By Dr. Shahram Ebadollahi

As we look forward in 2018 to the next wave of technological advances that will impact health care, it’s hard to ignore the word on every health care technologist’s tongue – blockchain.

Like “big data” before it and “the cloud” before that, the term is grabbing the attention of most health care audiences as a critical peak in the wave of the future for making health data more fluid and valuable for a variety of health care stakeholders.



While the implications of blockchain as they relate to the meteoric rise of Bitcoin prices are well known, its potential impact to propel innovation within the health care industry is only just beginning to reveal itself.

Many of the intrinsic properties of blockchain technology — such as transparency, security and authenticity — are well suited to help address some of health care’s most pressing challenges with respect to the data exchange process. Here, we will explore three key benefits that blockchain can bring to health care.

Patient consent and health data access
As we all know, health data is exploding with the growth of EHRs, wearables, advanced imaging capabilities and genomics research. According to IDC’s Data Age 2025 report, hypercritical data – of which health information is a major component – is growing at an astonishing 54 percent compound annual growth rate. So, while the reality of “big” data finally benefiting our health care system is upon us, the fact is that “long,” or longitudinal, data is not. In other words, the different pieces of patient data lack fluidity and are sitting in silos, unable to be easily shared and collectively interpreted for the patient’s benefit. For example, a patient could go to one facility for imaging and another for blood work, yet none of the results are shared or available to one another, which results in tremendous waste.

Giving patients the opportunity to share their data securely, for research purposes or across their health care providers, creates opportunities for major advancements in health care. With blockchain, the massive amount of siloed patient data being generated and captured every day could be shared across a group of individuals and institutions. Using the blockchain framework in this way could be a critical enabler for making a truly fluid health information system possible – allowing patients (or consumers) to be the true owner of the data and in charge of providing consent for the exchange and use of it by various entities. To date, the top-down model for data sharing among institutions hasn’t worked and has encountered many challenges in adoption, not necessarily from a technological standpoint, but with ownership and reluctance to share the data by various entities. Creating the capabilities to access data based on an owner’s consent, and aggregating it into a truly longitudinal view of the patient, may be able to unlock many possibilities for a new set of services. This is already a reality in certain parts of the world – most notably Estonia. In addition, certain regions like Europe with General Data Protection Regulation (GDPR) are advancing new ways of properly regulating models of consent for consumers.

Payment and claims
While it’s important to recognize that blockchain will not be a solution to all problems in health care, it holds tremendous promise when there are many transactions with a multitude of involved entities, where each transaction or interface between entities must abide by certain policy or predefined rules. An example is the general area of payments in health care and related issues such as preauthorization, and bundle-based payment methods.

For example, in bundle payments, tracking the various services provided, their costs, their associated outcomes and mapping them to the specifications of the bundle are critical for timely adjudication of the bundle. Blockchain could play a key role because it creates visibility and an audit trail on what has happened, by whom and to what outcome.



At IBM Watson Health, we’ve been working and experimenting with various blockchain-based smart contract implementations that help with capturing all kinds of important patient information like medication adherence, tracking benefits eligibility or capturing patient outcomes for enabling value-based care models. Smart contracts enable automation of business processes that transcend organizational boundaries in a secure and decentralized manner, and enable a better network, when multiple people and factors are contributing, yet all must be tracked appropriately.

Clinical trial results
Another area where there are numerous collaborators, contributing factors and a lot of accompanying paperwork is during clinical trials. As pharmaceutical companies advance treatment candidates to later stage clinical trials, they must prepare a dossier for review by federal regulators, like the Food and Drug Administration.

Once a pharma company comes up with the treatment-testing protocol, it, or a contract research organization, must recruit sites with principal investigators (doctors) to conduct a portion of that trial. After recruiting trial participants, the investigators must conduct the protocol by collecting enormous amounts of data on multiple subjects – often daily – to test the treatment. This process, as many physicians already know, can be ripe for introducing errors and/or duplicate records – something that can be potentially very damaging for the trial drug’s final submission to regulators.

With blockchain as the backbone for tracking all of this information, you don’t have to wait three to four months to collect, process and review all of the research. The secure, decentralized framework blockchain provides allows you to have instant and clear visibility into the data, seriously reducing errors and duplication. This has the potential to speed the time and potentially lower the cost of bringing new treatments and diagnostic capabilities to market.

These are just a small handful of the many potential benefits for applying blockchain within our health care system. The bottom line is that blockchain shouldn’t be a scary word that the general medical community only associates with the world of cryptocurrency. It is, in my opinion, a very viable technology that will open the door wider for better health care delivery, enable organizations to better work together and ultimately improve patient care.

About the author: Dr. Shahram Ebadollahi, Ph.D., MBA, is the vice president, Innovations and the chief science officer, IBM Watson Health Group. As the head of Innovations, he oversees development, solutions and strategic partnerships for the IBM Watson Health business unit. He has global responsibility for the innovation and technical strategy for IBM Watson Health and the global health informatics research in IBM Research.