The healthcare industry has seen waves of hype around an array of technologies over the last century or so — each one promising to be revolutionary in its own way. Most recently blockchain has become the go-to topic in the future of healthcare. Industry players are promising the technology can link patients' medical records, verify medications and more, but like many new tools it has been met with a healthy dose of skepticism.
“It is like any new technology or innovation or government structure: there is a big learning curve. Think about it, it took a long time for the internet to get there. At the beginning people were laughing — what’s this internet thing, what’s this email? They were saying, ‘Oh, you don’t need email.’ Look around now, [and] everyone has an email,” Ameer Rosic, cofounder and marketing adviser at Blockgeeks, a Canadian blockchain innovation hub, told MobiHealthNews. “I think the more people we educate with real clarity the better. Because like anything — if you are familiar with the Gartner Hype Cycle — there is always the hype, then the decline, then the slow gradual improvement. It’s like a roller coaster ride. So it is really important that people who are really interested in the space get the real information to think long term.”
Many industry experts have stressed the importance of using blockchain for a particular purpose rather than implementing blockchain because the technology is in vogue right now.
“There are places in healthcare we can see immediate application for this technology," Abel Kho, director of the Center for Health Information Partnerships at Northwestern University and cofounder of Data Link, said at Dev4Health in Cleveland earlier this year. "A lot of this has to be focused on identifying very clearly the problem, ... because I think right now what we have is a lot of hype around a potential solution. We have to really focus on what is that aspect of healthcare you are trying to problem solve around.”
So what are the experts saying are real areas we can use blockchain, and where is there just a lot of hype with a dead end? Although it’s not as glamorous as a lot of the use cases, industry players are seeing blockchain as a big game changer in healthcare administration.
“It can solve double input problems, it can solve double invoice problems, it can solve digital identity problems, which is really important in the healthcare [industry],” Rosic said. “For example, let’s say I go to a lab to do my blood work and my doctor can only release information to me. Just as of late we are allowed to get the results by email [in Canada]. Before you had to get a physical form with your blood results. So it is difficult to transfer medical records, including my blood result from province to province.”
This kind of application can already be seen in some parts of the world.
Notably, Estonia uses blockchain technology to help give its citizens control over their health records and facilitate proper use of the records by the medical community. The system was designed to “ensure data integrity” as well as “mitigate internal threats to the data.”
“From my perspective, I think actually the first wave of applications we are going to see are around compliance and regulated activities in which putting together a very expansive audit or report are a challenge,” Emily Vaughn, product development director at Change Healthcare, said at Dev4Health. “And the reason for that is because there is a business case for building out this infrastructure. Once you get out of this data administration bucket of use cases, you can start to move on to data synchronization and automation of workflows.”
It would be hard to talk about blockchain without cryptocurrency coming up. In fact, several healthcare companies have implemented the technology into their model. For example, Sweatcoin is a free app that tracks users’ outdoor steps using their phones’ accelerometer and GPS locator. The steps are then translated into the currency, which can be used for goods, services and experiences that range from yoga classes to high-tech shoes.
Rosic expressed uncertainty on the topic of healthcare and cryptocurrency rewards, in particular lesser known tokens.
“I’m very skeptical of people giving data for money because money skews behavior. When you have money to be gained it invites the worst behavior possible. People will automatically game the system,” Rosic said. “If you are trying to create a system like that it can’t be for a 'funny money' token. There are some valuable tokens out there. For example, I’d rather get paid in USD than Canadian money any day, just because the premium of the USD has a stronger value. So it’s the same thing with tokens. We work with freelancers around the world and none of our freelancers want any tokens besides bitcoin. Bitcoin has the most credibility and value. No one wants to get paid in ABC token or CBF token.”
However, other companies in the space are using blockchain and cryptocurrency to solve for a specific problem.
Take Nebula Genomics for example. Nebula will sequence the participants’ DNA for no out-of-pocket cost. People can then sell their data to researchers and receive Nebula tokens in exchange. Participants use these coins to purchase information about their genome sequencing and what it means in terms of their, and their future children's, health. This removes third-party vendors and lets people choose which researchers they would be willing to sell their data to.
But in addition to the cryptocurrency element, the data is stored and accessed using blockchain.
“What blockchain enables is to establish a single source of truth, irrevocable data ownership. What we do for example is associating data owners with the hashes of the data and we store that information on the blockchain,” Dennis Grishin, CSO of Nebula, told MobiHealthNews. “And this is added once, and blockchain being our only database it can’t be revoked essentially.”
Grishin said that in the past privacy and ownership have been hurdles in getting people to have their DNA sequenced.
While the overarching trend appears to using the technology first to address administrative problems and then moving into more innovative arena, there are still a lot of questions about how the technology can work in practice and what is just hype.
“There is a massive potentiality. We are in the first inning or, as I say, the first yard of the 100-yard football game,” Rosic said. “We are just at the beginning of this new type of technology that has massive potential.”