Hashed Health After Action Report: HIMSS 2017

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The Healthcare Information and Management Systems Society (HIMSS) has held an annual conference for around 50 years and rarely, if ever, has a new topic garnered as much attention as blockchain did this year. “Blockchain” was one of the key buzzwords that was circulating around the show and lots of people seemed to be looking for more information. The frenetic activity at Hashed Health’s booth this year demonstrated that healthcare blockchain technology has arrived and will be commanding attention for years to come.


Hashed Health greatly benefited from a few things early on at HIMSS 17. At the beginning of the show, keynote speaker Ginni Rometty from IBM mentioned blockchain after talking about Watson. Hashed Health had the good fortune of being the only booth that was specifically findable by searching for the keyword “blockchain,” and by luck the booth was positioned across an open presentation space from our friends at Hyperledger. All that, in combination with pre-booked meetings, resulted in three days of unbroken blockchain discussions.


Conversations generally fell into three categories:

  1. Tell me about blockchain.
  2. What are the uses cases for blockchain in healthcare?
  3. I get it, let’s go — where do we start?


Within the first two categories, people ranged from intrigued to skeptical but after even a short conversation, most began to see a path to the third. We know that our challenge in a land of fast followers is to give them something to follow — our key takeaway is that healthcare-specific use cases and demos are that path forward.


Hyperledger and Hashed Health

Hyperledger hosted a booth just across the conference Innovation Zone from Hashed Health. We had a great exchange and collaboration of ideas and customers with the consortium. We built our provider data management use case on Hyperledger Fabric, so every time someone asked if there were real healthcare products being built on Hyperledger, Brian Behlendorf and the Hyperledger team could simply point our way.  Many in-depth discussions resulted from this pattern and we certainly appreciate the partnership opportunities that Hyperledger has and continues to provide.


Hashed Health in the Innovation Zone

Hashed Health had a tiny, modest booth (at least compared to the behemoths in the high-rent end of the exhibition floor). The booth activity was non-stop and our small footprint was often four deep. The traffic demonstrated the broad interest in blockchain from across the industry. By our rough estimate, the breakdown of interest was as follows:


  • 20 percent financial-related (healthcare-related financial services).
  • 15 percent pharmaceutical-related.
  • 15 percent health-insurance related.
  • 15 percent HIT-vendor-related including IoT, wearables, analytics and API/integration solutions.
  • 15 percent entrepreneurs interested in operating under the Hashed Health umbrella.
  • 10 percent health-system- and other provider-related.
  • 10 percent device manufacturers, suppliers and other service providers.


Hashed Health’s Provider Data Management Demo

Our first demo focused on the provider data management use case detailed in last month’s newsletter. Running a sandboxed blockchain, the demo tracks updates to discrete pieces of provider data which are essential in the credentialing process and with ongoing provider directories. The demo performed flawlessly, processing and distributing over 150 manually-entered updates over the course of the conference. We plan to post a video of the demo shortly and may make it available on the web.


We see this demo as not only a solution to a well-known problem in provider management but also as a broader “gateway project.” We believe that the fundamental framework of the demo, distributing a shared data asset, has applicability in a range of other use cases. The Fabric demo, though still very rough and simple, provided a really nice use case for people to better understand the value of the technology.


Blockchain in Healthcare: A Rock Stars of Technology Event

The Institute of Electrical and Electronics Engineers (IEEE) hosted a one-day blockchain event at HIMSS that featured several speakers and a panel. Here are a few of the highlights from the event.


Tamara St. Claire: Dr. St. Claire did a nice job kicking things off. Thankfully, she didn’t go through the typical, awkward “what is blockchain?” introduction and, after a warm up, got in to the use cases which included Master Patient Index, Auto-Adjudication of Claims, Interoperability, Longitudinal Health Records and Supply Chain. It was especially exciting when she gave Hashed Health a “key stakeholder” shout-out (along with Hyperledger, MIT and others).


Jon White and Steve Posnack of the ONC: The regulators of HIT in the room were saying all the right things and made some excellent points as they encouraged the blockchain community to work with them on both ideation and commercialization. Much of the discussion was focused on explaining the role of the ONC. Dr. White particularly is an excellent speaker and a friendly face for the organization. ONC’s upcoming workshop in D.C. will be a major blockchain event.

We asked Dr. White and Steve Posnack when the right time would be for us to get involved with the ONC on projects (design phase or after). The responses I received:


“We like to learn what people are doing up front…  In some cases, we can shape our regulatory framework for certain flexibilities for what the market needs as opposed to not having that insight ahead of time. If you are in a position to educate a regulator, go for it. You don’t lose anything there and it helps them understand the market and the challenges you face.” — Steve Posnack


“Life is a lot more fun as a scavenger hunt than it is as a surprise party.” — Dr. Jon White.


Ted Tanner, Pokitdok: Ted can come across as a bit prickly on stage, probably because he is so damn smart. It makes him a little scary to people (especially during the Q&A session), but if you listen, you always learn something. Specifically, it was enjoyable to hear how Pokitdok is positioning its successful API business on the blockchain, a topic Ted knows well and has been wanting to put into play for years. What he and Lisa Maki are putting in place is impressive (APIs, identity, clearinghouse, payments and more) and should make some of the healthcare middlemen nervous.


Brian Behlendorf of Hyperledger; David McCallie of Cerner; Srinivas Attili of IBM; and Josh Greenberg of IEEE: Any time that Brian leads a panel it will be thoughtful and educational. If you don’t know his background, check it out. He has the perfect blend of healthcare and technical experience to back up everything he says.


This panel also featured Dr. David McCallie, SVP of medical informatics at Cerner. Dr. McCallie is the Cerner rep: old school, conservative, skeptical. He posits that while he is trying to be hopeful for blockchain, he is not trying too hard. It was good to have him on the panel to balance out the “yay for blockchain” contributors. Like many in healthcare, he is not convinced and is stuck on understanding how private blockchains are different from traditional database solutions. Brian (who has known Dr. McCallie for years) softly provided examples of the counterpoints to Dr. McCallie’s concerns. There wasn’t time to make it to the microphone and ask whether the debate had changed Dr. McCallie’s mind in any way, but it likely did not.


Srini Attili was the bookend on stage who provide a nice and balanced perspective from IBM, who seems to be all-in, especially on use cases such as prior auth, provider data management and patient consent.


Jon Mattison: Dr. Mattison is the SVP and CMIO for Kaiser. His presentation closed out the day. It did a good job of highlighting the exciting role of blockchain in the future while reminding us that success requires “engineering, security, workflow redesign, contracts expertise, integration and successful consortium efforts.” He mentioned the word “consortium” over and over as a key ingredient during his presentation, focusing in on the specialized skillset and visionary leadership required for success. Among Dr. Mattison’s favorite use cases are autonomous eligibility adjudication, cohort qualification for clinical trials/research, provenance and interoperability.


(Note: Unfortunately, time did not allow us to attend several of the presentations, including a fireside chat with Gem’s Micah Winkelspecht and the Hyperledger Roundtable Lunch).


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