The American Council of Technology and Industry Advisory Council (ACT-IAC) hosted a Healthcare – Blockchain Forum on March 28, 2019 at the Renaissance in Washington, DC to discuss the future of blockchain in the healthcare sector, as well as accomplishments to date. Representatives from the Departments of Health and Human Services (HHS) and its Operating Divisions (OPDIVs), Veterans Affairsan (VA), Defense Health Agency (DHA), and Pharma discussed their plans for future use of blockchain, evaluations of on-going processes, and early outcomes for projects utilizing blockchain. Jose Arrieta, Acting Deputy Assistant Secretary for Grants Acquisition Policy and Accountability (HHS), provided a demonstration of the new “HHS Accelerate” initiative, which showcased how blockchain, artificial intelligence, and automation can be effectively utilized

Agencies Presented:

• Health and Human Services (HHS)
• Food and Drug Administration (FDA)
• National Institutes of Health (NIH)
• Centers for Disease Control and Prevention (CDC)
• Defense Health Administration (DHA)
• Department of Veterans Affairs (VA)

For the full speakers list, please visit: https://www.actiac.org/2019-healthcare-blockchain-forum

Blockchain, in short, is a series of immutable records of data that is managed by decentralized sources, allowing access to many entities simultaneously while reducing redundancy. Blockchains are anticipated to have many potential uses in the healthcare field, which this forum outlined. Although this technology provides many benefits, Commander Roger Boodoo with the DHA explained that government and healthcare fields are conservative entities and historically slow to innovation. Michael Akinyele, Department of Veterans Affair, clarified that the VA has certain regulations and guidelines that provide difficulties for a full embrace of blockchain technology. Akinyele’s long term goal for the VA is to reduce the overall spending budget to fit the declining veteran population, and believes the most effective way to accomplish this would be through a blockchain solution. An RFI was previously released in June 2018 to identify how blockchain may be used to simplify and streamline the department's contract procedures.

The HHS has been the most active in utilizing blockchain to date. Dr. M. Khair ElZarrad, Deputy Director, Office of Medical Policy (FDA), provided information of the future Real-Word Evidence Program (RWE), which is based on the framework of information gathered in 2018. The RWE will be developed by analysis and utilization of real-world data (RWD) that is available to the FDA. Moreover, RWE is anticipated to assist with internal processes, guidance development, and demonstration projects from evidence provided by randomized trials, including large simple trials, pragmatic trials, and observational studies. The real-world data for the RWE program will be collected from Electronic Health Records (EHRs), claims and billing activities, product and disease registries, patient-generated data including in home-use settings, and data gathered from other sources (i.e. mobile devices) that provide health status information. Dr. M. Khair ElZarrad stated the comment period for the RWE program closes April 16, 2019. The FDA is also conducting the INFORMED program to also evaluate the use and management of health data from sources such as the EHR, genomic data, data from clinical trials, and data from registries. The INFORMED program is intended to assist the FDA in regulatory decisions by expanding organizational and technical infrastructure for big data infrastructure. Utilizing data in more efficient programs is the center point for the FDA in current and future projects.

The CDC also explained their intention to utilize blockchain in response to outbreaks, or mobilizing surge capacity. Currently, there are risks effecting response time for mobilization including “siloed” data, legacy systems, and the overall lack of trust in data from different “silos”. Sachiko Kuwabara, Director Office of Risk Management & Operational Integrity, mentioned the challenges associated with how the CDC currently operates during an outbreak and said that adopting emerging technologies, including blockchain, can help eliminate these challenges. A blockchain for emergency response brings benefits such as secure cross-organizational data sharing, immutability of critical data for compliance, and high-trust data and immutability, creating a robust foundation for artificial intelligence. Sachiko Kuwabara provided a proof of concept, stating it is the intent of the CDC to begin with a small sample inclusion with a future expansion plan. The next steps for the adaptation to new technology is scaling the solution and refocusing the business and agency mindset to accept blockchain. The CDC is also applying blockchain in a new joint program with IBM, titled EHR Blockchain, to better understand the benefits of blockchain by using EHR data received for National Ambulatory Medical Care Survey (NAMCS). Currently, they are only using synthetic NAMCS data for the EHR blockchain proof of concept but hope to have this working in full capacity soon. Askari Rizvi, Chief, Technical Services Branch (CDC) and David Mcelroy, Blockchain Lead, IBM, provided a demonstration of the program’s prototype, specifically the process in which information is input into the blockchain and in turn distributed among different entities using the new program. 

The Forum concluded with a demonstration of the HHS Accelerate Program. The HHS Accelerate program, created as part of the ReImagine HHS initiative, is the development of a new tool utilizing blockchain and automation for real time information to assist the acquisition team in developing fully fledged requirements with accurate information. This new tool is anticipated to reduce redundancy in contracts and provide historical information with ease of access, including incumbent or spending information. The blockchain within this program allows the information to be shared across all sub agencies within HHS in real time as information is added into the tool. All of which is tailored towards the acquisition team to help build a complete solicitation package, by actively keeping associated scientists, doctors, or non-acquisition personnel informed on the construction, status, and development of a requirement related to their work. The new HHS Accelerate tool utilizes automation and blockchain to help HHS streamline the acquisition process and provide the industry with more accurate, up-to-date information for requirements.

The ACT-IAC Healthcare – Blockchain Forum was a discussion of what the aforementioned agencies are planning and achieving with the aid of new technology. Blockchain is anticipated to provide many opportunities to reshape the healthcare field and this forum demonstrated the future use of this technology in transferring safe data and immediate information across many users.