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15 blockchain whitepapers awarded winners of US Department of Health and Human Services Challenge

A challenge held by the US Department of Health and Human Services (HHS)  to encourage Blockchain use in the Health Information Technology field resulted in 15 winning whitepapers. The Department’s Office of the National Coordinator for Health Information Technology (ONC) first announced the “Use of Blockchain in Health IT and Health-Related Research” challenge in July.

A challenge held by the US Department of Health and Human Services (HHS)  to encourage Blockchain use in the Health Information Technology field resulted in 15 winning whitepapers. The Department’s Office of the National Coordinator for Health Information Technology (ONC) first announced the “Use of Blockchain in Health IT and Health-Related Research” challenge in July.

More than 70 submissions were received by ONC, “addressing ways that Blockchain technology might be used in health and health IT to protect, manage, and exchange electronic health information,” the Department revealed.

US Department of Health Human Services“The ‘Use of Blockchain in Health IT and Health-Related Research’ Ideation Challenge solicits white papers on the topic of Blockchain technology and the potential use in health IT to address privacy, security, and scalability challenges of managing electronic health records and resources.”
— – U.S. Department of Health & Human Services

With this Challenge, ONC is also looking for proposals of how blockchain technology can advance industry interoperability needs, as expressed in the ONC Shared Nationwide Interoperability Roadmap, as well as for Patient Centered Outcomes Research, the Precision Medicine Initiative, and delivery system reform, among other healthcare delivery needs.

Winning papers from schools, businesses, and individuals around the country were chosen by the ONC based several different criteria, including market viability, creativity, the ability to inform and foster transformative change, and the potential to support a number of national health and health information objectives.

Vindell Washington“We are thrilled by the incredible amount of interest in this challenge. While many know about Blockchain technology’s uses for digital currency purposes, the challenge submissions show its exciting potential for new, innovative uses in health care.”
— – Vindell Washington, M.D., M.H.C.M., National Coordinator for Health Information Technology

No two of the 15 papers covered the same use of blockchains. Topics range from using the technology to renovate payment systems to complete redesigns of the entire health records system. Some targeted specific improvement, like the medical claims process or Medicare, while others were wide-ranging multi-system plans to improve every system.

Although each paper is already a winner and would make an interesting read on its own, several stand out as imaginative, or offer new use cases for blockchains.

A group of researchers and students from Project PharmOrchard of MIT’s Experimental Learning lab penned the first whitepaper on the HHS’ list, “Blockchain and Health IT: Algorithms, Privacy, and Data.” The team proposed a strongly-encrypted, peer-to-peer, blockchain-based healthcare records database called “OPAL/ENIGMA.”

The system has many innovative features including the use of smart contracts to better manage access to healthcare records. The solution could enable certain parties, like doctors or drug companies, to jointly store and analyze healthcare data with varying access levels and in complete privacy. The project’s overall goal would be to empower precision medicine clinical trials and research, but patients would ultimately own their own data.

Accenture’s whitepaper, “Blockchain: Securing a New Health Interoperability Experience,” focuses on “three of the most important applications relevant to the mission of the ONC.” The applications are creating secured and trusted care records, linking identities, and recording patient consent.

Citing that “a blockchain must be additive to the healthcare ecosystem— users should not view it as a ‘rip and replace’ technology that invalidates or minimizes existing technology investments,” the firm asserts the importance of integrating blockchain solutions with current health IT investments.

Accenture“Blockchain technologies solutions can support many existing health care business processes, improve data integrity and enable at-scale interoperability for information exchange, patient tracking, identity assurance, and validation.”
— – Accenture

Solution Architect at Humana, Kyle Culver, submitted “Blockchain Technologies: A Whitepaper Discussing how Claims Process can be Improved.” Culver explored how the claims process and overall healthcare experience could be significantly improved if smart contracts and blockchain technology are combined into a platform.

Given the rising cost of healthcare in the U.S., he proposes using “a platform through which a consortium would share information and execute smart contracts.”

Big-four professional services firm Deloitte, the second largest network in the world by revenue, threw their hat in the ring by submitting a multi-use-case healthcare paper, “Blockchain: Opportunities for Health Care.”

The firm promotes the use of the technology as an enabler of “Nationwide Interoperability,” and presents a framework for using blockchains in several roles; As part of a smart contract-based health information exchange, as a digital identity layer, and as a precision medicine database.

MIT Media Lab and one of the world’s leading hospitals in Boston, Beth Israel Deaconess Medical Center, submitted “A Case Study for Blockchain in Healthcare: ‘MedRec’ Prototype for Electronic Health Records and Medical Research Data.” The prototype uses Ethereum smart contracts to demonstrate how principles of decentralization and blockchain architectures could contribute to secure, interoperable electronic health record systems.

MIT Media Lab logo“We believe MedRec fits squarely in the White House’s goals for the ONC to support the development of interoperability standards and requirements that address privacy and enable secure exchange of data across systems.”
— – MIT Media Lab and Beth Israel Deaconess Medical Center

The Use of a Blockchain to Foster the Development of Patient-Reported Outcome Measures,” submitted by the National Quality Forum (NQF), was also among the winners. NQF is a nonprofit, nonpartisan, membership-based organization that works to catalyze improvements in healthcare.

The Forums’ paper explores the use of the Internet of Things (IoT), in combination with Blockchain technology, for Patient Reported Outcome Measures (PROMs), which are traditionally a series of questionnaires given to patients before and after surgery.

PROMs provide the patient’s opinion of both the outcome and the quality of care delivered, and the NQF feels that the combining the IoT and blockchains can help gather and store more detailed data than simple questionnaires.

Adrian Gropper, MD, independently submitted a whitepaper called “Powering the Physician Patient Relationship with ‘HIE of One’ Blockchain Health I.” The HIE of One, or Health Information Exchange of One, “shifts the trusted intermediary role away from the hospital and into the blockchain,” Gropper explains. “The blockchain can also provide the link between physician credentials and patient identity.”

IBM took a much broader approach, submitting a paper with almost 20 different use cases, from payments to preventing counterfeit drug overdoses. “Blockchain: The Chain of Trust and its Potential to Transform Healthcare – Our Point of View” addresses the security, scalability, interoperability, and privacy of several key healthcare data issues, including many involved with electronic medical records.

IBM logo“It is vitally important that healthcare organizations understand and explore blockchain technology today to ensure they are ready for the changes sure to come tomorrow. […]  IBM is committed to helping make blockchain real for business, and we will put the same force behind our efforts that we did in working to mainstream Linux, Eclipse, Java, Spark, and other open source technologies."

  • IBM

Drew Ivan joined the winners with “Moving Toward a Blockchain-based Method for the Secure Storage of Patient Records.” Citing that nearly all medical records are currently stored in electronic health record systems, and still largely non-portable, Ivan states that blockchain technology has the potential to solve the problem by providing a single, secure, decentralized storehouse of clinical data for all patients.

“While a blockchain-based solution may be an option at some point in the future, the near-term requires a bridge solution,” states Ivan. “The following, proposed solution includes creating a new facility for storing clinical data that is based on blockchain technology, while continuing to use today’s EHR (and other) systems to capture and store patient data.”

Another winner was written by three authors from the University of California and VA San Diego Healthcare System, “ModelChain: Decentralized Privacy-Preserving Health Care Predictive Modeling Framework on Private Blockchain Networks.” The trio propose improving the security and robustness of distributed privacy-preserving healthcare predictive modeling. They designed a framework called ModelChain to integrate online machine learning with blockchains.

Laure A Linn and Martha B Koo, MD, turned in a well-illustrated whitepaper titled “Blockchain For Health Data and Its Potential Use in Health IT and Health Care Related Research.” The pair propose the use of a public blockchain as an access-control manager to health records that are stored off blockchain.

"There are currently no open standards or implementations of blockchain that utilize this approach but research supports the feasibility of the proposed solution. Bitcoin has already demonstrated that trusted, auditable computing is possible using a distributed network accompanied by a shared ledger."
— – Linn and Koo

The Mayo Clinic, a non-profit medical practice and medical research group with over 3,300 physicians, scientists and researchers, also submitted a winning whitepaper. “A Blockchain-Based Approach to Health Information Exchange Networks” discusses using blockchain technology to solve the challenges of data sharing in healthcare. “Simply sharing data is not enough – we’ve shown that effective data sharing networks require consensus on data syntax, meaning, and security,” the author wrote.

“Building on techniques used successfully by other blockchain applications, we’ve introduced a new consensus algorithm designed to facilitate data interoperability,” states the Mayo Clinic. “Ultimately, we believe that a blockchain-based data sharing network is a tenable solution for the complex problem of sharing healthcare data.”

Ramkrishna Prakash, the CEO of an Austin-based HealthCare Software Company called TrustedCare Inc, submitted his entry as an individual. “Adoption of Blockchain to enable the Scalability and Adoption of Accountable Care” discusses the “transformational possibilities of a peer-to-peer healthcare framework built on the block-chain technology.”

Prakash addresses how to build a framework to its benefits, and concludes with his view of the long-term impacts of this technology in transforming the healthcare landscape.

The Blockchain Futures Lab winning paper, from the nonprofit Institute For The Future (IFTF), explores creating a “Smart Health Profile” in order to help healthcare in several ways, but mainly targets Medicaid patients. “A Blockchain Profile for Medicaid Applicants and Recipients” offers a solution to the problematic Medicaid program.

IFTF lofo“The Blockchain Futures Lab at IFTF is a research initiative and a community for identifying the opportunities and limits of blockchain technologies as well as their social, economic, and political impacts on individuals, organizations, and communities over the coming decades.”
— – Institute For The Future

King Yip authored a whitepaper addressing how blockchain technology can effectively enable or assist alternative payment models, citing that the current IT infrastructure tends to be “insufficient in terms of speed or scope for APM to succeed.”

“Blockchain may help organizations understand where there are barriers arising from policy, regulation or business models as slow workflows will no longer hide inefficiencies,” states Yip. “Technology is only part of the solution. But if blockchains are utilized in the right application, they can provide the information needed to drive programs and process that enable alternative payment models to achieve their aim of linking value and quality.”

According to the HHS website, the winning whitepapers will be awarded a cash prize in the range of $1,500 – $5,000. In addition, up to 8 winners may be invited to present their paper at the industry-wide workshop co-hosted with the National Institute of Standards and Technology (NIST). The event will take place on September 26 and 27 at the NIST headquarters in Gaithersburg, MD.


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