A recent study suggested that the average healthcare organization spends about 95% of its technology budget on implementing new technologies and only about 5% on managing the cybersecurity risks that come with them.
Despite this, healthcare has a mixed record adopting technologies that stand to have the biggest impact on efficiency and efficacy of care.
In 2017, seven years after the Affordable Care Act mandated Electronic Health Records, 86% of office-based physicians had successfully implemented it; 80% had adopted an EHR system certified to meet requirements established by the Secretary of Health and Human Services. Prior to ACA in 2010, barely half (51%) of office-based physicians had adopted any form of EHR.
Doctors and administrators have maintained a “love-hate” relationship with technology. Again, the impact of EHR looms large in the professional consciousness. According to research by Stanford Medicine, 63% of doctors surveyed say EHR has led to better patient care. Yet, feelings about EHR only turned generally positive in 2017, reflecting a shift from “fixing” to “improving“ them.
The example of EHR is instructive, showing two things:
- Despite high technology investments, providers can take a conservative attitude to technology
- Technology-driven care environment disruptions are often felt acutely by physicians for years
This context is crucial to understanding why healthcare providers often seem to be behind the times on technology, even as an enormous amount of institutional time and energy is expended on it. It comes as no surprise, then, that hospitals have not been clamoring to institute blockchain applications.
In fact, despite intense and wide-ranging conversations about blockchain in other industries, its use cases in healthcare remain generally less known. It’s worth asking, then, what reasons there are to be excited about blockchain’s potential in healthcare – and how that potential might be realized faster.
What Are the Use Cases for Blockchain in the Healthcare Sector?
Substantial academic research has raised awareness around the place of blockchain in the healthcare world. Writing in the Journal of Network and Computer Applications, Thomas McGhin et al. note that foundational blockchain features such as authentication, security, and immutability serve to make it more compatible with rigorous regulations, including HIPAA. At the same time, various blockchain-specific vulnerabilities, like mining attacks, present novel challenges for cybersecurity experts.
Despite those issues, blockchain-driven innovations in healthcare are already emerging. Writing in the international science journal Symmetry, Marko Hölbl et al. describe its capacity to facilitate patient-centered applications and enable secure data sharing between disparate systems.
Performing a meta-analysis of blockchain literature within healthcare, they discovered the following:
1) The Great Majority of Research Work Is in Proposals, Not Solutions
Blockchain has not yet entered a solution-oriented phase when it comes to healthcare. In 2014 and 2015, no research centered on solutions that had already been implemented. In 2017, there were 12 proposals and four implemented solutions; in 2018, ten proposals and one solution.
2) Blockchain is Poorly or Vaguely Described in the Majority of Work
The attempted meta-analysis was stymied by the fact that “The blockchain elements are typically poorly described or not described at all.” Among the salient details, “almost half” of proposed solutions were found to integrate smart contracts. “In most publications,” the researchers concluded, “proposals are made that could be implemented but mostly were not.”
- Data sharing
- Health records
- Access control
- Supply chain management
- Audit trail management
Work published in the International Journal of Medical Informatics in 2020 bears this out, with the researchers finding highest proposed impact in the area of Electronic Health Records, and stating “endeavors of using blockchain technology in the health domain are increasing exponentially.”
Blockchain’s Mainstream Moment in Healthcare Is Coming
Despite the dearth of workable solutions in the literature, the business world remains bullish about blockchain. Ongoing discussion about blockchain’s capacity to combine interoperability and security means it may possess innovative solutions for the high-threat cybersecurity environment.
The distributed and secure nature of blockchain may help healthcare institutions to reduce the growing threat of ransomware attacks. As data sources are restructured for ease of use within blockchain, it may enhance business continuity and enable more robust responses with less loss of data during attacks.
The prospect of fewer, more limited data breaches has the potential to help avert the most disastrous outcomes, such as the infant death allegedly caused when a ransomware attack blocked EHR access, resulting in missed opportunities for a potentially life-saving procedure.
From the perspective of healthcare administrators, blockchain may help slam the brakes on the ever-increasing cost of regulatory compliance. When compliance failures do occur, their impact could be better contained, resulting in fewer regulatory fines and – at least theoretically – better visibility into vulnerabilities and threat vectors when post-breach audits are performed.
In research by IBM, about 70% of healthcare leaders foresee that blockchain’s greatest impact will be in improved clinical trial management. With the possibility of continuing complications around COVID-19 variants, gathering and evaluating data quickly could save millions of lives over the next decade.
Survey respondents also cited regulatory compliance and EHR sharing as key uses for blockchain.
Vendors and Healthcare Providers Must Partner to Accelerate Blockchain Advantages
When blockchain arrives in healthcare, it won’t look like the flashy cryptocurrencies or NFTs that have upended the financial world. Despite the generally optimistic response to all things crypto, blockchain applied to healthcare might not be greeted with much fanfare. But it could have a more profound impact even than EHR itself.
The stakes are no less than a complete re-engineering of the healthcare value chain – one that makes it impossible, for instance, for hackers to access a major hospital records and systems through a back door. One such case was the hospital HVAC vendor that breeched a major hospital’s data network . The technology may finally exist for day-to-day healthcare operations to fulfil the intention behind HIPAA and other regulations.
To get there sooner, healthcare technology vendors must entice providers with new partnerships that reduce risk, ensuring secure, “plug-and-play” blockchain implementation from Day 1. Otherwise, the industry will continue waiting for an ACA-style trigger event that might never arrive.
JP Boyle & Associates is a HealthTech executive search firm at the intersection of healthcare and emerging technologies as Blockchain and Digital Health.
We help client leadership with emerging technologies companies identify and recruit impact players that will make a measurable difference when reaching for goals, overcoming challenges and capitalizing on opportunities.
