Since the cryptocoin bull market in late 2017 (and the price crashes that followed), blockchain technology has reached a new level of mainstream notoriety.
It's unclear now whether that's a good thing. On the one hand, speculative trading bubbles can make some people shy about an otherwise solid technology. Does a Bitcoin bear market hinder useful tech adoption?
On the other hand, a wide variety of industries has begun to assess the potential for blockchains. From energy companies in central Europe to modern farmers, industry experts around the world are looking into whether the technology can improve the way they do business.
We are firmly in the camp of people who believe blockchains can help healthcare improve the way it does business. The key word here is "improve." For all of the potential we see in blockchain technology, it has specific, but important, applications in healthcare. We spell out these use cases in our DokChain white paper:
- Identity management
- Autonomous auto-adjudication of medical claims processing
- Efficient prior authorization and referral
- Event-driven supply chain management
Let's take a look at how those specific applications can improve healthcare IT infrastructure as it exists today.
An Example of the Faults in Today's Systems
Anthony Back, who heads up the Blockchain Research & Content team at Intrepid Ventures, has an excellent hypothetical example of how current authorization and referral systems could fail someone.
Back's patient is experiencing constant fatigue and muscle aches, for which they've sought several consultations, run many tests, and tried a variety of treatments, all to no avail. Still, with each treatment and with each specialist's opinion, data gets lost along the way. It's an inefficient referral system. Specialist No. 6, for example, might not have full access to everything Specialist No. 2 discovered about the patient's condition.
"Even though the doctors who treated the patient in this fictitious, albeit credible real-world example may have followed the right medical procedures to treat the problems they were trained to handle, the fragmented nature of the healthcare system resulted in no coordination and ultimately substandard patient care," Back writes.
This is where a blockchain solution could allow the patient to save each specialist's information in one place, and grant the next referred specialist easy access to the cumulative knowledge collected up to that point.
"A permissioned blockchain brings together trusted collaborators," says IBM Watson Health Chief Science Officer Shahram Ebadollahi. "Each of them can join the chain, or run their own chains, and the distributed ledger will keep track of all the events that are of importance for that particular iteration of providers within a patient's care team for whatever task they're trying to accomplish."
That's what we mean by complementing the healthcare IT infrastructure already in place.
Understanding When to Apply Blockchains
Jaquie Finn, head of digital health at Cambridge Consultants, argues that blockchain's role in healthcare -- at least for now -- should be focused on protecting the integrity and movement of data.
Specifically, she sees blockchains as excellent fits in systems where data is dynamic, the current infrastructure is fragmented, and the system is vulnerable to malicious actors. "Those three things are like a red flag, where we could talk about when designing the system to add some blockchain technology, simply to protect the data," Finn said during a fireside chat at CES 2018.
That's very much in line with our own vision for DokChain. Three of our four primary use cases deal with patient data, access to that data, and the automated processing of transactions. Integrating the silos, where patient data and payments currently live, would go a long way toward creating massive new efficiencies in healthcare.
A Roadmap for Implementation
The implementation of other complementary technology has blazed a trail for us.
Brennan Bennett of Blockchain Healthcare Review, says telehealth is the model to follow if not the actual technology that will carry blockchain applications forward. After all, he says, both share a common goal of reducing administrative costs.
But as with telemedicine, blockchains will experience pushback from those with entrenched positions. "Medicine's metamorphosis through integration of modern technologies naturally causes a paradigm shift in clinical practices, and often a divide among professional opinion follows the change," Bennett explains. "Using cryptocurrencies in healthcare is not immune, as believers opt to reside in either camp. Standardization of any process creates interest groups, and as always, there are advantages and disadvantages to adoption."
Disadvantages can be handled naturally. Useless applications will fall by the wayside, and the technology itself will strengthen during the many tweaks and iterations it undergoes. What cannot be handled naturally is momentum. Healthcare, like any big industry, gets stuck in its status quo, says the FY18 HIMSS Blockchain Work Group, creating problems for individual health systems that "may be accustomed to working with established large vendors in healthcare and traditionally leery of engaging with startups as part of their broader health IT infrastructure strategy."
Abhinav Shashank, CEO and co-founder at Innovaccer Inc., notes that healthcare organizations might be unwilling to adopt a new technology when it's unclear to them how much work they will have to do and how that technology will integrate with what they already have.
The solution, then is to clearly communicate responsibilities, focus on discrete use cases, and prove the technology step by step. We think the specific use cases are clear, so now it's just a matter of development, launching pilot projects, and proving the concept to industry participants. As Ernst & Young's Angus Champion de Crespigny puts it: "Use blockchains for what they are valuable -- being a framework to establish trust -- but otherwise, keep initial deployments simple with familiar technologies while leveraging the new technology for its added power."
The future of blockchain is exciting. Already applications are creating billion-dollar administrative efficiencies, fixing broken supply chains, and making health data exchangeable yet secure. With new blockchain applications unfolding all the time, the revolution has just begun.
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Tags: Blockchain, Health Innovation