Does blockchain have a role in transforming healthcare? The focus of this article is to offer a few objective thoughts about this question as well as to provide a few use cases for which blockchain might be used in healthcare. The material presented assumes minimal technical knowledge.

The purpose of this article is not to introduce blockchain technologies. There are many excellent sources with that aim. Performing an Internet search for “introduction to blockchain” will return countless articles and sorting through the hype to and tease the facts can be challenging, but this is the case with any disruptive technology like blockchain.

Paradigm Shifts in Computing

There have been four major paradigm shifts in the history of computing thus far:

1. Mainframes

2. Personal computers

3. The Internet

4. Social networks

Blockchain is considered by many industry experts to represent the fifth. The importance of blockchain technologies cannot be overstated. As with each of the preceding shifts, there is a distinct cycle of adoption characterized by hype, exploration, early-adopters and ubiquity.
The adoption cycle for each new shift has accelerated rapidly with the emergence of Internet technologies.  In 2017 blockchain is currently in the early-adopter stage with organizations applying the technology to solve actual business problems across a wide variety of verticals. Industries such as manufacturing and financial services are realizing tangible benefits from the strategic use of blockchain. As with most new technologies, much of the industry maintains a position of cautious optimism and invests only when the success of competitors is realized. Early adopters, therefore, tend to establish a leadership position enabled by new technology. Such is the case with blockchain. Companies small and large are taking the initiative to run blockchain pilots to quickly assess the value to their business.

Healthcare Diversity and Integration

The healthcare industry is large and multi-faceted and includes a vast array of specialized domains. Traditional patient-based healthcare, genomics research, bioinformatics, and pharmaceuticals are examples of the diversity. Imagine how production and consumption of data between each domain is intertwined; cancer research produces genomic data that is consumed by pharma to develop new drugs which, in turn, are prescribed by doctors and delivered to patients at the point of care. The amount of data and decisions based on that data from the beginning of the pipeline to the end is unimaginably large. Big data technologies are available to manage the volume of data and to analyze this data, but what’s missing is a trusted link between each of the participating domains involved in the pipeline. Consider the FDA regulations that govern each step in that pipeline. It is a monumental task to maintain records of proof of the correctness and integrity of data that will satisfy FDA submissions as well as audits. Certainly each participant can expose software interfaces that allow some level of interoperability, but this involves implied trust between parties as to the provenance and reliability of the exchanged data. In other words, how does Company A validate and prove that medical data obtained from Company B has not been tampered with and that it is correct. Can it be relied upon to make downstream decisions that, if incorrect, could result in a human fatality? What are the regulatory penalties for the organizations involved if their data is tampered with?

Misplaced Trust

One only has to consider the news about Theranos to see how the effects of data and decisions driven from that data are significant and very real.

Could blockchain have saved Theranos? The answer is “no”, not by itself. There was a conspiracy of factors in play and no single technology would have provided the silver bullet “fix”. Operational, not technological, maladies were evident; broken internal processes, a company culture that valued financial performance over safety, and investor-driven pressure on management. What blockchain could have offered, however, was non-repudiation of chain of custody and validity of data throughout the pipeline from research to consumer. This could have gone a long way towards demonstrating commitment to safety and reliability. In effect, blockchain could save people from companies like Theranos that have engaged in dubious practices.

Healthcare Use Case Examples

In no order, I’ve listed a handful of opportunities for leveraging blockchain in connected healthcare:

• Sample Tracking (chain of custody)

• Instrument maintenance

• Regulatory compliance proof

• Immutable accessioning

• Supply-chain tracking and validated consumables handling

• Inventory management and control

• Establishing smart contracts and voting via a blockchain congress

It’s not a stretch to envision startups that focus on providing blockchain services for very specific, even niche, markets. While this article only scratches the surface of possibilities I’m sure that, with only a minimal understanding of blockchain, you will imagine many more.

Conclusion

There is a place for blockchain in healthcare and its future looks very bright. Adoption of this technology is still early stage, but expect there to be many disruptions through the application of blockchain technologies and those organizations that can apply its use to achieve competitive advantage stand to reap significant benefits such as provable cryptographic trust, cost reductions through automation, and accelerated transactions by eliminating “middlemen”.

Is your company looking to get started with blockchain? You may be asking yourself the following questions:

• Can blockchain play a strategic role in my technology roadmap?

• Could I benefit from a low-risk, targeted proof-of-concept?

• Who can I partner with for guidance?

The RND Group has the experience to help answer these questions. Feel free to reach out.