New Kids On The Blockchain

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There’s a good chance you haven’t given any thought to blockchain, yet this digital transaction system made famous by Bitcoin has the ability to revolution healthcare from the inside out. Here’s your water cooler primer.

What is blockchain? It’s become a buzzword within health tech and telemedicine, yet 99% of people still have no idea what it is. Many physicians and hospital admins see blockchain as a panacea for healthcare’s information woes, yet their eyes glaze over halfway through its explanation.

Let’s get something straight out of the gate. You don’t need to know about blockchain. Yet. Experts agree that it isn’t going to change the way healthcare is practiced any time soon. But for the future oriented, this technology can offer an important glimpse into where telemedicine is heading.

Blockchain 101
Originally devised as the undergirding of Bitcoin, the digital currency, blockchain is a digital ledger that records transactions. Think of it as an open database of information where each party on a blockchain has access to the entire database and its complete history – not unlike the way we interact with a Google Doc. No single party controls the data or the information. Every party can verify the records of its transaction partners directly. What makes this revolutionary is that by its structure it eliminates the need for third party verification, such as one might require from a bank or insurance company.

“Above anything else,” writes the author Ian Khan, “the most critical area where Blockchain helps is to guarantee the validity of a transaction by recording it not only on a main register but a connected distributed system of registers, all of which are connected through a secure validation mechanism.”

Once an event is recorded into the database and the accounts are updated, the records cannot be changed or deleted.  Events, recorded as “blocks,” are linked to the events that directly proceeded them and linked together (hence the term “chain”).  A lot of complex algorithms, math, and technological wizardry are used to verify chronicity, permanence, and appropriate access to others on the network.

Healthcare Applications
Imagine that Hospital A wants to add an admission note as an event to the Patient Record B. This event is broadcasted to the network of other members holding a copy of the blockchain for validation that this event is real and accurate.  The network verifies that this event is valid and accurate (using that tech and math wizardry we spoke about). The event is added to the blockchain permanently. The database is automatically updated for all members of the network now ready to accept the next transaction or addition to the blockchain.

Why is this important? We now have created a highly secure dataset that is not bound to an intermediary and is still openly accessible to parties who have the correct permissions. Blockchain’s greatest potential is to standardize secure data exchange, deemphasizing the healthcare system as the keeper of data and placing the patient at the center.

There you have it. The oversimplified, health-oriented explanation of blockchain.  Still a little lost? Don’t worry, blockchain needs a more time before its ready for primetime, and healthcare applications need even longer.    

Blockchain is already coming to healthcare. Here’s a sampling:

Gem Health:
Started in April of 2016, Gem Health is working with Phillips as its first partner to promote collaboration in the healthcare space using blockchain.

Utilizing the Ethereum blockchain, MedRec manages medical records and gives user access to census level data for both research and clinical purposes.

Launched DokChain, a blockchain platform to better augment its existing services, including checking patient insurance eligibility and incorporating bitcoin payments with insurance providers.

Illustration by Erin Lux


Contributing Editor
Dr. Madhok began his career as an emergency physician at New York Presbyterian Medical Center before moving to the West Coast to pursue med tech startups. Madhok as served as the technical lead for EMCounter, the informatics chair at the Pediatrics for Physicians Network, and currently serves as the Chief Medical Officer at NS1ghter.

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