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Many healthcare technology professionals believe blockchain – an open, distributed ledger of transactions initially developed to support bitcoin – could be the key to achieving the secure sharing of medical data.
“While interoperability and HIE frameworks evolve to address a range of challenges in health IT, blockchain could deliver an alternative for where these technologies may fall short,” IDC research director Mutaz Shegewi wrote in a recent report. “The ability to feasibly exchange data across and beyond the enterprise level with far greater degrees of decentralization, distribution, and immutability makes blockchain a noteworthy proposition for exploring new ways of shaping the future of health IT interoperability."
But not everyone is convinced that blockchain potentially can be a healthcare interoperability panacea. Writing in Forbes, Raj Sharma, co-founder and CEO of Health Wizz, a secure mobile platform for consumers to aggregate, organize and share health records over blockchain, argues that though “blockchain and interoperability of medical records could have a symbiotic relationship, there is nothing inherent in blockchain that addresses the interoperability problem of healthcare data.”
A major interoperability barrier, Sharma writes, is how different electronic health records (EHR) systems interpret or identify the multitude of clinical documentation and reporting terms and definitions used by providers.
“When delivering care, it is vital that these codes are understood and interpreted in a consistent manner across healthcare settings,” Sharma says. “The problem is that different EHR systems have their own implementation of clinical definitions. As a result, the same health information has the potential to be identified by a number of different values and hence subject to misinterpretation.”
Fortunately, he says, the Fast Healthcare Interoperability Resources (FHIR) standard developed by healthcare standards organization Health Level Seven International (HL7) can help by validating document formats as data is exchanged between providers.
Other possible solutions, Sharma says, include using an external terminology server in conjunction with FHIR that stores the latest code systems and vocabularies. Likewise, FHIR also can work with blockchain to ensure the security and integrity of shared medical data, he says.
“Even though they work in very different ways, their potential to disrupt traditional health care is far-reaching and full of promise,” Sharma writes. “However, nirvana lies in true semantic interoperability of clinical information and blockchain is not going to help with that.”