Of all the technologies likely to make an impact on healthcare, few are struggling to get out of the starting blocks like blockchain.
When we looked at blockchain previously, 35% of health and life science companies said they planned to start using blockchain technology in some form in 2018.
Blockchain has generated a ton of interest and is bandied about as a solution for everything from cybersecurity to interoperability, but according to the latest numbers from HIMSS Analytics, 45% of healthcare technology decision-makers surveyed said that their organizations are still investigating or learning about blockchain. Only 6% of organizations are in the process of building a business case or securing technological support for exploring blockchain use cases.
The HIMSS report concludes that healthcare organizations are still in the early stages of blockchain adoption and will remain there for the next couple of years as they upgrade and streamline their infrastructure systems. As of now, few are even ready to test a blockchain proof of concept.
What is Blockchain Being Targeted For?
Of all the touted use cases for blockchain, it’s not exactly clear which ones should be prioritized or are likely to come to fruition first. There’s little doubt about blockchain’s potential, so market research firm CB Insights examined the outlook for different use cases, attempting to classify them into three categories: short-term applications, medium-term applications and long term.
In the short-term category, managing provider information and the drug supply chain were two primary use cases. Claims management, payments, prior authorization, health information exchange, research and trial design all fell into the medium category. Long-term applications included universal identities, patient records and application services.
The technology has so many possibilities that figuring out the best use case for one organization or the entire industry is a lengthy process. Obviously, HIE, interoperability and controlling access to electronic health records (EHRs) is a major target for blockchain, but figuring out how to standardize the technology used to access or manage the digital ledger across differing levels of infrastructure is a complex challenge.
A Blockchain Example
One of the more interesting initiatives to take shape in the last year is between insurer Aetna, CVS Health, PNC Bank and IBM. The four have come together to target more efficient claims and payment processing to facilitate secure exchanges of health information and maintenance of accurate provider directories.
With IBM in a leading role, the group has developed a platform that can facilitate a blockchain network between them and allow them to collaborate and test blockchain solutions. As they move forward, the group will look to add more healthcare providers, startups and technology companies.
Its areas of focus include using blockchain to aid in the transition to value-based care priorities, such as bundled payment arrangements, reduction of administrative waste and revenue cycle management.
Barbara Hayes, general manager for payers at IBM Watson Health, told Fierce Healthcare that blockchain could also tackle issues around access to data, the accuracy of the data and transparency in that collaborative ecosystem.
“Five years ago, we talked about wanting a portable health record, now it becomes a real-time health record that is actually in the workflow. That would be a tremendous advancement for healthcare.”
Rising Skepticism
Issues that lead some to doubt blockchain include scalability and the financial obligation that comes with it. The former is an issue of throughput, as it can only handle so much work at a given time. While its speed will increase over time, expectations have to be managed and its impact on the bottom line has to remain in focus with the overall value that will be achieved.
While in the long run blockchain will likely lead to cost savings, its upfront investment may be a tough sell to management and stakeholder groups expected to establish governance over the system.
Another reason for caution is the pace of innovation thus far. Because of this, McKinsey recommends extremely careful vetting of blockchain concepts in any business before investing in them.
“A particular concern, given the amount of money and time spent, is that little of substance has been achieved,” the report said of blockchain trends across industries, be it finance or the internet of things. “Of the many use cases, a large number are still at the idea stage, while others are in development but with no output. The bottom line is that despite billions of dollars of investment, and nearly as many headlines, evidence for a practical scalable use for blockchain is thin on the ground.”
