It's 2017, but medical records are still mostly stuck in the dark ages. Most hospitals use electronic health records, but if you want your primary care doctor to share information with your allergist or surgeon, it’s a pain.
The most popular idea right now for connecting medical records — without compromising privacy — is blockchain. The platform used for Bitcoin, the digital currency system, could serve health care.
Blockchain's hype in health care
Some of us can remember the old days when doctors thumbed through paper records. These days, they mostly look at records on computers, but the same problems exist: the records from your eye exam, from your blood test — they’re not connected. Even worse, they’re saved on central servers, so they’re easy to hack.
Now, imagine instead, all those pieces of digital paper are encrypted. You need a code to see any single piece. Then the pieces are uploaded into a peer-to-peer computer network. For a doctor who has permission, those digital pieces come together like a puzzle.
That’s blockchain. Right now, Bitcoin uses blockchain to track financial transactions. Folks in health care want to use it to encrypt and share medical information.
Venkatesh Hariharan is CEO of HealthNextGen in Dallas.
“So if I get even one piece of it that’s not good enough, it’s useless. How many places are you going to hack?”
There is a lot of hype around blockchain in health care at the moment.
“Blockchain’s going to be game changing. I can’t think of a more disruptive technology on the market at present.”
Major companies have blockchain initiatives
Greg Harris just spent a week at the health-tech industry’s largest conference demonstrating how his company’s product, Patient Wallet, would use blockchain to give patients power over their health records.
“And the idea of using this would be: I go to the hospital and it’s a new hospital, maybe I’m in a different country, and I have to go for an emergency visit and I don’t want to spend four hours filling out paperwork, which is typically what I have to do. So all I do is ask the hospital for their identification and I delegate access to all of my health care records, or all the ones I want to give them, and they can automatically ingest those into the EHR.”
Instant access to an EHR, or Electronic Health Record, would mean less paperwork, lower administrative costs, and possibly, fewer costly medical mistakes. That’s why major companies — IBM, Phillips, Merck — all have blockchain initiatives.
In Austin, Hector Torres with ULA health is also working at the intersection of blockchain and healthcare. He helped put together an innovation summit at Google Fiber in October that attracted 150 attendees.
Securing health care transactions
Even the U.S. government is interested. Steven Posnack directs the office of standards and technology in the U.S. Department of Health and Human Services. He says the department is holding a co-sponsored “blockchain code-a-thon” event with the Chamber of Digital Commerce.
“We’re inviting teams of people to demonstrate how blockchain can be applied in practice in health care. The variety in different ways it can be used is really exciting to health care stakeholders.”
Posnack says government agencies like the FDA, the Centers of Medicare & Medicaid Services are exploring how the technology could make health care transactions more secure.
“There’s a lot of real interest, but it’s extremely early,” says Dr. John Halamka, who manages the IT system of Beth Israel Deaconess Medical Center in Boston.
Halamka, along with researchers at MIT, ran a six-month test of blockchain in the real world. They entered patient's medication data — prescriptions, vaccination history, etc. — on separate sites and used blockchain to see if specific doctors could easily access those records. The prototype worked, and they’re planning more pilots with larger networks of hospitals. Halamka says technology isn’t really the challenge.
“It’s psychology that’s a challenge. We still have the culture where every health care provider thinks of themselves as the single steward of the data that is deposited in that organization. With blockchain, every time I make a change to your data I’m telling the public ledger that the data has changed and now thinking of it as a community wide resource, is a very different psychology than the past.”
In other words, before we use advanced blockchain technology to stitch together our medical records, we should address some more philosophical questions: Who owns health data in the first place and who can grant permission to share it?