Change Healthcare Launch Raises Questions About Blockchain Scalability

Posted on January 12, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Healthcare technology vendor Change Healthcare has introduced a blockchain-based network focused on managing claims. Change says its Intelligent Healthcare Network is the first enterprise-scale blockchain network in healthcare.

According to the vendor, using technology will let organizations track the status of claims submission and remittance across the claims lifecycle accurately. It also contends that by using blocking technology in Intelligent Healthcare Network, companies will have a greater ability to audit trace and trust those involved in transactions.

To build out its blockchain infrastructure, Change Healthcare used Hyperledger Fabric 1.0, an open source blockchain framework hosted by The Linux Foundation.

Within the release, the company predicts that blockchain technology could ultimately offer providers a single viewpoint for accurately tracking the complete patient healthcare encounter, starting, say, when an individual arrives for a preoperative visit to the procedure care received, then later billing and payment.

All of that is well and good, but the following is more noteworthy.

In its statement, Change says its Intelligent Healthcare Network already processes more than 50 million claims and up to 550 transactions per second. It says that the capacity and speed of its network already exceeds the daily national transaction load, and that its network can scale as blockchain technology use grows.

Still, Change tells us that it will be building out its apparently massive network infrastructure “as the solution is further optimized and scaled to address demand.”  This suggests that Change may know something that we don’t about blockchain implementation. It’s not entirely clear, but I think the vendor thinks that its blockchain solution will generate significant network overhead, enough that even with its huge existing capacity, and eventually won’t be able to keep up with blockchain demands as is.

So that brings us to the real issue buried in this release. If Change needs to build out its super-high-capacity network as its blockchain customer base grows, it suggests to me that enterprise blockchain may not scale effectively overall at present.

If there is a scalability issue with Change’s blockchain service, there could be a number of reasons why. For example, it could be related to some idiosyncrasy within the company’s network architecture. Another guess is that Change is already having throughput problems it doesn’t want to discuss, and that blockchain is just adding insult to injury.

Still, one has to wonder whether the problems are inherent to blockchain itself. As far as I know, we don’t yet have much information on how blockchain solutions like Hyperledger perform in an enterprise environment. Perhaps we’ll learn something about this by keeping an eye on Change’s launch.