John D. Halamka, chief information officer at Boston's Beth Israel Deaconess Medical Center, has helped popularize the use of blockchain as a solution to the EHR interoperability challenge. As he wrote in Harvard Business Review this spring, the idea is blockchain, which was originally designed as a ledger for secure financial transactions, would use cryptographic techniques —or keys —to allow auditable access to patients' records.
Physicians Practice recently interviewed Tim Smith and Florian Quarre, principal/national leader for healthcare IT and senior manager, respectively, at consulting firm Deloitte, to learn about the promise blockchain holds for physician practices.
Physicians Practice: Explain the relevance of blockchain to small- to medium-sized physician practices.
Smith: For right now, small- to medium-sized physician practices should be aware of blockchain, but it could eventually help practices provide patients with a more comprehensive view of their healthcare in a way that's not possible today.
The difference — and much of this is within the realm of possibility and not proven yet — is the ability to aggregate patient information into one view across all information silos. That means bringing in health plans, benefits, claims data, and revenue cycle information from across all of a patient's visits at all of their healthcare providers.
Physicians Practice: Who will pay for blockchain?
Quarre: One of the concepts with the encryption-based system is to have patients — or the end-user, such as the practice — participate in the operating cost of the whole blockchain network by paying a micro-fee. That allows the ecosystem to remain active.
Physicians Practice: What's the timeline for widespread implementation of blockchain in the healthcare industry?
Quarre: Gartner's analysts say it will take five to 10 years for a full, industry-level, adoption of blockchain. That's because vendors don't want to go too far in their embrace of blockchain — largely because they don't know what other vendors are doing and they don't want to have to stop in midstream if an industry alliance decides to go in another direction with this technology.
Smith: Here's the analogy I like to use: No one wants to buy the first fax machine. You don't get a lot of bang for your buck when you're the only one who owns a fax machine. But blockchain seems to be the first technology in 15 years that can solve the information silo issue. What's required is a coming together of all these vendors to crack that code — where the focus is on enabling the patient with access to a more comprehensive view of her healthcare information.