In the tech world, blockchain technology appears to be the panacea to all problems.  As blockchain technology becomes increasingly popular, many industries are trying to determine the best way to use the new phenomenon. Healthcare is no different in this quest. Health care is an optimal candidate to benefit from development of innovative ways to solve its impending issues using transformational technology. Blockchain could be the technology that helps to alleviate some of health care’s problems, such as the incredibly fragmented delivery of care and the painstakingly slow reaction to technological advances.

What is Blockchain Technology?

An over-simplified explanation of blockchain is an online database that stores information on a network of computers. Information also known as “a record” is stored in a block. For example, a record of you paying Mr. Smith 10 dollars is stored in a block. Traditionally, that information is saved in a database at a data center. However, blockchain technology stores that record on an individual computer with a time stamp (the “block”).  Any change to that information is then stored on another individual computer with a time stamp.  Each individual computer holds a block of information that is chronologically time stamped, which creates the blockchain. Thus, information cannot be edited or changed without the verification from all parties who have access to a block in the blockchain.  Blockchain technology distributes and decentralizes information.  There is no central company or one person that holds the information. This makes it extremely difficult for any one person to take down or corrupt the network. Traditionally, blockchain technology is used as a public transaction ledger for bitcoin. Bitcoin users utilized the technology to mitigate the issue of double spending, spending the same single digital coin more than once, without the need of one trusted authorizer or central server. 

Blockchain and Health Care

Blockchain technology could play a role in the industry’s goal to improve the quality of care through care coordination. Care coordination often involves the sharing of information between multiples providers. Blockchain technology could be used to facilitate this process in a more efficient manner by storing a variety of information, including provider and patient details, within electronic health records (EHR) on a network of computers. Blockchain would store the information on various computers, such that information entered into an EHR could be stored across a network of computers that includes providers and the patient. Providers and the patient would hold blocks of information, allowing each provider and each patient to validate the updates to that patient’s record with the consensus of all the providers and the patient. Using blockchain in this fashion would give patients control over their care while also encouraging care coordination because providers would have to interact with one another to update a patient’s file. In this sense, Blockchain could take the first step in facilitatating the improvement of patient care as a whole.

Blockchain could also reduce the health care industry’s susceptibility to privacy attacks or breaches because of its decentralized and distributed structure. Privacy attacks often involve a hacker entering a system or a database, but, with blocks held in multiple locations instead of one database, blockchain technology would help to minimize hacker infiltration.

However, as with any heavily regulated industry, implementing blockchain will not be easy. There are state and legal roadblocks that hinder blockchain’s viability. Health Insurance Portability and Accountability Act (“HIPAA”), for example, could hinder the ability of sharing health information technology between a network of computers due to restrictions on sharing of Personal Health Information (PHI). Furthermore, state and federal laws would have to be updated to facilitate this technological advance. Despite these hurdles, there may be a glimmer of hope. The Centers for Medicare & Medicaid Services is dedicated to improving interoperability and patients’ access to health information through its Promoting Interoperability program. The agency’s push for moving health towards EHR has the potential to be pivotal if the industry uses blockchain or a similar technology to improve patient access to health information.

Blockchain may not be a today solution—it will take time to change state and federal laws regarding health information to facilitate such technology. However the promotion of initiatives encouraging use of EHR, may be priming the industry’s palate to provide a place for blockchain in the future.

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