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dEFINITION
 Definition simplified
 Significance
 Who is using it?
 Impact of Blockchain
 How it works?
 Automobiles industry
 Healthcare examples:
 Problems in healthcare
 Universal Patient Identifier
 Supply chain in healthcare
 Revenue cycle management
 Value based payments
 Patient compliance
 Currently, most people use a trusted middleman such as a bank to make a
transaction. But blockchain allows consumers and suppliers to connect directly,
removing the need for a third party.
 Using cryptography to keep exchanges secure, blockchain provides a decentralized
database, or “digital ledger”, of transactions that everyone on the network can see.
This network is essentially a chain of computers that must all approve an
exchange before it can be verified and recorded. See a small video here>>
https://youtu.be/6WG7D47tGb0
 The technology can work for almost every type of transaction involving value,
including money, goods and property. Its potential uses are almost limitless: from
collecting taxes to enabling migrants to send money back to family in countries
where banking is difficult.
 Blockchain could also help to reduce fraud because every transaction would be
recorded and distributed on a public ledger for anyone to see.
 In theory, if blockchain goes mainstream, anyone with access to the internet would
be able to use it to make transactions.
 Currently only a very small proportion of global GDP (around 0.025%, or $20
billion) is held in the blockchain, according to a survey by the World Economic
Forum’s Global Agenda Council.
 But the Forum’s research suggests this will increase significantly in the next
decade, as banks, insurers and tech firms see the technology as a way to speed up
settlements and cut costs.
 Companies racing to adapt blockchain include UBS, Microsoft, IBM and PwC. The
Bank of Canada is also experimenting with the technology.
 A report from financial technology consultant Aite estimated that banks spent $75
million last year on blockchain. And Silicon Valley venture capitalists are also
queuing up to back it.
 It is distributed. Means it is de-
centralized. Nobody is a owner.
 It is public. Everyone can see it.
 Things that have happened are time
stamped, recorded and coded.
 It is persistent. As far as everyone is
participating, it is for forever.
 SECURITY AND PRIVACY is built
into the system. (In internet the
problem was that TCPIP is not built
in for identity or encryption.)
 Smart contracts are built in- which
means once a transaction is made
automatically the laws of the
contract are applied and executed.
Value, data and money can be
moved now.
For an example if everyone in a conference room
has a spreadsheet of no. of shirts they own and
they share it. The data miners after every 10
seconds will find out the new shirts added, shorts
deleted, ownership of shirts changed etc.. The
miners will then publish this to everyone holding
a ledger who participated in blockchain. This is
called block of work chained to the initial block
and hence blockchain- that is why it is persistent
and you get a running, consistent account of
things that is time stamped, verified by everyone,
virtually un-hackable because no one can reverse
it.
And this is the reason why for Bitcoins, financial
services it is an imp tech because this is why you
wait for 3 days for your cheque to get cleared.
Blockchain is often called as the 4th Industrial revolution
 Well any situation of public record of something that is verifiable and is not under
control of any single entity.
 -title registration- car, name, ownership etc.
 Property
 Digital title/ work registration- jpg, art, journal, patent etc.
 Smart contracts
 (User-friendly, digital, organised, searchable-> ready to be used by everyone on a
public domain Available forever-- digital ledger, distributed records.)
1. Improves service
2. Improves warranty
3. Improves Recall costs
at end of life.
Blockchain seeks
• Access
• Permission
• Records
• Consensus
• Validation
……automatically through
the network.
 Healthcare waste
 Bad prognosis
 Readmissions
 Over-diagnosis
 Patient discomfort
 Lack of home support
 High cost of new innovations
 Lack of access to advanced treatments
 When we do clinical trials we find molecules. Sometimes we find molecules outside
the area we are looking as well. Scientists that one hires also belong to a specified
area meaning a lot of molecules found during the process just sit on the shelf.
These molecules if shared with other companies, scientists and agencies like WHO
can solve world’s biggest problems.
Imagine a blockchain for molecules that can be shared
with scientists based on their capability and expertise
and then creating an economic model to discover and
patent these molecules to manufacture life saving drugs.
 Universal patient identifier
(Patient centric care coordinator)
Aggregates data about a patient
across multiple disparate
systems without moving records
to central location. Hence have
longitudinal data of a patient
available for clinical decision
support, stratification and
modelling.
Predictive
Analytics
fuels
 Supply chain costs ranks
second only to
reimbursement problems
as the issue top of mind
for hospital executives
today.
 The supply chain is the
second largest expense for
healthcare providers,
according to Cardinal
Health, which also
estimates $5 billion of
annual waste in high-
value medical
devices alone.
 Revenue cycle management –
coordinate payments between
payers, providers, bank- saves
time and cost and the need of
data reconciliation between
these parties and relevant
stakeholders.
 The goals of value-based payment are to give
healthcare providers adequate resources to deliver
efficient, quality care and to remove the penalties
that exist today for improving quality and
efficiency.
 Episode-of-care payment and comprehensive care
payment systems can help providers prevent
health problems; prevent the occurrence of acute
episodes among individuals who have health
conditions; prevent poor outcomes during major
acute episodes, such as infections, complications,
and hospital readmissions; and reduce the costs of
successful treatment.
 By using payment changes to help address these
major sources of waste and inefficiency, healthcare
costs can be reduced significantly without
“rationing” or denying care that patients need.
 By properly securing the identity
of patients through cryptography
and storing individual health
records to a blockchain we will
make available an aggregate
database of community health
records that can be used in
community focused preventative
care programs, driving population
health without violating the
critical rules of HIPAA. This
would make it possible to use ALL
data from ALL medical records for
populations rather than relying
on voluntary release.
1. Barnes K, Levy D, Lutz S. Customizing healthcare: How a new approach to diagnosis, care, and cure could transform employer benefits in a post reform world.
PwC Health Research Institute. Available from: http://www. pwc.com/us/en/view/issue-13/customizing-healthcare. jhtml.
2. Mirnezami R, Nicholson J, Darzi A. Preparing for Precision Medicine. N Engl J Med 2012;366:489-91
3. Committee on Quality of Health Care In America, Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21st Century. Available
from: http:// www.iom.edu/~/media/Files/Report%20Files/2001/ Crossing-the-Quality-Chasm/Quality%20Chasm%20 2001%20%20report%20brief.pdf.
4. http://www.bio-itworld.com/2013/10/18/5-ways-technology-is-changing-personalized-medicine.html
5. MIT Technology Review http://www2.technologyreview.com/briefings/personalmed/
6. https://youtu.be/6WG7D47tGb0
7. http://cmuscm.blogspot.in/2014/09/healthcare-mass-customization-and.html
8. http://www3.weforum.org/docs/WEF_GAC15_Technological_Tipping_Points_report_2015.pdf
9. http://blogs.wsj.com/cio/2016/06/15/microsoft-to-launch-blockchain-middleware/
10. http://blogs.wsj.com/digits/2015/04/02/ubs-to-open-blockchain-research-lab-in-london/
11. https://www.wsj.com/articles/bank-of-canada-explores-blockchain-technology-1466107171
12. https://qz.com/576671/banks-will-their-quintuple-spending-on-blockchain-by-2019/
13. https://www.youtube.com/watch?v=GO9Q7i-IcA8
14. https://www.ncbi.nlm.nih.gov/books/NBK53906/
15. http://www.triple-tree.com/files/6014/0744/4834/TripleTree_-_Revenue_Cycle.pdf

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Blockchain in Healthcare: Applications and Use Cases

  • 2.  Definition simplified  Significance  Who is using it?  Impact of Blockchain  How it works?  Automobiles industry  Healthcare examples:  Problems in healthcare  Universal Patient Identifier  Supply chain in healthcare  Revenue cycle management  Value based payments  Patient compliance
  • 3.  Currently, most people use a trusted middleman such as a bank to make a transaction. But blockchain allows consumers and suppliers to connect directly, removing the need for a third party.  Using cryptography to keep exchanges secure, blockchain provides a decentralized database, or “digital ledger”, of transactions that everyone on the network can see. This network is essentially a chain of computers that must all approve an exchange before it can be verified and recorded. See a small video here>> https://youtu.be/6WG7D47tGb0
  • 4.  The technology can work for almost every type of transaction involving value, including money, goods and property. Its potential uses are almost limitless: from collecting taxes to enabling migrants to send money back to family in countries where banking is difficult.  Blockchain could also help to reduce fraud because every transaction would be recorded and distributed on a public ledger for anyone to see.
  • 5.  In theory, if blockchain goes mainstream, anyone with access to the internet would be able to use it to make transactions.  Currently only a very small proportion of global GDP (around 0.025%, or $20 billion) is held in the blockchain, according to a survey by the World Economic Forum’s Global Agenda Council.  But the Forum’s research suggests this will increase significantly in the next decade, as banks, insurers and tech firms see the technology as a way to speed up settlements and cut costs.  Companies racing to adapt blockchain include UBS, Microsoft, IBM and PwC. The Bank of Canada is also experimenting with the technology.  A report from financial technology consultant Aite estimated that banks spent $75 million last year on blockchain. And Silicon Valley venture capitalists are also queuing up to back it.
  • 6.
  • 7.  It is distributed. Means it is de- centralized. Nobody is a owner.  It is public. Everyone can see it.  Things that have happened are time stamped, recorded and coded.  It is persistent. As far as everyone is participating, it is for forever.  SECURITY AND PRIVACY is built into the system. (In internet the problem was that TCPIP is not built in for identity or encryption.)  Smart contracts are built in- which means once a transaction is made automatically the laws of the contract are applied and executed. Value, data and money can be moved now. For an example if everyone in a conference room has a spreadsheet of no. of shirts they own and they share it. The data miners after every 10 seconds will find out the new shirts added, shorts deleted, ownership of shirts changed etc.. The miners will then publish this to everyone holding a ledger who participated in blockchain. This is called block of work chained to the initial block and hence blockchain- that is why it is persistent and you get a running, consistent account of things that is time stamped, verified by everyone, virtually un-hackable because no one can reverse it. And this is the reason why for Bitcoins, financial services it is an imp tech because this is why you wait for 3 days for your cheque to get cleared. Blockchain is often called as the 4th Industrial revolution
  • 8.
  • 9.  Well any situation of public record of something that is verifiable and is not under control of any single entity.  -title registration- car, name, ownership etc.  Property  Digital title/ work registration- jpg, art, journal, patent etc.  Smart contracts  (User-friendly, digital, organised, searchable-> ready to be used by everyone on a public domain Available forever-- digital ledger, distributed records.)
  • 10. 1. Improves service 2. Improves warranty 3. Improves Recall costs at end of life. Blockchain seeks • Access • Permission • Records • Consensus • Validation ……automatically through the network.
  • 11.  Healthcare waste  Bad prognosis  Readmissions  Over-diagnosis  Patient discomfort  Lack of home support  High cost of new innovations  Lack of access to advanced treatments
  • 12.  When we do clinical trials we find molecules. Sometimes we find molecules outside the area we are looking as well. Scientists that one hires also belong to a specified area meaning a lot of molecules found during the process just sit on the shelf. These molecules if shared with other companies, scientists and agencies like WHO can solve world’s biggest problems. Imagine a blockchain for molecules that can be shared with scientists based on their capability and expertise and then creating an economic model to discover and patent these molecules to manufacture life saving drugs.
  • 13.  Universal patient identifier (Patient centric care coordinator) Aggregates data about a patient across multiple disparate systems without moving records to central location. Hence have longitudinal data of a patient available for clinical decision support, stratification and modelling. Predictive Analytics fuels
  • 14.  Supply chain costs ranks second only to reimbursement problems as the issue top of mind for hospital executives today.  The supply chain is the second largest expense for healthcare providers, according to Cardinal Health, which also estimates $5 billion of annual waste in high- value medical devices alone.
  • 15.  Revenue cycle management – coordinate payments between payers, providers, bank- saves time and cost and the need of data reconciliation between these parties and relevant stakeholders.
  • 16.  The goals of value-based payment are to give healthcare providers adequate resources to deliver efficient, quality care and to remove the penalties that exist today for improving quality and efficiency.  Episode-of-care payment and comprehensive care payment systems can help providers prevent health problems; prevent the occurrence of acute episodes among individuals who have health conditions; prevent poor outcomes during major acute episodes, such as infections, complications, and hospital readmissions; and reduce the costs of successful treatment.  By using payment changes to help address these major sources of waste and inefficiency, healthcare costs can be reduced significantly without “rationing” or denying care that patients need.
  • 17.  By properly securing the identity of patients through cryptography and storing individual health records to a blockchain we will make available an aggregate database of community health records that can be used in community focused preventative care programs, driving population health without violating the critical rules of HIPAA. This would make it possible to use ALL data from ALL medical records for populations rather than relying on voluntary release.
  • 18.
  • 19. 1. Barnes K, Levy D, Lutz S. Customizing healthcare: How a new approach to diagnosis, care, and cure could transform employer benefits in a post reform world. PwC Health Research Institute. Available from: http://www. pwc.com/us/en/view/issue-13/customizing-healthcare. jhtml. 2. Mirnezami R, Nicholson J, Darzi A. Preparing for Precision Medicine. N Engl J Med 2012;366:489-91 3. Committee on Quality of Health Care In America, Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21st Century. Available from: http:// www.iom.edu/~/media/Files/Report%20Files/2001/ Crossing-the-Quality-Chasm/Quality%20Chasm%20 2001%20%20report%20brief.pdf. 4. http://www.bio-itworld.com/2013/10/18/5-ways-technology-is-changing-personalized-medicine.html 5. MIT Technology Review http://www2.technologyreview.com/briefings/personalmed/ 6. https://youtu.be/6WG7D47tGb0 7. http://cmuscm.blogspot.in/2014/09/healthcare-mass-customization-and.html 8. http://www3.weforum.org/docs/WEF_GAC15_Technological_Tipping_Points_report_2015.pdf 9. http://blogs.wsj.com/cio/2016/06/15/microsoft-to-launch-blockchain-middleware/ 10. http://blogs.wsj.com/digits/2015/04/02/ubs-to-open-blockchain-research-lab-in-london/ 11. https://www.wsj.com/articles/bank-of-canada-explores-blockchain-technology-1466107171 12. https://qz.com/576671/banks-will-their-quintuple-spending-on-blockchain-by-2019/ 13. https://www.youtube.com/watch?v=GO9Q7i-IcA8 14. https://www.ncbi.nlm.nih.gov/books/NBK53906/ 15. http://www.triple-tree.com/files/6014/0744/4834/TripleTree_-_Revenue_Cycle.pdf