Wednesday, August 31, 2016

The Blockchain Challenge

Early this year, I posted a collaborative discussion about the potential applications of Blockchain for healthcare

Ariel Ekblaw from the MIT Media Lab collaborated with BIDMC to actually implement Blockchain medication reconciliation with deidentified patient data.

ONC selected it as a winner of the Blockchain Challenge

The idea is simple.   Blockchain was invented to handle financial transactions such as deposits and withdrawls.

Medication management is very similar to a bank account.  Think of your body as a vault.   When a clinician prescribes a new medication, a deposit is made.   When a clinician discontinues a new medication, a withdrawl is made.    If we add up all the deposits and withdrawls we end up with a perfectly accurate medication list of what you should be taking.

The advantage if this approach is that is does not require complex CCDA parsing or manual intervention to figure out what medication list is redundant, incomplete or inaccurate.   It’s simple debit/credit accounting across multiple sites of care.

I can imagine the same approach could be taken for problem lists, allergy lists, care plans, care teams, and anything that requires reconciliation of multiple lists created at different times by different people.

I highly recommend reading Ariel’s paper.    As we consider new approaches to interoperability, the blockchain concept holds real promise.  Maybe a FHIR enabled API in front of a blockchain driven health information exchange?

2 comments:

Brian Ahier said...

You have to meet the requirements of macra for clinical reconciliation :-)

M Banks said...

Awesome.Love it. Though....It will Never work. Not with Cert requirements for EHR. Not in MACRA. Makes innovation dead for at least 7 more years. MU and EHR cert may have set back things like this more than a decade. Maybe its time for you to remind CMS/ONC friends to stop EHR cert and allow innovation back into EHRs. You have to admit, we are staring at the abyss in medicine. We may be irreversibly damaged by all these complex onerous burdensome policies.