Blockchain Applications in Healthcare: A Review of the Health Data Exchange Landscape
What does the future of healthcare look like? Do you find it hard to believe that providers still use fax machines? In this article, we’ll provide an overview and analysis of the companies, consortiums, and players participating in the application of blockchain technologies in the health data exchange space. A dive into the innovators aiming to completely revolutionize healthcare by solving the challenges of sharing healthcare information across ecosystem stakeholders by leveraging blockchain technologies. — Authors: Erin Zagadailov,PharmD,MS, Pavel Zagadailov, MD
Despite the FTX debacle and crypto winter market sentiments in 2022, momentum is building for blockchain applications in healthcare. This article details the 2023 landscape of blockchain applications in healthcare with a focus on Health Data Exchange.
Figure 1. Blockchain Applications in Healthcare: Health Data Exchange Landscape 2023
Keeping an eye on Avaneer Health and Equideum Health
Avaneer Health was launched in June 2021 by the Health Utility Network, a collective of healthcare titans and household names. Founding members include Cleveland Clinic, CVS Aetna, Elevance, Health Care Service Cooperation (HCSC), Merative (formerly IBM Watson Health), PNC Bank, and Sentara Healthcare (Figure 1). With the aim to set aside their competition and individual interests, they banded together to advance solutions for healthcare transformation. With the 50 million seed round, Avaneer Health has been building a ‘Health Data Exchange to Rule Them All [1].’ In 2022, their enterprise blockchain-enabled SparkZone™ platform went live for founding members who are testing data exchange across partners. Avaneer Health also has its sights set on releasing an industry version for payers and providers in the near future.
Equideum Health is a ConsenSys Mesh portfolio company building Web3 person-centered healthcare and research networks. Equideum Health’s Chief Scientific Officer, Sean Manion, PhD, admits that ‘widespread [blockchain] adoption hasn’t taken hold yet [2]’; however, most of the major pharma, payers, and providers ‘are exploring it.’ As an Enterprise Ethereum Alliance member, Equideum Health uses the Ethereum platform to transform healthcare by combining zero-knowledge cryptography with off-chain hybrid blockchain infrastructures. Elevated Compute™, their platform, is the first commercially available combination of blockchain technology, decentralized AI, self-sovereign ‘Personal Data Lockers’, and consented NFT data exchange. The platform powers Equideum Health’s Data Integrity and Learning Networks (DILNs), which aims to remove long-standing barriers with a ‘vision of an equitable, person-centered, learning health system [3].’ Additionally, the DILNs are also anticipated to play a role in clinical trial matching to support industry enthusiasm for decentralized trials.
Rounding Out the Field With MediLedger, SolveCare, and Hashed Health
MediLedger, a Chronicled portfolio company, is a network that combines blockchain technology and advanced cryptography to be the ultimate privacy-first platform for healthcare trading partner transactions. Participating partners include the big 3 US wholesalers (AmerisourceBergen, McKesson, and Cardinal Health) and several biotechs (Pfizer, Gilead, Bayer) (Figure 1). However, MediLedger appears less focused on health data exchange and more on the transaction ecosystem with featured use cases that include ‘Contracts & Chargebacks’ and ‘Product Verification.’
SolveCare is utilizing blockchain technology to ‘radically reduce the unacceptable administrative burden placed on healthcare providers and enhance the care experience of individuals [4]’. SOLVE, their native utility token, is an ERC20 token on the Ethereum network aimed to power the first cryptocurrency-enabled marketplace for healthcare. Based on their light paper, SolveCare piloted their decentralized and distributed platform with the Arizona Care Network, an accountable care organization (ACO) [4]; however, their focus, similar to MediLedger, appears to be more so on the healthcare transaction ecosystem and less so on health data exchange. As such, the next article in this series will cover SolveCare and MediLedger in more detail.
Last but not least, Hashed Health is a venture studio focusing on the use of blockchain and web3 as enablers of new models in healthcare by actively recruiting entrepreneurs and investors into the space. CEO John Bass is ‘placing bets’ on web3-powered data markets, data exchanges, and programmable data transfers [5].
Is Protected Health Data where blockchain ideas come to die?
As a highly regulated industry, health information, and more specifically protected patient information, tech solutions in the health data exchange space often face high barriers to entry. As such, a handful of blockchain projects have concluded, gone quiet, or fizzled out, including PharmaLedger, MedicalChain, and MedRec.
While the PharmaLedger project officially closed at the end of 2022, the consortium initially identified ‘Health Data’ as one of three use case pillars. The PharmaLedger project was sponsored by the European Federation of Pharmaceutical Industries and Associations (EFPIA) as part of the Innovative Medicines Initiative (IMI). Several pharmaceutical companies, universities, patient organizations, and hospitals participated in the 3-year project (Figure 1).
The IMI project fact sheet states two areas of focus concerning health data: a use case that matches patients with clinical trials and a use case that will strengthen patients’ ownership of their data, enabling a health data marketplace. After that, however, the project shifted focus to the flagship use case: blockchain-enabled electronic product information (ePI).
Further, upon closing the IMI project spun out the PharmaLedger Association (PLA), a swiss-based non-profit, aimed to continue the work of the initial PharmaLedger consortium. Recently, PLA project leads Dan Fritz and Marco Cuomo, both Novartis veterans, discussed on the Health Unchained podcast how health data projects were deprioritized in favor of blockchain solutions applicable to supply chain, noting that supply chain use cases were more palatable overall by consortium decision-makers [6].
With a mission to ‘improve care for people by placing the patient at the center of the digital transformation of healthcare [7],’ MedicalChain started as a project to improve discharge summaries. They are building two apps using the Hyperledger Fabric architecture: doctor-to-patient telemedicine and health data marketplace. In 2018 MedicalChain crowd-raised with an initial coin offering (ICO) with MedToken, distributed on the Ethereum network [7]. In November 2021, CEO and Founder Dr. Abdullah Albeyatti appeared on the Healthy Discussions Podcast, where a discussion regarding the impact of a rigid bureaucracy on innovation and free markets was fully displayed. The project has gone relatively quiet since then.
Several years ago, MedRec took on the appearance as a ‘solution for physician burnout’ [8]. Initiated by Ariel Ekblaw as her thesis project at MIT Media Lab, MedRec evolved as a way to improve access to patient electronic health records. However, the project ceased activity in September 2019. Today, MedRec is a case study loaded with learnings on tokenomics, interoperability, scalability, security, and privacy.
Conclusion
The health data exchange space may not be the lowest-hanging fruit with respect to blockchain applications in healthcare; however, there are promising disruptions and innovations in development designed to revolutionize digital trust and transparency to improve outcomes for the ultimate end-user, the patient. Blockchain-enabled solutions in the healthcare transaction ecosystem, supply chain, and clinical trials may be favored by biotech and healthcare executives frustrated with poor returns on digital investments, long sales cycles, and arduous product development in a complex, regulated industry.
About the Authors:
Dr. Erin Zagadailov, PharmD, MS is an intrinsically motivated biotech executive with expertise in patient-focused drug development, market access, early/late phase new product planning, real-world evidence, artificial intelligence and machine learning applications in real-world data, data science, health economics, patient advocacy, value demonstration, and health technology assessments.
She is passionate about rare diseases, infertility, and women’s health. Dr. Zagadailov is presently taking a biotech career sabbatical to explore applications of blockchain in biotech and healthtech verticals at MIT Sloan and the Blockchain Founders Group.
She and her family live in rural New Hampshire, where she is the founder and creator of Lady Grantham Apiary, a bees first flower farm that prioritizes the survival of honeybees and produces locally grown specialty cut flowers. In her spare time, she volunteers with the New Hampshire Women’s Foundation, where she serves on the Grants Committee.
Dr. Pavel Zagadailov is a physician-scientist with expertise in women’s health, assisted reproductive technologies, outcomes-based research, and real-world evidence. He is the founder and managing director of CORG DATA, your partner in decentralized science.
References:
[1] Demassa J. Forget Micro-Networks: How Avaneer Health is Building The One Health Data Exchange to Rule Them All — The Health Care Blog. Accessed January 12, 2023.
[2] Bruce G. How healthcare is using blockchain and what’s slowing its adoption — a chief scientific officer’s perspective. Accessed January 12, 2023.
[3] Equideum. Data Integrity and Learning Networks (DILNs). Accessed January 12, 2023.
[4] SolveCare Lightpaper. Accessed January 12, 2023.
[5] Lin J. Payment Matters:John Bass, CEO and Founder, Hashed Health. Accessed January 12, 2023.
[6] Dogum R. Health Unchained Ep. 107: Digital Trust Ecosystem — PharmaLedger. Accessed January 12, 2023.
[7] MedicalChain Whitepaper. Accessed January 12, 2023.
[8] Molteni M. Moving Patient Data Is Messy, But Blockchain Is Here to Help. Accessed January 12, 2023.
