Four ways Blockchain can be used to provide better quality healthcare

Blockchain isn’t the most interesting dinner conversation. In fact, it can often be a conversation killer as people’s eyes glaze over. Others pretend to keep up with it as everyone seems to have an opinion on Bitcoin and other altcoins. This short post hopefully simplifies the discussion.

Earlier this year, I went to HIMMS in Las Vegas. Amidst all the noise and discussion, I noticed several Blockchain providers who all had the same problem – a technology platform but no healthcare use-case or relevant example. This technology is the modern-day “solution looking for a problem.”

For the uninitiated, I’ll try to explain Blockchain in a simple way. Blockchain is not Bitcoin - they are related, but not the same. Blockchain is the technology that underpins bitcoins and other coins such as Ethereum and Litecoin and has a much wider use-case.

A blockchain is a growing list of encrypted stored records. Each block in the chain contains a jumbled-up version of the previous block (called a cryptographic hash) and a timestamp of any transaction. These previous blocks form a chain and new transactions are added on as they occur (once validated) to this chain, hence the name.

Blockchain creates a powerful ledger (a record of transactions that can be added together). This ledger is then synchronised with thousands of computers at the same time. Any changes to the ledger requires all the computers to verify the accuracy of the change, which is one of the ways that the chain restricts the ability of rogue individuals changing the record maliciously.

This simple, yet incredibly clever and versatile technology creates a fast, trusted and transparent method for two or more organisations that need to communicate and verify transactions. And this is where it can be incredibly effective in healthcare since payors, providers, patients, insurance companies and life science companies can all transact in a transparent and secure way.

I think there are 4 use cases that make the most sense to me.

1.    Warehousing and supply Blockchain. Warehousing and supply can track the delivery, storage, compliance, sales and stock levels utilising a Blockchain between payors, providers and warehousing/supply teams. This allows Just-In-Time production if needed, delivery logistics costs to be lowered and provision of drugs quickly to the hospital/care setting improving patient care. This is all done in a set of seamless transactions, removing all admin and bureaucracy and engendering trust.

2.    Payment and Reimbursement. Value based pricing and outcomes-based pricing models can be utilised effectively. To date the most common method of pricing is to discount the introduction of a new drug and increase the price as adoption increases. Blockchain allows the utilisation of true outcomes-based pricing as payors pay as outcomes are delivered, ensuring that value is achieved. This incentivises Pharma to develop high cost drugs that are effective in their value proposition, since payment would not be approved otherwise and this naturally improves patient care.

3.    Transparent de-identified/anonymised real world data (RWD). As long as the new GDPR regulations are respected, Blockchain allows for patient care to be anonymised and linked to diagnosis, procedures and prescription data which can allow for a number of RWE studies to take place. This is made easy by the transparent, secure blocks between payors, providers, patients and potentially regulatory bodies. This approach would need a commercial agreement first since the data would need to be approved for collection.

4.    Prospective real world evidence (RWE) studies using Blockchain to measure the impact of drugs as utilising the same method above, but tracking the adoption and outcomes of drugs prospectively rather than retrospectively.

Below is a suggested diagram that the team at Health iQ have developed to demonstrate how Blockchain could work in a general abstracted way to help illustrate the technology.

Jilani Gulam ( https://twitter.com/Jilani_HealthiQ ) is founder and CEO of Health iQ.