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As a practicing physician I would be considered negligent if I had not embraced evidence-based medicine. The rigor of the scientific method has transformed health care from the times of bleeding and patience to robotic surgery and genomics and we should be grateful. Life expectancy is higher, smallpox has been eradicated and the invention of anesthesia means we no longer need restrictions or a large bottle of brandy to perform an amputation.
However, just as we need good clinical trials before recommending any therapy, we also need financial evidence that is worth it financially. With so many interventions on offer and health spending as limited resources, it is important to evaluate which ones are to be prescribed. Whether it's a surgical procedure, a pharmaceutical product, high-tech gadgets or even software, the tax payer or private insurer deserves to know that their contributions are not spent frivolously.
The National Institute for Excellence of Health and Care (NICE) of the United Kingdom and the National Institute for Health Research (NIHR) are both doing actively. Health technology assessments are performed in a number of categories, including medicines, medical devices, diagnostic techniques, surgical procedures, or health promotion activities.
At the moment, this does not apply to Blockchain technology.
Billions of dollars have been poured into many health blockchain start-ups in recent years. Now that the ICO season (initial supply of coins) is practically over (and ignoring the scams) we are all patiently waiting to see the promises fulfilled.
Almost all published white papers state that their solution will benefit health care by reducing costs, improving data integrity, improving privacy and creating a trail of cryptographic truth that is completely transparent and verifiable.
Each interested party has its own interest. Investors no doubt want to know what their profits will be. Insurers and groups of hospitals want to see a healthy fund line for their shareholders. Patients (for whom you should discuss this is all) want different outcome measures. They are not particularly worried if their doctor writes notes on papyrus or tracks on a computer, but instead are concerned about the speed of access to quality treatment, cost of care and the knowledge that their data is available in a safe and convenient way .
The market paradigm that determines the value of a product is based on the evaluation of the buyer on the utilized utility. The cost of a bitcoin transfer worldwide may be lower than the sending of the equivalent fiat value through an office of remittances, and this could influence an individual to choose the method prior to the latter. The same principle can also be applied to a hospital manager who decides which IT system to buy.
In health care, however, the consumer is not (at least directly) the client. Patients are vulnerable and rely on the health system to make good decisions for them. Therefore, it is the responsibility of prescribers and buyers to ensure that good evidence exists for the technology being used.
The philosophical goals of blockchain solutions are idealistic and seem to have great merit. Democratizing health care, empowering patients, ensuring data integrity and ensuring the provenance of drugs are ambitious and worthy goals.
Just as the medical community has defined the levels of evidence by which innovations are judged, so decision makers in health care must also be responsible for evaluating the technology in a way that is based on evidence – taking into account the results. related to the patient.
We are witnessing a shift from value-based service fee models as the insurance market evolves. Surely, we have to apply this test to all healthcare costs?
Evidence-Based-Medicine and Evidence-Based Management must go hand in hand if we want to see the four-fold Health objective (improving patient experience, population health, reducing per-capita costs and reducing burnout staff) to succeed.
And following these lines, we will have to define how we measure the usefulness of blockchains.
- Can this technology improve the patient's experience? Will the promises of easier access to records, shorter expectations through simplified services and convenient blockchain-based prescriptions materialize?
- Does the improved data integrity result in less medical errors and will reduce the mortality rate?
- Does knowledge of the origin of medicines reduce the negative effects of counterfeiting and improves the general health of the economy so that patients benefit from it?
- What is the amortization period, the internal rate of return, the net present value (or any other metric used to define the ROI) for the solution implemented and how the savings have been redistributed for use by the patient?
- Are there any doctors who leave medicine or commit suicide because they are no longer slaves to an administrative system that takes them away from caring for patients?
It is very important that the technology is nascent. The proof of concept tests are just heating up.
McKinsey recently published an article suggesting that Blockchain has a problem with Occam's razor. Too many hypotheses with not enough solutions that emerge beyond the pioneering phases. Is it a life cycle phenomenon or a technological solution looking for a problem?
It depends on what you're trying to measure.
If the adoption of organizational mass still needs to be realized, it could be explained by an immature technology not ready for prime time. An alternative view, however, is that those who have implemented have lost the philosophical point of view. Blockchain concerns the removal of intermediaries and the sharing of a common fiduciary brokerage infrastructure. This is fundamentally different from the implementation of an IT solution by a competitor and requires the large-scale adoption of coopetition models. Blockchain speaks of a sharing economy, in which all participants own and enable the network.
Whether it is an evangelist or a prophet on the day of judgment, what we have learned in medicine is that decisions based on evidence are the best we have. In the absence of such evidence, we simply do not know it yet.
And while a healthy profit can satisfy shareholders and investors of new health tokens, the real end result is whether we are providing a solution whose value proposition is a better quadruple bottom line than the historical manager.
Because it is, after all, on health.
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As a practicing physician I would be considered negligent if I had not embraced evidence-based medicine. The rigor of the scientific method has transformed health care from the times of bleeding and patience to robotic surgery and genomics and we should be grateful. Life expectancy is higher, smallpox has been eradicated and the invention of anesthesia means we no longer need restrictions or a large bottle of brandy to perform an amputation.
However, just as we need good clinical trials before recommending any therapy, we also need financial evidence that is worth it financially. With so many interventions on offer and health spending as limited resources, it is important to evaluate which ones are to be prescribed. Whether it's a surgical procedure, a pharmaceutical product, high-tech gadgets or even software, the tax payer or private insurer deserves to know that their contributions are not spent frivolously.
The National Institute for Excellence of Health and Care (NICE) of the United Kingdom and the National Institute for Health Research (NIHR) are both doing actively. Health technology assessments are performed in a number of categories, including medicines, medical devices, diagnostic techniques, surgical procedures, or health promotion activities.
At the moment, this does not apply to Blockchain technology.
Billions of dollars have been poured into many health blockchain start-ups in recent years. Now that the ICO season (initial supply of coins) is practically over (and ignoring the scams) we are all patiently waiting to see the promises fulfilled.
Almost all published white papers state that their solution will benefit health care by reducing costs, improving data integrity, improving privacy and creating a trail of cryptographic truth that is completely transparent and verifiable.
Each interested party has its own interest. Investors no doubt want to know what their profits will be. Insurers and groups of hospitals want to see a healthy fund line for their shareholders. Patients (for whom you should discuss this is all) want different outcome measures. They are not particularly worried if their doctor writes notes on papyrus or tracks on a computer, but instead are concerned about the speed of access to quality treatment, cost of care and the knowledge that their data is available in a safe and convenient way .
The market paradigm that determines the value of a product is based on the evaluation of the buyer on the utilized utility. The cost of a bitcoin transfer worldwide may be lower than the sending of the equivalent fiat value through an office of remittances, and this could influence an individual to choose the method prior to the latter. The same principle can also be applied to a hospital manager who decides which IT system to buy.
In health care, however, the consumer is not (at least directly) the client. Patients are vulnerable and rely on the health system to make good decisions for them. Therefore, it is the responsibility of prescribers and buyers to ensure that good evidence exists for the technology being used.
The philosophical goals of blockchain solutions are idealistic and seem to have great merit. Democratizing health care, empowering patients, ensuring data integrity and ensuring the provenance of drugs are ambitious and worthy goals.
Just as the medical community has defined the levels of evidence by which innovations are judged, so decision makers in health care must also be responsible for evaluating the technology in a way that is based on evidence – taking into account the results. related to the patient.
We are witnessing a shift from value-based service fee models as the insurance market evolves. Surely, we have to apply this test to all healthcare costs?
Evidence-Based-Medicine and Evidence-Based Management must go hand in hand if we want to see the four-fold Health objective (improving patient experience, population health, reducing per-capita costs and reducing burnout staff) to succeed.
And following these lines, we will have to define how we measure the usefulness of blockchains.
- Can this technology improve the patient's experience? Will the promises of easier access to records, shorter expectations through simplified services and convenient blockchain-based prescriptions materialize?
- Does the improved data integrity result in less medical errors and will reduce the mortality rate?
- Does knowledge of the origin of medicines reduce the negative effects of counterfeiting and improves the general health of the economy so that patients benefit from it?
- What is the amortization period, the internal rate of return, the net present value (or any other metric used to define the ROI) for the solution implemented and how the savings have been redistributed for use by the patient?
- Are there any doctors who leave medicine or commit suicide because they are no longer slaves to an administrative system that takes them away from caring for patients?
It is very important that the technology is nascent. The proof of concept tests are just heating up.
McKinsey recently published an article suggesting that Blockchain has a problem with Occam's razor. Too many hypotheses with not enough solutions that emerge beyond the pioneering phases. Is it a life cycle phenomenon or a technological solution looking for a problem?
It depends on what you're trying to measure.
If the adoption of organizational mass still needs to be realized, it could be explained by an immature technology not ready for prime time. An alternative view, however, is that those who have implemented have lost the philosophical point of view. Blockchain concerns the removal of intermediaries and the sharing of a common fiduciary brokerage infrastructure. This is fundamentally different from the implementation of an IT solution by a competitor and requires the large-scale adoption of coopetition models. Blockchain speaks of a sharing economy, in which all participants own and enable the network.
Whether it is an evangelist or a prophet on the day of judgment, what we have learned in medicine is that decisions based on evidence are the best we have. In the absence of such evidence, we simply do not know it yet.
And while a healthy profit can satisfy shareholders and investors of new health tokens, the real end result is whether we are providing a solution whose value proposition is a better quadruple bottom line than the historical manager.
Because it is, after all, on health.
