Halamka on the ONC Blockchain Challenge

Dr. John D. HalamkaEarly this year, I posted a collaborative discussion about the potential applications of Blockchain for healthcare. Ariel Ekblaw from the MIT Media Lab collaborated with Beth Israel Medical Center (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?