Healthcare interoperability research propositions of the ONC blockchain challenge

One paper moves past theoretic results to practical research domains exploring the autonomous monitoring of ubiquitous medical devices using blockchain technologies.

The National Institute of Standards and Technology (NIST)in partnership with the Office of the National Coordinator for Health Information Technology (ONC), requested healthcare and technology leaders submit research papers to explore the “use of blockchain in Health IT and Health-released Research.

One submission titled, Co-Creation of Trust for Healthcare: The Cryptocitizen Framework for Interoperability with Blockchain, in particular addresses future research propositions within the paper.  The co-authors submit that there are three primary areas in need of further research including the monitoring of medical devices.

The paper was authored by Peter Nichol and Jeff Brandt. Peter Nichol is an expert in digital, innovation, and healthcare. Jeff Brandt is an expert in mobility, security, and healthcare. Together they co-authored a paper for the ONC Blockchain Challenge titled, Co-Creation of Trust for Healthcare: The Cryptocitizen Framework for Interoperability with Blockchain.

Autonomous monitoring of ubiquitous medical devices

The immutability of blockchain can improve access to medical information. How will care change over the next three to ten years? Will the definition of treatment change? Today, when we think of preventative thoughts of a physical doctor appointment rise to the top of mind. Tomorrow robotics, nanobots, and nanomachines may be a common part of the new definition of preventative.  The co-authors present the concept of blockchain being leveraged for healthcare device maintenance, where nanomachines will autonomously communication device-to-device.

“Device-to-device distributed sharing will create a new market for semi-autonomous devices. These devices – such as delivery robots providing medical goods throughout a hospital autonomously or disinfection robots that interact with people with known infectious diseases such as healthcare-associated infections or HAIs – will be reporting information not to a central authority but to other devices. Medical nanotechnology is expected to employ nanorobots that will be injected into the patient to perform work at a cellular level. Ingestibles and internables bring forward the introduction of broadband-enabled digital tools that are eaten and “smart” pills that use wireless technology to help monitor internal reactions to medications. Medical nanotechnology is just the beginning.” 

Monitoring Afib with the blockchain

The research proposition adds color to the how medical device maintenance is possible with blockchain with an example.

“The following is an example of how blockchain technologies could manage medical devices. A patient named John, with atrial fibrillation, is having an atrial defibrillation device implanted: commonly known as an Afib device. This implantable defibrillator allows quick restoration of the sinus rhythm by administering a low-energy shock. The Afib device was manufactured by company “X” with a serial number “Y.” During manufacturing, a blockchain was created to track this device. The US Food and Drug Administration (FDA) mandated that a hash of the unique device identifier (UDI) be stored in the blockchain along with other pertinent information. The hash of the device information is stored and verifiable in an immutable digital ledger. The implanted Afib device is assigned to John (patient), and the device’s blockchain is updated with information such as the hospital, doctor, emergency contacts, and advance directives around care for patient John. The Afib device is supported by a series of smart contracts that can autonomously notify John (patient) and providers when the device needs service, e.g., battery expiration, or when health irregularities are detected.

Today, device preventive maintenance is rudimentary at best. For example, when an Afib device requires maintenance, the device starts to audibly alarm Jon (patient), [in his chest] which can be disturbing. A smart contract could also send preventative maintenance information to the patient and provider, reducing the chance of a catastrophic failure.”

The two authors Peter Nichol and Jeff Brandt, present compelling arguments offering new exploratory propositions that require more research. The research propositions identify three areas that required more in-depth research including:

  • Proposition 1: Healthcare Device Maintenance Ranging from Medical Devices to Nanomachines Will Autonomously Communicate Device-To-Device.
  • Proposition 2: Personal and Public Self-sovereign Will Place Identity Ownership in the Hands of the Patient.
  • Proposition 3: Electronic Health Information Exchanges (HIE) and All-Payer Claims Databases (APCD) Will Establish Trust Using Blockchain Technologies.

Blockchain technologies do offer answers to healthcare’s interoperability struggle. The solution to this national crisis won’t, however, be purely solved by adding yet another layer of technology. The underlying broken payer and provider processes need to be addressed in parallel for a complete patient-centric solution.

The patient ownership of data accelerates health data transparency. Blockchain technologies can observe what data is being accessed, who can access the data, and for what period. Self-sovereign identity provides sovereignty, security, and privacy to promote benefits for the patient and the organization or agency by reducing risk, strengthening security, improving accuracy, deepening permission control, and decreasing the time required for regulatory oversight.

The paper titled, Co-Creation of Trust for Healthcare: The Cryptocitizen Framework for Interoperability with Blockchain, can be downloaded from this location. The ONC Blockchain Challenge will publish the results of the competition on August 29, 2016. Blockchain technologies can spark the co-creation of trust in healthcare. 

Download the FULL paper Here: Co-Creation of Trust for Healthcare: The Cryptocitizen Framework for Interoperability with Blockchain.

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Peter is a technology executive with over 20 years of experience, dedicated to driving innovation, digital transformation, leadership, and data in business. He helps organizations connect strategy to execution to maximize company performance. He has been recognized for Digital Innovation by CIO 100, MIT Sloan, Computerworld, and the Project Management Institute. As Managing Director at OROCA Innovations, Peter leads the CXO advisory services practice, driving digital strategies. Peter was honored as an MIT Sloan CIO Leadership Award Finalist in 2015 and is a regular contributor to on innovation. Peter has led businesses through complex changes, including the adoption of data-first approaches for portfolio management, lean six sigma for operational excellence, departmental transformations, process improvements, maximizing team performance, designing new IT operating models, digitizing platforms, leading large-scale mission-critical technology deployments, product management, agile methodologies, and building high-performance teams. As Chief Information Officer, Peter was responsible for Connecticut’s Health Insurance Exchange’s (HIX) industry-leading digital platform transforming consumerism and retail-oriented services for the health insurance industry. Peter championed the Connecticut marketplace digital implementation with a transformational cloud-based SaaS platform and mobile application recognized as a 2014 PMI Project of the Year Award finalist, CIO 100, and awards for best digital services, API, and platform. He also received a lifetime achievement award for leadership and digital transformation, honored as a 2016 Computerworld Premier 100 IT Leader. Peter is the author of Learning Intelligence: Expand Thinking. Absorb Alternative. Unlock Possibilities (2017), which Marshall Goldsmith, author of the New York Times No. 1 bestseller Triggers, calls "a must-read for any leader wanting to compete in the innovation-powered landscape of today." Peter also authored The Power of Blockchain for Healthcare: How Blockchain Will Ignite The Future of Healthcare (2017), the first book to explore the vast opportunities for blockchain to transform the patient experience. Peter has a B.S. in C.I.S from Bentley University and an MBA from Quinnipiac University, where he graduated Summa Cum Laude. He earned his PMP® in 2001 and is a certified Six Sigma Master Black Belt, Masters in Business Relationship Management (MBRM) and Certified Scrum Master. As a Commercial Rated Aviation Pilot and Master Scuba Diver, Peter understands first hand, how to anticipate change and lead boldly.