Shahram Ebadollahi, VP of Innovation & Chief Science Officer, IBM Watson Health
Imagine for a moment a healthcare system where patients control who sees their data. An individual at home recovering from a procedure might sign in to her medical account through a personalized dashboard on her phone, and with a couple of swipes give her physician consent to share her health record with her pharmacist. Or that same patient—determined to get a second opinion after a follow-up visit for imaging and labs—again might give permission to an off-site provider to go into her account and take a look at her results.
In this imaginary world, there would be no need to travel from hospital A to hospital B for another appointment and another round of testing; and that pharmacist, wherever he might be, wouldn’t need to be part of the same integrated network as his patient’s referring physician. Medical information would live in “digital medical wallets”—and these wallets would be carried by the patients themselves.
If it all sounds a little farfetched, that’s because it is, at least for right now. But a few years down the road? Blockchain technology holds the promise to make it a reality.
Blockchain is the cryptographic technology developed for Bitcoin to allow secure transactions without a central clearinghouse. With blockchain, buyers and sellers connect directly, and their exchanges are recorded in blocks of data on a digital “distributed ledger” visible to everyone in the network. Transactions go through when blocks are linked together using cryptographic validation. In Bitcoin’s case, the blockchain is public (transactions are anonymous), so anyone can participate and add to the ledger. That’s not quite the way blockchain will work in healthcare.
For healthcare applications, it is anticipated each person’s “wallet” would employ a blockchain where information would only be visible to those who had permission from that individual. Each person grants access to participants in their network—such as primary care physicians, specialists, and family members. Network participants would access data only after that participant’s unique digital fingerprint had been validated. Interoperability between electronic health record systems would no longer be an issue because data would sit on the individual’s personal data cloud.
Blockchain, through its secure and decentralized data-sharing framework, will be the solution that healthcare needs
Blockchains establish a platform to automatically enforce privacy regulations. As health data is shifted or linked to blockchains, organizations can track who has shared data and with whom, without revealing the data itself. Further, with blockchain technology, permissible data visibility will be better than ever, which in turn may lead to gains in value-based care. Whereas today patient data sit in disparate silos, from the EMRs of different physician practices to medical devices in consumers’ homes, in the future that information will be fluid—and always at the fingertips of healthcare providers. Once they’ve secured a patient’s consent, providers will have access to a 360-degree and longitudinal view of that person’s status, and insight as to their status on the care-delivery continuum. And if a medical expert combines that visibility with analytics and cognitive computing? They’ll get trustworthy, data-driven insights to help provide better patient care.
The growing pool of patient data available to providers is looking more like an ocean every day: biometric data collected by mobile and wearable devices; clinical data gathered in exam rooms; administrative and claims data used for billing and insurance; and genomic data sequenced and analyzed from laboratories. Additional data sources include “social determinants” data regarding lifestyle-related factors like education, family structure, and socioeconomic status and other patient-generated data. This information is coming in from all directions, and could be immensely valuable to clinicians. Unfortunately, it is not put to use consistently today and often winds up in disarray, or locked up and unreachable in unconnected technologies.
Blockchain, through its secure and decentralized data-sharing framework, will be the solution that healthcare needs—a technological fix to a high-tech problem. And the best news is, it will be cost-effective. It is expected that organizations with legacy information systems or newly purchased EMRs won’t have to gut their existing infrastructures and won’t have to invest in major IT undertakings. They could simply access the technology using SaaS and bring their “off-chain” records to the blockchain.
Blockchain for healthcare is still a work in progress, but all signs are it’s coming soon. When that day arrives, data sharing will change forever—as will the prospects for improving patient care.