Analysis of the Healthcare Blockchain Market: 7 Companies Changing Medicine for the Better

Introduction:

Blockchain is certainly the word of the year. Simply referring to the technology can sky-rocket valuations of a company (e.g. Long Island Iced Tea, now Long Blockchain Inc, increased 500% in a day; Kodak’s stock tripled after announcing an ICO). Blockchain is dominating pop-culture and discussions in many industries; however, this innovation is more than just hype. Blockchain is truly a global phenomenon – you can find taxi drivers illegally trading cryptocurrency from their phones in China or see the practical use of blockchain in the allocation of resources to refugees in camps in Africa and Europe. It’s a solution that is applicable to almost every industry. Why? It provides a decentralized, unalterable, and distributed ledger system that may be used for the tracking of any sort of “transaction” across systems – and is seen as a technology that eliminates the “middle-man” in many processes. In simpler terms, the user, be it an individual, government, company, or some other combination of actors, can see the past and present conditions of whatever they are tracking without need for “independent” verification as an intermediary. Further, this information is independently verified by a multitude of people and processes. In the modern day, the trifecta of artificial intelligence, blockchain, and the internet of things (IoT) is representative of a powerful system. Each of these represent an organ system – artificial intelligence is the nervous system (the brain), blockchain is the cardiovascular system (the lungs and heart), and IoT is a sensatory system (the hands, nose, eyes, ears, and taste buds). All of these together represent the human body – a critical thinking system that integrates these systems to collect information, analyze it, and make decisions. Most interestingly to us at DHB Global are the potential applications in healthcare. Leaders in the medical fields have been identifying problems and working to find solutions since the advent of modern medicine; however, many problems have not yet been adequately addressed.

Blockchain may be the answer that could revolutionize the industry and make the clinical cycle of care for all actors cheaper, safer, more efficient, and more effective.

This post will examine the current landscape of blockchain in healthcare by exploring potential use-cases and further diving into companies implementing blockchain in practical applications with their associated coin offerings.

Because of its nature, blockchain could be used in many instances across the clinical care cycle to solve issues ranging from data access to data security to product verification/reliability and more. One of the most intuitive (and thus most common and wide-ranging) applications relates to the digitization and sharing of health records. Currently, patients’ health records are fragmented across the healthcare system; further, even if they are effectively shared, data hygiene is a consistent problem due to frequent changes to patient identifiers (e.g. name, address, insurance policy). Without comprehensive health records being quickly accessible, the level of difficulty of effective healthcare provision for everyone from doctors to insurance companies increases exponentially. Blockchain solutions aim to create a Master Patient Index (MPI) that could safely and securely enable the sharing of health information in a streamlined system, even enabling patients to set “permissions settings” for their data. You could let a designee have access to your entire file, while ensuring your ophthalmologist wouldn’t be able to access your sexual health history. In an MPI, which includes one’s genomic data, many possibilities are opened up for patients. One such possibility is the option to sell one’s genomic data (or demographic, fitness, nutrition, or innumerable other kinds of personal data) for scientific research or other purposes. This could help solve the massive patient recruitment and retention problem impacting clinical trials.

Over 50% of trials are delayed, 30% of successfully recruited patients drop off, and 85% fail to retain enough patients to continue. Further, for trials that do complete, 80% are delayed by at least one month. At an estimated cost of anywhere from $600,000 to $8,000,000 in cost per day for trials, the waste of time and money is substantial.

Genomic data that is quickly available would help identify patients who could qualify and benefit from participation. Genomic information could also enable machine learning applications that use these diverse, wide-ranging data sets to show that specific behaviors, genomic traits, biomarkers, or other personal identifiers have positive or negative health impacts. This, in turn, would allow doctors and patients to attempt to alter behaviors for positive health outcomes or to monitor certain aspects of one’s health that appear to be at risk. One such example of this is related to precision medicine, which is an emerging field that combines robust and comprehensive data sets of multiple natures over a patient’s life-cycle to determine likely health risks and outcomes. However, the personal sale of genomic data raises some ethical concerns – and requires further verification within service providers dAPPs to ensure that people do not provide untrue information to attempt to make their own data more valuable. The use of blockchain to minimize and eliminate fraud is also promising. Related to this is the verification of pharmaceuticals.

Annually, 800,000 people a year die worldwide as a result the complications of taking counterfeit drugs. Further, the pharmaceutical industry suffers an annual loss of up to $200 billion because of the production and sale of fake drugs.

Blockchain has already been widely used in verification across the supply chain for everything from designer handbags to luxury alcohol brands – so its use in verifying manufacturing materials, date, and location is certainly possible. Also related to fraud is billing and claims for health insurance. Smart contracts could be instated that automatically links the satisfactory completion of a procedure to billing to create a seamless environment for doctors and patients. Further, blockchain could be used to double verify patient’s treatments at doctors offices and hospitals, to ensure that insurance claims are both real and accurate. Double verification would help insurance companies verify claims and ensure that patients and care providers are on the same page before bills come back in the mail.

Companies and Use Cases:

To raise money and find success, it is frequently stated that blockchain companies need both a minimal viable product (MVP) and a protocol. Many companies resort to using initial coin offerings (ICOs) to raise money in early stages. There are a few notable blockchain health companies utilizing the ICO route that have both an MVP and protocol:

Digitization and Sharing of Health Records:

• Medicalchain – London, England, United Kingdom – Medicalchain aims to combat various issues associated with healthcare from fragmentation of healthcare services to a lack of patient centricity to security risks and cost increases/fraud. They aim to create user-focused electronic health records that utilize a hyperledger fabric architecture to allow the end-user to set levels of permissions for different care providers. The system will record every interaction between patients and the healthcare system on the blockchain which simultaneously makes the data secure, transparent, and reliable, also allowing for audits if needed. The Medicalchain system also serves as a platform for the development of dApps. Currently, two are available with others in the pipeline and the ability for user/community design on the back-end. One current option is a telemedicine service that allows patients to utilize the ecosystem’s MedToken to pay doctors directly for a video consultation. The other current solution dApp is a marketplace, similar to that of Nebula’s except lacking genomic data, that allows users to negotiate terms for their health data and be paid in tokens. Medicalchain is conducting an ICO with Medtokens being issued at a rate of $0.25 in ETH or BTC.

Genomic Sequencing and Data Marketplace: 

• Nebula Genomics – Palo Alto, California, United States – With a solid team of developers and advisors (including George Church of Veritas Genomics), Nebula Genomics aims to address four current obstacles for genomic sequencing: sequencing costs, data protection, data acquisition, and the memory cost of genomic “big data.” Through the use of their nebula token economy, data owners will have their data subsidized by buyers in the research or pharmaceutical industries. Eventually, individuals will be able to make money from their data. Further, lowered sequencing costs will incentivize more people to sequence their genome, thereby growing the data marketplace. The data will be kept secure using decentralization, cryptography, and blockchain. The system will keep sellers anonymous while making buyers completely transparent. The system will also help to create comprehensive data sets through smart surveying tools and will execute smart contracts to ensure a seamless marketplace experience. The memory efficient encryption of this platform will minimize the data footprint while keeping it accessible and available. This project is promising and innovative within the space.

Personalized Medicine:

• Gem (Health) – Venice, California, United States – GemOS – a project already established for over four years - is a wide enterprise platform with healthcare-related projects still ongoing. Its initial conception was as a consolidated digital asset wallet – and these digital assets may include your healthcare-related data or medical records. Specifically, this service helps ensure that personalized care is possible for patients with the highest standards of privacy and security within a universal infrastructure. Gem utilizes three combined solutions to make this a reality. Gem integrates distributed resource registries, multiparty identity and access management, and logic automation to create a secure, all-compassing wallet system. These approaches enable information securitization within a blockchain, granting of permissions to access information, and the ability to seamlessly exchange and integrate information across companies and their systems. This further enables secured access to sharable data with user-designated permissions. Regarding healthcare use cases, Gem has already partnered with four large groups. In 2016, they partnered with Phillips, as well as CapitalOne, to collaborate on blockchain-based approaches to patient-based care. Following that, they partnered with both Tieto, a European health services provider, and the United States Center for Disease Control and Prevention (USCDC). With Tieto, Gem serves to connect to specific data stores, like blood banks and DNA registers, to ensure supplies and help respond to specific hospitals real-time needs. With the USCDC, Gem manages population health data and on-demand data after disasters to optimize and coordinate an adequate response. 

• Doc.ai – Palo Alto, California, United States – Doc.ai is a precision medicine focused project that, like Nebula Genomics, is also backed by George Church. Founded in 2016, it hopes to utilize various sources of healthcare data uploaded by users to paint a detailed picture of a patient at a specific time. End-users can upload their data and recruit (receiving tokens as compensation) researchers and data scientists create predictive models and draw conclusions on the platform that they can then share with their personal doctor. This “data trial” gives patients access to data scientists and, in theory, online second opinions. This service also contains the “Robo-Genomics” chatbot which educates the end-user by answering queries about their genetic data. The chatbot is knowledgeable in a variety of fields ranging from diseases, traits, pharmaco-genomics, and family planning.

Cost Savings and Waste Reduction - Treatment Optimization:

• SimplyVital Health – Hartford, Connecticut, United States – SimplyVital Health is a blockchain firm seeking to increase the level of security and transparency throughout the entire clinical care cycle. Included in their platform are general practitioners to specialists and supplemental services such as therapists. ConnectingCare centralizes different medical organizations onto a single platform. Here, records are shared across the network for shared patients, enabling better communication and more synergistic collaboration for treatment. Further, embedded algorithms utilizing AI analyze financial and clinical data to provide actionable suggestions for treatment to optimize cost and patient outcomes in real-time.  The idea is that providers both can and must work together to minimize cost and duration of care for the patient. For example, in the modern context, orthopedic surgeons and physical therapists are relatively disconnected. The disconnect between therapists and specialists results in both money and time-wasted for both the patients and the entire healthcare system. The ConnectingCare System aims to prevent that by tying reimbursement to variables like patient outcomes and cost, as well as interoperability and coordination between providers, monitored by an audit trail. Thus, the system drives providers to collaborate in the patient’s best interest and focus on results and patient follow-up. Further, by examining the patients’ treatment and results, the system can suggest beneficial paths of treatments for the same individual and other individuals thereafter. HealthNexus is another SimplyVital product – this is a healthcare blockchain protocol that is the first to be Health Insurance Portability and Accountability Act (HIPPA) compliant. Utilizing the Ethereum platform, it combines a new validation and governance protocol for safe health data sharing.

Tracking Prescription Medication:

• Chronicled – San Francisco, California, United States – Chronicled is a smart supply chain platform with use foundational cases specifically in the medical space. In 2017, Chronicled teamed up with The LinkLab to work on the MediLedger Project, which aims to improve the track-and-trace capabilities across the supply chain for prescription medicines. In this process, the groups tackling this project have met with both manufacturers and wholesalers to align goals and develop a product that is suitable for all actors in the pursuit of minimizing fraud and verifying manufacturing and transportation details, including materials used, temperature during transport, etc. This project is practical, as it was designed to comply with the U.S. Drug Supply Chain Security Act and GS-1 Standards; further, Chronicled has worked to ensure that the system could also be interoperable so that it would also meet the needs of the pharmaceutical industry. Supply chain components that were once unlinkable can now be connected. The open network allows fully privacy and the protection of business intelligence, while still allowing for the necessary levels of verification and reporting across the supply chain. For the end user, it allows identity provisioning, app-based verification, and counterfeit product fraud reporting integrated with law enforcement.
• Note: Blockpharma of Paris, France has created a similar platform that allows the end user to instantly verify the authenticity of drugs that utilizes machine learning algorithms as the dApp is used to make it more accurate. This execution and use case is very similar to that of Chronicled’s platform. 

Healthcare Payment Method & Models/ Development Platform:

• PokitDok – San Mateo, California, United States – PokitDok is an integration-capable platform-as-a-service for healthcare organizations to build consumer experience across the healthcare value chain. With over 700 trading partners, PokitDok offers both useful transactional data and effective commerce linkages. It offers modular services that can be implemented individually or in-combination from identity management to benefits management to patient payment risk assessment to patient-facing scheduling and payment systems and even to optimal health claims management systems. Notably, PokitDok partnered with Intel to develop Dokchain. This payment token, built on top of the platform, allows for the payment of various healthcare services and products. The Dokchain standard is already supported by many large companies including Ascension, Amazon, and Guardian. The technology and platform complies with many standards and has received various important certifications, such as HIPPA, PCI, SOC 2, EHNAC – OSAP HIE, HiTrust CSF certification, and the Council for Affordable Quality Healthcare’s CORE Phase IV certification.

Conclusion:

All of these companies have great ideas, solid teams, and potentially revolutionary products with real-world applications to solve some of the largest issues in healthcare now, including:

• Fragmented Health Records
• Data Privacy/Security
• Fraud (Insurance and Reimbursement)
• Pharmaceutical Supply-Chain Verification (Fake Drugs)
• Payment Systems
• Data Availability/Clinical Trial Patient Recruitment

DHB Global is excited to follow their progress and is gearing up to enter the space with a use-case so far unexplored. Stay updated on our project by checking this blog with regular updates.