So far in this series, I have reviewed blockchain and highlighted the potential it presents in revolutionizing the world of clinical trials and healthcare data exchange. So far, my focus has been on accentuating the benefits of the technology and pointing out how it can play a major role in shaping the future of digital health. In this third and final blog though, I change perspectives and look into some of the challenges faced by blockchain and how they can be overcome.
To briefly recap, through its decentralized setup, encrypted & immutable data, and consensus mechanisms, blockchain uniquely lends itself to the highly regulated world of healthcare. These features allow for more secure data storage, transparency & accountability across organizations, and overall better control over one’s own data. This, in turn, contributes towards the confidence in blockchain’s ability to achieve some of healthcare’s long-standing goals like patient centricity and trusted collaboration.
However, as is the case with any new piece of technology, blockchain too has its fair share of challenges and obstacles that it must get past before it can truly shine. From logistical requirements to social stigma caused by cryptocurrency bubbles, blockchain enthusiasts and believers have their work cut out for them in making the technology mainstream and persuading critics and skeptics to look beyond their preconceptions.
In the following sections, I share my thoughts on some of the steps that can be taken by these enthusiasts and believers to address such challenges that stand in the way of broader adoption of the distributed ledger technology.
Scalability and Accessibility
One of the biggest deterrents to blockchain usage is the issue of scalability. There is abundant real-world proof of blockchains working successfully for smaller networks with limited data, but when dealing with complex data sets like EHRs and clinical trial / research data, the cracks start to become apparent. Traditional blockchain mechanisms like Proof of Work & Proof of Stake are ineffective or too costly for such solutions, thus requiring some level of trade-off between data security / integrity and efficiency.
In order to truly be able to adopt blockchain in healthcare use cases, innovative solutions need to be developed such that cost effective consensus and trust can be built without compromising on data immutability. In addition to creatively handling vast amounts of data, it is also important to ensure a user-friendly interface with better accessibility for individuals and smaller organizations that may otherwise be discouraged from blockchain due to the complex nature of the technology.
Interoperability Standards
Interoperability is a challenge faced by the healthcare industry as a whole and the case is no different for blockchain. Despite regulatory and compliance laws like HIPAA to ensure universal rules for the privacy and security of PHI, there are no standardized protocols established for healthcare data. This has resulted in multiple different systems being used by various organizations across the US.
In order for a blockchain solution to be truly successful, it must factor in all of these different existing systems and standards. While the establishment of protocols like FHIR and HL7 are steps in the direction of improving seamlessness, care must be taken to ensure inclusivity for smaller organizations that may not be up to date on these newer standards.
Pilot Programs and Proofs of Concept
As I have already touched upon above, real-world applications play a big role in building trust in the technology. Given the large infrastructure requirements for blockchain, it is natural for investors and healthcare providers alike to be apprehensive in investing time and resources towards an unproven solution. Pilot programs focused on building smaller solutions that can act as proofs of concepts for real-world applications is a good method of building that trust and alleviating worries.
Stakeholder Collaboration
Collaborations and partnerships sit at the very heart of the values represented by blockchain. For a truly successful implementation it is important to create a cohesive ecosystem of stakeholders such as healthcare providers, tech partners, regulatory bodies, and insurance companies. Beyond it being in the spirit of blockchain, a collaborative approach also ensures that the needs of all the stakeholders involved are addressed successfully.
Conclusion
While the road ahead for blockchain is definitely lined with challenges and hurdles, they are ones which can be overcome through planning, innovation, and teamwork. Collaborative and creative efforts from healthcare experts, technology providers, and policy makers can prove to be very effective in realizing the potential of blockchain and removing the skepticism that often seems to surround it.
As I said in my very first blog in this series, the biggest hurdle faced by blockchain is people’s mindset towards it. For the healthcare industry to realize how it can adopt blockchain to revolutionize the future of healthcare, it is important for those of us who believe in the technology to continue having conversations and educating others.
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