Sharing technologies like blockchain could help healthcare institutions establish a consistent, accurate, and trusted approach to data collection and dissemination.
As the healthcare industry moves towards digitization, there are signs of progress and a need to address more sensitive issues such as data sharing and privacy across networks and organizations. Healthcare is perhaps unique in that it can collect and share a vast amount of extremely personal data about individuals, while at the same time maintaining unmatched levels of privacy and patient disclosure of that information.
Recently, healthcare facilities have also been expected to provide pricing consistency and transparency, an equally gargantuan task given the complexity of the industry, which only 14% of hospitals accomplish.
While the ecosystem presents seemingly insurmountable challenges, here is an opportunity to address the issues with both existing and emerging technology.
Recent regulations such as the 21st Century Patient Spa Act and the Price Transparency Judgment have created a basis and standards for data sharing between healthcare institutions. A range of data assets and data-driven products – such as publicly available datasets such as social determinants of health, digital twin data, AI models for risk stratification, etc. – are available in formats that enable fast and secure data sharing.
Modern tech stacks for new healthcare products are based on a modular framework with microservices and application programming interfaces (APIs) that enable rapid compatibility with platforms. Agencies responsible for managed care, such as the Centers for Medicare & Medicaid Services (CMS), have also pushed the need for efficiencies and cost savings in health care delivery. Technology is a core competency to achieve this. Consumers are demanding more technology-enabled care pathways tailored to their unique lifestyle and health conditions. And we now have access to scalable and relatively inexpensive services like blockchain that are capable of building fast and resilient networks of trust.
These regulatory, market, technological and consumer forces are the key sources of complementarities in the ecosystem. Why are solutions so long in coming?
A major problem in healthcare is the slow adoption of new technologies. Partly due to regulatory pressures, privacy and security concerns, the problem is exacerbated by the lack of open architecture (by design) of established systems like electronic health records (EHRs). Finally, there is a general reluctance to adopt technology that might disrupt the normal functioning of a healthcare system, agency, or healthcare plan.
Healthcare needs platforms built for trust
One approach that would enable controlled testing of new technologies and faster adoption would be for the healthcare industry as a whole to develop a platform-based ecosystem consisting of a developer platform and a trust framework for permission-based access to data and objects. Blockchain comes to mind as an available technology that could handle the necessary complexity and privacy to make this happen.
Unfortunately, the bottlenecks in the implementation of this approach are manifold. First, a critical mass of healthcare organizations would need to sign up for such a platform. Many existing legacy systems within these institutions would need to be retooled to interface with this platform. Because it is a long-term project with multiple installations, tests, and training to make it work, the return on investment (ROI) for this working system cannot be realized in a short period of time.
A critical mass of IT developers would need to collaborate across the industry to either rewrite the legacy programs or develop interfaces compatible with the platform. Access to more healthcare facilities as a potential market would attract more of these developers and create a smooth path to adoption. Scaling this network effect would likely require a large upfront investment in building the platform. At the same time, healthcare facility leaders needed to be brought on board and show an active willingness to overturn outdated methods of technology adoption.
Since developers bring the most value to this ecosystem, the initial table stakes will likely need to be free or even compensated for the initial mass of popular products. These developers must carefully review the technology and fine-tune capabilities to customer needs in a detailed and rapid manner.
Healthcare facilities must transform their operations to include “innovation labs” that are serious about inviting new technology into their previously closed systems, albeit in a controlled manner. A slowdown in product purchases and adoption could cause developers to lose interest in continuing to build for the platform; This can be countered by change managers continuing to challenge orthodoxy across the organization, especially when the value chain can be broken down into finite elements and addressed through technology. An example of this could be using an optical character recognition (OCR) application to read complex unstructured contracts and feed them into an intelligent database.
While it may seem like a stretch to many of today’s industry leaders, I believe this type of highly functional, trust-based ecosystem could go a long way towards solving many of the deep-seated problems in the US healthcare system.
Bhrugu Pange is Managing Director and leads the Digital & Technology practice at AArete, a global management and technology consulting firm.