AWS Presents: Managing a Healthcare System with Blockchain

Earlier this month, I was in New York City at the AWS Pop-up Loft in SoHo - our Co-Founder & CTO Ted Tanner, Jr. was part of a panel discussion covering healthcare blockchain. This topic has moved to center stage.

There was such a large turnout, the original room wasn't big enough. It was relocated to a wide open space in the loft where the crowd filled nearly every chair, beanbag, and barstool on the second floor of this truly eclectic space.

Moderated by Amazon's Dr. Oxana Pickeral, the Global Segment Leader for Healthcare & Life Sciences at AWS, the dialogue focused on emerging use cases - managing patient identity, insurance claims, and the supply chain - and how early adopters are fostering blockchain innovation in the $3.2 trillion US healthcare economy.

Joining Ted and Oxana, were Mike Jacobs, a Distinguished Engineer at Optum, the Healthcare Services division of UnitedHealth Group; Mary Butler-Everson, SVP, Design & Development, Healthcare Innovations for PNC Bank, and for those of you with glasses, Jay Sales, Director, The Shop, at VSP Global.

Three main themes emerged from a very animated discussion:

1) The most valuable currency is your personal health data.

"We are thinking deeply about the value of your healthcare data and the transaction level value of that data." - Ted Tanner, Jr., Co-Founder & CTO, PokitDok

What could be achieved if consumers owned and accessed their own health data, just like they do the cash in their bank accounts? For example, to help support clinical research, consumers could grant access to specific data from unified health records on a blockchain in exchange for payment.

In a world where data is cash, forget gold, forget bitcoin, instead of handing over a credit card, what if consumers could offer their health data as payment for medical services?

Health is a whole new asset category. Ted and Jay in particular, encouraged the industry to start looking at health data as a measurable asset. A personal asset that can be utilized, traded, or augmented according to with whom the owner decides to share it. From this perspective, the industry can look at health data as its own asset class, just like real estate or derivatives.

This shift will also change compliance technologies. A consumer's blockchain wallet, which houses digital maps to the locations of encrypted personal information, will evolve to manage dynamic data interactions in the delivery of consumer health.

That's why with DokChain, PokitDok is placing a premium on building out smart contracts that protect data and enable auditable, encrypted data transmission.

2) Blockchain isn't hype, it's here.

"Last year was the year of discovery. We had to educate, evaluate, and work through the 'should vs could' circumstances." - Mike Jacobs, Distinguished Engineer, Optum

The industry is in the very early stages of adoption so there's interest brewing in what the inevitable transition will look like and where organizations are on the blockchain journey.

Before joining PNC, Mary spent her professional life in healthcare, on both the payer and provider sides of the table. Now that she's in the business of "moving data and dollars" in the healthcare industry, she's paying close attention to the mechanisms that can do that most effectively, which I'd conclude is why her eye is on blockchain.

Mike emphasized that healthcare companies really need to keep on top of what they think they need, and what the industry is doing. There is bound to be consolidation and integration of blockchain efforts at some point, and businesses need to be prepared to both operate with agility and merge tech stacks as blockchain technologies and development mature.

Given the pace of innovation, customers need to learn fast through experimenting and running with a proof of concept, rather than wait for things to be theoretically perfect. The industry is starting with proof of concepts, beginning with identity, in isolated areas like radiology services for example. Once there's evidence of utility in these basic use cases, the use of blockchain technologies is expected to permeate other areas of healthcare, such as claims adjudication and the pharmaceutical supply chain.

During the event, Ted prefaced PokitDok's work on our permissioned blockchain for healthcare, DokChain, with "execution is everything; code is law."

In July of 2016, we deployed a blockchain running on top of Ethereum and demoed a live eligibility request to Cigna. Since then, we have built out full hardware consensus via Intel's Hyperledger Sawtooth and are actively working together with AWS on full compute resources and Amazon Machine Images for easy deployment of DokChain with Intel's Hyperledger Sawtooth.

While adoption will take a while, the panelists agreed that blockchain is not hype, it is here to stay.

3) Blockchain will shrink units of work.

"If you're in the business of making money on float, get out of the building." - Jay Sales, Director, The Shop at VSP Global

The issue of healthcare claims was a topic of discussion because blockchain makes a great case for shrinking units of work - both computationally and administratively.

The 2016 CAQH Index Report estimated that "administrative costs in the U.S. healthcare system consume well over $300 billion annually, or nearly 15 percent of all healthcare expenditures by some estimates."

The truth is, HIPAA-driven format and content standards and FTP protocols from the 1980s gave rise to a cottage industry of companies that are paid to move data from point A to point B. These toll operators run on legacy systems that isolate data. The panelists agreed that we have to get rid of the unnecessary middlemen to sharply reduce waste and enable innovation. It is going to take awhile to see industry wide blockchain adoption because not everyone has an incentive, especially when it comes to claims adjudication.

For PokitDok, we believe compensating physicians and other care providers as soon as a procedure is complete, is simply the right thing to do.

Blockchain gets us there.

I'll close with a round of applause to the panelists and Dr. Pickeral for orchestrating a great, educational and informative conversation.