Servers and storage are a primary focus for one hospital’s support upgrades.
The healthcare industry is in the midst of a digital revolution, but despite improvements to data collection capabilities, interoperability and access remains problematic. That’s where blockchain technology comes in.
Popularized by Bitcoin, the distributed ledger technology uses a decentralized network to collect and selectively share data through the use of private keys or smart contracts that provide an additional layer of security. Although practical applications of blockchain are still untested in healthcare, many believe the new technology could improve interoperability and quality care.
“There’s a lot going on; a lot of people are excited,” said Steven Posnack, director of the office of standards and technology at the Office of the National Coordinator for Health IT (ONC), which announced 15 winners of its blockchain research challenge in September. “It seems like it’s on the three-to-five-year horizon of when we think that we would start to see some implementation and production at some scale.”
Hype may overshadow practicality in these early stages, but blockchain remains a key focal point for the healthcare industry. Here are four areas where the promising technology could make a substantial impact.
The current medical claims processing system is plagued with improper payments and delays. In 2015, Medicare and Medicaid alone racked up $89 billion in improper payments. Using blockchain technology and smart contracts, providers could communicate faster and more accurately with payers to determine eligibility status and cost-sharing expenses.
“This is an improvement to the current landscape in which providers are either working directly with each payer or using an intermediary to help coordinate the communication across the potentially hundreds of payers,” says Kyle Culver, a solution architect at Humana.
Blockchain could cut down on fraud, waste and abuse while limiting administrative costs. However, several barriers remain, including scalability and value proposition. It may be several years before mainstream adoption, but Culver says the insurance industry is “eager to see something real.”
Although most discussions surrounding blockchain in healthcare are theoretical, researchers at the Massachusetts Institute of Technology (MIT) Media Lab may be on the verge of a practical solution.
They developed MedRec, a record management system that sits on top of existing electronic health record (EHR) systems and uses blockchain technology, cryptography and digital signatures to provide patients and physicians secure access to medical information.
“We want a patient to be able to just click a share button, send their record to a doctor for a second opinion,” said Ariel Ekblaw, a graduate research assistant at the lab, during a conference hosted by the National Institute of Standards and Technology (NIST) in September. Ekblaw added that the group has already tested the program at Beth Israel Deaconess Medical Center and expects to release its findings next year.
Patient-reported outcomes (PROs) are taking on a growing role in healthcare. Although less than 20 percent of hospitals use PROs regularly, nearly three-quarters indicate they will use PROs in the next one to three years, according to a survey by Health Catalyst.
Currently, hospitals collect PRO measures through surveys or questionnaires, but blockchain offers the potential for a fast-paced alternative that integrates health information from mobile devices and mHealth apps, opening up a robust new data set for providers.
“Rather than a measure being done at a point in time and then reevaluated during a particular interval, there’s the possibility of changing the paradigm and dynamic to something that is real time,” said Jason Goldwater, senior director at the National Quality Forum in Washington, D.C. He noted that the approach could particularly impact providers that rely on PROs to treat mental illness.
Blockchain provides easy and secure access to medical information, which could shift more control to patients, allowing them to take on a larger role in managing chronic conditions and their overall health.
“We’re looking at an era where consumer technology and consumer engagement and empowerment is becoming much more the focus to make sure they are leading healthy lives outside of their interaction with the healthcare system,” Posnack says.