I have heard countless young companies talk about hockey stick growth patterns but over time you learn how rare they actually are. So when mentions of blockchain technology formed a clear hockey stick in our social media trend data, we started paying attention. It is clearly time to take a closer look at some places where this technology may be grabbing a foothold.
Management of Patient Medical Records
What if all patient records from all health providers were available in a unified and unmodifiable form? What if access to these records was controlled by each patient or their legal guardian? What if this system drastically reduced data management costs while improving overall security? This system is possible for a medical records system controlled by a blockchain. Based on this vision, numerous companies have raised a lot of money to try and make this happen.
Unfortunately I see a blockchain based system of this type as being at least a few years away. In the mean time new regulations are forcing hospitals and other medical facilities to move to digital records in the next five to ten months. This is a big problem for those pursuing blockchain solutions for health records and is one of the reasons why I do not see blockchain playing a major role in this aspect of healthcare in the short or even the medium term.
To understand why it can take years to create a blockchain solution consider this list of huge challenges:
- Identity Management
- To strictly manage control of medical records so that only authorized people can see them we have to be sure that people are who they say they are.
- Permissions Management
- We have to have a flexible system for allowing access to records that can handle a huge number of standard and emergency scenarios.
- Data Management
- While we want to protect individual’s records, aggregate data across a population can have a huge positive benefits for the industry. Providing a secure solution that protects individual’s records but also accurately reports on populations is not easy but blockchain solutions are in the works such as Project Enigma at the MIT Media Lab.
- Systems Integration
- Existing software systems using a staggering variety of protocols and formats for their data. Getting agreement on standards and then creating adapters to conform to those standards is a gigantic enterprise that will require large scale industry cooperation.
So the big prize of Health Care Records on the blockchain seems out of reach for the foreseeable future. Where are the real opportunities for blockchain?
Plugging in a blockchain-based plug-in module to reliably handle the identities of patients and health care professionals could be huge for the industry. Fortunately, this is true for almost every industry and not just healthcare. Accordingly, there are hundreds of companies, large and small, working on this problem.
Last May a huge step forward was taken when Microsoft, Uport and several other companies formed the Decentralized Identity Foundation (http://identity.foundation) to create consensus standards for identity management. Since then another 25 companies have joined the effort including IBM, Accenture and Hyperledger. This unified effort seems to be the best hope for a blockchain-based identity system within a year or so although there is competition from the ICON foundation among others.
Organic Material Supply Chain Management
Tracking the movement and delivery of drugs, organs, blood, tissue and the like is a huge problem area in healthcare. Billions are lost from fraud, theft, and spoilage. Here a blockchain-based solution can serve to track the movement of shipments by adding records to the blockchain at each step of the delivery process. The unmodifiability of the records provides a reliable means to discover exactly where the problem occurred when goods are lost or stolen.
A few months ago we learned that IBM is spearheading a blockchain-based supply chain solution in food delivery along with partners including Walmart, Dole, Kroger, Unilever, Hersheys and other big names in agriculture and food processing. This suggests that blockchain is ready to make a difference today by improving the efficiency and security of the world’s food supply.
It turns out that the leaders of top pharma companies were not ignoring this trend. According to an IEEE report, most are involved with or else thinking about starting pilot projects along these lines. The first public announcement of a blockchain drug supply chain pilot project came on September 21 when Genentech and Pfizer revealed that the MediLedger Project is underway using JP Morgan’s Quorum blockchain.
Of particular note is additional technology provided by a startup company named Chronicled. They provide a portable temperature logger that puts temperature data on the blockchain as well as a tamper-proof sticker that makes recording the movement of drug shipments dirt simple.
A wonderful thing about this use case is that with enough automation at the various shipment checkpoints there may be little need for the people moving the materials to change the way that they perform their work. This makes technical adoption easy.
At this point it is entirely reasonable to maintain a skeptical attitude towards blockchain-based solutions in healthcare, however the chance for disruption is very real. My assessment is that Supply Chain Management will be the initial ‘killer app’ for blockchain in healthcare, but there are other interesting projects worth knowing about as well. We will present some of these in a future blog post.
If you want to know more about this topic I suggest starting with the recent presentation by the HIMSS Blockchain Work Group entitled ‘Navigating the Blockchain Landscape’ (http://www.himss.org/news/part-1-navigating-blockchain-landscape-opportunities-digital-health).
If you have your own hot story about anything in the healthcare industry, let W2O Group help you build your very own social media hockey stick.