Blockchain advocates say a breakthrough “killer app” is imminent that will change the business of healthcare as we know it. In the meantime, however, there are at least five practical uses for the technology that permits the distribution of digital information, but not the copying of that information.
- “Smart” contracts. Contracts automatically go into effect when certain previously agreed upon conditions are met.
- Supply chain processes. The new technology could make supply chains more efficient and transparent, improving the warehousing and delivery of medical goods and supplies.
- Physician credentialing. A company called ProCredEx recently launched Professional Credentials Exchange to do this with a private Medicare claims processor, a private provider of Medicaid managed care and Medicare Advantage plans, and the Michigan-based Spectrum Health System.
- Peer-to-peer data exchange. A system with features that can include preventing people from getting multiple opioid prescriptions and verifying clinical trial data. The hope is that this function can also be used to shrink processing time for prior-authorization requests down to less than five minutes.
- Proof of work. In medical liability cases where attorneys may claim that physician defendants have altered their records, clinical notes entered in blockchain time-stamped blocks create a tamper-proof ledger of what a physician did and when.
The proof-of-work application was cited by John D. Halamka, MD, chief information officer for the Beth Israel Deaconess System and the editor-in-chief of Blockchain in Healthcare Today, a new online, peer-reviewed journal that debuted in March.
As evidenced by his position at the journal, Dr. Halamka believes in blockchain’s potential, but his opening column includes a description of the overhyped sales pitches he hears every day from startup operations.
“An increasing number of them sound like this: ‘We’ve got a cloud-hosted, big-data, machine-learning, API-driven mobile app, with blockchain!’” Dr. Halamka wrote. “If we are not careful, blockchain will become a meme for overpromising and underdelivering in health care IT.”
No government or corporate control
One reason the promise of blockchain technology shines so brightly is because neither governments nor corporations can control it.
While speaking at an event at the AMA’s Chicago headquarters, Joe Hernandez, the founder of the Chicago Blockchain Project sometimes known as “Disruption Joe,” described blockchain as an “open and generally permissionless system that uses bitcoin as a form of peer-to-peer cash system that no government can shut down.”
The intended purpose of blockchain, Hernandez added, is to bring together “hundreds of thousands of people without a boss.”
So far, the disappointment of blockchain is that no one has truly figured out its best use for health care.
“We still haven’t had a ‘killer’ application yet,” Conrad Barski, MD, founder and CEO of founder of Forward Blockchain, said at the same event. Dr. Barski added that the emergence of such an app will change the world by creating a beachhead for the technology from which there will be no turning back.
“It will cause a domino effect,” he said.
Another panelist was Charles Aunger, managing director of Health2047, a Silicon Valley-based innovation enterprise developing and commercializing solutions for data liquidity, chronic care and other health care concerns. The AMA is an anchor investor in Health2047, and Aunger said that the technology will eventually need “air traffic control.” He suggested that the AMA could fill that role.
The AMA event was held on the tenth anniversary of the release of a white paper outlining the principles of a peer-to-peer electronic cash system. A recent report released by Deloitte Consulting describes blockchain as a “potential game-changer” in health care because it “may offer a solution to more easily aggregate health data in a secure, trusted, automated and error-free way.”
And blockchain is just one technology with the power to reshape medicine, as evidenced by the announcement from Amazon.com that the company has developed machine-learning techniques with the aim of helping physicians and hospitals deliver better care.