Healthcare data and blockchain technology

April 20th, 2018 / By Paul LaBrec

The recent sensational press around Bitcoin and world financial markets may have piqued your interest about the digital currency and the blockchain technology that supports it. If you work in healthcare IT and data security, you may be investigating whether or not this technology can solve some of your biggest challenges.

Blockchain technology emerged in 2009 as the infrastructure to support the digital currency Bitcoin. A blockchain provides a permanent record of an online transaction or exchange. Each digital transaction is the “block” and the ledger that connects these blocks is the “chain.” The records forming the chain are shared among a network of computers, not stored in a single central database, and are encrypted.  Transactions are verified by “miners” who assign a “hash,” a unique series of letters and numbers linking each transaction to the transaction directly before it, which effectively seals the event and provides an immutable record of transactions. Since the transaction records are stored across many computers anyone with access to the chain would know if a record was changed. To date, blockchain has found its more prominent expression in the financial industry where it allows the movement of data in real time with reliable accuracy and security. 1

The potential to streamline payment transactions, verify contractual agreements, create large transactional databases, and ensure security of patient information, as well as the growth of the Internet of Things (IoT) in healthcare, and the benefit of linking numerous disparate pieces of information about a patient make blockchain technology worthy of serious investigation by the healthcare industry.

We can outline several potential use cases for blockchain technology in healthcare, including:

Medical Records – blockchain has the potential to create a secure, continuous medical record accessible by the patient or any provider to whom the patient provides access. This access could eliminate gaps in medical history and the time and expense spent gather copies of records from various providers.

Claims and Billing History – the static, traceable and secure records created by blockchain technology could streamline claims processing and billing, saving both money and time and reducing the risk of billing fraud. Also, various claim types (inpatient, outpatient, professional, and pharmacy) could be connected.

Data Security – the digital security and monitored accessibility described above gives blockchain solutions the potential to be the infrastructure that is needed to keep health data private and secure and avoid the data breaches that have recently plagued electronic records.2

Clinical Trial Research – demographic, diagnostic, and therapeutic history detail contained in blockchain data could be useful in identifying patients (and their healthcare providers) who may eligible for clinical trials, streamlining the currently expensive and time-consuming clinical trial patient recruitment process.

Linking sources of health-related data – if a unique individual can be identified in multiple datasets (and that’s a big IF), blockchain could be used to connect healthcare claims and medical record data with personal biometric data from IoT devices, consumer purchasing data, data on social and physical environment, or other exposure data based on occupation or residence.

When considering the potential benefits of blockchain in healthcare, several non-trivial barriers must also be considered.

Proven history of securing health data – the primary concern in working with healthcare data at a patient level is protecting personal health information (PHI). Blockchain will need to establish a record of success in securely managing healthcare data before it could be considered a preferred transactional process.   

The distributed nature of the data – the Data Use Agreements that dictate to business partners like 3M HIS how we must store, manage, move, and manipulate data from our clients universally dictate that PHI is secured in specific locations with access limited to those who must access the data to perform services outlined in contractual arrangements.  The distributed nature of blockchain data storage would require a significant change in current practices of healthcare data security.      

No universal patient identifier – like the case that exists today in linking disparate electronic databases, assembling blockchain transactions from different sources—healthcare claims, electronic medical records, social services systems, personal monitoring devices, consumer purchasing databases, etc.—would still need to match individuals who are identified differently in each system.

The use of blockchain technology in health care is clearly in an experimental state. The maturation of blockchain in health care will be an interesting trend to watch in the years ahead.

Paul LaBrec is research director for Populations and Payment Solutions with 3M Health Information Systems.


References

1 Becker’s Hospital Review. “9 things to know about blockchain in healthcare.” October 3, 2016. Accessed April 7, 2018.

2 Marr, B. “This Is Why Blockchains Will Transform Healthcare.” Forbes. November 29, 2017. Accessed April 10, 2018.