Scaling Blockchains to Support Electronic Health Records for Hospital Systems

Electronic Health Records (EHRs) have improved many aspects of healthcare and allowed for easier patient management for medical providers. Blockchains have been proposed as a promising solution for supporting Electronic Health Records (EHRs), but have also been linked to scalability concerns about supporting real-world healthcare systems. This paper quantifies the scalability issues and bottlenecks related to current blockchains and puts into perspective the limitations blockchains have with supporting healthcare systems. Particularly we show that well known blockchains such as Bitcoin, Ethereum, and IOTA cannot support transactions of a large scale hospital system such as the University of Kentucky HealthCare system and leave over 7.5M unsealed transactions per day. We then discuss how bottlenecks of blockchains can be relieved with sidechains, enabling well-known blockchains to support even larger hospital systems of over 30M transactions per day. We then introduce the Patient-Healthchain architecture to provide future direction on how scaling blockchains for EHR systems with sidechains can be achieved.

The full article can be downloaded below.  

In recent months, momentum has grown for new federal legislation governing the privacy of consumer data, including health data. Learn about what's ahead for the year, specifically the bills that have already been introduced or are in the works, their status, and what’s likely to move forward. 

A link to the presentation slides can be found at the bottom of this page.

Speakers

Alice Leiter, JD
Vice President & Senior Counsel

Alice is a health regulatory lawyer with a specialty in health information privacy law and policy. She previously worked as a Senior Associate at the law firm Hogan Lovells, where she worked with clients on Medicare and Medicaid pricing and reimbursement. Alice spent several years as policy counsel at two different non-profit organizations, the National Partnership for Women & Families and the Center for Democracy & Technology. She currently sits on the DC HIE Policy Board, as well as the boards of Beauvoir School, Educare DC, and DC Greens, the latter of which she chairs. She received her B.A. in human biology from Stanford University and her J.D. from the Georgetown University Law Center. Alice and her husband, Michael, live in Washington, D.C. with their four children.

Alaap Shah, JD
Attorney at Law, Epstein Becker and Green

Alaap B. Shah is a Member of the Firm of Epstein Becker and Green in their Healthcare and Life Sciences group.  Mr. Shah advises clients on compliance and risk management issues related to federal and state privacy and data security laws and regulations, cybersecurity, data breach, digital health and data asset management strategies.  He has established compliance programs, conducted privacy and security risk assessments, established trust networks for data collection and sharing, provided guidance regarding development of compliant digital health solutions, responded to data breaches, and managed government investigation issues. Prior to joining the firm, he served as Senior Counsel and Chief Privacy and Security Officer at the American Society of Clinical Oncology where he helped establish CancerLinQ, a big data initiative focused on improving quality of care by harnessing cancer patient medical information.

The economy of connecting

Right now, patients don’t know their own strength. But as they wake up to their emerging role as keepers of their own healthcare data, the economic clout that comes with ownership will hand them a controlling stake in the new business models that are set to disrupt traditional financing across the sector.

Forecasts give a strong indication of the potential scale of that role – and the reasons why technology startups, insurers, providers and researchers are gearing up for the age of value-based health, in which patients will trade their data as currency, investing in their own care outcomes and the tools that will help to identify and realise them.

The full Healthcare IT News article can be viewed at this link.  

2020 Predictions: The Health IT Year Ahead​

When I started my career almost 40 years ago, I had no idea just how gratifying it would be to work in an industry devoted to helping people get, feel and stay better. Focusing on the IT side of healthcare has been nothing short of inspiring, always pushing forward, proactively paving the way to safer, more secure patient care.

I’ve learned a lot along the way, and look forward to what’s next. My bet is that safety and security will be at the wheel in 2020. I recently shared my top predictions of what we can expect in the year ahead with MedCity News. Check them out below:

1. Trust emerges as a major competitive differentiator
2. Information blocking rules will matter
3. The real-world impact of price transparency becomes evident
4. Time to therapy for specialty medications decreases with better information flow
5. Artificial intelligence chips away at the cognitive burden on physicians
6. Opioid prescribing becomes smarter
7. Pharmacies become sites of care delivery
8. Consumer-oriented digital health services are challenged to mature

The full Surescripts article can be viewed at this link.  

What will 2020 bring for medicine and science? We asked 16 leaders for predictions

Last year, when we asked science and health care soothsayers to peek ahead to 2019, they told us that methamphetamine use would rise (it did), tumor organoids would near clinical use for personalizing cancer treatment and better targeting clinical trials (that’s happening), and price transparency wouldn’t bring lower health spending (that’s true, too). But nobody predicted the outbreak of lung injuries tied to vaping, the failure and attempted resurrection of Biogen’s Alzheimer’s drug aducanumab, or the restoration of cellular functions in pig brains after death.

We’re back with a new set of predictions for 2020. Let’s see how our experts do this time.

The full STAT article can be viewed at this link.  

Inside the 2019 Forbes Healthcare Summit

Healthcare is a $3.75 trillion dollar industry that touches every aspect of our lives. It’s also facing a number of challenges, from rising drug prices and the fragmentation of medical records to antibiotic resistance and more.

At the eighth-annual Forbes Healthcare Summit, which took place in New York City December 4-5, the brightest minds in healthcare converged to find solutions to these and other challenges facing the healthcare industry. Here, learn about key takeaways they shared on the future of healthcare for the brain, body and business.

Best Practices 

1. Eradicating the Mental Health Stigma - In an engaging discussion moderated by Dr. Mehmet Oz, media personality Charlamagne tha God, former congressman Patrick Kennedy, and NFL wide receiver Brandon Marshall discussed their own struggles with mental health and the importance of reducing the stigma around it so that people can get the help they need.
2. Replacing Antiquated Regulations with Market-Friendly Policies - Seema Verma is the administrator of Centers for Medicare & Medicaid Services, but she doesn’t think her office has all the answers in healthcare. “Government is not the solution, and government is often the problem,” she said. Her team spends a lot of time unraveling past policies that no longer apply to the way healthcare works today, she said.  Though Verma doesn’t always think government is the solution, she does think it can nudge the system toward more free-market principles—such as an increased emphasis on price transparency for medical treatments and drug prices.
3. Improving Patient Care with Better Data - Forty years after founding Epic, billionaire CEO Judy R. Faulkner shared a rare look inside the clinical database and healthcare software company. Considering the future of electronic health data, she predicts a Cambridge Analytica-esque challenge: the risk that family members’ data will be compromised by a members’ data authorization.
4. Saving Costs by Focusing on Primary Care - Moderator Moira Forbes joked with Sir Andrew Witty, President of UnitedHealth Group and CEO of Optum, about the mystery surrounding his company. “It is one of the biggest healthcare companies that no one knows anything about,” she said. Yet while many people may not know the inner workings of Optum, it touches millions of healthcare consumers across the U.S. What makes the company so profitable? A focus on efficiency without compromising patient care, Witty said.
5. Bring Technological Innovation to Emerging Markets - Partners in Health cofounder and Harvard Medical School professor Paul Farmer reflected on progress he made in 11 resource-poor countries the past 32 years, tackling widespread diseases like AIDS, tuberculosis, ebola and malaria. Asked what new technologies have been most critical in his mission, he emphasized that definitions of “technology” in healthcare should include vaccines, therapies and diagnostics—not just devices and gadgets.
6. Empowering Patients with AI and Telecommunications - How do you help patients make better health choices? Empower them to take control of their health with telemedicine, three digital health companies said. 

The full Forbes article can be viewed at this link.  

Hospital execs say they are getting flooded with requests for your health data

Hospitals, many of which are increasingly in dire financial straits, are weighing a lucrative new opportunity: selling patient health information to tech companies.

Aaron Miri is chief information officer at Dell Medical School and University of Texas Health in Austin, so he gets plenty of tech start-ups approaching him to pitch deals and partnerships. Five years ago, he’d get about one pitch per quarter. But these days, with huge data-driven players like Amazon and Google making incursions into the health space, and venture money flooding into Silicon Valley start-ups aiming to bring machine learning to health care, the cadence is far more frequent.

“It’s all the time,” he said via phone. “Often, once a day or more.”

Hospitals have access to vast amounts of people’s health information, including lab and imaging results and medication lists. This data can help software programmers train their systems to recognize patterns that in turn can lead to better care. For example, it can help recognize signs of disease to make a diagnosis. But health systems administrators say it could also be used in unintended or harmful ways, like being cross-referenced with other data to identify individuals at higher risk of diseases and then raise their health premiums, or to target advertising to individuals.

The full CNBC article can be viewed at this link.  

Why Big Tech Companies Won’t Solve Healthcare’s Biggest Challenges

With a combined market cap of more than $2 trillion, technology giants Google and Apple are placing big bets on disrupting the $3.6 trillion healthcare industry. 

Earlier in the year, Apple CEO Tim Cook repeated a claim that “there will be a day we look back and say Apple’s greatest contribution to mankind has been in healthcare.” Meanwhile, Google Cloud CEO Thomas Kurian wrote in September that “we can transform healthcare and improve lives.” 

Based on their past innovations (and earnings), there are very few things Apple and Google can’t do. One of those things, I predict, will be transforming healthcare. 

Three announcements last month suggest that Google and Apple stand to make a lot of money on health-related products and services. But none of their recent acquisitions or consumer plays will make a substantial impact where it matters most: On the quality and cost of U.S. healthcare. Here’s why. 

1. Consumer Preferences Are Different Than Medical Needs 
2. No Major Tech Company Is Willing To Accept Medical Liability
3. Tech Companies Will Face Major Data-Ownership Issues Ahead  

The full Forbes article can be viewed at this link.  

Applications of Blockchain Technology for Data-Sharing in Oncology: Results from a Systematic Literature Review

Timely sharing of electronic health records across providers, while ensuring data security and privacy, is essential for prompt care of cancer patients, as well as for the development of medical research and the enhancement of personalized medicine. Yet, it is not trivial to achieve efficient consent management, data exchange, and access-control policy enforcement, in particular, in decentralized settings, and given the gravity of the condition such as cancer. Using blockchain technology (BCT) has been recently advocated by research communities and gained momentum from the industry perspective. However, most of the proposed solutions are at the level of a prototype, and blockchain-based healthcare data management systems are not in place yet.

This paper presents a systematic literature review, aiming to analyze the motivations, advantages, and limitations, as well as barriers and future challenges faced when applying the state-of-the-art distributed ledger technology in oncology. We then discuss its outcomes and propose the direction of the future research that can help to attain integration and adoption of the BCT for data-sharing, medical research, and the pharmaceutical supply chain in oncology, as well as in healthcare in general.

BCT has the potential to enhance data-sharing (for primary care and medical research), as well as to attain optimization of the pharmaceutical supply chain by bringing properties such as transparency, traceability, and immutability to the applications. However, BCT itself cannot guarantee data privacy and security. Thus, it is never proposed as a stand-alone technology, but as a combined technology with cryptographic techniques. Regardless of the number of existing prototypes of blockchain-based healthcare systems, due to the existing barriers of the adoption (e.g., legal, social, and technological limitations), there is a lack of evaluation in real-world settings. Aiming to overcome these limitations, we propose future research directions that include design of the privacy-preserving hybrid data storage, interoperable infrastructures and architecture, and are compliant with the international laws and regulations.

The full article can be downloaded below.