There has been a lot of hype around blockchain technology lately. Just in case you haven’t taken the time to keep up with new[er] technology, “blockchain” is the term used to define the technology behind digital currency Bitcoin™ (est. 2009). But at its core, blockchain is an infrastructure that allows for information and data to be distributed using a shared ledger. Blockgeeks.com explains it best: “Imagine a spreadsheet that is duplicated thousands of times across a network of computers. Imagine that this network is designed to regularly update this spreadsheet. You now have a basic understanding of the blockchain.”
Because of its potential to contribute to and provide a backbone for the rise of interoperability, this technology has healthcare IT professionals shaking in their boots .You may be asking yourself, “How could this benefit healthcare? Wouldn’t PHI be visible to everyone in this model?” (see above illustration) While this is true in its basic format, healthit.gov has taken the initiative to propose a solution. They have proposed that through mobile devices, providers could be granted access to a patient’s PHI by the patient, using a unique identifier to decrypt and authenticate access to specific PHI data. With each block on the blockchain only containing the metadata of a patient’s information, sensitive PHI cannot be accessed without a digital signature/unique identifier. All PHI is stored in a secured “data lake,” virtually invisible to anyone without approved access. Not seeing the value of blockchain? Healthit.gov has outlined 5 benefits that show how blockchain will aid interoperability and improve patient/provider communication. 1. The user would have full access and control over how his/her data would be shared. Through easily accessible dashboards, patients would have complete control and visibility over who has seen what information and when. This is through secured encryption and timestamping (as used with Bitcoin Ledger). 2. Blockchain is based on open source software, commodity hardware, and open APIs. This allows for enhanced scalability of data volume and application customization. And because open source software is peer reviewed, it would be increasingly reliable. 3. Blockchain would allow patients, the health care community and researchers to access one shared data source to obtain timely, accurate and comprehensive patient health data. The “Data Lake” or EHR would contain all the sensitive PHI. It would be extensively encrypted and inaccessible without explicitly granted access from the patient. 4. Viewable data in Real-time, 24/7, via mobile devices and wearable technologies. With a unique identifier, physicians would have access to real-time data captured by wearables or historical data regarding the patient. Another way physicians can “go home with the patient.” 5. As blockchain collects health data across a patient’s lifetime, it offers data ideal for longitudinal studies.  This captured data would be categorically organized by community, population, background, etc. to paint a clearer picture of patient diagnoses and outcomes. Update: It’s happening already! IBM Watson Health and the FDA announced an initiative to create an exchange of health data using blockchain technology to boost public health.
Seth Hobgood is the Principal and CTO at Interoptex.