Blockchain, The Missing Link to Deliver Affordable Care
I have worked in healthcare and Information Technology for 30 years now. The past twelve years or so have been the best, though. That is because of Cloud Computing and mobile technology (specifically consumer mobile tech – not Blackberry or Windows Mobile), and all the alternatives they have enabled. More than any other time in my career, we have been able to see information technology truly deliver value by enabling greater productivity, reducing overhead, and creating new sources of revenue.
As CIO, I wish I had a dollar for every time I heard another CIO, CTO, or someone from Compliance or Legal or Audit say “we can’t put our data in the cloud.” Nowadays, you are scrutinized if your company is not using “the cloud.” And, you should be. There are inherent benefits to using Cloud-based solutions such as: turning fixed costs into Variable Costs; enhanced security, reduction in time to market, reduction in cost and complexity, and increased opportunities for innovation.
In more general terms, though, Cloud Computing (and Software as a Service, and Platform as a Service, and Infrastructure as a Service) was a paradigm shift, or a simplification for Information Technology departments. A shift away from everything in IT having to be a do-it-yourself effort to having a world of Service options to leverage that could be purchased as subscriptions. This is how those benefits like speed to market, and reducing fixed costs were realized.
This past year I have been in discussions about blockchain many times, and I frequently find myself saying “that reminds me of the early days of Cloud Computing.” And, every time I make that comment I actually get some comfort from it. I get comfort because we have seen cloud computing go from being the exception to the rule. As a result, companies are getting more benefit from their information technology spending. I think Blockchain will go from being the exception to rule as well. The fundamental concepts and inherent benefits to it are so great that, like Cloud Computing, all legitimate concerns or issues will be solved.
Some of those fundamental concepts and benefits are:
There is no need for a trusted third party or intermediary to validate transactions; instead a consensus mechanism is used to agree on the validity of transactions.
Once the data has been written into the blockchain, it is extremely difficult to change it back. Changing data is extremely difficult and almost impossible, this is seen as a benefit to maintaining an immutable ledger of transactions.
Highly secure –
All transactions on a blockchain are cryptographically secured and provide integrity.
For healthcare, the potential of blockchain is immense. And, it all adds up to, like Cloud Computing, a paradigm shift. But this paradigm shift is so much bigger than just a better way to deliver IT services. This one enables a better way to deliver healthcare.
A key barrier to better, more affordable care is ownership and control of patient data. American healthcare is plagued by siloed data making it difficult for affordable, innovative alternatives to come to market because organizations, not individuals, own and control the patients’ medical data.
The Electronic Health Records (EHRs) used by health care providers in the U.S. are not Open (and only somewhat Interoperable, and only then if you stretch the meaning of the word). As a result, sharing data between health care providers, if it happens at all, is only accomplished at great expense and inconvenience.
Health Information Exchanges (HIEs) are Middlemen that exist to be a work-around for the lack of interoperability of EHRs. But, even if they worked they only connect health care providers (and sometimes payors) to each other. The same is true of the various EHR interoperability efforts underway.
Moreover, the solution is not going to come from the organizations that make up our traditional healthcare system. These organizations view this data as theirs, and as competitive leverage. This is fundamentally wrong, but it is the way it is.
Now, think about those fundamental concepts and benefits of Blockchain relative to these data sharing issues that plague healthcare. Blockchain goes right to the heart of the matter. In the current model in healthcare, multiple entities maintain their own EHRs, and data sharing is very difficult due to the disparate and proprietary nature of the systems. But, a blockchain-based health record owned and mediated by the individual can serve as a single shared ledger among interested parties.
If individuals had control of their own medical data, smartphone applications could leverage it, link in more information, and connect individuals to services. Individuals could be paid for the use of their data, as well as for healthy behaviors, creating a real incentive towards wellness.
Utilization of a blockchain-based health record could engage millions of individuals, providers, payers, researchers, and various other health related entities. Health data from providers to genetic data to diet and lifestyle data can be shared with security and privacy assured. And, through tokenization, individuals are appropriately compensated to collect and share their data.
A blockchain-based health record would make interoperability and the HIE middlemen irrelevant.
Computing keeps evolving. We had mainframes in the 60s, mini-computers in the 70s, PCs in the 80s, the internet in the 90s, and smartphones and cloud computing in the 2000s. Blockchain is today’s evolution in computing, and it is the technology advance needed to solve our healthcare crisis.