Hyperledger HC-SIG Quarterly Report

Special Interest Group

Healthcare Special Interest Group (HC-SIG)

HC-SIG Overall Health

The HC-SIG continues to evolve as it grows its membership participation, and SIG engagement activities. We have successfully completed our transition to structure the 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 and various ad hoc teams.

HC-SIG General Meetings are held regularly and are generally well-attended. It's clear that meeting topic and/or special guest speaker typically drives attendance numbers.

HC-SIG Subgroups

HC-SIG Subgroups continue to evolve and include:

• The Patient/Member Subgroup
• The Payer Subgroup
• The Healthcare Interoperability Subgroup

Both the Patient/Member Subgroup and the Payer Subgroup are meeting regularly and seeing repeat member participation. Patient/Member Subgroup leadership changed hands in June, with cadence of this subgroup increasing as the team develops and grows. The Healthcare Interoperability Subgroup--the newest HC-SIG subgroup–debuted earlier this quarter, and continues to establish itself within the HC-SIG community.

HC-SIG Ad Hoc Teams

HC-SIG Ad Hoc Teams are developed around a specific need or use case, generally of a fixed duration. Ad hoc team leadership, if necessary, may determine that through their investigations, the team should become more regularly established for the sake of membership, and request to become a subgroup. HC-SIG Ad Hoc Teams include:

• Active
  • Academic Research Team: developing a white paper to identify how best to engage the academic/healthcare community as the topic relates to blockchain technologies. This team was temporarily on hold as leadership stepped away on sabbatical, but had again begun working to re-establish a regular cadence.
  • Use Case Development Team: charged with the discussion and development of use cases as applicable in the context of the healthcare industry. This team held a very productive first meeting, but with a recent change in leadership, has been paused, and will likely resume with new team leadership in place.
    
  • Survey Review Team: our annual review team has again begun preliminary work on the annual HC-SIG membership survey.

• Inactive
  • Charter Review Team: charged with reviewing, rewriting, and maintaining the HC-SIG Charter. Currently in recess until a charter review is required.
  • 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 (disbanded after making recommendations to leadership team)
  • 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. Currently in recess until needed for any future design/redesign efforts.

Of Merit

• Special recognition to HC-SIG member Steven Elliott for kicking off the long-awaited HC-SIG Healthcare Interoperability Subgroup (HIS) with the goal of investigating and developing a blockchain architecture that's able to correctly manage syntactic/semantic interoperability within an existing healthcare system

• Special thanks to Deniz Coskun for the successful transition of the HC-SIG Patient/Member Subgroup to an extremely vibrant and productive team. Deniz's team has requested development access to Hyperledger Labs to move forward with their work efforts in this domain space.

•  HC-SIG General Meetings hosted the following guest speakers to present on topics relevant to the blockchain technologies in healthcare community:
  • Alex Zhovnuvaty, CTO of RideChain, and the creator of Sawtooth Healthcare (managed through Hyperledger Labs)
  • Tory Cenaj, Founder and Publisher of Blockchain in Healthcare Today (BHTY)
    
  • Spiritus CEO Susan Ramonat shared her companies views about the problems faced by health systems, device manufacturers and 3rd party service providers
    
    
• Engaged HC-SIG membership with relevant professional opportunities to:
  • Work with Joe Guagliardo, Partner with Pepper Hamilton LLP, who has developed an online Blockchain in Healthcare Certification through Jefferson University’s Digital Health Institute of Emerging Health Professionals. Members of the HC-SIG were interviewed as part of this certification program.
    
    
• HC-SIG Chair interview on the Hyperledger.org blog, served to help engage new potential members

Issues

Ongoing difficulties in assessing the value of work efforts exercised by HC-SIG leadership and membership attempting to broaden the overall appeal of the HC-SIG to new members. Engagement metrics would be greatly appreciated in helping to assess the overall success of such efforts.

Overall Activity in the Past Quarter

General Group

The general group 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 and related events), as well as a means for promoting and encouraging the project engagement and accomplishments of each of its HC-SIG subgroups and ad hoc teams.

The general group holds a regular meeting on a bi-weekly basis on Friday mornings at 0700 (Pacific Time). As a regular agenda item, HC-SIG 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 listserv(healthcare-sig@lists.hyperledger.org) appears to be stable. Our chat channel, #healthcare-sig (https://chat.hyperledger.org/channel/healthcare-sig), is seeing only periodic exchanges.

New this quarter has been the deliberate attempt to extend HC-SIG General Meeting invitations through various social media channels, particularly for HC-SIG guest presentations. It's currently unclear if new membership signups are correlated to these efforts.

Patient/Member Subgroup

Active since June, 2018 and led by Deniz Coskun, 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 for details).

The Patient/Member Subgroup underwent a transition in leadership in January and again in June, so we are again in the midst of a leadership pivot. Since the start of this quarter, subgroup membership has been surveyed on topics to investigate, and we believe to be settling around a work effort that will investigate the workflow of clinical trials utilizing Hyperledger Frameworks as a means to harmonize and integrate disparate clinical trial management software (CTMS) solutions. The first focus is the Informed Patient Consent process. 

Payer Subgroup

The Payer Subgroup continues to work on the white paper and refine the use cases and to ensure the right use cases are being selected for POCs.

• We are working on the Blockchain 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. Due to the lack of consistent members joining the meeting, this has slowed down. We are still continuing slowly to keep the momentum

• Hyperledger Meetup group had really good engagement and we are planning for the next meet up in December. More details will be worked out in next meetings
• Group has also started talking about how to engage additional volunteers

Healthcare Interoperability Subgroup

The Healthcare Interoperability Subgroup began meetings in August and despite low turnouts for the three meetings continues to be optimistic members will begin to coalesce around the goals of the group. Currently the group is working to:

• Build out a timetable divided into major epics of work so stories can be created to complete the epics.
• Define frameworks capable of representing clinical artifacts from episodes of care.
  • Is an episode of care a sufficient unit of work? 
  • What frameworks are currently being used in the medical domain?
  • Are they semantically interoperable?
• What policies of consensus are needed to guarantee assets are semantically interoperable?
• How are assets stored and how are they retrieved?

Planned Work Products

General Group

Continuing activities planned by the general group include:

• 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. To date, our HC-SIG Guest Speaker presentations have been very successful at driving new HC-SIG membership interests

• The establishment of additional HC-SIG subgroups or ad hoc teams that appeal to membership healthcare specialties

• The ongoing design/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 and ad hoc teams from general group coordination activities and governance

Patient/Member Subgroup

With the shift to new leadership in June, the subgroup team has been active in identifying a clinical trials use case. The plan for this upcoming quarter will be to explore and mature the use case to a point where a POC for Informed Consent Process can be defined and requirements expressed. Standardization of API`s and Hyperledger Solutions is a high priority. Great participation from different cultures; (including, but not limited to, East & West Coast US, England, Switzerland, Hong Kong, Argentina, and India).

Completed:

• The use case for the Informed Patient Consent process is fixed
• Two high level preliminary solution architectures are already in place
• Regulatory compliance is already discussed and compliance governance is defined
• GitHub repositories have been proposed
• Proposals to two conferences were sent. A lessons learned paper is to be prepared

Payer Subgroup

• We are looking to expand the membership to include team members through our new recruitment approach. 
• Starting to finalize POC/Use Case with one of the Vision Payers. They have requested not to be public till they establish the internal plan. 

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

Participant Diversity

This is a very diverse membership with global representation (including, but not limited to, member participation from West Coast US, England, Canada, Switzerland, Hong Kong, 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

None to date.