Beyond bitcoin: Five possible uses for blockchain in health care

When the term “blockchain” is mentioned, there are typically two reactions: It is either seen as being synonymous with bitcoin and other digital currencies, or seen as an overhyped technology. While there is much hype, there is the potential for blockchain to streamline and improve a number of processes across health care.

Blockchain is essentially a living list of linked digital records. Each transaction is verified and stored by each network participant based on a set of previously agreed-upon rules—and without a governing central authority. While information can be added, it can't be copied or deleted. As a result, multiple groups—health plans, physicians, hospital systems, and even patients—can add to and share information through a secure system.

In a survey last fall, about 70 percent of health plan and health system IT executives said blockchain holds significant promise for health care interoperability.¹

Here are five areas where blockchain might be useful in health care:

• Supply chains: Most biopharmaceutical companies are at least exploring ways that blockchain could be used to monitor and track products. Along with following the flow of products, other bits of information could be included, too. Certain biologics, for example, might need to be kept at a precise temperature. Sensors included in a shipment could transmit temperature data to the blockchain. The technology might be helpful in guarding against counterfeit or substandard products. Blockchain also could be used by biopharma manufacturers to capture and record interactions with regulators.
• Clinical trials: Using blockchain, companies can securely share data generated by clinical trials, such as patient demographics and information about adverse reactions. Interim results could be shared with sponsors and regulators. The technology also can help manage and track informed consent across multiple sites, systems, and protocols. Blockchain could be used to collect, build upon, and share patient data profiles across multiple trial sites—even virtual trial sites as they are developed. If applied to consent management, blockchain could give the patient control to grant access to other researchers who might access their data in the future.
• Provider directory management: Blockchain-based hospital and physician directories could leverage the technology's decentralized consensus protocols to help enable providers and health plans to update listings more quickly. If a provider changes networks or if someone finds a mistake, they can initiate a correction, which can be automatically accepted or rejected by smart contracts, which would be governed by other information in the blockchain (e.g., a recently rejected claim).
• Patient records: Most people have access to just a sliver of their health history, but blockchain could help pull together a lifetime of transactions from multiple health systems, pharmacies, and health plans. This information could be processed into readable information for a patient's own use, or converted into records that can be read by a variety of electronic medical records systems. Links to detailed information about procedures, encounters, diagnoses, claims, and prescriptions could be added over time, and access to this information could be managed by the patient or the patient's designees.
• Insurance coverage, preauthorization, and claims adjudication: The ability to ensure that claims are accurate, and to spot fraudulent claims, is particularly important in Medicare and Medicaid where payments must be coordinated between payers, providers, the federal government, and banks. A smart contract could be used to show proof of adjudication. For example, the act of a patient checking in for a clinic visit, or logging into a virtual appointment online, could be confirmed by the health system's financial or clinical systems. This transaction could be combined with others from the same clinic that day and uploaded to a blockchain that is accessible to the health plan. An employee at the health plan could see the completed transaction, and reimburse the health system accordingly. Claims review could be streamlined because encounter data would be accessible and easily verified on a blockchain. Health systems and physicians also could connect with health plans to determine information about a patient's health coverage, or to verify patient demographics.

We might be moving beyond the hype of blockchain and into the reality of potential applications. Learn more by clicking here.

Footnotes

1. Black Book Market Research. “Healthcare Blockchain Interest Heats Up: Black Book Survey,” Press Release, October 3, 2017, https://blackbookmarketresearch.newswire.com/news/healthcare-blockchain-interest-heats-up-black-book-survey-19973867, accessed October 9, 2017.

Greg Reh leads the DTTL Global and US Life Sciences practices for Deloitte. In his role with Deloitte's US member firm, he leads the life sciences sector practices for consulting, audit, tax, and financial advisory services. Greg has more than 25 years of experience helping clients in the life sciences, process manufacturing, consumer, and government sectors. In his role consulting to clients, his career has spanned such topics as technology strategy, integration solution development, and implementation of emerging and disruptive technology.

His clients have included multinational pharmaceutical, biotechnology, and chemical manufacturing organizations where he has successfully led consulting services in support of regulatory, clinical, commercialization, and manufacturing operations.

Prior to his consulting career Greg held positions at a government research lab, where he led teams in the design and development of life support devices; and was a lecturer at the University of Pennsylvania.

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