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According to IDC, 20 percent of health organizations will use blockchain by 2020. So should the healthcare space startups use it now? Well, not necessarily. While many digital health startups they are putting the blockchain to good usefor others it could be premature or even a stranger.
"I think the companies in the last two years have asked the question" I want to use blockchain; we find a problem, "I think it's the wrong approach," he told MobiHealthNews Dennis Grishin, co-founder and CSO of Nebula Genomics "In our case we started with the question" How can we solve the problem of personal genomics? "There were some privacy problems and we looked for some technologies that would help to solve these problems and bring them together. I think this way of thinking is what I would encourage, starting from an existing problem and then from the research, in an impartial way, of the available technologies. "
Many "founders" told MobiHealthNews that it could be a "blockchain company" because space is hot and sought after by investors. But the reality is that blockchain is a tool that should be introduced to solve particular problems.
"In the beginning, say that the word blockchain has opened many doors for us," said Troy Bannister, CEO of Particle Health. "Everyone was very interested in what different use cases were being applied to blockchains.Today, a year later, I absolutely feel that people are much more focused on the blockchain details.We have to think about the purpose, the energy consumption, the transaction. "
Is the blockchain right for you?
Blockchain means making data transfers transparent, making verifiable actors and giving data owners control over how their data is used. So the use cases in which it is really wanted are use cases in which one of those functions is missing.
For example, The start of Anthony Begando ProCredEx is focusing on the use of blockchain for clinical credentials, a case of use that involves the efficient transfer of signed and verified documents.
"What we are using blockchain is a component of the exchange that manages trust and lets you know that what you receive comes from the St. Joseph's Hospital on December 3, 2012," Begando said. "That resource of verification, you know where it comes from and then we can trace and track that asset throughout its life cycle during the exchange, to do everything like the same operations, convert the property, prevent other parts from sell access ".
Likewise, Particle Health, the Bannister company, focuses on hospital authorization documents, which need to be shared in a similar but carefully controlled manner.
"If you sign an application form at a hospital, that form stays in the hospital," Bannister said. "The other hospitals can not get it, the insurance companies can not get it, it only exists in a silo with that signature, so what is nice about blockchain is that you can sign the authorization form and everyone will receive a copy of that authorization We allow all stakeholders to access this information. "
For Open Health Network CEO Tatyana Kanzaveli, her company was building an app called MyCardiacCoach for patients who were recovering from heart attacks.
"If you look at the trial, patients who are discharged from the hospital go into cardiac rehabilitation, right? And they have to bring documents or write manually every time they do anything.There is no way for them to share anything" he said. "… [So] we examined the best way to enable it and realized that if I had to use certain parts of the blockchain technology – the middleware that was created, the entire ledger where you can keep track of the different paths and interactions of the data, who logged in when – it's useful, is not it? Want to see what was done with your data. So this is where the Blockchain makes sense for us to use. And we have people who can help us build ours. This is basically how, from the point of view of decision, it is only a natural extension of the things we have done ".
For Grishin, blockchain was the answer to a long-standing problem he had seen wrestling with his mentor and counselor, geneticists and Harvard professor, George Church.
"Professor Church has long been trying to encourage gene sequencing, she has tried different approaches and met different obstacles … And one of the biggest obstacles is the privacy concerns that people have towards of their genomic data, "he said." These concerns have always existed but have been improved over the past two years due to developments such as other personal genomics companies increasingly monetizing client genomics data, which has led to big questions about privacy. And we realized that blockchain can be part of the solution to solve this problem.In particular, with blockchain, the sharing of genomic data can be transparent and therefore controllable. "
Is the blockchain ready for you?
Even if you have a use case that would benefit from the blockchain, it's not necessarily the right move. Karoline Starczak, CEO of Nutrimedy, said her company has looked into the blockchain and has decided to move on now.
"Like every startup, we need to monitor our roadmap very closely in terms of what we are adding and prioritizing and redefining the priorities we are focusing on," he said. "… If we are looking at something like the exchange of secure information, if none of our customers are really adopting and having readily available, then putting the resources to have that capacity does not necessarily make sense. health tends to move very slowly.The adoption has many difficulties and challenges. "
For example, there is no guarantee that organizations will adopt blockchain systems that work well with each other and with legacy systems, in which case the technology could cause more problems than it solves.
"Unless you can really prove that it will be much better, it will be much more than an improvement, and it gives us a reason to take this cost of time, I'm not sure that many institutions literally adopt it," he said. "And yet at this point you can not imagine, but I think we will need some additional evidence of the concept, particularly in the health sector in particular, and have some kind of fitness in a healthcare organization throughout the system and not necessarily in an area like the awarding of claims and having more than one solution, but it will probably take a long time. "
Bannister agreed that the blockchain is at a crucial time to prove itself.
"The question is, is the value of the …. Added potential benefit," he said. "We will not really know until we have a very diverse group [of users]. If we can get groups that traditionally do not share information to start sharing information, then it's worth it. If they can understand the value of the anonymity of the data and the security of the transaction, and can use it, they become a very valuable architecture. "
Another advantage of waiting is that if blockchain continues to work the way it is going, it will become easier to buy turnkey solutions rather than building a brand new platform.
"I feel strongly that what you will see emerge as a reality, there will be people offering blockchain as a service, it is happening right now," said Begando, of ProCredEx. "I think you'll see people say" We have a blockchain service where we offer to license it to you and you can use it as if it were a database engine and do not worry about designing all the functionality you need to engineer with the blockchain side of application. & # 39; "
Another five questions for aspiring blockchain adopters
Begando says that there are three questions that a startup must ask before tackling the blockchain.
"The first is the governance model, the second is the technical model, the third is the business model," he said. "And all three of these things have to be aligned, and it's hard, you've heard dozens and dozens of blockchain cases that have been shot on the market, and what you have to do is align these three things. to have a significant solution that will achieve traction on the market ".
The business model and the technical model are fairly simple requirements: a company needs to know how they will use the blockchain (public vs private vs hybrid, for example) and how they will earn from the platform. As for the governance model, it is particularly important for startups that use the public blockchain that will essentially create a market.
"In the governance model, our members govern the exchange just like any exchange," he said. "It will have a governing board that establishes a policy, which drives the market conditions and resolves disputes and all those good things, and we will facilitate the needs that they give priority, so we will not create a monopoly of credentials. to determine what makes sense and establish their priorities ".
A fourth question that a startup must ask is whether it has done homework on both the health and the blockchain side.
"When it comes to health care, there's a lot of bureaucracy around," said Syed Abrar, founder and CEO of Azaad Health, who is using the blockchain for health data exchange. "… So if a new company wants to get into this, it should learn all about how HL7 works, how the Fast Healthcare Interoperability Resource works, how HIPAA applies, what the clinical terms used are, ICD -10, clinical terms and diagnostic codes used to identify any disease or drug or disorder, so you need to be able to translate all of this into blockchain, in creating those health records transactions. "
Finally, Begando stressed, health use cases could have both privacy and calculation requirements that other cases of use of blockchain do not have.
"We have to have something that fits a level of market performance," he said. "A lot of blockchain protocols out there have never been designed to work at that level of performance … If you look at things like bitcoins, you know it's the first generation protocol, but it could never support the type transaction that would require day by day or hour by hour. "
No blockchain regrets
To recapitulate, before adopting blockchain, health startups should ask:
- Is the blockchain organically presented as a solution to a problem or am I looking for blockchain use cases?
- Is my area of interest ready for blockchain in terms of adoption, infrastructure and culture?
- Do I have a business model, a technical model and a governance model?
- Do they all line up with each other?
- Am I considering the normative realities of health care?
- Do I have the power of calculation to use blockchain on a corporate scale?
If blockchain is not the right technology for your startup now, do not worry. Starczak says he has not looked back after broadcasting the technology.
"It never happened when we have conversations with the site security team and we are going through security protocols or even talking about any type of data transfer," he said. "And who knows, what if a completely different way of managing data is created in two or three years and we realize that blockchain is not really a good thing for health care? it moves very fast, so this may not be the only solution we will meet in the near future. "
