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The HC-SIG continues to evolve as it grows in membership, participation, and activities. We have successfully completed our transition to structure the General Group general group to serve as a “front door” to better engage and keep prospective new members active in the community, align them with resources, and connect them more directly with our three HC-SIG subgroups.
HC-SIG General Meetings are held regularly and are well-attended.
HC-SIG Subgroups
HC-SIG Subgroups continue to evolve and include:
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Both the Patient/Member Subgroup and the Payer Subgroup are meeting regularly and seeing repeat member participation. At the end of 2018 the EMR Subgroup was disbanded due to inconsistent meetings. The Healthcare Interoperability Subgroup--the newest HC-SIG subgroup--is due to come online in early April.
HC-SIG Teams
HC-SIG Teams include:
- The Academic Research Team: developing a white paper to identify how best to engage the academic/healthcare community as the topic relates to blockchain technologies
- The Charter Review Team: charged with reviewing and rewriting the HC-SIG Charter (completed)
- The Wiki Redesign Team: initially convened to redesign the HC-SIG wiki, now working to manage wiki page conversion to Confluence, and sync with other SIG design efforts
- The Subgroup Review Team: convened to review the status of the EMR Subgroup, and to consider how other subgroup models may influence future HC-SIG subgroup designs
HC-SIG membership participated in three guest presentations: Seattle-area attorneys to speak on open source and IP-sharing; a development team interested in creating a healthcare solution using the Hyperledger Sawtooth framework; and Microsoft Corporation to speak on blockchain technologies and security in healthcare.
Of
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Merit
- The Charter Review Team successfully reviewed and rewrote the HC-SIG Charter
- The Subgroup Review Team successfully reviewed existing subgroup infrastructure, and in reporting back their findings, introduced the proposal for a new "bottom up" design for HC-SIG subgroups
- The HC-SIG became a sponsor for a healthcare-related Github Lab project entitled "Sawtooth Healthcare
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- HC-SIG members participated in the KidneyX Challenge
- HC-SIG members participated in the 2018 Hyperledger Global Forum, and participated in the 2019 HIMSS Conference
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Issues
None to date.
Overall Activity in the Past Quarter
General Group
The general group (HC-SIG) serves as an entrée for prospective members in the global healthcare community interested in understanding how best to educate themselves and participate in the implementation of blockchain technologies–ostensibly using the Hyperledger Project umbrella of frameworks, tools, and extensive community–in order to create secure and healthcare-compliant enterprise solutions. For more established members, the general group serves as a resource for the notification and publication of relevant community healthcare activities (e.g., healthcare conferences), as well as a means for promoting and encouraging the project engagement and accomplishments of each of its three subgroups.
The general group (HC-SIG) holds a regular meeting on a bi-weekly basis on Friday mornings at 0700 (Pacific Time). As a regular agenda item, HC-SIG Subgroup subgroup leads (or their proxy) “roll up” their subgroup activities so as to educate prospective new members on active project opportunities.
Membership and activity across the healthcare-wg listserv(healthcare-sig@lists.hyperledger.org) continue to grow. Listserv membership is currently at ~1045 ~1050 members. Our chat channel, #healthcare-sig (https://chat.hyperledger.org/channel/healthcare-sig), is seeing semi-regular daily exchanges.
Patient/Member Subgroup
Active since June, 2018 and led by Marissa IannaroneBenjamin Djidi, the Patient/Member Subgroup continues to work towards a build effort leveraging Hyperledger tools in the healthcare space. We have meetings every other week and we are active in the healthcare Special Interest Group mailing list (see #patient-member-subgroup and #DonorMilk for details). We aren't seeing a lot of engagement on Rocket.Chat or on the Wiki, but we continue to work to engage folks on those platforms.
While Hyperledger Global Forum application cited in the June update was not accepted, we continue to move the Human Donor Milk Use Case forward. Enough cannot be said about the incredible contributors to this subgroup, and collaboration with Rapid Healthcare has been a great asset as the project continues to grow and mature. A summary of activities are as follows:
Applying for and receiving the Labs designation and the HubSpot holds the code - Lab approved on 8/3/2018
We continue working to build requirements (even rather informally) via the wiki reviewing national guidelines and doing independent research in order to understand the network and how Fabric can be leveraged to solve existing challenges
Subject Matter Experts (SMEs) have been engaged both on the donor bank and Hospital side in order to ensure that what we are building is meeting actual business needs; we continue actively look for more SMEs
We completed a HiMSS AsiaPac submission for this PoC and we are waiting to hear back - submitted 9/14/2018
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The Patient/Member Subgroup underwent a transition in leadership in January which also served as a documentation effort. The main challenge currently facing our subgroup is the loss of our main sponsor for the Donor Milk POC upon which we were focusing our primary efforts. This has left us without product guidance for the development of our blockchain POC as well as without the perspective of a pilot sign off for any MVP. As a result we are currently investing in two options:
- An active lead generation where we hope to find an industry leader able to both guide the product and commit to a pilot
- A call for project ideas so that, should our first option fall through, we would have foundations to move the subgroup past the Donor Milk POC
Payer Subgroup
The Payer Subgroup has been actively working since inception in June 2018 and is being currently led by Raveesh Dewan from CareFirst BlueCross BlueShield. The group subgroup continues to refine the use cases and to ensure the right use cases are being picked selected for POCs. See the activity at https://lists.hyperledger.org/g/healthcare-wg/search?q=%23payer-subgroup&ct=1.
The subgroup meets on a regular basis every Tuesday from 3:00 PM to 4:00 PM EST.
The subgroup started with exploring current problems in the payer industry that can leverage blockchain solutions. The group started having discussion around scoping the activities and decided on two specific deliverables:
A white paper focused on the challenges with healthcare payers using Hyperledger: this paper will review valid use cases, pick a few use cases and demonstrate how Hyperledger can help
Creating a POC based on one of the use cases identified in the white paper
We started discussions around various use cases and a number of meetings were dedicated to following use cases:
Authorizations
Provider Data Management
Value Based Care
The subgroup did get a chance to invite various SMEs from the industry to understand the business processes. Thanks to Tony Little, who shared a use case that Optum is focused on addressing the Provider Data issues in the payer industry. Thanks to Richard Cole, Steven Elliott, Chris Cole who shared other use cases that have great potential.
As we discussed these use cases, it became clear that we need to have a decision framework to establish the validity of a use case for blockchain use. Subgroup members decided to come up with a decision framework white paper. The team is activity working through that as of now. While the subgroup team is starting at a general level, it will be later customized for application in the payer industry. Thanks to Jeff Stollman for walking us through the initial decision flow he came up with.
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is back on track with work in-progress with the paper:
We are working on the Block Chain Decision paper that will help payers understand and identify the need for blockchain.
Link to the work in-progress white paper - Link to White Paper - IN-PROGRESS
We are targeting release this paper by end of Q2
POC and Prototypes
We plan to start initial discussion regarding picking up a use case and start creating a prototype
Plan to kick off this effort with the group sometime early May 2019
Healthcare Interoperability Subgroup
With the recent charter approval in mid-March, the Healthcare Interoperability Subgroup (HC-SIG HIS) has not yet had its first meeting, but preliminary membership interests are high. Steven Elliott serves as the HIS Lead.
The Healthcare Interoperability Subgroup has completed its charter and will begin regular meetings mid May. Initial work will be to deliver a roadmap that will culminate with a working POC that will demonstrate how a consortium of health systems and patients might store and access clinical information on a distributed ledger. This bottom-up approach will focus on the assets, transactions and policies needed to ensure clinical artifacts stored on the ledger have the same semantic meaning across members. One of the goals of the subgroup will be to complete a working system that at some level could be reused as a service by other healthcare related blockchains.
The HIS will also engage with industry and clinical SME's to solve and discuss work already done towards interoperability in the medical field. Work already done by groups at HL7, HSPC and Reginstrief will be leveraged by HIS and invitations to present will be extended to individuals from these institutions as SMEs who can help guide the processes and modeling needed to achieve our goals. Contact has been made with individuals including Stan Huff of HSPC and Claude Nanjo of HL7 for initial presentations of FHIR and alternative interoperable models.
Planned Work Products
General Group
Upcoming activities planned by the general group include:
A revision of the HC-SIG Charter: the original charter was drafted in 10/2016, and does not include a number of sections that have since been added to the charter draft. A planned review of the HC-SIG mission statement/scope is also anticipated
The establishment of regular speaker presentations from across the healthcare community to provide “real world” experiences in the design, implementation and establishment of a Hyperledger Project solution within their enterprise context
- The establishment of additional HC-SIG subgroups that appeal to membership healthcare specialties
- The development of an online HC-SIG healthcare resource for blockchain technologies. Numerous HC-SIG members have asked for academically-based educational resources to both learn about, and better communicate the value proposition of blockchain technologies in healthcare
The completion of the redesign/migration A redesign of the HC-SIG Wiki in order to:
Provide a more meaningful “front door” experience for new members to quickly discover HC-SIG resources and subgroups
For established members, serve as a dashboard of activities and accomplishments
Better separate (and highlight) our subgroups (where the real action is) from general WG group coordinating activities/governance
Patient/Member Subgroup
The Patient/Member Subgroup will continue to to work on the donor milk use case through next quarter, finalizing the PoC, and then looking at expanding to additional use cases. This work will include building/refining requirements and building the code base.
Payer Subgroup
Activities planned for the next quarter include:
Continue working on a white paper on the General Decision Framework and Decision Framework for Payer Industry (target for completion in Q4-2018)
Future plans:
Start working on a white paper around Challenges with HealthCare Payers and HyperLedger/Blockchain (target for completion in Q1-2019)
Apply and select a use case for POC and execute a POC
Presentation of the Decision Framework and POC at various events as we progress
We will soon be looking for members who can help with the coding of the POC.
EHR Subgroup
For the next quarter, the subgroup plans to deliver a 10-15 page document describing the following for its EHR blockchain use case:
Depending on whether our search for a new sponsor is successful, we would either resume the work on the Donor Milk POC or, if not, begin a selection progress to determine which project idea should replace it. The main intent is still to contribute to the broader Hyperledger code base through the lab. Given the current uncertainty, we do not have a defined product roadmap but we expect to engage in recruitment activities (especially around developer resources) either way.
Payer Subgroup
We are looking to expand the membership to include team members. I do plan to organize a local event in Maryland and invite various payers and leaders from the industry to start helping with this group. As well, we plan to finalize the POC/Prototype for a use case and kick off that effort in this upcoming quarter.
Healthcare Interoperability Subgroup
The HIS team plans to deliver the following work products:
- Documentation describing the requirements for a semantically interoperable healthcare ledger including:
- Policies that guarantee interoperability
- Transactions needed to complete an episode of care
- Semantically interoperable Assets that can represent clinical artifacts whether or not the actual artifact is stored on or off chain
- Use-cases that reflect real-life episodes of care
- POC : A functional (minimally viable) blockchain
- Multiple health systems capable of storing / retrieving assets
- Software and system design documentation (SDD)
- Git code repository
- Lessons Learned and next steps
Benefits of storing/indexing EMRs in blockchain
Impacts for the healthcare ecosystem: patient, providers, care centers, pharmas, payers, authorities, changes in data governance
Incentives, impact on the current patient data economy, use of tokens
Benefits/challenges vs privacy compliance: HIPAA, GDPR
Impact on government regulation
Challenges: EMR fragmentation, standards, interoperability, availability/access to EMRs, Master Patient Index, size of data in transactions
Use of standards: HL7
User interface considerations
Timing for deployment
Participant Diversity
This is a very diverse membership with global representation (including, but not limited to, member participation from England, Canada, and India). The majority of membership represents corporate healthcare entities, though we do regularly see regular (and perhaps increasingly so) participation from smaller healthcare startups.
Additional Information
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