Should Health IT be Interested in Blockchain Technology?

blockchainOver the course of the last several years a new commerce has sprung up seemingly overnight which offers to support a global currency called Bitcoin.  The underlying technology which is used to support  and secure Bitcoin transactions, similar to ATM withdrawals or ACH/Wire payments, is called Blockchain technology.  The premise of Blockchain is that a public infrastructure of secure contracts and audit history “chains” could be established, providing a level of security which even extends beyond government controls.

However, Bitcoin is not the focus of this article.  Instead, we’re going to discuss the security problems of early US banking institutions, how they relate to modern day challenges in health IT, and how we may soon look to Blockchain to address some of those challenges.

IJesseJamesn the beginning, banks were not as hardened as they are today. How many old movies, especially westerns, featured dastardly bank robbers? The truth is they were not so uncommon in real life either, and many changes had to occur in our banking institutions because of them.  As Bitcoin has grown in popularity, it too has attracted the attention of a similarly nefarious group of characters.

To protect Bitcoin, we rely on a so-called hardened infrastructure (in a sense Wells Fargo meets the Internet).  Some early Bitcoin implementations – specifically their Blockchain architecture – suffered a similar fate as our early banking institutions. Several high profile thefts have occurred in Bitcoin’s relatively short history, the latest being Bitfinex in Hong Kong who reportedly lost $72M USD in a single theft.  This leads many critics to question the security of Blockchain, but is the technology simply too early in the hardening process to count out?

There are a number of industries across the US currently exploring whether Blockchain technology could be used in other ways to protect sensitive and confidential information.  One if these industries is US Healthcare.  As of yet, these are only exploratory discussions and exercises – not being piloted in a manner which will risk any PHI or PII (Protected Health Information and Personally Identifiable Information, respectively), or exchanging any type of information in clear-text.  A number of leading subject matter experts – individuals with a deep understanding of the current security protocols being used across the industry, from local EHRs to national health information exchanges – are working to publish new potential use cases.  One such example of note is a recent blog post by John Moehrke on Blockchain and Smart-Contracts applied to Evidence Notebook.

Later this September the US National Institute of Standards and Technologies (NIST), along with ONC and other representative Agencies and Departments will take part in a day devoted to the Blockchain and myself, @Interopguy, will be in attendance to add a perspective on approaches to testing these early implementations of Blockchain technologies, as well as the security being integrated into those solutions.

In summary, while Blockchain has hit a few bumps in the road, it’s still young – we’re going to take this  opportunity for a fresh look to see if we can truly determine, speaking of old westerns, “the good, the bad, and the ugly.”  Does Blockchain technology have a place in the future of US Healthcare?  Stay tuned, we will find out together.

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