Amid the buzz for Bitcoin, blockchain, the underlying technology caught the attention of everybody and eventually, industries realized its potential beyond enablement of an alternative form of currency exchange only.
For starters, it can be defined as a list of linked digital records; a distributed ledger, that permanently stores and updates via a consensus among those who share it. It eliminates the requirement of a central repository as every transaction is recorded in the block itself. It allows information to be added each time but copying and deletion are forbidden. According to Gartner Inc., blockchain is expected to reach $176 bn by 2025 in terms of business value-add.
However, while it is slowly getting evaluated in different verticals, it has not yet penetrated the life sciences and healthcare industry well and is just scratching the surface. A Deloitte bBlockchain survey, “Blockchain reaches beyond financial services with some industries moving faster”, conducted in 2017, however, has revealed that organizations in the life sciences and healthcare industry (35%) have surpassed other industries in terms of their plans for the deployment of blockchain technology. There are various offerings evolving around blockchain technology but they are still hatching from the eggs and remain little more than prototypes. However, evolution is taking place at lightning speed, and now the time is apt to get into the field and review some of the emerging use cases.
Blockchain, in life sciences and healthcare, can be utilized to improve trust, interoperability, collaboration, traceability, and audibility across a variety of functions such as supply chain management, financial transactions, clinical trials, credentialing, and claims processing. Talking about the earliest practical use cases in the industry, electronic health records and beyond are the ones in which blockchain can help - handle identity better.
Imagine convergence of multiple, duplicative records, into a coherent, longitudinal patient record which could be accessed by all the stakeholders, be it the patient, doctor, insurer, researcher, etc. without any threat to security or privacy.
Some of the key potential blockchain use cases, include but are not limited to-
- Medical records and interoperability: Blockchain technology can be used to centralize a patient’s medical history which gives patient complete visibility and control. Also, patient care and experience could be enhanced as relevant information could be seen by providers, patients, insurers, etc.
- Prescription sharing: Improving transparency and data validation by having personal prescriptions tracked and operated on the blockchain with patient’s consent.
- Patient wearables: Offering real- -time, scalable solution for monitoring and treating patient outcomes through this connected device [on blockchain network] that broadcasts patient information.
- Supply chain and logistics: Making supply chain and logistics more robust by following a pattern/chain using blockchain technology with beginning recording at the manufacturer, followed by intermediaries for updates, and finally coming to the buyer for authentication.
- Drug Discovery and development: Improving the efficiency of drug discovery and development by directing tracking and reporting of results to a blockchain network.
- Value-based Care: Determining the quality of care over time by using blockchain network to track a patient’s episode of care and related medical events.
- Compliance and Adherence: Enforcing controls and streamlining adherence by immutably tracking the complete history of changes through blockchain.
Currently, a variety of blockchain solutions are being offered by different firms. Some of them are outlined below:
- Introduction of an enterprise scale blockchain technology by a healthcare technology and business solutions firm, change healthcare, for revenue cycle management in hospitals and health systems
- Partnership between Factom, a blockchain-based record-keeping service, with HealthNautica, a major US medical services provider, for deployment of blockchain solution for digital health records
- Philips Healthcare joined hands with Gem, to work on the blockchain technology and develop enterprise healthcare applications, such as wellness apps and global patient ID programs
But every technology comes with its own set of challenges and blockchain is no different. One of the major challenges would be to unite the group of required multiple stakeholders and get them on a standard platform, including health plans, providers, and individual governments and to make them understand the nuances, the benefits, and risks of deploying this technology.
Additionally, technological challenges cannot be ignored as it would need a new way of working altogether.
Taking into consideration the nature of information in this industry, data protection is of utmost importance. Although one aspect of security is being catered to by blockchain, additional steps might be required to ensure data security.
The distinction between identified and de-identified data will be crucial to the operation of a blockchain and to how well it maintains privacy standards in life sciences and specifically in healthcare.
Organizations can carry out a self-assessment in the following areas to understand the effective difference blockchain could make:
Scalability: Going in-depth to explore the emerging use cases further would require scalability of the blockchain processes in place hence, it becomes essential to determine and maintain a balance between different blockchains – ones offering more computing power and the ones offering faster processing as many of these blockchain processes would require further scalability
Regularization: Implementing governance to determine and control what type of information can be put into a blockchain. It will help nurture greater efficiency and performance
Cost: Cost-benefit analysis for operating a blockchain is a must. Firms should be aware of the costs which would be incurred in R&D, upskilling previous resources, and hiring new talent and in the technology itself for implementing a blockchain solution. A careful assessment needs to be carried out to weigh the benefits it would bring in a long-term with the upfront costs it would require.
Regulatory: Regulatory bodies should consider a deeper collaboration with the industry to facilitate adoption. Separation and encryption of PHI/PII data could be done to address the Health Insurance Portability and Accountability Act (HIPAA) privacy rule using a blockchain solution.
Strategizing clear business plans around blockchain or association with ecosystem partners for mass adoption is being hindered by the operational silos. In reality, time and dedication is what is required to reach largescale adoption. We have reached that stage where trust and adoption amongst stakeholders, including patients, would be required for the expansive implementation of blockchain in the industry.
Experimental, low-scale use cases of the new architecture could be carried out by working in partnership with different stakeholders to truly understand the benefits that blockchain brings to the table. An architecture that can connect everyone must have broad acceptance before it does connect everyone.