In 1994, the internet grew by 2300% in a single month.
Recognising the opportunity to create a business which could capitalise on the internet’s colossal growth, Jeff Bezos left his job in finance to build what would eventually become the world’s largest e-commerce store, Amazon. Blockchain in 2016 is the internet of 1994. As the decentralised and distributed technology that lies behind the the notorious cryptocurrency - Bitcoin, Blockchain will unequivocally and irreversibly upend the healthcare industry, creating opportunities to substantially reduce the costs of healthcare.
Blockchain is a peer-to-peer distributed ledger that establishes transparency and trust. It provides a way for a unique piece of digital property to be transferred to another, “such that the transfer is guaranteed to be safe and secure”, and cannot be challenged. It will mount a challenge to the Goliath's of healthcare, and represents the dawn of a new day where large volumes of sensitive patient information can be exchanged securely and quickly between two parties. But, the real value in Blockchain lies in value-adds and use-cases that we have not, and cannot yet even begin to imagine; much like the promise of the internet in 1994. Here is by no means an exhaustive list of ways that Blockchain could disrupt healthcare in the not too far off future:
A Shared Secure Single Score
In 2014, 12.6 million electronic patient healthcare records were stolen in America. By 2015, that number had increased to 113 million. While a stolen credit card can easily be cancelled, a healthcare record is far more valuable to hackers, to the sweet tune of $363. The reason being is that healthcare records can be used repeatedly, as they contain social security numbers, occupations, spouse, children, as well as the obvious…your medical history.
The distributed nature of Blockchain means that there is no single point of failure. A public ledger records all transactions that are conducted and distributes ledgers of those transactions amongst all computers using the network, resulting in a crowd owned, decentralised record of all transactions. This makes it difficult, if not impossible to access, edit, or steal patient information without being discovered. Estonia, a model nation in the adoption of emerging technology, has partnered with GuardTime, an industrial Blockchain security firm, to store the healthcare records of its citizens using Blockchain. “Every update to healthcare records and every access to healthcare records is registered in the Blockchain. That makes it impossible for the government or doctors or anyone to cover up any changes to healthcare records and that’s really powerful”, Mike Gault, CEO of Guardtime.
For the People, By the People
If it’s free, you’re the product. Unwittingly, we have become the product, our data sold to the highest bidder in the pursuit of more. Blockchain opens the democratic floodgates through the creation of smart contracts, where a patient’s own data works for them, rather than against. Personal health records stored on Blockchain will empower patients by giving them access to, and full ownership of the entirety of their health data, a seismic shift of power from the current status-quo. Given this model, patients will be able to sell or altruistically grant providers, universities, or researchers access to their anonymised data in the pursuit of medical breakthroughs, the development of novel new drugs, or in the prevention of chronic conditions. Access can be granted with specific conditions attached, which are determined by the patient, such as the extent or length of time that information is shared. Anonymised data mined from entire populations as opposed to strictly being from volunteers will enable more accurate results in studies and clinical trials, leading to a market-based exchange system for data. Blockchain embodies the antithesis of our fragmented and disjointed healthcare system, providing an environment of transparency where the patient for the first time, is the captain of their own information.
Trust in a Trustless World
Throughout history, technological advances including the use of currency, the invention of the Gutenberg printing press and the growth of the internet have all led to a profound expansion of trust. This in turn has fuelled economic activity by creating systems where two parties can safely engage in trade with one another. Trust is the critical element which underpins all transactions, and is for the most part now is provided by a Trusted Third Parties (TTP). TTP’s are entities which facilitates interactions between two parties who cannot trust each other, and require a separate trusted party to review and approve transactions between both parties. But trusted third parties that exist today create friction, raise costs and slow down the speed of business, think VISA, MasterCard or PayPal.
Blockchain presents the opportunity for frictionless business, replacing antiquated and restrictive business practices, and removing need for a central trusted authority to govern a transaction. It reduces the need for a trusted intermediary to be involved in any transaction, instead creating a distributed trustless consensus. Patients, governments and businesses will be able to share information almost instantly and pay bills without incurring transaction fees, all without a third party that was previously required to independently transact and verify information. Replacing TTP’s will pave the way for vast efficiencies while dramatically reducing the administrative burden and cost of healthcare that exists today.
The real value in Blockchain lies in value-adds and use-cases that we have not, and cannot yet even begin to imagine; much like the promise of the internet in 1994. For the time being, Bitcoin is the killer application on Blockchain, but if the healthcare industry is willing to embrace disruption, its future looks bright. This exciting new technology is a great equaliser, a digital democracy of sorts, but much in the same way that we all need to trust the principal of currency or a third party before its true value can be realised, we first need to place our trust in Blockchain as a system which we can use to facilitate meaningful value exchange.