In last week’s blog, Point: The Promise of Blockchain, we discussed some of the exciting features of blockchain technology as it begins to take hold of the healthcare IT field. This week, we’re looking at the other side of the coin by outlining some of the pitfalls related to this technology.
Blockchain is regarded as secure for two main reasons: 1. cryptographic “fingerprints” included in each block in the chain, and 2. the “consensus protocol” through which nodes in the network mutually confirm the validity of the information. But as this MIT Technology Review article explains, people have already come up with clever ways to cheat this kind of system, including “selfish mining” and hacking smart contracts.
With the growing availability of data, we need to take precautions to protect it. Data theft is rampant, and while gathering data from EHRs can be risky in itself, at least they are hopefully aware of the sensitivity of that data, whereas other sources may not be. Even patients themselves often don’t understand how to keep their data secure, or recognize the consequences of failing to do so.
Make no mistake: blockchain will certainly face security issues as the technology continues to mature in the Healthcare IT field. Healthmonix spends a large amount of talent, time, and money on protecting what we collect, calculate, and send to CMS; and we will be cautious if and when we accept data from other sources, vetting the security and the appropriate privacy considerations. However, this remains one of our greatest concerns in relation to blockchain.
Despite the fact that Bitcoin is just one of many ways to use blockchain, the technology itself still carries negative associations with the cryptocurrency and by extension the dark web. And it makes sense that the two concepts are so closely linked, considering that Satoshi Nakamoto (the pseudonym used by the mysterious inventor or inventors of Bitcoin) created both Bitcoin and blockchain at the same time, and for the same function.
Even disregarding the reputation of Bitcoin, though, blockchains have already proven vulnerable to several kinds of flaws in the short history of their implementation. blockchains “bloat,” using excessive energy and lowering network speed as the amount of stored information increases, which leads to serious issues of scalability and efficiency. They are also vulnerable to bugs, faulty coding, and social engineering. Overall, these associations could spook potential investors and trailblazers, and could prove to be an obstacle to buy-in for pioneering projects.
Because blockchain is such a hot buzzword, everyone wants to throw it around—which makes it harder to tell who really knows what they’re talking about, or even if anyone does. The novelty and complexity of the technology means that those with the knowledge and skills to really leverage it are still rare, and resources are still lacking. But that doesn’t prevent start-ups from jumping on the trend to generate hype for themselves. So for now, any person or organization that sounds like they have all the answers in this area should be treated with a healthy dose of skepticism.
Nor should you too readily trust the hype surrounding blockchain itself. Blockchain has been massively over-sold as the solution to all of our problems, from fraud to population health. But can it really live up to those expectations in terms of practical implementation? Although the technology seems promising, it’s simply not ‘ready for primetime’ yet.
We are excited about the potential of blockchain, but we also recognize the need for caution and skepticism in the face of so much overpromising hype. As we attend conferences on Health IT and read papers and talk with our colleagues, we keep aware of advancements. If opportunities and energy arise around a promising pilot, we are ready to participate as appropriate.