A leader at the Blockchain Research Institute details how the technology could transform medicine, from information sharing to patient outcomes.
Blockchain can’t cure cancer. No, duh? Well, with all the hype surrounding the secure data technology, the Blockchain Research Institute’s Hilary Carter, MSc, couldn’t resist cracking the joke. Then again, she adds, blockchain might one day enable and encourage more research into cancer, possibly leading to a cure more quickly than anyone expects.
Blockchain, of course, has become something of a buzzword, an excitement generator. But the technology’s promise for healthcare is real, and its potential uses are many.
Even so, it’s becoming clear that industry leaders don’t yet understand blockchain and how it can benefit healthcare organizations, patients, and the system as a whole. They know it might pack a punch, but that’s about it. That disconnect led Healthcare Analytics News™ to Carter, who is the faculty director and project leader of the Blockchain Research Insitute, an engine designed to explore new applications of the technology, cofounded a year ago by Don and Alex Tapscott, 2 key opinion leaders in the space.
During the conversation, Carter discusses what blockchain actually is, how it works, how healthcare organizations and hospitals can leverage it, and advice for decision makers. Below are the key takeaways, and they are critical for anyone who wants to get a feel for the technology or expand their existing knowledge.
Let’s get this out of the way: Blockchain and Bitcoin often come up together because the cryptocurrency was the world’s first use of blockchain, Carter says. But the 2 terms are not interchangeable, and blockchain is capable of far more than fueling a decentralized monetary system. That said, the tactics employed by blockchain to transmit cryptocurrencies are the same ones that stand to shake up data sharing in healthcare.
Broadly, blockchain fosters secure data transfers using a distributed database, or a ledger of transactions, that include a list of dealings, which are organized into blocks. The ledger is shared over a network with peers, who confirm that the transaction is indeed legitimate. At no point can the list of past data transmissions be altered.
So, a cryptocurrency enthusiast may send 1 Bitcoin to a friend, the deal is vetted by the fellow users through the blockchain and then permanently recorded, but only the individual with the key may access the Bitcoin. Translated to healthcare: A hospital may send an electronic health record (EHR) to another organization, in a move that is secure and independently confirmed as legitimate. If an unauthorized employee were to somehow access the record, however, that act would be forever preserved, opening the bad actor to consequences.
And that’s just one potential use of blockchain.
First, the big picture: “Disintermediation of the industry is, I think, one of the outcomes of blockchain,” Carter says. “Every industry has intermediaries and siloed groups, different stakeholders. They serve their purpose of establishing trust, but they also impose a heavy cost and a friction.”
What Carter means is that blockchain stands to deeply disrupt healthcare in ways that could infuriate some segments of the industry and delight others.
Say, for instance, that a patient wants their EHR data. Under the existing system, that individual would need to contact the physician’s office, physically go there, negotiate with the front office, pay a fee, and get the records. It’s costly, Carter says, because it requires employee input and processing.
“Blockchain will enable patients to own and control their health identity, their health information,” she notes. “Our health histories will become assets that are now transferrable.” The technology may also improve interoperability, powering smart contracts that enable patients to set protocols for when their EHRs may be transferred, like if they are caught up in an emergency or traveling abroad, Carter says. That arrangement bodes well for patient empowerment, a movement supported by many but hardly realized to this point.
EHR data might also be monetized through blockchain. A person with a rare disease, for example, may choose to sell that information to researchers, earning money for the trials and, possibly, value generated from drug development, Carter says.
Blockchain will boost the integrity of each patient’s data, making the technology a boon for notoriously challenging healthcare databases and those charged with managing them. The revelation could be welcome in an industry that has struggled to make its data actionable.
Clinicians, meanwhile, could be freed of their geographic boundaries, Carter says. Through new telehealth frameworks, they may diagnose patients over the phone, through a connection that’s guaranteed to be secure. This application is especially promising for dermatology and behavioral health, she notes. And healthcare organizations and their patients may opt to use more peer-reviewed diagnoses, leveraging the expertise of experts across the world, Carter says.
The Internet of Things (IoT) will take well to the technology. Fitbits, smartphones, and all sorts of connected medical devices can be registered on a blockchain, measuring biometric responses to drugs, alerting remote stakeholders, and allowing for real-time, data-driven decisions, Carter says. Of course, the IoT has long been hailed as a game changer for medicine, but concerns over privacy and the like have, at times, left the technologies stuck in neutral, at least for clinicians.
What’s mentioned above are just some of the ways in which healthcare might use blockchain to its advantage. The tech might also fuel better efficiencies, streamlined workflows, and just about anything else that wide-eyed innovators can conjure. Still, Carter notes, it can’t cure diseases or clean the floors.
“But it can tell you who last cleaned the floor and how well they did,” she says. “Technology is simply a tool, and a fool with a tool is still a fool.”
Healthcare leaders who want to learn more can open their EHRs up to research and collaborate with other hospitals, governments, and insurers on new blockchain applications, she says. They may participate in pilot projects and reach out to all healthcare stakeholders to determine which needs aren’t being met.
“Come to the table willing to innovate for the benefit of patient care,” Carter says.
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