Healthcare and the Blockchain

Healthcare and the Blockchain (Part 1)??????????2/24/2022

I remember using AOL in 1995 to look up the top high school football players across the US and getting a glimpse into the power that the internet might hold.??The excitement of endless searches of useful or useless information that could be used to help with homework, streamline vacations, or settle any high school cafeteria debate. Over the past 3 months, I have experienced this same teen excitement as we move into Web3 and the begin to think about what the blockchain technology may look like over the next decade. Although I am not an expert by any means in crypto, I understand enough about it to begin to understand why Silicon Valley is investing heavily in Web3 projects.

Covet What We See

I know this an extremely horrific quote from Silence of the Lambs, but we tend to think about new technology and then overlay what it could look like in our own life or industry.??As I dove into blockchain and crypto over the past 16 months, I cannot think of a better eco system for this technology than the US Healthcare system as it begins to embrace technology. My occupation has been in the healthcare field for the past 11 years so I am excited about the potential and will attempt to simplify it for all audiences.

To Encrypt or Not to Encrypt That is NOT The Question

Personal Health Information or PHI is always a hot topic that is discussed as we move into digital health that involves wearables, home health devices, EHR/EMR (electronic health records), secure payments, patient portals, digital front doors or clinical approved medical devices (this list could literally go on for days). The point is that there is a lot of data/PHI being generated every second in the healthcare system and the struggle is trying to keep it safe while also keeping it easy to use/access to drive down the cost to care for the patients/employers/government. This is really where the blockchain begins to solve lots of problems in our industry so I will insert a long dissertation below on blockchain tech in the next paragraph.?

Annoying & Long Dissertation on Blockchain

A blockchain is blocks of data that are stored chronologically to form a digital ledger of all transactions on a decentralized peer to peer network made up of nodes/validators (I know that is a lot to digest but I will try to make it simpler later in this paragraph). Every computer/node on the network has a copy of the digital ledger and is notified of any changes/additions to the ledger (addition of a block of data or change to a block). When a change is made, a block is added to the block chain with the addition of a new block that has a reference to the previous block with a transaction hash. The best analogy I have heard on the blockchain, and the security is to think about it like a playground football game where all 22 students are keeping score so any changes to the score must be validated by all 22 students or else the recess monitor will experience a riot. If someone tries to cheat and embellish the score of the playground football score, they will need to get agreement across all 22 players (or nodes in the blockchain). This is where the security occurs as getting consent on the changes from all nodes and then documenting who made the change to the blockchain is now in a digital ledger for all to see that theoretically cannot be altered without consent. The beautiful part as it relates to PHI is that the data on the blocks is encrypted until the requester of the data uses their private key to unlock/decrypt the data on the block. This eliminates a storage area that is continually growing with PHI and becoming a larger target for hackers.

I thought Blockchain/Crypto was all about money?

The payment/currency on these defi (decentralized) networks is used to pay the nodes/validators (proof of stake) and miners (proof of work) to change/access/collect all the information that is being requested or changed on the blockchain. The problem is that the coins usually upstage the technology, so folks think of it as a currency and not a technology. The validator or miner that retrieves or edits the blockchain is rewarded with an Ethereum, Bitcoin or whichever native coin is used on the network. For this reason, many folks are skeptical on the market cap being realized for these crypto projects. The value of the coin oscillates based on the number of projects on the network and the capped (or not capped) scarcity of the native coin. Bitcoin has a supply of around 18 million while Ethereum has a supply of around 120 million tokens, so they have very different value and are sometimes compared to gold and silver.

Why the US Healthcare system is perfect for this technology!

Imagine having all your vaccinations, allergies, procedures, diagnosis, recorded BMI, blood pressure, etc. on a decentralized blockchain/digital ledger for any provider around the world to access in real time. When was the last tetanus shot? How long ago was my appendix taken out? When was my heart stent? What is my blood type? What medications am I on? What co morbidities does this patient have? What are your past labs???I know you are thinking that some of this already exists in a patient portal, but that portal is not on a decentralized network that can be accessed by every provider network or health plan. Hence this is the current challenge of the current US Healthcare system where we are generating tons of data in silos that is creating problems for us to aggregate, analyze and weaponize to reduce the overall costs.??

Over the next several weeks, I am going to be writing about where these digital ledgers could add value in the US Healthcare system ranging from secure payments to AI and all the way to a value-based payment arrangements for the provider network.??I am a terrible writer with tons of run on sentences, sentence fragments so be patient with me as I attempt to tackle this topic. Hopefully I was able to clearly walk through some of the technical aspects above to get our collective wheels turning.