The healthcare blockchain use cases and value proposition
The healthcare industry has reached a good understanding of blockchain use cases and the value this technology can create in the industry. There are many blockchain opportunities in health care that can be categorized as follows:
1) Supply chain. The one use case getting most momentum across pharma currently is around counterfeiting. Controlled substance monitoring, Cold Chain monitoring and monitoring the source and provenance of active pharmaceutical ingredients are additional use cases which position the drug supply chain as the most obvious candidate for improvement with blockchain, bringing transparency, trust and a drug supply system that is more efficient and less expensive to operate in.
2) Clinical trials. With clinical trials being highly regulated and requiring a multi-site and multi-entity collaboration, there is a number of use cases around the clinical trial data tracking, regulatory reporting, end-to-end tracking and sharing of the safety data between license partners. In this field, benefits for the ecosystem participants that use blockchain technology will translate into tangible savings, e.g. a distributed immutable no-cost audit trail.
3) IoT, Patient devices. Blockchain can be used to exchange health-related data in a secure and efficient way between devices connected to the Internet of Things (IoT), wearables, and mobile devices.
4) Health Data marketplace: As a natural evolution of health-related data exchange, a number of initiatives aim at creating the infrastructure for a secure and privacy-compliant data marketplace for personal health data. The marketplace will allow individuals to trace data usage and to benefit from its monetization. As an example, the HIT Foundation is the first ecosystem that allows its participants to be rewarded for sharing health information digitally instead of paying others to process or store it. In the last weeks, Nebula Genomics announced a genomics data market place.
5) Consent management and EMR. Blockchain can be leveraged to manage consents. In practice, the proof of existence for consent will be timestamped and stored in Blockchains, enabling clinical research stakeholders, such as sponsors, investigators and IRBs, which can be numerous in multi-center clinical investigations, to share consent and re-consent related data in real-time, archive and historicize consent sets, which can be matched with each revision of the protocol. The blockchain can also securely store health records and maintain a single version of the truth.
What prevents blockchain adoption in Healthcare?
As one can see, blockchain promises to improve the way medicines are developed, manufactured and delivered to patients — all while increasing the trust between all involved parties. Most of the big pharma have made a number of experiments. There is an increased interest across the industry to adopt blockchain and create value; however, initiatives continue to be driven by a limited number of industry members and consultancies. If the healthcare blockchain market grows ( see Open-source landscape map for healthcare-related blockchains), an uncoordinated approach runs the risk that benefits to patients and the industry may take many years to mature and materialize, especially considering the environment’s complexity and amount of coordination required to achieve tangible outcomes.
Why do we need a Healthcare Blockchain Consortium?
As one can appreciate, most of the use cases involve several parties and are “ecosystem”-driven. This is not a big surprise, considering that one of the main value propositions of the blockchain is to create trust. Blockchain is a technology that requires collaboration to be effective, which is why companies — both allies and competitors — need to work together to define standards and to enable the development of new infrastructures.
The finance industry has equipped well-funded and -staffed consortia that have attracted leading industry players. As an example, R3 consortium has received more than $100 million funding and includes more than 80 of the world’s largest financial institutions, regulators, and central banks. Another consortium is the B3i, the Blockchain Insurance Industry Initiative dedicated to developing trading platforms across the whole insurance value chain using blockchain-based technologies. The number of consortia by sector is referenced below:
Source : Banding together for blockchain (Deloitte)
There is a number of technology consortia such as the Hyperledger one, the Enterprise Ethereum Alliance with dedicated Healthcare Working Group or IEEE. These technology consortia however are de facto not « technology agnostic » and focus primarily on implementing technology for specific use cases. Such consortia will not drive the necessary industry standards, standards that need to be business use cases driven.
What should a Healthcare Blockchain Consortium look like?
A Healthcare Blockchain Consortium needs to be business focused and aimed at defining Standards for interoperability, for information stored in the blockchain and for medical devices integration. Starting from business use cases and agreed industry requirements, such consortium would make agreements or recommendations on the technology foundation and would define and implement an architecture framework for an industry-wide blockchain network. The architecture framework will be vendor agnostic and will include design of processed, system, data and organizational model for adoption by industry and health care providers (HCP).
Such consortium would have also a key role to play to align with existing and anticipated healthcare regulations (Such as DSCSA for sellable returns, FDA, EMEA, … ) and would also have a need to drive the shift of mindset and drive a fast adoption in the industry.
There is a few critical factors for Healthcare Blockchain Consortium to be successful:
1) The first would be to secure a significant investment and several years’ worth of commitment to technical implementation. As a reference, R3 consortium has a 100 $M investment.
2) Second is membership. To achieve its goals, such Healthcare Blockchain Consortium needs to integrate the major actors of the pharmaceutic industry, the patient representatives and Public health institutes, the regulatory agencies, the payers, the academia and the solution builders.
3) Third is governance. The consortium needs good governance structures to facilitate consensus around standardization issues and to be capable of getting traditional competitors to collaborate and work together. A number of smaller subgroups will be required to work on delineated issues and to provide several levels of potential engagement, ranging from participation in monthly calls to active technology development. In a spirit to leverage the good practice already defined, the blockchain consortium needs to interconnect and leverage the various existing working groups.
4) Fourth is the agility. Many of consortia have failed to deliver due to time to make decision or long roadmap to provide outcomes. Considering the pace of technologies and the business expectation to get rapid outcomes, it is essential that such consortium runs with an agile mindset and with the objectives to have concrete and tangible deliverables every quarter.
5) Fifth would be collaboration/integration of work with start-up. Blockchain is still in its early years of adoption, with foundational development still in progress. There is a need to partner/sponsor some of the start-ups and to periodically review technology stack decision / recommendation once new technology becomes available.
Time is of the essence, we need to act now!
“Business-driven Healthcare Blockchain consortium will be critical to unlocking mass-scale value and accelerating the adoption of blockchain technology”. The primarily value will be for patient, not only by putting the patient data in the right hands, but also by protecting the patient against counterfeiting or by making sure that the adverse events are well processed end to end. This will also bring treatment sooner to patient by reducing the time and cost of clinical trials, and allow for novel treatments to be found more easily, thanks to the potential leverage of the huge data market place combined with machine learning. Time is of the essence, we need to act now!
Thanks to Zoya, Marco, Dan, and Sebastian for their valuable input, review, feedback, and help with thinking things through.
Please let me know what you think about this post, and if you have any recommendations for further reading on the topic, please let me know, too!