One of the monumental shifts we are experiencing in the healthcare industry is the digital decentralization of the care delivery models. Digitization of drugs (therapies), devices, services and business models are democratizing current healthcare systems, unlocking new values by displacing high-cost gatekeepers and previously inaccessible segments. This has made the digital transformation theme a core strategic priority for all healthcare industry participants as they strive to justify the value in the much-anticipated data-driven, outcome-based reimbursement regime, Forbes writes.
Concurrently, at a federal level today, most countries have policies or strategies outlining digital health objectives, which have increased the adoption of digital health records such as electronic health records/electronic medical records (EHR/EMR) and other health IT (HIT) systems or infrastructures.
Regardless of these digital initiatives, current limitations around security, integrity, and access control for personalized health data are creating critical bottlenecks for care delivery innovations. This, in turn, creates an inefficient digital health workflow with acute data silos between different providers, hospitals and payers, and even various departments within a health system, impeding care coordination. As the healthcare industry struggles to find the trade-off between risk and reward of going digital, potential application of blockchain technology provides a timely solution to mitigate some of these pressing needs.
GROWTH OPPORTUNITY 1: Addressing the Cybersecurity Challenges
While the healthcare industry is known for its strict compliance policies and regulations to ensure data security and privacy, growing instances of cybersecurity threats are creating new concerns and dilemmas for implementing emerging digital workflows. Today, health systems, payers, and drug and device manufacturers need a secure and trusted connected health IT ecosystem to manage healthcare data and promote value-based care. According to the 2017 IBM Security and the Ponemon Institute study, the cost of data breaches for healthcare organizations has increased, averaging $380 per record, while for other industries it has dropped by 10%. Consequently, cybersecurity threats are becoming a grim concern for medical device and technology companies.
For example, last year, Johnson & Johnson warned patients that their “OneTouch Ping” insulin pump was vulnerable to hacking. Most recently, the United States Food and Drug Administration (FDA) also reported findings of cybersecurity vulnerabilities in St. Jude Medical heart devices. With a growing number of connected health devices, the potential for hacking any medical device, whether or not it is connected to a network, is a problem that deserves serious attention by medical device original equipment manufacturers (OEMs).
Unlike existing security systems, blockchain-based systems operate on distributed network consensus with built-in cryptography techniques that make all record of digital events immutable and nearly impossible to hack. These unique properties of blockchain could potentially provide an additional layer of trust to minimize cybersecurity threats for HIT systems, connected medical devices and embedded IT systems. With this new blockchain technology, health systems, medical device OEMs, and healthcare technology companies can now append more reliable and secure strategy around device identity management, promote the Internet of Medical Things (IoMT) applications, and improve patient privacy, while providing selective access to patient-generated health data.
GROWTH OPPORTUNITY 2: Health Data Exchange and Interoperability
Data exchange in healthcare is complex. With the increasing digitization trend, good health data interoperability is necessary to stimulate care coordination. It is important to understand that true interoperability is more than information exchange; it is the ability of two or more systems or entities to trust each other and then use the information with shared accountability. With this, the real challenges for health data interoperability transcend the technical facets to more fundamental concepts, such as lack of trusted frameworks and integrity with existing HIT systems.
As a result, despite increasing adoption of EMR/EHR systems and digital health solutions, lack of trusted digital workflows has resulted in disparate HIT systems and centralized health data management models.
These trends have become essential to deploying new solutions, such as blockchain, which promises to offer a fresh approach to interoperability.
The unique properties of this technology provide an immutable and trusted workflow with a “single source of truth” to warrant integrity around health data exchange, minimize cybersecurity threats, and augment health data governance applications.
At its core, blockchain offers the potential of a shared platform that could decentralize health data interactions while ensuring access control, authenticity, and integrity of protected health information exchange. Furthermore, successful deployment of blockchain on top of existing HIT systems will minimize administration-related inefficiencies by replacing traditional trustee administrators or registry owners in the existing workflow of health data exchange.
GROWTH OPPORTUNITY 3: Healthcare Consumerism and ‘Quantified-Self’:
The advent of digital health solutions is creating a plethora of personalized health and lifestyle data, manifesting a sense of healthcare consumerism. Today, consumers are more receptive to healthcare information, and they want to actively participate in healthcare at all levels of care. For example, a recent Frost & Sullivan survey revealed that about 69% of consumers in the U.S. track their health symptoms.
Moreover, 41% will definitely change their physicians if they are not allowed to access their health records, and 74% of patients appreciate receiving customized alerts and news feeds post care.
However, a majority of health consumers acknowledge that the existing patent engagement initiatives of major healthcare enterprises fail to effectively engage them during their experience in primary care. They seldom receive access to personalized treatment options, referral support and adherence alerts outside physician offices in real time. This raises important questions around patient data ownership, access, and privacy issues with current HIT systems and emerging digital health solutions.
Additionally, in this multilayered digital patient engagement space, interoperability and trusted workflows will be critical for future success.
Blockchain, as an open-sourced tool with peer-to-peer data-sharing networking models, provides identity management features with predefined user access rules to increase patients’ control over their health data and reliability for patient engagement initiatives. Further, permanent storage of encrypted patient-generated health data on immutable blockchain systems could provide a single, simplified view of patient data.
This, in turn, empowers consumers to selectively share their anonymized personal health data for research, direct payment of incentive and health tokens toward positive and healthy behavior, and other adherence programs.
GROWTH OPPORTUNITY 4: Value-based Care:
The digital democratization of care delivery models toward a value-based care paradigm will require healthcare providers to make better use of health IT standards and advance healthcare interoperability.
Nowadays, the new vision for healthcare is not just about access, quality, and affordability, but also about predictive, preventive, and outcome-based care models promoting social and financial inclusion. With rising regulatory hurdles and pressures to decrease healthcare costs globally, blockchain technology promises to unlock new economic advantages by disintermediating high-cost gatekeepers and automating transactional services across healthcare workflows.
Blockchain-based distributed ledger makes it easier to create cost-efficient commercial relationships where virtually everything of value can be tracked and traded without requiring a central point of control. Successful deployment of blockchain systems will provide radical new possibilities to promote outcome-based care delivery and reimbursement models across healthcare workflows to save billions of dollars for the industry.
GROWTH OPPORTUNITY 5: Precision Medicine:
Pharma companies are facing increasing pressure to justify the value of their medicines.
Based on industry estimates, about $300 billion is wasted each year on drugs that do not work on people with certain gene types and fail to provide the expected benefit, while others experience precarious side effects.
For this reason, the drug industry must shift from blockbuster to patient-centric drug development models for future targeted therapies.
The precision medicine concept promises a paradigm shift in the care delivery arena. It aims to integrate personalized health data from direct and indirect sources, targeting individuals’ health and well-being. However, with personalized health data being the “Holy Grail” for precision medicine, it is not unique to some of the prevailing challenges involving health data interoperability, privacy, ownership, and security. Additionally, current legal and ethical frameworks for health data exchange were built with a very different generation of medical and research practices in mind and raise some serious challenges for seamless exchange of personalized data to population-based genomic studies and research commons.
Blockchain technology, with its ubiquitous security infrastructure for seamless health data exchange, promises to drive unprecedented collaboration between industry participants, academia, researchers and patients to foster innovation in medical research and execution of larger population-based genomic studies to promote precision medicine. As the drug development industry is betting big on precision medicine, blockchain-based, time-stamped immutable records could potentially eliminate the burden and cost of clinical trials data reconciliation, and facilitate interoperability and research commons.
Blockchain technology provides an inimitable convergence potential across several digital initiatives. It could help the healthcare industry resolve some of its pressing challenges, such as cybersecurity, data interoperability, drug supply chain provenance, insurance notarization, billing fraud issues, etc. Additionally, blockchain could also provide significant scope to optimize existing IT systems or digital workflows and introduce new business models to improve care coordination.
Despite the potential of blockchain across these digital themes, it may not be the universal solution for managing conflicting data standards with disparate terminologies in the healthcare industry.
It is critical for healthcare industry stakeholders to selectively evaluate the blockchain deployment trade-off across potential healthcare use cases.