As federal organizations increase their exploration into the uses and applications of emerging technologies, opportunities for synergy between these technologies increase in tandem. Specifically, the combined effect between blockchain and robotic process automation (RPA) can be readily explored as adoption increases throughout the public sector.
Briefly defined, blockchain is a digitized, distributed ledger that can be public or permissioned, composed of “blocks” of records and linked together using cryptographic hashes. New blocks are appended to previous blocks based on consensus amongst peers, thus forming a chain that serves as a digital ledger of trusted transactions maintained among and across participants.
In place of multiple independent and isolated ledgers, there is a single shared record of events distributed across all blockchain ledger participants. While blockchain is used to store information, RPA is used to aggregate, clean, and transform it. RPA is a form of business process automation that utilizes software robots, or “bots”, to perform tasks through interactions in an application’s graphical user interface (GUI). Bots replicate human actions through performance of rules-based and manual tasks.
A 2018 Gartner CIO survey shows that 13% of U.S. federal organizations are in short-term planning and/or actively experimenting with blockchain. While the same report indicates that 6% of U.S. federal CIO respondents have already invested and deployed smart robot (i.e. robotics) technologies.
Additionally, a 2018 CIO Agenda: Government Insights report indicates that 7% of Government respondents rank process automation as a top business and mission objective. Given these statistics, technological collaboration amongst emerging technologies should be explored as possibilities for impactful solutions. Specifically, the impact of RPA across highly complex peer-to-peer business processes could be facilitated by blockchain providing a network effect of impact
Blockchain Today
Blockchain’s potential virtues have been touted widely for a number of years. The peer-to-peer, distributed nature of blockchain allows for near real-time settlement of recorded transactions without the need for trusted third-party verification.
Federal agencies have begun to explore how blockchain implementations can enhance rapid information sharing, facilitate real-time asset tracking, or enable federated digital identities. Since blockchain ledgers contain cryptographically secured, verifiable records of each transaction in a chain—which have all been validated by a network-wide confirmation process—the technology helps to prevent double spending, fraud, abuse, and transaction manipulation.
Additionally, blockchain can be used to facilitate transactions through smart contracts. Smart contracts are pieces of code that can execute predefined tasks when specific conditions are met. Smart contracts further increase the capabilities of blockchain applications because they can digitally mediate, corroborate, enforce the negotiation of, or monitor the performance of a contract.
This can significantly augment data infrastructure, as demonstrated by organizations such as the Depository Trust and Clearing Corporation using smart contracts in the clearing and settlement of $1.5 quadrillion worth of securities in 2015. These strengths have reinforced blockchain as an opportunity for growth in both the public and private industries — forecasted to be a $20 billion global market by 2024.
While blockchain adoption is becoming more widely accepted as an innovative way of storing and transferring data across a distributed network, blockchain systems still depend on a user interface or an external system interface to capture this data.
If the blockchain interfaces directly with raw user inputs, then the blockchain will capture those raw user inputs. When blockchain is combined with an intelligent data ingestion process that can sift through a large set of noisy data, users on the network can benefit from this shared, digitally verified repository of data.
Robotic Process Automation (RPA) Today
Robotic process automation, known as RPA, is a technology that automates rules-based, manual processes. It has gained momentum in recent years as a promising solution to both improve speed and accuracy of various workplace challenges.
Federal organizations are continuously challenged by unfunded mandates, a shrinking workforce, pressure to deliver improved cycle times, and legacy systems housing valuable data that can be difficult and expensive to access or extract.
Implementation of RPA not only produces tangible results, such as improved processing times by up to 80%, improved accuracy by up to 99.9%, and increased throughput by 3-5x, but also leads to positive intangibles such as increased employee morale due to shift from low-value to high-value work activities and happier customers due to improved response times and accuracy of responses.
Blockchain and RPA as a Packaged Solution
While each technology has its own merits in addressing business challenges, utilizing the two technologies in conjunction with each other allows for innovative solutions that leverage the strength of both technologies, beyond the benefits of isolated implementations.
As government organizations graduate from experimental proofs of concept and look to build production-ready solutions, a common challenge they face involves the integration of a blockchain proof-of-concept prototype with existing RPA systems, processes, and interfaces. This point of integration can serve as an opportunity to demonstrate what happens when you combine the value of blockchain and RPA.
Case Study: Medical Record Consent Management
Medical information is one of the most intimate forms of data that exists. It can describe a person’s identity at a level that reflects one’s genetic history, lifestyle, and even their future. As a result, medical information has now also become a sought-after commodity. An electronic health record (EHR) is now more valuable to a hacker than a credit card number, as these records typically contain names, birth dates, billing information, and medical history.
Despite the importance of securing and managing control of medical data, this information can be scattered across medical centers, physician offices, health plans, and other entities. Often these health care organizations store this sensitive data in different digital formats and EHR systems, which makes the task of securing and sharing this information very difficult for patients.
The Department of Health and Human Services (HHS) Office of the National Coordinator (ONC) for Health Information Technology is at the forefront of tackling this challenge in their efforts to promote of nationwide health information exchange to improve health care.
An integrated RPA-Blockchain solution could be particularly valuable for ONC when it comes to patients providing consent for medical providers to share health records across organizations.
Current State – A Slow and Fragmented Process to Share Patient Data
Today when a patient visits a new doctor the physician may not have access to any of the patient’s historical medical records. In order to access them, the doctor must make a request to the patient’s other health care providers asking them to share the individual’s data. To complete this exchange, the patient must sign a medical release form to establish their consent for their previous providers to share their health records with their new provider. Once a patient’s consent is verified, the record is transferred and the receiving provider intakes and parses the data.
The process of requesting records, verifying consent, consolidating information, and transferring data is time intensive and disparate across different providers and provider organizations. With time being of the essence in certain care scenarios, a lengthy consent verification process could delay a life-saving diagnosis or procedure.
In addition, the current health record sharing process does not allow for the customization of sharing permissions or efficient audit trails of those permissions. For example, a patient is typically not able to set specific opt in and opt out preferences when giving access to specific medical information, e.g., mental health, substance abuse, and sexual and reproductive health records.
Health organizations not only need ubiquitous access to all consent permissions when it comes to the sharing of protected information under HIPAA, but they must also be prepared to immediately respond to patient changes to these preferences.
Appropriate and timely sharing of vital patient information better informs decision-making at the point of care and allows clinicians to:
- Decrease duplicate testing
- Avoid medication errors
- Avoid readmissions
- Improve decision making
Traditional solutions and technologies have not been able to completely solve these issues, leaving patients in a position where they face challenges in taking advantage of their own medical information to improve their health care. A game changer is needed.
Future State – Leveraging RPA and Blockchain to Improve Interoperability, Speed, and Security When Sharing Patient Data
Imagine a world where all members of the health care ecosystem across health plans, providers, pharmaceutical firms, and patients could be connected on a single health care information network. All players know the rules of operation and can freely exchange information digitally between one or more parties without fear of data leakage or compromise.
A packaged RPA-blockchain solution could make this vision come true by enabling an efficient, trusted mechanism for verifying patient consent, increasing interoperability between health information systems, and providing auditable record sharing. How?
On the most basic level, RPA can be used to bridge integration gaps between legacy software. Bots can push and pull patient data from existing systems owned or stored by providers, provider organizations, electronic health record aggregators, government entities, or insurance companies and then convert the data into a consumable format.
Blockchain accelerates the integration speed and value of RPA by providing “smart contracts” that enshrine the permissions and automate the processes surrounding what type of health data is allowed to be shared, with whom, and under what circumstances. Furthermore, the blockchain logs a digital record of exactly when an action happens so it can be audited for compliance and be verified by any party participating in the blockchain network.
In a dual deployment of blockchain and RPA, blockchain serves as the solution’s backbone, supplying the rules-based information sharing platform, while utilizing RPA optimizes the solution’s output. The benefit of RPA bots is that they can operate exponentially faster than humans with near perfect accuracy across IT infrastructure and can effectively bridge multiple disparate systems to the blockchain.
Essentially, RPA enhances the blockchain’s data ingestion and extraction processes across the many dispersed and detached legacy systems that dot the health record infrastructure landscape. This concept is summarized in Figure 1 above where an RPA-driven blockchain solution can seamlessly integrate pre-existing data collection points across an enterprise or network to consolidate permissions and act as the single source of truth for patient consent.
By utilizing RPA, organizations can maintain their current systems without overhauling their IT infrastructure to achieve integration with blockchain. Thus, the RPA solution transforms data into usable formats, eliminating the need to replace legacy systems. This packaged solution allows organizations to reduce investment costs, implementation time, and the impact of technological transformation, keeping the transition near invisible to the consumers of affected IT systems while allowing organizations to reap all benefits of blockchain.
In contrast to the existing method of having administrative staff conduct database queries, track down paperwork, or contact other health care providers via phone, fax, or courier, a consent management system that leverages RPA and blockchain-based smart contracts could verify patient consent preferences near instantaneously.
The table below summarizes the current state of patient consent management, and a future state where RPA and blockchain technologies can come together and work in tandem to realize efficiencies and automate the consent management process.
| Current State | Future State |
|---|---|
| Patient signs medical release paperwork at each individual health care provider or provider organization | A patient visits one provider or provider organization that uses an electronic health record data sharing platform with all other providers and provider organizations in the health care ecosystem. The patient can manage their consent preferences for each provider or provider organization on one platform, including managing what information they consent to share at a more granular level (e.g. mental, substance abuse, and sexual and reproductive health records) or macro community level (e.g. full hospital group or full care network) |
| Health care organizations communicate via e-mail, phone, fax, or courier to request and transmit health records | When one health care provider or provider group needs data from another, RPA bots will query the platform’s database for the patient’s consent preferences, then the blockchain smart contract initiates an automatic execution of record sharing based on the validated permission settings |
| Receiving health care provider or provider organization compiles and parses records in various digital formats and data structures, sometimes manually | RPA efficiently consolidates and parses all the available data into one consolidated, uniformly structured and formatted record |
| All health care organizations maintain an individual, sometimes paper-based, often manually managed, record of when health record data was shared and whom between | The blockchain maintains an incorruptible electronic record of all health care data exchanges that occur between network participants and is auditable by everyone in the ecosystem |
Deep Dive: RPA as a Mediation Layer
As organizations look to implement blockchain, they must also examine methods and strategies for tying in the technology with their existing infrastructure. Two places in which integration occurs is the process for which users attempt to “write” data onto the blockchain and the process for which users attempt to “read” data from the blockchain.
While organizations could elect to directly access and write data from and to existing IT systems through an Application Programming Interface (API), raw data may not always live in a usable format. This restriction is especially true for the case of smart contracts. Smart contracts are built with specific data standards that must be contextualized and formatted properly to be written to the chain.
Selecting RPA as the bridge between blockchain and existing IT systems addresses both the issue of cost and user familiarity. From a data ingestion perspective, the end-user would input data with their existing standard operating procedures using an already accustomed system and UI. This removes any cost and time associated with a new user interface and allows for a simpler implementation of blockchain into the day to day processes.
The bot would then locate the input data through the existing system’s data endpoint, whether that be a database, flat files, or other storage formats. Once located, the bot will filter for relevant information and transform the data to a blockchain consumable format to be passed through the configured API and added to the blockchain, as depicted in the figure below.
From a data extraction perspective, a bot would scan the blockchain and locate relevant data on the blockchain to be pulled. The bot would then transform the data, cross-referencing any ancillary database, into a format digestible by the consuming IT system. An end-user would be able to access the data within their familiarized systems without any modifications to their standard operating procedures.
In the case of patient consent, HIPAA compliance authorities, such as HHS could participate in health information exchange networks to verify whether parties in the network comply with HIPAA requirements. These scenarios increase the transparency and accessibility of information between parties and across systems.
Conclusion
Implementing RPA and blockchain as a packaged solution allows organizations to reap the benefits of blockchain while reducing costs, implementation time, and need for users to adapt to new systems and processes. In a future state, RPA and blockchain could reduce communication channels, the need for third-party exchange networks, and automate portions of the electronic health record management process.
As other emerging technologies mature, possibilities of collaborative solutions, such as the relationship between RPA and blockchain, should be considered. These packaged solutions may offer unique approaches to challenging problems, expanding the realm of what is possible through digital evolution.
About The Author
Chetan Hebbale is currently a graduate student at the Johns Hopkins School of Advanced International Studies (SAIS) in Washington, D.C. focused on international economics, climate change, and sustainability.
Prior to this, he spent over 4 years at Deloitte Consulting working on technology and strategy projects at the CDC and U.S. Treasury Department.
He is a native of Atlanta, GA and attended the University of Georgia.
Chetan Hebbale 