Blockchain has the potential to address many struggles that providers, payers, and patients all face—struggles like interoperability, patient ownership of data, and misaligned expectations in stakeholder relationships.
What is blockchain?
Blockchain technology establishes a single, shared record of events between decentralized communities of people and organizations. A new piece of data can be added to the end of an existing blockchain through a unique digital footprint of the last block on the chain. Data can't be altered without corrupting the entire chain and all existing blocks of data.
Blockchain users (which could include different health care stakeholders like clinicians, payers, and even patients) work together to verify the validity of all new information as it is added to the historical chain of data, even if they don't know one another. This unique, shared ledger of information allows for increased security and trust of information.
3 potential benefits of blockchain
1. Greater system interoperability
A lack of interoperability is one of the greatest pain points within health care. Even though EHRs are widespread, it's still challenging to share data between EHRs and other digital health tools, like remote patient monitoring devices. This can make patients' lives more difficult, such as when patients move to a new provider.
The search for a new provider is often accompanied by piles of paperwork and requires existing patient charts to be sent to the new provider. Blockchain simplifies data transfer with its decentralized structure. Patients don't need to worry about finding a provider who operates on the same EHR system that their previous provider used. This is because blockchain's decentralized structure allows any provider with the proper authorization to access a patient's chain of health information.
This same style of blockchain data recording can be applied to remote patient monitoring devices, allowing for greater data sharing and care continuity.
2. Give patients more ownership of their data
Patients usually have little say over how their data is used. Instead, health care organizations effectively own and control the use of patient data, with the potential for deidentified health data to be sold to third parties. Some patients view the commodification of their deidentified health information as a violation of their trust and autonomy.
Clauses that allow this practice to persist are often hidden within consent forms required to receive care, and patients are rarely notified or contacted for approval when their information is shared. Beyond that, patients don't know how their information will be used once third parties receive it.
Blockchain can enable patient ownership of data by authorizing patients to provide rescindable access to their chains of health data. Only the stakeholders who have received authorization can view and update data, empowering patients to take a greater role in their own health data.
BurstIQ is an example of a company who sees this potential and is working to make it a reality for patients. They offer an end-to-end, blockchain-enabled data management system specifically designed for health care. Their system incorporates consent for data sharing and viewing, which embodies their mission to put the patient in control of their own information.
3. Mediate stakeholder relationships
Blockchain offers the ability to mediate stakeholder relationships via smart contracts and procedure auditing. Providers and payers often have strained relationships due to misaligned incentives—providers to maximize payment for their services and payers to minimize payment to contain costs.
As an example, Simply Vital Health is a blockchain technology that offers a way for providers and payers to work together more efficiently. Their online tools and checklists utilize blockchain's immutable audit trail to help track provider actions and keep treatment within federally approved and commercially insured guidelines. This way, providers and payers can feel confident that the payment is fair without having to go back and forth about denials.
Blockchain has great potential, but faces certain obstacles
Health care leaders have approached blockchain with hesitant optimism due to a number of factors that make blockchain complex and that don't yet have guaranteed solutions.
One of these obstacles is the lack of clear regulations surrounding blockchain's use and management. There's a potential liability since blockchain deals with sensitive patient information. Without a clear protocol on how to manage access to information and the physical data itself, organizations could be held responsible if patient information is mishandled.
Another point of concern is the speed and scalability of blockchain. A public ledger that anyone can access with the approved authorization runs the risk of becoming too large and complex to efficiently transfer information. This may prevent blockchain from being efficient on a larger scale.
The good news is that blockchain is still a relatively young and constantly developing technology. Given the kind of potential this digital health investment offers, health care leaders who are proactive and can solve for some of the complexities of blockchain will find themselves ahead of the curve as the technology becomes more widespread.
Blockchain is a digital ledger that enables parties with no history of trusting one another to securely commit to contracts and record transactions, without the need for an intermediary such as a bank. While blockchain’s major successes to date have been in finance, the technology has potential to provide value to health care, particularly in the areas of payment adjudication and supply chain integrity.