The Blockchain race in healthcare has yet to begin
Supporters say it has everything to offer healthcare security and transparency, but what do
practical, on-the-ground C-levels really think about Blockchain's potential today?
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.
The healthcare C-suite views on Blockchain
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.
KLAS context and insight
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.
Lacking vendor adoption
If vendors don’t actively embrace and support Blockchain,
the technology isn’t feasible for the sector.
KLAS context and insight.
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.
Shiny toys don’t guarantee shiny results
Blockchain today is a shiny toy, but it’s still far from
KLAS context and insight.
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.
The future of healthcare Blockchain
So, what does all this mean for Blockchain in
healthcare? Is it doomed?
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.
- Healthcare is watching Blockchain closely but with reservations. In healthcare, patient safety usually (and understandably) takes precedence over innovation
- Prominent CISOs say they don’t see a use for Blockchain in the near to mid-term
- HIT community support for Blockchain is still in the distant future
- It’s early days for HIT Blockchain viability, but the tech has not been written off