Successful blockchain projects strengthen prospects for use in digital health
Slowly but surely, blockchain is making its way center stage in the conversation about the future of digital medical records.
A recent article in Wired does a good job of both describing the once-somewhat-shadowy technology (“shadowy” largely due to its connection with bitcoin, the equally shadowy digital currency) and, via a conversation with Beth Israel’s John Halamka, the strengthening case for its use in the future of medical records.
Summing up that case, the article notes, “While blockchain is most best known for powering bitcoin, it’s really a generic tool to keep secure data in a distributed, encrypted ledger—and control who has access to that ledger. Rather than having one central administrator that acts as a gatekeeper to data—a list of digital transactions—there’s one shared ledger, but it’s spread across a network of synchronized, replicated databases visible to anyone with access. Which gives it unprecedented security benefits. Hacking one block in the chain is impossible without simultaneously hacking every other block in the chain’s chronology.”
Which, the writer observes, makes the technology “incredibly appealing to the doctors and hospitals that need secure access to a patient’s entire health history.”
Moreover, as Halamka sees it, “Now is probably the right time in our history to take a fresh approach to data sharing in healthcare.” If a patient’s every healthcare interaction goes into a ledger every provider can see, he says, “The EHRs may be very different and come from lots of different places, but the ledger itself is standardized.”
On a practical level, the technology is very much in the prototype stage, but signs are encouraging. Beth Israel participated in a blockchain pilot project called MedRec that was declared one of 15 winners of a competition ONC held last year. Developed by researchers at MIT Media Lab, MedRec successfully tracked patient information like lab work and prescriptions, and researchers are lining up additional pilot projects with other health systems.
And other stakeholders are getting involved, with the FDA announcing a research partnership in January with IBM Watson to find ways to safely share data from EHRs, clinical trials, genetic sequencing, and even mobile wearables using the blockchain approach.
Finally, there’s the new administration’s perspective to consider, and here things could get interesting. On the one hand, Rep. Tom Price, the nominee for HHS secretary and a doctor himself, has voiced concerns about EHRs given their impact on many doctors. On the other hand, he recognizes the value of digital records and has said the government has a role to play when it comes to facilitating interoperability.
If blockchain continues to impress to the point that federal pursestrings are once again opened, it could become the beginning of a beautiful friendship.