EHR Blockchain Proof of Concept (POC)

1. EHR Blockchain Proof of Concept (POC) Askari Rizvi, Chief Technical Services Branch Division of Health Care Statistics National Center for Health Statistics National Center for Health Statistics Division of Health Care Statistics March 28, 2018

2. BLUF • NCHS/DHCS Surveys • NAMCS Overview • Reasons for Blockchain POC • Research Collaborative Agreement • Key Players • Overarching Blockchain Benefits & Benefits to EHR Data • Current “As Is” Process” • Today’s Demo Scenario • Q & A 2

3. NCHS/DHCS Surveys To carry out its mission, the Division of Health Care Statistics administers the National Health Care Surveys, which is a family of surveys covering a wide spectrum of health care delivery settings from ambulatory and outpatient to hospital and long-term care providers. NHDS NAMCS NEHRS NHAMCS (ED, OPD, ASL) NSLTCP Next Survey To Be Added NHCS (Inpatient, ED, OPD) Development Underway NAMCS (Traditional, CHC, & EHR) EHR Blockchain POC 3

4. NAMCS Overview • National Ambulatory Medical Care Survey (NAMCS) • Produces national statistics about ambulatory care services which are used and provided by office-based physicians and various types of clinicians at community health centers (CHCs). • Historically, data have been collected by medical record abstraction on-site at the physician’s office by Census Field Representatives. • More recently, we’ve started working on obtaining data from EHR Systems as well. Note: All data used in the EHR Blockchain POC is completely synthetic. 4

5. Reasons for EHR Blockchain POC • Collaborative effort between CDC’s Innovations Committee & NCHS/DHCS • Research & Development • Searching for innovative solutions to resolve CDC’s business problems • Create a blockchain “use case” to potentially resolve current/future EHR data collection challenges for multiple surveys 5

6. Research Collaborative Agreement • Center-wide Data Call for POC submissions • Electronic Health Records (EHR) POC was selected as the POC by NCHS/CDC and IBM 6

7. Key Players CDC OIT/OIS CDC: Serve as a Blockchain SME for CDC DHCS OIT/OIS: Serve as a NCHS Blockchain SME IBM DHCS: Provided the business use case and institutional knowledge for EHR Blockchain POC IBM: Building the technical solution for Blockchain POC EHR Blockchain NCHS EHR Admin Provider NCHS Auditor • Uploads data & grants access per data type • Accesses data for processing & analysis • Audits data access 7

8. Overarching Blockchain Benefits • Easier to manage consent & share data • Embeds inherent Privacy & Security controls • With embedded audit trails, disclosure risks are minimized • Improved healthcare • Improved public health 8

9. Current “As Is” Process EHR No No Registration (160K EPs) Sample Registered Providers Testing and Validation Provider Sends EHR data Edit Data NCHS Review Yes Yes PFI Eligible? Correct format and useful? Integrated file Provider Public Use File NCHS Data Store NCHS Census In-house file Legend Abstracted Sample (3K EPs) Census pre-field process FR visit (Collect data) Census data processing Edit Data NCHS review 10

10. Today’s Demo Scenario Provider - Emily NCHS MU Admin NCHS Auditor EHR No No Registration (160K EPs) Sample Registered Providers Testing and Validation Provider Sends EHR data Edit Data Yes Yes PFI Eligible? Correct format and useful? Consent • Check Consent • Download Data • Decrypt EHR • Check Consent • Encrypt EHR • Upload Data 14

11. Questions? National Center for Health Statistics Division of Health Care Statistics 16