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Blockchain's Most Practical Healthcare Application Could Be In Quality Measurement


Nobody knows for certain where blockchain will (or won’t) deliver in healthcare. One health IT veteran makes the case for quality measurement.


at the Venetian in Las Vegas and asked a crowd of several hundred attendees a pointed question.

“How many of you have heard the following: ‘Blockchain will solve everything that ails us in healthcare’?”

The room filled with laughter as just about every hand in the room shot up towards the ceiling. Goldwater chuckled too, and acknowledged that blockchain is not a panacea — at least not yet. But that doesn’t mean it’s not on the precipice of delivering on tremendous potential for healthcare.

Most of that potential will be realized in quality measurement, according to Goldwater. For years, quality measurement has taken place in-person, in the clinic. A patient walks into a doctor’s office and receives a diagnosis, then the doctor follows evidence-based best practices, gives the appropriate medication and discharges the patient. It’s a limited time frame that leaves out a huge slice of the continuum of care (plus all its data, learnings, and opportunities to achieve better outcomes).

Blockchain can fill that gap by helping physicians and health systems measure quality dynamically over time, Goldwater said. It broadens the limits of what can be measured, how often, and how effectively, and does so automatically. Moreover, with blockchain, health facilites can receive several transactions per minute that each receive and combine digital signatures. Data from those transactions moves up the chain to the provider, and it's immutable—it can't be changed, just appended.

Public blockchains can give physicians simple access to “more data than we could ever envision. Data about your medical chart, your mental wellbeing, your mindfulness, your diet, your exercise, even your genomic data,” Goldwater said. That data can be pulled from all sorts of places — electronic medical records (EMR), wearable tech, mobile apps and even social media. As the population becomes more adoptive of these technologies, more valuable data will continue to flow into blockchains.

But more data only means more insight for physicians if they can access it. As it stands, health systems are in need of tools to help them move data from its genesis in social media or wearables, for example, to the right providers. “Blockchain, in my opinion, provides the best option for that,” Goldwater said.

Through the aggregation process, the patient maintains ownership of their own data. That’s one of the perks of harnessing blockchains as storage units for health data—access can only be granted by the owner, which makes their data relatively safe and secure.

“That takes care of the 2 reasons why [people are skeptical]—you’re reducing the burden on providers by allowing the information to come to them automatically, and providing, for the most part, a secure channel for that information to get from the patient, to the provider, back to the patient again,” Goldwater said.

All that data provides a firm foundation upon which to build more accurate, evidence-based quality measures, which blockchains can help generate in 3 key ways, Goldwater said. First, they can measure the success or failure of a patient encounter over time, as opposed to at a point in time. Second, they capture information and show if the evidence that led to the creation of a quality measure was thorough and effective, or in need of refinement. Third, they inform the reporting of data for quality measurement with little effort from providers.

Even with all the excitement surrounding blockchain, proponents tend to hit a wall when looking for meaningful use cases.

“People who tell you blockchain will solve everything—nobody knows that for sure. Many of us believe it will, but nobody really knows which use cases will be successful and which won’t,” Goldwater said.

In true Vegas fashion, Goldwater’s betting big on quality measurement.

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