How Blockchain Will Transform the Healthcare Industry

By Cara Sloman, Executive Vice President, Nadel Phelan, Inc.
Twitter: @NadelPhelanInc
Twitter: @Cara_Sloman

While blockchain technology was initially developed to support the exchange of bitcoin and cryptocurrencies, its decentralized, distributed ledger of digital events also offers many appealing possibilities to the healthcare industry. A recent report by Deloitte notes that blockchain has significant potential to improve data interoperability, security and privacy.

The technology is able to address multiple industry pain points, including the need for health information exchanges, varying data standards and inconsistent rules and permissions. The application of blockchain in healthcare is still in early stages of development, but is envisioned to solve the following challenges:

1. Data Privacy:
The goal of HIPAA is to keep personally identifiable information (PII) and personal health information (PHI) private and secure. HIPAA limits how and under what circumstances this data may be used without patient authorization. A blockchain solution could assist with HIPAA compliance by segregating and encrypting patient identity, PII and PHI into discrete units, accessible at any time by those who have authorization to do so.

In addition, blockchains are an ideal platform for regulatory compliance because they establish a trusted audit trail that can be verified in real-time. Blockchains don’t merely track compliance; they also streamline enforcement and discourage fraudulent behavior from the beginning.

2. Medical Data Management:
Because blockchain can simplify the exchange of data across authorized parties, it can be applied in healthcare to enhance the management of electronic health records (EHRs). Current health information exchanges (HIEs) are hampered by a number of technology issues, including the need for an intermediary trust network, data interoperability issues and inconsistent rules and permissions. These issues prevent the safe transfer and sharing of data. However, it is now possible for healthcare organizations to build blockchains based on data pulled from existing databases, creating a complete data picture and single source of truth.

This paves the way for an HIE that is patient-mediated. Patients would be the owners of their own data, accessible to each individual via the blockchain’s private key mechanisms. Patients could share this data with whomever they choose within their healthcare team. This would give patients and the caregivers of their choice a longitudinal history of their health.

3. Billing Management:
While complex billing procedures can lead to unintentional inaccuracies, intentional medical billing fraud is a serious issue. In July 2017, a Medicare fraud task force charged more than 400 people, including dozens of doctors, with defrauding the government of $1.3 billion. Current processes are incapable of detecting all instances of fraud. Blockchain’s security and auditability make it an ideal choice for claims adjudication and payments processing, as well.

4. Medical Research:
Blockchain can assist with clinical trial data. The COMPare Trials Project found that out of 67 trials they examined, only nine were correctly reported; 354 outcomes were not reported, and 357 new outcomes were silently added. This casts doubt upon the accuracy of medical information derived from clinical trials and the resulting care that patients receive.

To create transparency and trust, those conducting clinical trials could use blockchain to record and time-stamp each event in the trial’s protocol. This would prevent selective reporting, ensuring that reporting of trials is correct and not “spun” to achieve a desired outcome.

Blockchain: The Determining Factor
Though blockchain is still in the early stages of development, its potential for disruption can’t be ignored. How healthcare providers and researchers leverage the possibilities of blockchain now will likely determine their longevity within a few years.