Tech
Healthcare blockchain leader talks DLT challenges and trends
Blockchain technology has started to attract the attention of healthcare IT leaders and is very promising.
“While blockchain technology is not a panacea for data standardization or systems integration challenges, it offers a promising new distributed framework to amplify and support the integration of health information across a wide range of uses and stakeholders. ” explained the consultancy firm Deloitte. “It addresses several existing pain points and enables a more efficient, disintermediated and secure system.”
In January, healthcare blockchain technology and services company Avaneer Health announced new backing from several blue-chip healthcare organizations, who are committing $50 million in seed funding to the Avaneer Health network.
THE new funding comes in founding network participants including Aetna, Anthem, Cleveland Clinic, Health Care Service Corporation, PNC Financial and Sentara Healthcare. The network, founded by these participants and others in 2021, is built using blockchain technology and uses HL7’s FHIR specification to expand data access across healthcare organizations, with a focus on data exchange between payer, eligibility and prior authorization.
Healthcare IT News spoke with Stuart Hanson, CEO of Avaneer Health, to talk about the healthcare industry’s reluctance to adopt blockchain, blockchain use cases in healthcare, challenges for blockchain in healthcare, and what might come next by blockchain in 2022.
Q. What explains healthcare organizations’ hesitation in adopting blockchain? How can this hesitation be overcome?
A. I remember when numerous healthcare organizations began exploring the potential of blockchain in 2018 and 2019. Many large technology organizations identified ways to use blockchain and started projects, and innovation teams at health systems and payers created teams to focus on blockchain’s potential .
But many of these initiatives have since been abandoned. It seems to me that while there were many good ideas and the best intentions, one challenge in particular may have been very difficult to overcome: blockchain is not a plug-and-play technology.
It is also not a silver bullet as a standalone or even enabling technology solution. Blockchain is not an app that can be easily installed, nor is it a platform that can be added to the technology stack. To use blockchain effectively, entire processes must change, workflows must evolve, technology stacks must be adapted to leverage real capability strengths, and the mindset about how to run the business must fundamentally change.
This level of change is obviously not easy to achieve in large organizations, especially in an industry with so much complexity existing in both clinical and administrative use cases.
Hesitation to adopt blockchain can be overcome by organizations ready to move beyond experiments by adapting processes and technology stacks to exploit the potential of blockchain. Over the past two years, organizations like IBM and PNC Bank have worked with companies that typically compete with each other – Anthem, Aetna, HCSC, Cleveland Clinic and Sentara Healthcare – to design the governance structure needed to create a community and healthcare network that can it is blockchain enabled.
As different organizations work together towards a common goal, there is a greater likelihood of success. More often in healthcare, we see a single tech company come out with a good idea and try to make it happen themselves.
But blockchain, at its essence, is about community, being together, openness and collaboration. Therefore the industry needs more organizations to commit to changing their overall mindset to reflect these values in order to broaden blockchain adoption, which can unlock significant value from the underlying technology investments made over the last decade.
Q. What are some common use cases for blockchain in healthcare?
A. Currently, the most common use cases of blockchain in healthcare leverage smart contract capabilities for medical supply chain, healthcare and vaccine credential validation, provider credentialing, patient data security, and data relating to clinical studies in the life sciences.
In most cases these are simple use cases that can leverage the distributed ledger functionality of blockchain technology to solve problems. I see the industry moving towards more complex use cases beyond what is common today.
There is a significant opportunity to streamline some of the core and repetitive administrative use cases in healthcare, such as eligibility, prior authorization, benefits coordination, claims status, and myriad interoperable interactions between payers, providers, and financial institutions.
Furthermore, a blockchain-enabled network for a trusted ecosystem could emerge to enable some kind of marketplace, on which developers could implement solutions that benefit from access to permissioned data or collaboration in the healthcare ecosystem.
Q. What makes blockchain so attractive to other industries, yet challenging for healthcare? Why has it worked so well with cryptocurrency and NFTs but not with healthcare?
A. With its decentralized and “zero trust” nature, blockchain technology offers benefits to a variety of businesses across different industries. Perhaps one of the greatest features of blockchain is that it provides an unprecedented level of transparency and openness, so that each participant is held accountable and independently accountable for acting with integrity towards their community and customers.
Blockchain technology also increases efficiency by eliminating the need for a trusted intermediary or single arbiter. For example, in some industries such as financial services, blockchain facilitates faster transactions by enabling P2P cross-border transfers with a digital currency. In real estate, property management processes are made more efficient with a unified system of property records and smart contracts that automate tenant-landlord agreements.
Blockchain is also much more secure than other record-keeping systems, as each new transaction is encrypted and linked to the previous transaction, ensuring a level of permanence. Once a transaction has been placed on the chain, it cannot be deleted.
You can only add to the chain via a new block. Therefore, blockchains create a linear, historical record of events or transactions that cannot later be changed. This immutable and incorruptible nature of blockchain makes it safe from falsified information and hacker attacks, ultimately making it attractive to several industries.
Furthermore, many people continue to confuse blockchain with cryptocurrencies. There are significant differences between the potential applicability of blockchain in healthcare and its anticipated adoption in sectors such as NFTs and cryptocurrencies.
First of all, NFTs and cryptocurrencies came into existence much earlier and the first use case was Bitcoin and later Ethereum. It took Bitcoin and Ethereum many years to get to where they are today. Secondly, these ecosystems were created from scratch. We can’t just hit the reset button in healthcare and create new technology stacks. We need to help adopt new technological capabilities in a way that helps both unlock the technology investments that have been made – such as in EHR systems – and help the industry transform into a more fluid ecosystem.
Creating a greenfield or “clean slate” is often much easier than reinventing existing systems, especially at scale, for core business processes. Processes must continue to work while new ones are created, which is much more costly for innovators and requires a lot of courage and commitment to the vision of helping people in early-adopter organizations.
Third, healthcare requires a hybrid technology stack, because not all aspects of key processes lend themselves to smart contracts. Indeed, there are significant data barriers, smart data protection barriers in healthcare, to protect confidential and sensitive healthcare data. This data cannot – and should not – be propagated and distributed widely across various blockchain nodes.
Instead, this technology can be used to help index the industry’s complex data sources across a network and make this data more seamless and, therefore, valuable. In other words, we need to find a delicate balance between blockchain and other technology components within the stack in order to preserve the key value added by blockchain while making the entire system robust and optimized for healthcare use cases.
The obstacle to widespread adoption in healthcare is actually the same obstacle that originally slowed the adoption of cryptocurrencies and NFTs. We need to change our mindset and change our processes.
Once healthcare stakeholders are willing to think differently about how healthcare connects and identify ways to work together to create new processes that work for everyone involved, while building trust, then the adoption will increase, just as it has in other industries for the reasons mentioned above. .
Q. Is the blockchain industry working on anything that could drive adoption in healthcare this year?
A. I know that the healthcare industry is working to find ways to really leverage blockchain as a technology, just as financial services and fintechs have done in recent years. So, I firmly believe that the healthcare industry is poised to start adopting blockchain in a much more significant way over the next three years.
For example, our blockchain-enabled national healthcare network is launching. It aims to eliminate the need for point-to-point connectivity by creating a “once-to-many connection” environment. Furthermore, this blockchain-enabled network is designed to function as a verifiable trust layer for joint processes between network participants.
Thanks to such an agreed and verifiable trust function, the counterparty risk related to data sharing should be significantly reduced. Each participant on the blockchain will “know,” with certified verification, that other participants are “good actors” and will agree to interact with each other using automatically enforced standards.
No other intermediary data processing entity is needed to ensure the integrity of the data or transaction. Additionally, data moving across this new network will not be manipulated or stored centrally.
Data will simply move and be visible or accessible across this network of trust, enabling new insights, transparency and easy access for consumers. Only when all participants can trust each other about how, why and when they will interact, truly continuous dynamic data updating and sharing becomes possible. This is the vision for the future state I envision for all healthcare organizations.
Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.