When IBM and the FDA are working together on blockchain technology for healthcare, it’s a clear sign we should take it seriously. IBM Watson Health has entered a research initiative with the FDA to design a blockchain approach to exchanging health data.
The problems to address
Healthcare information sharing needs to simultaneously satisfy the requirements of security and availability. Blockchain technology provides a “highly secure, decentralized framework for data sharing that will accelerate innovation throughout the industry,” in the words of Shahram Ebadollahi, IBM Watson Health’s Chief Science Officer.
A survey by the IBM Institute for Business Value found that seven in ten of the industry leaders polled expect high benefit levels from blockchain in clinical trials, regulatory compliance, and medical records. From the standpoint of patients, a blockchain approach will help the in getting access to their own data and sharing their information securely.
This is the “long data” (longitudinal data) issue. Long data is all the information relating to a subject, however many sources it comes from. Blockchains are designed for bringing together many data sources in one place.
Because of federal requirements, many healthcare facilities have adopted Electronic Medical Records (EMRs). Sharing them, though, is currently difficult because they contain highly sensitive information and there’s no standard way to share them securely. Healthcare facilities have often been unable to share EMR data securely even with other facilities in their own group. The blockchain initiative aims at removing these barriers to sharing information.
IBM announced the agreement on January 11, 2017, and the initiative will cover a two-year period, but initial findings should be available in 2017. The initial focus will be on oncology.
Blockchain with identities and permissions
The blockchain approach in this initiative comes from the Hyperledger project. It differs in important ways from the better-known Bitcoin implementation:
- Bitcoin deals in cryptocurrency. Hyperledger doesn’t.
- Bitcoin participants are anonymous. The Hyperledger blockchain uses verified identities, but anonymity is available where it’s appropriate (e.g., clinical trials).
- The Bitcoin network is permissionless; anyone can participate. The Hyperledger blockchain network is permissioned, meaning that only authorized participants can contribute to it.
- Anyone can read the transactions in the Bitcoin blockchain. The transactions in the healthcare blockchain will be cryptographically protected.
- “Smart contracts” in which specified conditions trigger actions are part of the Hyperledger technology. Bitcoin doesn’t include them.
- In Bitcoin, a method called “proof of work” generates consensus on blockchain transactions. It’s often slow. Hyperledger uses a method called PBFT, which resolves transactions more quickly and is more scalable.
The key common feature is the use of a tamper-evident ledger, with multiple copies to assure its authenticity. This means that the information is widely available and very difficult to change improperly.
The promise for healthcare
Several startups have already experimented with blockchain approaches to healthcare records. IBM reports that 16% of the healthcare executives surveyed are planning some form of adoption in 2017. However technically sound the existing approaches are, their value is limited unless one of them gets wide acceptance. The entry of IBM, in collaboration with the FDA, has a better chance of setting a standard that everyone will have confidence in.
The collaboration will examine the use of data from multiple sources, including EMRs, mobile and wearable devices, and Internet-connected medical devices. Combining these sources will allow nearly real-time updates of patient status in the blockchain. Authorized healthcare providers will have up-to-date information on patients without having to struggle through paperwork. The result will be more effective treatment and more time available to spend with patients.
If it succeeds and gains widespread adoption, the blockchain healthcare initiative promises major advantages to both providers and patients.