Brad Pedrow, director of compliance risk at Chicago-based Grant Thornton's healthcare and life sciences practice, discusses areas of healthcare where blockchain has helped to advance, from managing clinical trials' data and EMRs to supply chain tracking and revenue management.
Responses have been lightly edited for clarity and length.
Question: Where is blockchain in healthcare now and how will it develop in 2019?
Brad Pedrow: Blockchain usage in healthcare has moved into the 'fast follower' phase. We see use cases developing in managing clinical trials' data, EMRs, outcome-based contracts, supply chain tracking and revenue management, to name just a few. One benefit from these early implementations is the recognition that consensus among stakeholders across the healthcare spectrum is necessary for success. Accordingly, in 2019, as that recognition grows, we predict steady advances and broader application of blockchain applications in healthcare.
Particularly, we expect to see drug traceability blockchain move from pilot and narrow-scope application to broader, national solutions in response to requirements to comply with the Drug Supply Chain Security Act. The DSCSA was designed to focus on efficiency, compliance and counterfeit prevention; the features intrinsic to many blockchain architectures that enable a focus on precisely the same things.
Given the increase in collaboration among healthcare participants, the increase in data traceability that blockchain promises, and the compliance mandates of the DSCSA, we envision 2019 will bring substantial developments that leverage blockchain technologies in healthcare. In turn, we believe the efficiency and integrity of these developments will increase both the quality and the efficient delivery of care, thereby reducing the total cost of care over time.
Q: What do you think will be the most significant blockchain applications in healthcare over the next five years?
BP: Blockchain technology can transform healthcare enterprises by enabling the evolution of new business models and new ecosystems. The long-term promise of blockchain is its ability to drive standardization across the healthcare landscape and to increase the safe, secure accessibility of healthcare data for analyses previously unimagined. Within five years, we will likely see pilot solutions that focus on patient-record security, allowing patients to better 'own' their data, supply chain traceability mandated via the DSCSA, and finance use cases around pre-authorization of services. We also anticipate blockchain solutions will facilitate more personalized medicine and outcome-based decisions in a manner that better connects providers, payers and the supply ecosystem within a more interconnected platform.
Q: What do health IT leaders at hospitals and health systems need to know about blockchain today?
BP: Leaders will need to contemplate the age-old pressures that they've always considered — vis-à-vis innovation in healthcare — namely, whether their regulatory agencies will respond in a timely enough manner to support innovation but carefully enough to protect the safety and efficacy of healthcare. This tension is often cited as the cause of lags in technological advancements in healthcare compared to other industries. To address this tension properly, healthcare leaders will need to engage regulatory agencies early and often in the development of blockchain use cases.
For reasons related to this tension, healthcare providers may be laggards when compared with players in the life sciences and payer sectors. That said, leaders within all healthcare segments need to be mindful of this tension and of the need to engage regulators. With this tension properly considered, the more traditional considerations of first-mover advantage, return on investment, data interoperability and change management can be contemplated in ways that advance the delivery of quality healthcare and maximize the impact of blockchain adoption.
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