Interoperability, Blockchain, and Other Dark Arts of Healthcare Data

A blockchain is essentially a peer-to-peer network with a unique security protocol that makes interference with the data practically impossible. It’s no wonder that banking is the poster child of blockchain, where the motivation to avoid central banks is strong, and the data passed between each node is unambiguous and static.

If I send you one bitcoin at 1:00 UTC on the first of April, then these data are not subject to interpretation; they’re facts that are set in stone on the blockchain, and it works great for that.  

However, let’s rewind to earlier in this conversation [found here in full Q&A] where we spoke about the subjective nature of provider data passed between parties. By avoiding the central server, blockchains also exclude the important role of that central server to normalize the data for its intended audience. And that’s its first strike.  

Another attractive value proposition of blockchains is that they ensure that the data can’t be tempered with between sender and recipient. For applications like provider directories, which are often touted as potential use cases for blockchain, this is solving a problem that quite frankly doesn’t exist. I’ve never heard of a case where somebody hacks a provider roster file as it moved between a provider group and a health plan. That’s not the underlying problem, and that’s strike two.  

Finally, blockchain only works when everyone shares a blockchain. Look at our experience with HIE and EMR, electronic medical records. We’re a decade into that journey, and there’s no line of sight to a national platform or a single unifying technology. There’s nothing inherently in blockchain that would address the commercial, political, or regulatory hurdles that have gotten in the way of HIE and EMR. And, quite frankly, that’s strike three.  

Now having said all of that, we do believe that small blockchains will exist between closely related parties that share a common set of data standards, and they’ll integrate with other networks or even other blockchains via a central server. To prove this point, we seamlessly integrated a provider data blockchain into the California Symphony Network to show how this hybrid approach can work, but that’s material for a whole other conversation.