The emerging role of blockchain and how it could change your practice

By Naveed Saleh, MD, MS
Published January 24, 2022

Key Takeaways

  • Blockchain is an immutabile cryptographic ledger, mostly used to record transactions.

  • Since blockchain is encrypted and distributed, it could one day serve another purpose: storing and distributing health data.

  • Policy makers have continued to signal that they’re interested in enhancing interoperability, and blockchain may be the technology to do it.

Blockchain is the digital ledger on which bitcoin and other cryptocurrency exist. Although sentiments about crypto are mixed, the underlying blockchain technology has diverse applications—including in health care.  

A blockchain-powered health information exchange could expand interoperability, with the potential to reduce the costs and hassle of intermediary systems, experts say. 

Blockchain background

What is blockchain?

Blockchain is a type of distributed database technology. Rather than being centrally located, the database is shared among individual nodes of a computer network. All information is stored electronically in a digitally encrypted format. Right now, the chief use case for blockchain is cryptocurrency.

You can think of the blockchain as a living ledger that records and stores transactions. It is an unmodifiable record shared via peer-to-peer transactions, built on transaction blocks hosted on a digital ledger. 

Since blockchain lacks a central governing authority, it uses cryptographic strategies to permit interactions between network users who have no history of trust. These interactions include storage, exchange, and viewing.

In blockchain, transactions are distributed among all network users. Any interactions are exposed to all network participants and necessitate verification by the network before data is added to the ledger. This step allows trustless collaboration between network users, while creating an audit trail—a function with direct implications for healthcare.

Nationwide interoperability

How might blockchain benefit healthcare? Deloitte, the international consultancy firm, sees great potential. 

“The promise of blockchain has widespread implications for stakeholders in the healthcare ecosystem,” the consultancy wrote in an analysis. “Capitalizing on this technology has the potential to connect fragmented systems to generate insights and to better assess the value of care.”

The Office of the National Coordinator for Health Information Technology appears to see a need for integration Deloitte described. The office published a shared roadmap for interoperability, and blockchain may be a highway to this destination. Policymakers wrote in a whitepaper:

"The nation needs an interoperable health system that empowers individuals to use their electronic health information to the fullest extent."

The Office of the National Coordinator for Health Information Technology

“The nation needs an interoperable health system that empowers individuals to use their electronic health information to the fullest extent; enables providers and communities to deliver smarter, safer, and more efficient care; and promotes innovation at all levels.”

According to Deloitte, blockchain may be the interoperability answer policymakers are looking for. The consultancy recommended that corresponding policy and technical components focus on a ubiquitous, secure infrastructure. And, means to verify identity and authenticate participants, as well as authorization to access electronic health data, are also required. Blockchain technology could solve both of these problems.

Although currently inchoate, blockchain has the potential for seamless coordination and interoperability regarding electronic health records, the consultancy wrote. However, technical, organizational, and behavioral obstacles must be overcome.

HHS is onboard with blockchain technologies and is tracking it to determine where government support may be needed to shape the future of healthcare technology. Deloitte recommended that HHS consider developing a blockchain ecosystem, encourage early adoption, and support dialogue/discovery. With government help, blockchain technology may decrease complexity of health records, bolster trustworthy collaboration, and create an immutable bank of healthcare information.

Related: Helpful or hype? Wearable tech makes its way into clinical practice

Other healthcare uses for blockchain

As explained by authors of an article published in the International Journal of Intelligent Networks, blockchain is useful in preserving and exchanging patient data, as well as identifying serious or dangerous mistakes in patient care. It can also reduce deception in clinical trials.

Here are some specific applications, according to the authors:

  • Blockchain will create a central repository for data pertaining to clinical outcomes, procedures, and medications. This may prove useful for precision medicine, as well as better understanding  how patients respond to prescription medications and interventions.

  • Seamless data exchange on blockchain would increase levels of diagnostic accuracy, as well as drive efficient therapies and cost-saving benefits in healthcare systems. 

  • Blockchain will usher in greater transparency around drug origin information. This information can ensure the quality of the drug and provide information about the manufacturer, flagging counterfeiters. The safety of drugs offered to patients would be better ensured, with prescription medications traced along the supply chain. In other words, physicians and pharmacists can ensure that their patients are receiving optimal pharmacotherapy.

  • Blockchain will support the veracity of data from clinical trials and ensure that the research question is addressed. It will also root out false results and false content.

  • Blockchain can facilitate patient care by ensuring that physicians have adequate access to medical supplies. It will also allow physicians to monitor patients remotely. 

What this means for you

Although blockchain is still an emerging technology, its potential to improve electronic health records and patient care is enormous. Clinicians should monitor this technology as it develops, since it has the potential to transform daily practice. In time, blockchain may become an indelible aspect of healthcare.


  1. Blockchain: Opportunities for health care. Deloitte United States.

  2. Connecting Health and Care for the Nation A Shared Nationwide Interoperability Roadmap. The Office of the National Coordinator for Health Information Technology.

  3. Blockchain technology applications in healthcare: An overview. International Journal of Intelligent Networks. 2021;2:130-139.

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