“It’s all possible with blockchain…”

You hear this over and over at industry conferences. But this time, at the Distributed: Health conference in Nashville, on 3rd October, this pie-in the-sky statement got a bit more pushback than usual.

According to many of the speakers at the show, blockchain tech stands to disrupt the complex and frustrating healthcare system in a positive way, mostly revolving around simplifying the management and transfer of health records and information.

Chris Kay, senior vice president and chief innovation officer at Humana, said during the morning keynote address:

“There’s a potential for blockchain and its enabling capabilities to solve core problems in healthcare. Healthcare is at a tipping point.”

In his mind, a blockchain — which provides trust without a central authority, security and data transparency — could marry the disparate processes in healthcare. For example, a blockchain-based health care system might provide insight into the variety of medical issues a person might be suffering from and integrate health care with the social care of family and friends.

While the biggest issues remain outside the scope of blockchain to fix – think the difficulty in choosing fresh, healthy food over McDonald’s – Kay believes busting down the silos in healthcare could be the beginning stages of a healthcare revolution.

Data needs to flow between primary health care providers, specialists and holistic medicine practitioners that a patient is using. In that way, people could get better, more targeted recommendations on what they can do to better their health.

While Kay was optimistic about blockchain’s impact on the healthcare industry, when it came to the breakout sessions, both panelists and the audience seemed more skeptical.

“Any IT person from a health organization should come in with a healthy level of skepticism,” said Andrew Beal, blockchain and distributed infrastructure lead at Ernst & Young (EY), adding:

“The tech is immature. Everything is in the proof of concept stage with dummy data and a couple partners.”

What the industry really needs

The idea that the market is too immature for production-ready services was supported by Wayne Vaughan, founder and CEO of Tierion, a blockchain proof engine, during a panel discussion.

“I would caution that nothing is production-ready right now,” he said.

That position was contested by Ted Tanner, co-founder and chief technology officer at PokitDok, a blockchain-based company focused on the healthcare industry. Tanner suggested that PokitDok’s proof-of-stake private blockchain is ready for production today.

“We have very large companies using our APIs. It’s just a matter of switching out the underlying infrastructure,” Tanner said.

But the goal, according to Jeff Cunningham, another panelist and chief technology officer at Informatics Corporation of America (ICA), a health IT company, is more about updating existing infrastructure rather than ripping it up and replacing it.

Even for an industry where settling times for claims can extend more than 180 days and health payers spent $375 billion sending out paper claims, “if there’s a better way, the costs of re-architecting are so high it doesn’t happen”, he said.

Healthcare today is largely a system of barriers. The industry itself is highly regulated, much like financial services. And this adds significant hurdles for any startup trying to enter the space.

Plus the federal government, through the Centers for Medicare and Medicaid Service (CMS) is the single largest payer of healthcare in America, so public/private entity partnerships are going to be a must.

“From a positive aspect, many of the challenges that exist in healthcare today are around complex distributed processes; it’s how the industry has grown up, all siloed,” said Cunningham. “But if you start to rethink how healthcare should look as a more complex, team-based healthcare plus finance and payment with the care, the blockchain could be the fabric to tie that together.”

The focus should be on how physicians, not patients, he said.

“For the most part to make progress in healthcare today … at least on the care side, it’s [about] how you interact with the provider,” Cunningham said. “Provider interaction will be about interacting with those physicians and how they are interacting with the technology.”

Security as a innovation motivator

Data security, from what event attendees and panelists had to say, seems to be the big driver in the push for the healthcare industry to adopt blockchain technology.

“Ninety percent of companies in this space have been affected by a data breach,” said Micah Winkelspecht, founder and CEO of Gem during an afternoon keynote. With a distributed network, there will not be a single point of failure for fraudsters to try and hack into anymore, he contended.

Others are skeptical as to whether blockchain would…

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