcare. “HIMSS’s strength in bringing together that network of organizations and convening that discussion, is in wonderful synergy with blockchain,” Houlding said.
Without connectivity, like most innovations, blockchain cannot thrive or achieve organizational goals. Recognizing this, the HIMSS Blockchain in Healthcare Task Force came together to gather as much information as possible to educate the ecosystem about what blockchain is.
“Ultimately, blockchain is a heterogenous, foundational network technology,” Houlding explained. “Any given blockchain network could have nodes deployed on-premise or some in cloud. There’s going to be a mixed deployment model, and blockchain can tolerate that. But helping people understand from a deployment standpoint – where it is, where does it actually run?” This is a key part of understanding what it is.
Understanding how enterprise systems connect to and work with them is another key part to mastering blockchain. This is critically dependent on interoperability, he explained, which is at the intersection of blockchain and health.
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Whether it is a technical network consisting of data, or a network of individuals or consortia – connectivity is always the driving force of value behind the scenes.
“This kind of technology cannot be used in isolation,” said Mari Greenberger, MPPA, director of Informatics at HIMSS. When it came to convening the Blockchain in Healthcare Task Force, Greenberger was the brains behind the operation internally at HIMSS. Leading with her interoperability expertise, her insights help keep the task force grounded, with a focus on the need for connectivity. “Health information exchange entities should be paying attention to this kind of technology, specifically because they have already built strong networks and consortia within their communities and they are trusted by their participants,” she explained. “There’s a terrific opportunity allowing us to move the needle on interoperable health information exchange, and this kind of technology could provide a strong business case for stakeholders who may not be considering this type of technology.”
“The good news is that blockchain can leverage much of the existing interoperability standards like IHE and maturing standards like, HL7 FHIR® and build on those,” Houlding added. “There’s no need to reinvent the wheel, and we provide guidance within the HIMSS Blockchain in Healthcare Task Force on interoperability as it relates to blockchain.”
“With the educational role that the task force has taken, it can help people understand: where is blockchain real, how should you think about potential use cases, business values; how to be successful from all of the technical standpoints, like interoperability,” Houlding continued. “HIMSS can play that educational role, and also that catalyst role, to Mari’s point, to build from those consortia that currently exist – leveraging blockchain to enrich the synergy between them.”
Understanding what blockchain means for your organization requires a full mindset shift, Houlding emphasized. “We go to great lengths to help people understand that when we talk about blockchain, we’re not just talking about cryptocurrencies like bitcoin. We’re not talking about fundraising aspects of blockchain. What we’re talking about is the healthcare enterprises’ value of blockchain like reducing healthcare costs, improving patient outcomes, engagement, and experiences, as well as the experiences of healthcare professionals. And then also helping them understand how they can address specific challenges along their journey with blockchain. Identifying use cases, articulating business values, cultivating and identifying consortia, building trust, establishing buy-in, addressing privacy security and compliance challenges, and mastering interoperability.”
Without interoperable systems, organizations will struggle with blockchain efforts and end up with different data being put on the blockchain in different formats, creating an even more complicated tangled web. To reach its full potential, data on the blockchain must be high quality, accurate, complete, up to date, consistent, and readable, Houlding explained.
“This is the first major volunteer effort that HIMSS has established as it relates to blockchain and distributed ledger technologies, and their intersection with healthcare,” Greenberger stated. “We’re focusing on the key strategic areas in which HIMSS excels – convening the right minds, the right experts from all across the healthcare ecosystem as well as providing our own perspective. That reach is fundamental to what HIMSS is and does on a daily basis. We have an exciting opportunity then to educate, to advocate, and to convene. I believe the task force is doing all those things within each of these pillars.”
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.
Originally published December 11, 2018