Jeff Rowe, Editor, Future Care

Jeff Rowe is the editor of Future Care and a veteran healthcare journalist and blogger who has reported extensively on initiatives to improve the healthcare system at the local, regional and national level.

How blockchain could make patient engagement a true partnership

April 12, 2017 AT 7:46 PM

What’s that saying about if you love something set it free?

It’s not a perfect analogy, but it comes to mind increasingly as the topic of blockchain gains ever greater prominence.

After all, one way of looking at the distributed ledger technology is that it essentially takes data currently kept in one place and scatters it, in a way, across a variety of locations. Or, conversely, it allows data that is already scattered to be accessed as one continuous record. Either way, the upshot is it “frees” the data for use by provider and patient with new flexibility.

In recent interview with HIStalk, Jason Goldwater, MA, senior director at the National Quality Forum, gave an in-depth look both at what blockchain could offer and how healthcare organizations should be approaching it in its still-early days.

Access to data and greater interoperability are the first two areas of potential Goldwater discusses, but, in his mind, the greatest potential for blockchain revolves around what it could do for patient engagement and empowerment.

As he explains it, “If I’m a patient and I have data that I’m able to view, and you’re a provider and you want to view that data, or you want to examine that data and then work with me on how to improve particular aspects of my health based upon what you’re reading, we can engage in a conversation where we both have access to the very same information. You could help me interpret what that information means. I would be able to look at that data on a regular basis to be able to see if I’m making improvements. As long as I’m authorizing you to be able to examine the data, then you’re able to look at that and then work with me on aspects of health that need to be improved.”

Perhaps more importantly, given how blockchain works, every time one piece of data changes, the entire blockchain changes. “Since I’ve authorized you to have access to that blockchain, you’re viewing that data as it’s changing. You can then view and see exactly what changes are being made in my health as a result of activities that I’m doing that may have been prescribed by you, if you’re a provider, or may have been prescribed by another entity.”

In other words, real-time data accessible by both provider and patient, for potential use in shared decision-making.

Another element to this real-time equation is its potential to assist the shift to value-based care.  “If you have a distributed ledger where data is going to be shared across a number of areas,” Goldwater explains, “you are authorizing the blockchain to receive the data, and you’re working with your provider to be able to look at that data on a regular and continual basis, the provider can understand what needs to be done in order to improve the outcomes of your health and what processes need to be taking place. That, in turn, then meets the value threshold for reimbursement. As such, by doing that, they’re able to continually examine and understand a patient’s health in a way that they may not have been able to before.”

As for how healthcare organizations should be approaching blockchain now, given that it is still in its practical infancy, Goldwater says, for starters, “they definitely need to be interested in it.” Beyond that, he points to the need for stakeholders to understand both the scalability of blockchain and how it could impact their data security considerations.