CONTRIBUTOR

Michael Myser
Essential Insights contributor, healthcare writer
Cardinal Health Expert

Jeff Graham
Principal, Big Data Analytics, Fuse by Cardinal Health
Blockchain is the latest technology darling, dubbed the next revolution of the Internet, inspiring new companies founded on the premise and causing stock price surges. Of course, many new and complex technologies with early success will garner this attention, but getting a handle on what blockchain is, and how it might impact the healthcare space, is an important next step in determining the feasibility of this new technology.
Here, Jeff Graham, principal of Big Data Analytics at Fuse by Cardinal Health, the company's innovation center, parses out the hype from the reality of blockchain and talks about opportunities for the technology in healthcare.
What is blockchain?


Blockchain was developed and came to prominence in 2009 as the underlying technology behind Bitcoin, the most popular cryptocurrency in circulation. In this case, the Bitcoin blockchain monitors financial transactions, which uses a unique cryptographic code created for each user and shared among Bitcoin nodes to confirm or deny those transactions. When a user makes a purchase or trade with Bitcoin, the blockchain records it, and once confirmed using this cryptographic code, the updates are made across the Bitcoin network, notifying all nodes that a Bitcoin changed hands. Every copy is then updated.
Why is blockchain so appealing, especially for healthcare?
Blockchain is enticing because each block is accessible to everyone on the network, and not controlled by a single entity. With hundreds or thousands of nodes confirming and backing up a transaction, discrepancies or attempts to change the information are easier to spot. Whether money or data, that peer-to-peer integrity and trust is built into blockchain.
“However, many conflate security with this trust," said Graham. While the data is nearly incorruptible, he said, due to the transparent nature of blockchain and the fact that the data sits on and is accessible by hundreds or thousands of individuals, it could also be accessible to bad actors.
That's one reason the Bitcoin blockchain is simply a record of transactions and not the coins themselves. As such, Graham believes financial and patient information shouldn't yet sit on a blockchain-based system.
However, Graham also pointed out that this distributed trust is what could in fact make blockchain ideal for several healthcare operations. The use of blockchain technology to support supply chain and product tracking is a particularly good fit.
With the passage of the Drug Supply Chain Security Act, which will require tracking pharmaceuticals down to the package level ─ from manufacture to patient distribution ─ those solutions are becoming even more critical. In fact, Genentech and Pfizer recently completed a pilot using blockchain technology to do just that.
Other uses of blockchain for healthcare
Blockchain explained (Deloitte US)
On the payer and patient side, blockchain could also be used to monitor and transfer patient consent, or allow access to patient records between different providers. When a patient changes providers or goes to a specialist, using a blockchain-based solution would give these new providers the consent needed to access the patient’s records, and update that across a shared payer, healthcare system or provider network. However, due to blockchain's transparency, only the consent data would reside on the blockchain, not the patient records themselves.
When payers like Medicare can see who is providing patient care at any point in time, it will allow them to more easily track the reimbursements they need to make. Meanwhile, physicians could use the same blockchain to more quickly get prior authorization from those payers.
“The beauty of a distributed share model like this is that it doesn't give any one entity control of that data, but allows everyone in the network to take advantage of that information," said Graham.
Looking to the future
Both of these healthcare use cases are in the early stages, as is blockchain in general. But the technology is beginning to reach maturity as companies understand its implications and figure out those areas that most benefit from distributed trust. Payers, for example, are extremely interested in the technology. A survey from research firm Black Book found that 76 percent of payers are considering or already deploying blockchain solutions in some capacity.
“Payers, drug companies and health networks are starting to utilize this technology, but it will be the end users like patients and doctors who really drive its adoption," said Graham. “I know we will all be working together across the system to ensure that efficiency is improved while protecting patient privacy. That’s the ultimate goal of any new technology.”