DeepRadiology is primarily an AI company, with solutions developed for head CT scans, and others under development. However, it plans to integrate blockchain technology for increasing its international presence, to support and incentivize ecosystem members who are part of developing and using DeepRadiology solutions, and to reduce healthcare costs. These second and third aims are also shared by the other player, MDW.
MDW is a blockchain-based decentralized platform that connects imaging facilities, radiologists, and AI developers. At the 2018 RSNA Annual Meeting, they unveiled their platform and also have existing clients on their system—individual radiologists, smaller imaging facilities and teleradiology groups. The goal with the platform is to provide crowd reading, second opinion, peer review, or quality control, in an open and transparent environment, as promised by the underlying technology itself.
MDW also specializes in sourcing medical imaging datasets for AI developers to access, allowing monetization of the anonymized, annotated data for imaging centers, while providing access to crucial training data for the developers. It has also launched a marketplace for AI algorithms to facilitate imaging facilities to make use of existing AI algorithms—this is expected to be similar to the cloud-based, on-demand platforms available from EnvoyAI, Nuance, and Blackford Analysis, but based on a blockchain-based payment platform. Next year, MDW expects to bring more functionality to the platform, while scaling up and acquiring more customers.
Other examples include MedNetwork and MediBloc, which both enable storing and sharing for medical information via blockchain networks. The former is focused solely on medical imaging data, while the latter store’s health records (including diagnostic results), providing access to providers when visited by the patient. MedNetwork also has a telemedicine platform providing AI diagnostics and second opinions, somewhat similar to the approaches above.
The benefits of the technology for smaller players, and for teleradiologists are clear. And yet, these two platforms are still addressing only parts of the radiology paradigm for blockchain. Another use case for the technology for providers involves equipment lifecycle management. A solution provided by Spiritus Partners addresses critical industry challenges around device safety, quality and lifecycle management as they apply to all medical devices, including imaging equipment. As is evident, use cases for the technology are varied and, as yet, emerging.
The road ahead
Blockchain will not disrupt existing workflows, nor will it replace existing health IT systems such as DICOM or PACS, nor will it affect the interoperability standards such as HL7 or FHIR. However, it will act as an additional layer of trust and security for seamless interactions by automating the traditional consensus mechanism which is mutually agreed upon by all participants. Moreover, the convergence of the technology with other emerging technologies such as the Internet of Things (IoT) and AI will boost trust around them, promoting new care delivery models and monetization options.
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Frost & Sullivan predicts that blockchain in healthcare will move beyond its hype next year. By the end of 2019, an estimated 5-10% of healthcare-focused enterprise blockchain applications will move from pilot stage to partial or limited commercial availability.
Blockchain for healthcare is still relatively immature, but select B2B commercial implementations examples include those by Change Healthcare and Hashed Health. This year, Change Healthcare announced limited availability of their Intelligent Healthcare Network for the claim adjudication use case. It also collaborated with TIBCO to develop blockchain-powered Smart Contracts for automating healthcare transaction processes. Hashed Health recently announced the initial corporate partners for their professional credentialing application called Procredex, including WellCare Health Plans, Spectrum Health, National Government Services, HealthLink Dimensions, LLC, and Accenture, among others. It is also planning to demo its performance-based contract adjudication and management platform called Signal Stream soon.
For radiology we expect some more organizations to get on board blockchain-based platforms such as MDW.
However, it is important to realize some of the limitations of this technology—blockchain is just one technology falling under the larger distributed-ledger technology umbrella, and it may not necessarily be the best. Over time, another technology may overcome blockchain as the better choice. Secondly, being a network play, the governance mechanisms need to be agreed upon first, before deployment of the infrastructure can begin, which is also why enterprise blockchain is a better near-time opportunity over a public network such as those being considered for national health records.
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