Ask any number of healthcare professionals what the term “blockchain” means and the answers will likely vary by the number of persons asked, but, nevertheless, the concept is coming to healthcare. And not just in small trickles, but flowing so quickly it can’t be ignored.
First, let’s take a look at what blockchain is so that we’re all singing from the same song sheet. According to Investopedia, a “blockchain is a digitized, decentralized, public ledger of all cryptocurrency transactions.
Blockchain is a continuously growing list of records, called blocks, which are linked and secured using cryptography. Each block typically contains a hash pointer as a link to a previous block, a timestamp and transaction data. By design, blockchains are inherently resistant to modification. The Harvard Business Review defines a blockchain as an open, distributed ledger that can record transactions between two parties efficiently and in a verifiable and permanent way. For use as a distributed ledger, a blockchain is typically managed by a peer-to-peer network collectively adhering to a protocol for validating new blocks. Once recorded, the data in any given block cannot be altered retroactively without the alteration of all subsequent blocks, which needs a collusion of the network majority.
Blockchains are secure by design making them more suitable for the recording of events, medical records and other records management activities, such as identity management, transaction processing, documenting provenance or food traceability.
While some claim blockchain doesn’t have an application in healthcare a recent study shows 19 percent of hospital leaders and 76 percent of health insurance executives are either thinking of deploying or are in the process of implementing the technology, according to Black Book Market Research. Digging deeper, 29 percent of hospital executives and 82 percent of payers claim a working knowledge of blockchain as of the 2017 third quarter. Nine in 10 medical group managers and IT specialists also agree that blockchain could solve a range of issues from connectivity to private data sharing.
The top three blockchain uses for both providers and payers are contracting, finances/reimbursement and big data collection. For providers, that’s followed by the healthcare internet of things, identity management and supply chain. Payers utilization differs slightly, with identity management, supply chain and IoT ranking fourth, fifth and sixth.
An earlier Deloitte survey found that 35 percent of healthcare and life sciences organizations planned to deploy blockchain solutions in 2017. ONC also sees its potential and announced in 2016 15 winners to its blockchain challenge. The winners were chosen for their potential to impact market viability, improve the flow of health information and nurture transformative change, among other things.
All of that said, only 9 percent of provider organizations have definite plans to deploy blockchain by the end of the first half of 2018. Seventy percent of payers expect to integrate blockchain with their systems by the first quarter of 2019. Fourteen percent of those companies said they are currently testing those solutions. For those in both the provider and payer communities, blockchain technology used for cryptocurrencies like Bitcoin have been particularly alluring as a way to facilitate information sharing.
"The lack of technical standards for this still-immature technology is causing regulatory uncertainty while the industry anticipates explanations from federal rules at some point in 2018,” Doug Brown, managing partner at Black Book, said in a release.
The survey included responses from 88 payers and 276 providers.
If nothing else, as the trend gains steam, perhaps more of us in the public will begin to better understand the structure of blockchain and what it does.