If this is the first time you’ve heard of blockchain, remember it.
If you’re like me, this will be puzzling and maybe a little bit unsettling, because people are saying it’s going to change the world, but it’s not at all clear what it even is, much less why it would change the world.
But I understand enough about it now to say (with reasonable(?) confidence) that they’re right, but it’ll be years before we all see it happening.
This is not specific to healthcare, but it will surely show up in health information.
It’s called blockchain, and the Wikipedia article on it doesn’t help much. But that’s why I like the two minute video I found last week (above), from the Institute for the Future…. how? Why, via Twitter, of course – hat tip to @Sasanof (David Grayson) for his tweet! Please click to watch it. (Email subscribers, if you can’t see the video, click the headline to come online.)
Blockchain is as fundamental a change as HTTP and SMTP.
Think about two new things a generation ago: http:// (which makes the Web work) and smtp:// (which makes email work). You may remember when you first heard of Web browsers and email; commonly, back then, most of us said “Who needs that?? I’m doing fine without it.”
But each enabled something that unfolded in the next few years and has undeniably changed the world and everything in it. The assertion is that blockchain will have similar impact: it will let people and companies do things one-to-one, with no middleman, no middleman fees. (I won’t go further – it would just get confusing.)
I’m reading Blockchain Revolution, a book by Don Tapscott (who wrote the prescient 2010 book Wikinomics) and his brother. It’s way over my head in its crazy claims about how blockchain will change the world: as they say in moviemaking, I have to “suspend disbelief” to get through each chapter. (That’s why it’s important to me that this is from the Wikinomics brain, which proved accurate.)
Healthcare? If you’ve gotten involved with your health data and medical records, you probably know that it’s not easy to get your information and not easy to organize it and put it where you want.
Time will tell. For now, just watch the two minute video and remember.
(Of course my crazy Dutch visionary friend Lucien Engelen, who produced my TED Talk five years ago, has already talked about how his university has chosen blockchain as the platform for what they’re building as a health system of the future: all data owned by the patient, securely stored, and able to be kept private and donated to researchers for your disease at the same time. Two weeks ago they even demonstrated a complete workflow (“proof of concept”) of one tiny but real piece.
When the Wikinomics author and Lucien both say something’s real and world-changing, I’ll listen.
“Understand” may be overstating the impact here (wry grin, but it’s a good introduction for folks not yet aware of the “what.” Me, I am still waiting for bigger lightbulbs about the “how” such that I can glean some sense of how it will work and why I should trust and welcome it.
Carla, that’s exactly what we all said about http, once upon a time. :-) My point exactly.
And that’s why I didn’t say “Drop everything and learn about this” – I just said “remember it.” :)
And, re “understand” – it’s a LOT clearer than anything else I’ve seen. If you’ve seen anything in the same league, please let us know.
More about blockchain in healthcare in my blog co-salud. Sorry only in spanish
http://www.co-salud.com/archivos/podria-la-tecnologia-blockchain-ser-en-una-alternativa-para-las-apps-de-salud/
Thanks dave to talk about this tecnology. Really I think have some advantages specially in privacy issues.
Haven’t forced myself to read the Blockchain book yet, so it’s great to see some of its thesis here. The idea of no one person being able to overwhelm the integrity of data on the network is appealing – like journalism a generation ago, before control shifted to a handful of media monopolies, silencing thousands of independent-minded reporters, editors and publishers.
Of course we don’t know (or maybe I would, if I better understood the blockchain concept) if, instead of being Security Nirvana, the blockchain might instead be like a string of Christmas lights: the whole chain constantly at risk when any bulb (or data packet) fails. Without a central system, who will troubleshoot and make it right?
For healthcare, perhaps the significance could be medical records getting a “check, check & double-check” each time data/MedRecs pass through a patient, caregiver, clinician or lab tech’s hands. That could be interesting.
Blockchain queasiness: not a medical issue, but I am strongly skeptical on Bitcoin and think goverment-issued currency is better for economic stability and opportunituly.
Francie, good to hear from you. I’m right now exploring the IFTF’s Blockchain Futures Lab stuff. You might be interested in some of their blog posts. Example:
That’s a good example of how easy it is to glaze over at the abstractions and “rethink EVERYTHING” requirement for grokking this subject. I mean, what the heck?? “Decentralized trust network”?? It’s a perfect match for the early http “huh?? Why would I need THAT? You guys are nerds.”
The title of that post, btw, is Bitcoin is the Sewer Rat of Currencies.
I’m only 1/3 of the way through Blockchain Revolution, btw, but the names in that excerpt have come up repeatedly.
Some info about Blockchain in Healthcare in my blog co-salud. Only in Spanish sorry :(
http://www.co-salud.com/archivos/podria-la-tecnologia-blockchain-ser-en-una-alternativa-para-las-apps-de-salud/
Thanks Dave for talking about this technology. I believe that have some advantages especially in privacy issues.
AB
Gracias, Andrea – Google helps my understand Spanish better than it translates most languages :)
It’s impressive that your post is from almost a year ago. I still don’t have a clear “gut feeling” about WHY blockchain provides what it does re trust – it’s hard to imagine that a dedicated criminal or hacker or evil corporation REALLY couldn’t cheat it. But in time we’ll see whether it works, and if so, nobody will need to understand why – same was HTTP etc.
I want this! I want blockchain, and I want it now!!!!
At least, the ideal of not just patient ACCESS to their own medical records, but patient **control** of their medical records.
Yes. I want more control over my medical records. I may not be able to delete doctors’ notes, but I want to be able to add my own “patient feedback” note to each and every note the doctor puts in there.
And I want that record to be the acknowledged property of ME! The patient! So that I don’t have to jump through some institution’s hoops in order to insert my own voice into my records — at the risk of offending a doctor who feels very proprietary about their notes and the judgments rendered therein.
Thanks Dave. A ‘firefly’ sized light is now glowing. Certainly not an “a-ha! moment” …..but at least a glow. Best Dave
Thanks to all, Dave and the replies. You have helped with the tidbit of understanding now recording in my white matter. Like Brenda, control by each patient who wants it of their own medical records now would be so beneficial, for those not sure they want it, well something more for patient advocates to use for them.
Sorry for the delay in releasing your comment, Sandi – I have a new smartphone and it’s not giving me notifications properly.
As I’ve continued listening to the audio of Blockchain Revolution it’s become clearer that what seems to be going on here is a great, big, public-but-encrypted, absolutely unerasable / uncheatable public record of everything that gets put into it, owned by no individual and managed by design by the millions of people who share it. Or something of that sort.
And THAT is so unimaginable that everything else the nerds say about it makes no sense.
But to again draw the http/Web analogy, that’s pretty much what the Web is: it’s huge and vast and although PARTS of it are owned and maintained by different parties, and some people keep trying to get CONTROL of the whole thing (e.g. the “net neutrality” debate), it pretty much cannot be stolen, at least so far, 20 years into it. Anyone who gets connected to it, anywhere in the world, can send something anywhere else, as long as they know the address.
(And, ahem, as long as their new smartphone doesn’t screw it up!)
I’m still far from understanding how that works and why the nerds say it should really be reliable. But the same was true with the Web back then.
So I’m still in the mode of learning, tentatively, and thinking ahead, to anticipate what things might look like.
Re patients WANTING their medical records, I’m having two separate things go on right now that reinforce my suspicion that as public awareness of THAT issue is raised, and THEN people have obnoxious problems, they’ll start getting mad. We’ll see.
Here’s an interesting development – Microsoft unveils open source blockchain framework for healthcare, other industries
“Hospitals can use the tech to create blockchain networks with governance, security and other transactional capabilities, the company says.”
Of course the devil will be in the details – the implementation, making it real – but two things strike me:
1. By making this Open Source, Microsoft is planting something in the “yard” that it doesn’t control. This probably means they want it to grow into something that disrupts other people’s power. In healthcare, that’s a DAMN good thing.
2. They’re intentionally not pointing it at healthcare – like the web and email (as I said in the post), it needs to be GENERALLY useful.
Time will tell.