Is Blockchain impacting the healthcare arena?

While the technology trend-o-metre and cryptocurrency world at large set off fireworks of exciting talk and disruptive use cases with Blockchain, the healthcare industry, by contrast, sits on the sidelines today as a mostly casual observer. Or maybe even as an opponent. When you consider that Blockchain is said to make data more secure and more transparent, more available and more reliable, the truth is that the very minimal use of Blockchain in healthcare today just doesn’t seem to make a lot of sense. In fact, with effective data sharing and security representing two of the biggest health information technology (HIT) issues that we struggle with, you would naturally think that the built-up frustration around interoperability and the high-profile recent cybersecurity attacks would create the ideal environment in which Blockchain would take off. Not so fast. 

Taking a step back to seek out the on-the-ground perspective and experience of healthcare CIOs and CISOs, the current hesitation on Blockchain becomes more clear, perhaps even pronounced. Asked if they would use Blockchain in the future, three healthcare CISOs of influence and recognition each shared with KLAS that, without hesitation, today they do not plan to use Blockchain for future projects. Following are key reasons they shared that contribute to their current conclusion, along with context and insight from KLAS on each topic.

To use Blockchain means you are not just leading out in terms of a new technology standard, but that you are operating on the bleeding edge. 

Healthcare organisations historically tend to be risk averse, and understandably so. Changes in health information technology and new, unproven standards are often questioned—if not directly perceived — as placing potential or actual risks on direct patient care. To be on the bleeding edge in terms of technology use and adoption gives healthcare providers concern that clinical care could be impacted. For healthcare, the bleeding edge isn’t just a matter of innovation where something could turn out to be a mistake and a widget is compromised—it could possibly lead to bleeding or other problems at the hospital bedside. In healthcare, the quest for safety almost always comes before starting a race on innovation, thus introducing a likely delay in the timing with which healthcare providers adopt Blockchain or other new technologies. 

If vendors don’t actively embrace and support Blockchain, the technology isn’t feasible for the sector.

The idea of a new technology standard in healthcare, particularly as it relates to interoperability, is anything but new. In recent years, standards such as Fast Healthcare Interoperability Resources (FIHR), Carequality, CommonWell, and others have come on the scene in hopes to help crack the thick interoperability nut. There is a great deal of industry talk about FIHR, and the recent connection of CommonWell to Carequality provides promising opportunity. However, we have not arrived at the destination of a healthcare industry-wide and deeply adopted standard for all, despite the best efforts of various healthcare leaders, influencers, and even the government.

Active support and ongoing investment from the HIT vendor community in Blockchain is only just starting—at best — thus leaving healthcare provider organisations with uncertainty about the future of Blockchain and with reservations about if and when to jump in. It’s not just a vendor thing, though. All stakeholders have a part to play. While not specific to Blockchain but still related to security, one interesting and important development KLAS has noticed is that some leading US healthcare organisations, including the Cleveland Clinic, Tufts Medical Centre, University of Pittsburgh Medical Centre, and others have joined together to mandate that, within the next 24 months, any third party vendors desiring to work with them must adopt “standard cybersecurity measures and achieve certification to demonstrate their products and services are safe and secure for use in a hospital or other patient care settings” (Tufts 2018). For Blockchain to be valid and valuable, support from the HIT community – vendors and healthcare organisations – will be necessary. That mature support is years away, if it ever fully comes.

Blockchain today is a shiny toy, but it’s still far from practical.

Just a decade or so ago one could have argued that electronic health records (EHRs) might be shiny toys, far from reality or practicality. While the value and clinical effectiveness of EHRs are widely researched and disputed, it’s common knowledge that nearly all hospitals use EHRs, with billions of dollars across the industry put into development, support, purchases, and enhancements of those systems today. With regard to Blockchain, the question stands, over the next decade, will Blockchain see such a rise? The handful of respected healthcare professionals who have shared their views with KLAS thus far have a difficult time seeing the landscape beyond the mountain of uncertainty and hesitation today. One CIO shared with KLAS that they are “watching Blockchain” but “don’t think anything is happening. Some payers are using it. Some claims clearinghouses are using it. It is something that could be really cool, but it is still really in its infancy, and there are not a lot of use cases you can attach to it.” The shine from what healthcare provider organisations today perceive as a “shiny toy” is far from shiny results. With the continued advance towards and pressure from value-based payment and models, the industry is turning its focus to practical results.

No. Even among the respected healthcare CIO and CISO leaders who have been candid in sharing their views with KLAS about Blockchain thus far, Blockchain pilots have either already taken place or are actively underway. And while in healthcare the technology isn’t seen as productive or practical as of yet, it’s also not being written off. The potential and promise of Blockchain has certainly not taken hold, but its demise is not certain, either. Simply said, the Blockchain race in healthcare just isn’t a real race yet.