Say you are a parent of three, married to a stay at home spouse, and you live in the Midwest. One day, your boss offers you a promotion. The catch is that you must pick up your family and move to the Seattle. You and the family agree enthusiastically (bear with me, this is hypothetical!).
You go to your pediatrician’s office and have the charts of all three kids copied to bring with you on your move. Once you get settled in Seattle, you seek out a new pediatrician and arrive at the reception desk hauling a thick stack of medical charts. The receptionist tries to force a smile. The receptionist is happy to see you, of course, but now she must scan 500 pages into her office medical record system. She is not happy. She turns her eyes toward the sky and silently asks “why isn’t there a better way?”
To the receptionist’s surprise, a voice answers “Why, there is a better way!”
The Interoperability Problem
The hypothetical scenario I’ve described is unfortunately a daily reality. Computerized medical records systems, now nearly ubiquitous in the US, simply do not “talk” to each other. There is no easy, seamless method of transferring medical information from one office to another next door, to say nothing of transfer between cities.
The problem is, in a word, interoperability. For several complicated reasons, the healthcare industry has evolved to a point where health information is sequestered and “stove-piped” in systems that do not communicate with the outside world, almost as if they speak different languages. In recent years, there have arisen various proposed solutions to the interoperability problem, such as the Health Level 7 standard, that attempts to act as a translator among different systems. These solutions tend to be expensive, and unfortunately, do not work very well.
Enter the Blockchain
What if I told you that there was a way to distribute health related information among providers, plans and institutions in a way that was accurate, secure and trustworthy? This is precisely what blockchain technology provides.
Blockchain technology can be described as a computerized ledger, a virtual sheet of information. Unlike paper ledgers locked in a safe, or computerized ledgers stored on a server, the blockchain is shared across a network of computers. There is no central location and no controller, and no governing body. Each computer, or node, on the network possesses a complete copy of the ledger in encrypted form. Once information is added to the blockchain, it is virtually impossible to alter or remove it. Access to the information stored on the blockchain is controlled by a series of public and private encryption keys. So even though every transaction is shared across a broad network, users retain tight control over who can access the data, and which portions of that data may be shared.
Early Adopters of Blockchain Technology
It’s impossible to tell the story of the blockchain without mentioning Bitcoin. The origins of the world’s most famous crypto-currency are shrouded in mystery. What is known is that a patent was filed in 2008 for a technology that permitted verifiable peer-to-peer transactions to occur over the internet in encrypted form. Soon after, Bitcoin emerged as decentralized alternative to the fiat currencies of the world.
Outside of the digital currency world, one of the first industries to recognize the power of the blockchain was the financial services industry. In recent years, several large banks have joined forces to create safe, secure and redundant systems for financial transactions.
The healthcare industry has been sticking its collective toe in the waters of the blockchain, but is reluctant to jump in, perhaps understandably. But this technology offers a viable solution to the interoperability problem that you encountered when you moved to Seattle. Instead of dropping a pile of paper on some poor receptionist’s desk, you could have entered a private key on a digital interface, accessed your children’s medical records (which you own) designated the Seattle pediatrician as the recipient, and boom: records are transferred seamlessly, securely, and almost instantly.
Into the Future
As with all hypothetical scenarios, this story is a bit removed from reality. There are still several problems to be worked out before private, protected health information can be shared among providers, health plans and home health organizations. Whatever hurdles remain in the way, the incentives to jump over them are enticing: removal of meddlesome intermediaries, lowered costs, confidence in the integrity of data, and protection from healthcare hackers.
As more and more players in the 21st global marketplace embrace the blockchain, the healthcare industry must jump on board or risk becoming mired in the expensive, inadequate solutions of the past. Our most valuable constituents, the patients, deserve nothing less than the best technology has to offer.