ONC seeks proposals for using blockchain in healthcare

Agency sponsors a challenge to elicit ideas for how this advanced technology could solve difficult problems in health IT.


A federal agency wants to take a closer look at proposals to use blockchain technology in healthcare.

To solicit potential uses for blockchain, the Office of the National Coordinator for Health Information Technology is sponsoring a challenge that’s seeking ideas for the use of the advanced IT technology.

In the challenge, announced last week, ONC is soliciting white papers on the technology and its potential use in health IT “to address privacy, security and scalability challenges of managing electronic health records and resources.”

Blockchain operates as a distributed, secure transaction ledger that uses open-source technology to maintain data. Records are shared and distributed over many computers of entities that do not know each other; records can be time-stamped and signed using a private key to prevent tampering.

According to ONC, a variety of potential uses are possible within healthcare, including:

  • Digitally signing information.
  • Enabling computable enforcement of policies and contracts.
  • Managing Internet of Things (IoT) devices.
  • Distributing encrypted storage.
  • Ensuring distributed trust.

Individual investigators or teams can submit white papers no longer than 10 pages describing the proposed subject. A panel of judges will pick as many as 15 of the submissions, eligible for cash prizes of $1,500 to $5,000. Eight of the winners may be invited to present at an upcoming industry-wide workshop on September 26 and 27.

ONC says it’s looking for ideas for using the technology can advance industry interoperability needs expressed in its Shared Nationwide Interoperability Roadmap, as well as for patient-centered outcomes research, the Precision Medicine Initiative (PMI), delivery system reform and other healthcare delivery needs. ONC also wants recommendations for blockchain's implementation within current HIT approaches.

Blockchain technology represents a radical departure from current approaches for storing and managing healthcare information, in which data is kept in a centralized environment, with a central authority holding the data. With blockchain, the entire network of combined computers is responsible for the integrity of the data.

Blockchain uses a simple approach to store highly sensitive information. The distributed database maintains a list of data records, but the list isn’t static and can be increased to add more records. The database consists of data structure blocks, which hold the data; information contained in the database is time-stamped and validated. Each block includes a “hash” identifier from the previous record block, and those hashes help link the blocks together into a virtual chain.

Transactions are stored on the block chain; transactions are created by the participants who use the system. Blocks record and then confirm when, and in what order, transactions are logged on the chain.

In healthcare, blockchain technology would offer the flexibility to incorporate the information from patients who receive treatment from various providers, which would be able to virtually connect to one network, work on shared information and collaborate with peers, without exposing information to theft or forgery. That’s because blockchains use a protocol that produce a log of network activity that is both secure and able to be relayed across distribution networks.

Blockchain would enable providers to work on patient data, and their interactions would be recorded in secure manner, paired with a log of network activity that provides an indisputable record of who posted records and include evidence of when changes were made.

The technology is not without significant challenges. For example critics contend that it would take enormous processing power and specialized equipment that would exceed potential benefits. And they note that blockchain technology is still evolving and maturing, especially in for its potential use within healthcare.

“Blockchain won’t fix interoperability overnight,” contends Jody Ranck, CEO of Krysalis Labs. “Some believe that it’s a way for patients to take more control over their data, and give them more control over who they share data with.”

Ranck lists a variety of potential applications for blockchain in the healthcare industry:

  • Medical banking between dis-intermediated parties
  • Distributed EHRs
  • Inventory management
  • Forming a research “commons” and a remunerative model for data sharing
  • Identity verification for insurance purposes
  • An open “bazaar” for services that accommodates transparency in pricing

More information on the ONC Challenge opportunity can be found here.

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