Last week, Lin Wan and I attended the largest conference dedicated to blockchain in healthcare, Distributed Health, which took place in Nashville, TN on Nov. 5 and 6. Learned, saw and heard a lot – from keynotes to company pitches to hallway conversations, so as I reflect back, here are some of my observations.
First, a little bit of history for contextual purposes:
- 2016: OMG, blockchain is going to change the world, save the world’s hunger, and cure cancer…
- 2017: The year of experimentation, lots of ideas and projects on potential use cases, big players start jumping in (payers, health systems, tech giants and government)
- 2018: OK, deep breath everyone – experimentations produce their first “lessons learned”, and some successful attempts at viable use cases (e.g. Synaptic Health Alliance, ProCredEx, Bramble, SignalStream, etc.) see the day of light
2018 is definitely the year where reality started to sink in. John Bass, CEO of Hashed Health, summed it best by describing that the best projects are those where business model, technology and governance all intersect and make sense. Blockchain is not the answer to every business problem out there, and frankly, not many solutions we saw at the conference had a good, compelling case to use blockchain (a blockchain for just audit log purposes or a private network with a single enterprise adds little value to the whole idea of blockchain…).
Leigh Sterling, Executive Director of the East Tennessee Health Information Network (etHIN), was also in attendance with us. It was fascinating to see the parallel between the process that HIE communities around the country went through as part of their formation (i.e. the trifecta mentioned above, business model – technology – governance), and what the blockchain community is coming to realize in terms of what it takes to create a viable network that can solve a real problem. Perhaps there are some lessons learned for the nascent movement to leverage, while applying new paradigms that blockchain provides in solving existing pain points in a cheaper, better, faster way.
HIEs do have the unique opportunity to be a leading force in the blockchain movement, and be part of shaping its direction by joining the conversation. Whether it is the “future of Internet” or not, only time will tell, but the technology is here to stay, as it does make sense for certain use cases such as patient identification (see article Mike Gagnon, Executive Director at HealtHIE Nevada, recently wrote), provider credentialing and relationship management, consent management, data provenance, secondary uses of data, supply chain management, and so forth. Leigh and Lin spoke about those in August at the Annual Strategic HIE Collaborative (SHIEC) conference. Also, blockchain is a good fit for use cases where there is potential for fraudulent activity or transaction – medication manufacturing and distribution supply chain is one that seems to be getting traction, globally.
As one of the keynote speakers, Richie Etwaru from Hu-manity.co said, “blockchain-enabling” existing solutions is not the way to think about this new technology. Blockchain brings about new paradigms, and we need to fundamentally re-think how to leverage those to solve existing challenges in new ways.